{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T22:58:55Z","timestamp":1788908335887,"version":"build-2803163510"},"reference-count":64,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Infodemiology"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The COVID-19 pandemic was accompanied by a barrage of false, misleading, and manipulated information that inhibited effective pandemic response and led to thousands of preventable deaths. Recognition of the urgent public health threat posed by this infodemic led to the development of numerous infodemic management interventions by a wide range of actors. The need to respond rapidly and with limited information sometimes came at the expense of strategy and conceptual rigor. Given limited funding for public health communication and growing politicization of countermisinformation efforts, responses to future infodemics should be informed by a systematic and conceptually grounded evaluation of the successes and shortcomings of existing interventions to ensure credibility of the field and evidence-based action.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n This study sought to identify gaps and opportunities in existing infodemic management interventions and to assess the use of public health frameworks to structure responses to infodemics.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We expanded a previously developed dataset of infodemic management interventions, spanning guidelines, policies, and tools from governments, academic institutions, nonprofits, media companies, and other organizations, with 379 interventions included in total. We applied framework analysis to describe and interpret patterns within these interventions through their alignment with codes derived from 3 frameworks selected for their prominence in public health and infodemic-related scholarly discourse: the epidemiological model, the socioecological model, and the environmental health framework.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The epidemiological model revealed the need for rigorous, transparent risk assessments to triage misinformation. The socioecological model demonstrated an opportunity for greater coordination across levels of influence, with only 11% of interventions receiving multiple socioecological codes, and more robust partnerships with existing organizations. The environmental health framework showed that sustained approaches that comprehensively address all influences on the information environment are needed, representing only 19% of the dataset.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Responses to future infodemics would benefit from cross-sector coordination, adoption of measurable and meaningful goals, and alignment with public health frameworks, which provide critical conceptual grounding for infodemic response approaches and ensure comprehensiveness of approach. Beyond individual interventions, a funded coordination mechanism can provide overarching strategic direction and promote collaboration.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/67119","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T23:06:33Z","timestamp":1742857593000},"page":"e67119-e67119","source":"Crossref","is-referenced-by-count":6,"title":["Understanding Interventions to Address Infodemics Through Epidemiological, Socioecological, and Environmental Health Models: Framework Analysis"],"prefix":"10.2196","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6076-0728","authenticated-orcid":false,"given":"Jennifer N","family":"John","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8255-0310","authenticated-orcid":false,"given":"Sara","family":"Gorman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5727-7148","authenticated-orcid":false,"given":"David","family":"Scales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"R1","unstructured":"World Health Organization. Managing the COVID-19 infodemic: promoting healthy behaviours and mitigating the harm from misinformation and disinformation. World Health Organization; 2020. URL: https:\/\/www.who.int\/news\/item\/23-09-2020-managing-the-covid-19-infodemic-promoting-healthy-behaviours-and-mitigating-the-harm-from-misinformation-and-disinformation [Accessed 17-04-2024]"},{"key":"R2","unstructured":"Amin K Ortaliza J Cox C Michaud J Kates J . COVID-19 mortality preventable by vaccines. Peterson-KFF Health System Tracker. 2022. URL: https:\/\/www.healthsystemtracker.org\/brief\/covid19-and-other-leading-causes-of-death-in-the-us\/ [Accessed 25-01-2025]"},{"key":"R3","unstructured":"Bruns R Hosangadi D Trotochaud M Sell K . COVID-19 vaccine misinformation and disinformation costs an estimated $50 to $300 million each day. Johns Hopkins Center for Health Security; 2021. URL: https:\/\/centerforhealthsecurity.org\/sites\/default\/files\/2023-02\/20211020-misinformation-disinformation-cost.pdf"},{"issue":"2","key":"R4","doi-asserted-by":"publisher","DOI":"10.1056\/CAT.22.0198","article-title":"Combating misinformation as a core function of public health","volume":"4","author":"Knudsen","journal-title":"NEJM Catalyst"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.31478\/202305b","article-title":"Identifying credible sources of health information in social media: phase 2-considerations for non-accredited nonprofit organizations, for-profit entities, and individual sources","volume":"2023","author":"Burstin","journal-title":"NAM Perspect"},{"issue":"5","key":"R6","doi-asserted-by":"publisher","first-page":"721","DOI":"10.7326\/M23-0490","article-title":"The credibility conundrum: can social media companies define credibility for users?","volume":"176","author":"Lalani","journal-title":"Ann Intern Med"},{"issue":"12","key":"R7","doi-asserted-by":"publisher","first-page":"1738","DOI":"10.1377\/hlthaff.2023.00717","article-title":"A systematic review of COVID-19 misinformation interventions: lessons learned","volume":"42","author":"Smith","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"R8","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.1186\/s12889-023-16612-9","article-title":"Fighting the infodemic: the 4 i Framework for Advancing Communication and Trust","volume":"23","author":"Sundelson","journal-title":"BMC Public Health"},{"issue":"6","key":"R9","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1027\/1864-1105\/a000407","article-title":"Psychological underpinnings of misinformation countermeasures","volume":"36","author":"Ziemer","journal-title":"J Media Psychol"},{"issue":"37","key":"R10","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.adh2132","article-title":"The efficacy of Facebook\u2019s vaccine misinformation policies and architecture during the COVID-19 pandemic","volume":"9","author":"Broniatowski","journal-title":"Sci Adv"},{"issue":"44","key":"R11","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.adg6799","article-title":"Partisan conflict over content moderation is more than disagreement about facts","volume":"9","author":"Appel","journal-title":"Sci Adv"},{"issue":"2","key":"R12","first-page":"72","volume":"4","author":"Thomson","journal-title":"J Adm Gov"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research","volume":"13","author":"Gale","journal-title":"BMC Med Res Methodol"},{"issue":"6","key":"R14","doi-asserted-by":"publisher","first-page":"2061","DOI":"10.46743\/2160-3715\/2021.5011","article-title":"Using framework analysis in applied qualitative research","volume":"26","author":"Goldsmith","journal-title":"Qual Rep"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1177\/13548565241255347","article-title":"Combating contamination and contagion: embodied and environmental metaphors of misinformation","volume":"0","author":"Eadon","journal-title":"Convergence"},{"issue":"8","key":"R16","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1056\/NEJMp2103798","article-title":"The Covid-19 infodemic\u2014applying the epidemiologic model to counter misinformation","volume":"385","author":"Scales","journal-title":"N Engl J Med"},{"key":"R17","unstructured":"SEARO Regional Office for the South East Asia. Strategic framework for action for strengthening surveillance, risk assessment and field epidemiology for health security threats in the WHO South-East Asia region. World Health Organization; 2023. URL: https:\/\/www.who.int\/publications\/i\/item\/9789290210030 [Accessed 04-03-2025]"},{"issue":"7","key":"R18","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1037\/\/0003-066X.32.7.513","article-title":"Toward an experimental ecology of human development","volume":"32","author":"Bronfenbrenner","journal-title":"Am Psychol"},{"issue":"2","key":"R19","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1590\/S1413-81232006000200007","article-title":"Violence a global public health problem","volume":"11","author":"Dahlberg","journal-title":"Ci\u00eanc Sa\u00fade Coletiva"},{"issue":"4","key":"R20","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1177\/109019818801500401","article-title":"An ecological perspective on health promotion programs","volume":"15","author":"McLeroy","journal-title":"Health Educ Q"},{"issue":"6","key":"R21","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1017\/S1368980011002655","article-title":"Developing and applying a socio-ecological model to the promotion of healthy eating in the school","volume":"16","author":"Townsend","journal-title":"Public Health Nutr"},{"issue":"1","key":"R22","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/1479-5868-11-22","article-title":"A socio-ecological approach to physical activity interventions in childcare: a systematic review","volume":"11","author":"Meht\u00e4l\u00e4","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"4","key":"R23","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1038\/s41591-023-02792-9","article-title":"Information is a determinant of health","volume":"30","author":"Graham","journal-title":"Nat Med"},{"key":"R24","unstructured":"Murthy V . Confronting health misinformation: the U.S. Surgeon General\u2019s advisory on building a healthy information environment. Office of the US Surgeon General; 2021. URL: https:\/\/www.hhs.gov\/sites\/default\/files\/surgeon-general-misinformation-advisory.pdf [Accessed 04-03-2025]"},{"key":"R25","unstructured":"Murthy V . A community toolkit for addressing health misinformation. Office of the US Surgeon General; 2021. URL: https:\/\/www.hhs.gov\/sites\/default\/files\/health-misinformation-toolkit-english.pdf [Accessed 04-03-2025]"},{"key":"R26","unstructured":"World Health Organization Regional Office for Europe. Digital solutions to health risks raised by the COVID-19 infodemic: policy brief. Regional Office for Europe; 2022. URL: https:\/\/iris.who.int\/handle\/10665\/356315 [Accessed 15-04-2024]"},{"key":"R27","doi-asserted-by":"crossref","unstructured":"Donovan J Friedberg B Lim G Leaver N Nilsen J Dreyfuss E . Mitigating medical misinformation: a whole-of-society approach to countering spam, scams, and hoaxes. Technology and Social Change Project; 2021. URL: https:\/\/mediamanipulation.org\/research\/mitigating-medical-misinformation-whole-society-approach-countering-spam-scams-and-hoaxes [Accessed 15-04-2024]","DOI":"10.37016\/TASC-2021-03"},{"key":"R28","unstructured":"Wanless A . Seeing the disinformation forest through the trees: how to begin cleaning up the polluted information environment. Carnegie Endowment for International Peace; 2023. URL: https:\/\/www.oecd-forum.org\/posts\/seeing-the-disinformation-forest-through-the-trees-how-to-begin-cleaning-up-the-polluted-information-environment?utm_source=user_mailer&utm_medium=email&utm_campaign=send_publish_notification_to_follower [Accessed 15-04-2024]"},{"key":"R29","unstructured":"Wanless A . The more things change. King\u2019s College London; 2023. URL: https:\/\/kclpure.kcl.ac.uk\/portal\/en\/studentTheses\/the-more-things-change [Accessed 15-04-2024]"},{"key":"R30","unstructured":"Joint Chiefs of Staff. Joint publication 3-13 information operations. 2012. URL: https:\/\/defenseinnovationmarketplace.dtic.mil\/wp-content\/uploads\/2018\/02\/12102012_io1.pdf [Accessed 04-03-2025]"},{"issue":"2","key":"R31","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1111\/j.1540-5907.2006.00183.x","article-title":"Citizens, knowledge, and the information environment","volume":"50","author":"Jerit","journal-title":"Am J Pol Sci"},{"key":"R32","unstructured":"Phillips W . The toxins we carry. Columbia Journalism Review; 2019. URL: https:\/\/www.cjr.org\/special_report\/truth-pollution-disinformation.php\/ [Accessed 15-04-2024]"},{"key":"R33","doi-asserted-by":"crossref","unstructured":"Phillips W Milner RM . You Are Here: A Field Guide for Navigating Polarized Speech, Conspiracy Theories, and Our Polluted Media Landscape. MIT Press; 2021. [doi: 10.7551\/mitpress\/12436.001.0001]","DOI":"10.7551\/mitpress\/12436.001.0001"},{"key":"R34","unstructured":"Vasan A . We must treat social media like the toxin that it is. The Hill; 2023. URL: https:\/\/thehill.com\/opinion\/technology\/4058281-we-need-to-treat-social-media-like-the-toxin-that-it-is [Accessed 15-04-2024]"},{"key":"R35","unstructured":"Shapiro AW Jacob N . A CERN model for studying the information environment. Carnegie Endowment for International Peace; 2022. URL: https:\/\/carnegieendowment.org\/2022\/11\/17\/cern-model-for-studying-information-environment-pub-88408 [Accessed 17-04-2024]"},{"key":"R36","unstructured":"Sundelson A Huhn N Jamison A Pasquino SL Kirk Sell T . Infodemic management approaches leading up to, during, and following the COVID-19 pandemic. Johns Hopkins Center for Health Security; 2023. URL: https:\/\/centerforhealthsecurity.org\/sites\/default\/files\/2023-04\/230407-nasempaper.pdf [Accessed 04-03-2025]"},{"key":"R37","unstructured":"Google Sheets. Combatting mis\/disinfo- best\/existing practices. URL: https:\/\/docs.google.com\/spreadsheets\/d\/1VjEwkR3tjgcPmd3ve6N03pqiHMF8hMEojUkRWx8QJFc\/edit?gid=872458924&usp=embed_facebook [Accessed 02-10-2024]"},{"key":"R38","unstructured":"World Health Organization, United Nations Children\u2019s Fund. How to build an infodemic insights report in 6 steps. World Health Organization and United Nations Children\u2019s Fund; 2023. URL: https:\/\/www.who.int\/publications-detail-redirect\/9789240075658 [Accessed 23-05-2024]"},{"key":"R39","doi-asserted-by":"crossref","unstructured":"Howlett M Cashore B . Conceptualizing public policy. In: Engeli I Allison CR , editors. Comparative Policy Studies: Conceptual and Methodological Challenges. Palgrave Macmillan; 2014:17-33. [doi: 10.1057\/9781137314154_2]","DOI":"10.1057\/9781137314154_2"},{"key":"R40","unstructured":"National Science & Technology Council. Roadmap for researchers on priorities related to information integrity research and development. Office of Science and Technology Policy; 2022. URL: https:\/\/web.archive.org\/web\/20250116082552\/https:\/\/www.whitehouse.gov\/wp-content\/uploads\/2022\/12\/Roadmap-Information-Integrity-RD-2022.pdf"},{"issue":"2","key":"R41","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/j.emc.2007.02.005","article-title":"Bringing order out of chaos: effective strategies for medical response to mass chemical exposure","volume":"25","author":"Kirk","journal-title":"Emerg Med Clin North Am"},{"key":"R42","doi-asserted-by":"crossref","unstructured":"Fowle III JR Dearfield KL . Risk characterization handbook. U.S. Environmental Protection Agency Science Policy Council; 2000. URL: https:\/\/www.epa.gov\/sites\/default\/files\/2015-10\/documents\/osp_risk_characterization_handbook_2000.pdf [Accessed 04-03-2025]","DOI":"10.1037\/e519222012-001"},{"key":"R43","unstructured":"The invid technologies. InVID. URL: https:\/\/www.invid-project.eu\/ [Accessed 14-03-2025]"},{"key":"R44","unstructured":"INTERLAND. be internet awesome. Google. URL: https:\/\/beinternetawesome.withgoogle.com\/en_us\/interland [Accessed 14-03-2025]"},{"key":"R45","unstructured":"AI powered information advantage. Logically. URL: https:\/\/logically.ai\/ [Accessed 14-03-2025]"},{"key":"R46","unstructured":"CrossCheck: together, now. First Draft. URL: https:\/\/firstdraftnews.org\/tackling\/crosscheck-together-now\/ [Accessed 14-03-2025]"},{"issue":"4","key":"R47","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","article-title":"Saturation in qualitative research: exploring its conceptualization and operationalization","volume":"52","author":"Saunders","journal-title":"Qual Quant"},{"issue":"6","key":"R48","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1136\/jamia.2010.005637","article-title":"Health information technology: fallacies and sober realities","volume":"17","author":"Karsh","journal-title":"J Am Med Inform Assoc"},{"issue":"1","key":"R49","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1089\/hs.2020.0226","article-title":"Social listening in Eastern and Southern Africa, a UNICEF risk communication and community engagement strategy to address the COVID-19 infodemic","volume":"19","author":"Sommariva","journal-title":"Health Secur"},{"issue":"8","key":"R50","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.7326\/M23-1218","article-title":"Addressing viral medical rumors and false or misleading information","volume":"176","author":"Lalani","journal-title":"Ann Intern Med"},{"key":"R51","doi-asserted-by":"publisher","DOI":"10.1017\/S0140525X22002023","article-title":"The i-frame and the s-frame: How focusing on individual-level solutions has led behavioral public policy astray","volume":"46","author":"Chater","journal-title":"Behav Brain Sci"},{"key":"R52","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.o1128","article-title":"The pollution of health discourse and the need for effective counter-framing","volume":"377","author":"Maani","journal-title":"BMJ"},{"key":"R53","unstructured":"Office of the Surgeon General (OSG). Social media and youth mental health: the U.S. Surgeon General\u2019s advisory. US Department of Health and Human Services; 2023. URL: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK594761 [Accessed 02-02-2025]"},{"key":"R54","unstructured":"Gounardes A . Establishes the Stop Addictive Feeds Exploitation (SAFE) for Kids act prohibiting the provision of addictive feeds to minors. URL: https:\/\/www.nysenate.gov\/legislation\/bills\/2023\/S7694\/amendment\/A [Accessed 02-02-2025]"},{"key":"R55","unstructured":"Myers SL Grant N . Combating disinformation wanes at social media giants. The New York Times; 2023. URL: https:\/\/www.nytimes.com\/2023\/02\/14\/technology\/disinformation-moderation-social-media.html [Accessed 02-08-2024]"},{"key":"R56","doi-asserted-by":"crossref","unstructured":"Otala JM Kurtic G Grasso I Liu Y Matthews J Madraki G . Political polarization and platform migration: a study of Parler and Twitter usage by United States of America Congress members. Presented at: Companion Proceedings of the Web Conference 2021; 224-231; Ljubljana, Slovenia. 2021.[doi: 10.1145\/3442442.3452305]","DOI":"10.1145\/3442442.3452305"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.2139\/ssrn.4192903","article-title":"Taming online public health misinformation","volume":"60","author":"Rubinstein","journal-title":"Harv J Legis"},{"key":"R58","unstructured":"Brandeis L . Whitney v. People of state of California.(supreme court 1927). URL: https:\/\/www.law.cornell.edu\/supremecourt\/text\/274\/357 [Accessed 02-08-2024]"},{"key":"R59","unstructured":"DiResta R . Free speech is not the same as free reach. Wired; 2018. URL: https:\/\/www.wired.com\/story\/free-speech-is-not-the-same-as-free-reach\/ [Accessed 02-08-2024]"},{"issue":"1","key":"R60","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1057\/s41599-020-00550-7","article-title":"Angry by design: toxic communication and technical architectures","volume":"7","author":"Munn","journal-title":"Humanit Soc Sci Commun"},{"key":"R61","doi-asserted-by":"publisher","DOI":"10.3389\/fcomm.2020.562588","article-title":"Going viral: how fear, socio-cognitive polarization and problem-solving influence fake news detection and proliferation during COVID-19 pandemic","volume":"5","author":"Salvi","journal-title":"Front Commun"},{"key":"R62","unstructured":"Surgo Ventures. How do we get America vaccinated?URL: https:\/\/surgoventures.org\/vaccine-persona-explainer [Accessed 29-04-2024]"},{"issue":"1","key":"R63","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s13731-023-00291-2","article-title":"Design thinking as an effective method for problem-setting and needfinding for entrepreneurial teams addressing wicked problems","volume":"12","author":"Bender-Salazar","journal-title":"J Innov Entrep"},{"issue":"6","key":"R64","doi-asserted-by":"publisher","first-page":"e397","DOI":"10.1016\/S2468-2667(24)00031-8","article-title":"Beyond misinformation: developing a public health prevention framework for managing information ecosystems","volume":"9","author":"Ishizumi","journal-title":"Lancet Public Health"}],"container-title":["JMIR Infodemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/infodemiology.jmir.org\/2025\/1\/e67119","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:28:11Z","timestamp":1785536891000},"score":1,"resource":{"primary":{"URL":"https:\/\/infodemiology.jmir.org\/2025\/1\/e67119"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,24]]},"references-count":64,"URL":"https:\/\/doi.org\/10.2196\/67119","relation":{},"ISSN":["2564-1891"],"issn-type":[{"value":"2564-1891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,24]]},"article-number":"v5i2e67119"}}