{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T08:43:40Z","timestamp":1787906620918,"version":"build-2784847793"},"reference-count":49,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:00:00Z","timestamp":1679961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["201803PJT-400444-RC2-CFCA-120159"],"award-info":[{"award-number":["201803PJT-400444-RC2-CFCA-120159"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Social media usage is growing globally, with an exponential increase in low- and middle-income countries. Social media changes the ways in which information-sharing occurs, intensifying the population\u2019s exposure to misinformation, including fake news. This has important repercussions for global health. The spread of fake news can undermine the implementation of evidence-based interventions and weaken the credibility of scientific expertise. This is particularly worrisome in countries, such as Brazil, in a sociopolitical context characterized by a lack of popular trust in public institutions. In this project report, we describe our experience with the spread of fake news through the social media platform WhatsApp during the implementation of a cluster randomized controlled trial aimed at reducing dengue incidence in children in Fortaleza (Brazil). During initial visits to selected clusters, the research team was met with resistance. Then, soon after data collection started, fake news began circulating about the study. As a result, the research team developed strategies to dispel suspicion and further promote the study. However, the climate of violence and mistrust, coupled with the COVID-19 pandemic, forced the interruption of the study in 2019. The lessons learned from our experience in Fortaleza can be useful to other researchers and practitioners implementing large-scale interventions in this era of health-related misinformation.<\/jats:p>","DOI":"10.3390\/ijerph20075299","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T02:03:53Z","timestamp":1680055433000},"page":"5299","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Social Media and the Influence of Fake News on Global Health Interventions: Implications for a Study on Dengue in Brazil"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5100-6790","authenticated-orcid":false,"given":"Marie-Catherine","family":"Gagnon-Dufresne","sequence":"first","affiliation":[{"name":"Department of Social and Preventive Medicine, School of Public Health of the University of Montreal, Montreal, QC H3N 1X9, Canada"},{"name":"Center for Public Health Research, Montreal, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5454-5776","authenticated-orcid":false,"given":"Mayana","family":"Azevedo Dantas","sequence":"additional","affiliation":[{"name":"Center for Health Sciences, Cear\u00e1 State University, Fortaleza 60714-903, CE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1413-8137","authenticated-orcid":false,"given":"Kellyanne","family":"Abreu Silva","sequence":"additional","affiliation":[{"name":"Center for Health Sciences, Cear\u00e1 State University, Fortaleza 60714-903, CE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7216-4747","authenticated-orcid":false,"given":"Jean","family":"Souza dos Anjos","sequence":"additional","affiliation":[{"name":"Center for Humanities, Cear\u00e1 State University, Fortaleza 60020-181, CE, Brazil"},{"name":"Center for Applied Social Studies, Cear\u00e1 State University, Fortaleza 60714-903, CE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delano","family":"Pessoa Carneiro Barbosa","sequence":"additional","affiliation":[{"name":"Kuya\u2014Cear\u00e1 Design Center, Fortaleza 60010-010, CE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8529-2791","authenticated-orcid":false,"given":"Rebeca","family":"Porto Rosa","sequence":"additional","affiliation":[{"name":"Center for Health Sciences, Cear\u00e1 State University, Fortaleza 60714-903, CE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6934-653X","authenticated-orcid":false,"given":"William","family":"de Luca","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Medicine, School of Public Health of the University of Montreal, Montreal, QC H3N 1X9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Zahreddine","sequence":"additional","affiliation":[{"name":"Center for Public Health Research, Montreal, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Caprara","sequence":"additional","affiliation":[{"name":"Center for Health Sciences, Cear\u00e1 State University, Fortaleza 60714-903, CE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9299-8266","authenticated-orcid":false,"given":"Val\u00e9ry","family":"Ridde","sequence":"additional","affiliation":[{"name":"Population and Development Center, French National Research Institute for Sustainable Development, University of Paris, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1388-1145","authenticated-orcid":false,"given":"Kate","family":"Zinszer","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Medicine, School of Public Health of the University of Montreal, Montreal, QC H3N 1X9, Canada"},{"name":"Center for Public Health Research, Montreal, QC H3C 3J7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,28]]},"reference":[{"key":"ref_1","first-page":"615","article-title":"WhatsApp and Information Sharing: Prospect and Challenges","volume":"4","author":"Mefolere","year":"2016","journal-title":"Int. J. Soc. Sci. Humanit. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/j.jbusres.2021.11.032","article-title":"Understanding patterns of COVID infodemic: A systematic and pragmatic approach to curb fake news","volume":"140","author":"Gupta","year":"2021","journal-title":"J. Bus. Res."},{"key":"ref_3","first-page":"764","article-title":"Infodemic, Misinformation and Disinformation in Pandemics: Scientific Landscape and the Road Ahead for Public Health Informatics Research","volume":"281","author":"Pool","year":"2021","journal-title":"Stud. Health Technol. Inform."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Rocha, Y.M., de Moura, G.A., Desid\u00e9rio, G.A., de Oliveira, C.H., Louren\u00e7o, F.D., and de Figueiredo Nicolete, L.D. (2021). The impact of fake news on social media and its influence on health during the COVID-19 pandemic: A systematic review. J. Public Health, 1\u201310.","DOI":"10.1007\/s10389-021-01658-z"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/s10389-021-01565-3","article-title":"Understanding misinformation infodemic during public health emergencies due to large-scale disease outbreaks: A rapid review","volume":"31","author":"Chowdhury","year":"2021","journal-title":"J. Public Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s11077-020-09405-z","article-title":"Fighting fake news in the COVID-19 era: Policy insights from an equilibrium model","volume":"53","author":"Hartley","year":"2020","journal-title":"Policy Sci."},{"key":"ref_7","first-page":"3909","article-title":"People are the Message? Social Mobilization and Social Media in Brazil","volume":"10","author":"Cardoso","year":"2016","journal-title":"Int. J. Commun."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.ijmedinf.2018.04.010","article-title":"The emerging use of social media for health-related purposes in low and middle-income countries: A scoping review","volume":"115","author":"Hagg","year":"2018","journal-title":"Int. J. Med. Inform."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1080\/02681102.2015.1011598","article-title":"Online Favela: The Use of Social Media by the Marginalized in Brazil","volume":"22","author":"Nemer","year":"2016","journal-title":"Inf. Technol. Dev."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Cosentino, G. (2020). Social Media and the Post-Truth World Order: The Global Dynamics of Disinformation, Springer International Publishing.","DOI":"10.1007\/978-3-030-43005-4"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1093\/jamia\/ocab219","article-title":"Dynamics of social corrections to peers sharing COVID-19 misinformation on WhatsApp in Brazil","volume":"29","author":"Vijaykumar","year":"2021","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_12","unstructured":"Resende, G., Melo, P., Sousa, H., Messias, J., Vasconcelos, M., Almeida, J., and Benevenuto, F. (2019). Proceedings of the World Wide Web Conference, Association for Computing Machinery."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.14763\/2019.4.1434","article-title":"WhatsApp and political instability in Brazil: Targeted messages and political radicalisation","volume":"8","author":"Evangelista","year":"2019","journal-title":"Internet Policy Rev."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Machado, C., Kira, B., Narayanan, V., Kollanyi, B., and Howard, P. A Study of Misinformation in WhatsApp groups with a focus on the Brazilian Presidential Elections. Proceedings of the Companion Proceedings of 2019 World Wide Web Conference.","DOI":"10.1145\/3308560.3316738"},{"key":"ref_15","unstructured":"Barroso, L.R., Fachin, L.E., and de Oliveira, R.M. (Resolu\u00e7\u00e3o No 23.671, de 14 de dezembro de 2021, 2021). Resolu\u00e7\u00e3o No 23.671, de 14 de dezembro de 2021."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4201","DOI":"10.1590\/1413-812320202510.2.28922020","article-title":"Fact or Fake? An analysis of disinformation regarding the COVID-19 pandemic in Brazil","volume":"25","author":"Galhardi","year":"2020","journal-title":"Ci\u00eanc. Sa\u00fade Coletiva"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ricard, J., and Medeiros, J. (2020). Using misinformation as a political weapon: COVID-19 and Bolsonaro in Brazil. Harv. Kennedy Sch. Misinf. Rev., 1.","DOI":"10.37016\/mr-2020-013"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1080\/17441692.2020.1807581","article-title":"Medical populism and the COVID-19 pandemic","volume":"15","author":"Lasco","year":"2020","journal-title":"Glob. Public Health"},{"key":"ref_19","first-page":"79","article-title":"Presidential Twitter in the Face of COVID-19: Between Populism and Pop Politics","volume":"29","author":"Waisbord","year":"2021","journal-title":"Comun. Media Educ. Res. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1590\/0100-85872021v41n2cap02","article-title":"de Negacionismo religioso: Bolsonaro e lideran\u00e7as evang\u00e9licas na pandemia COVID-19","volume":"41","author":"Guerreiro","year":"2021","journal-title":"Relig. Soc."},{"key":"ref_21","first-page":"562","article-title":"PRESS X GOVERNMENT: The populist rhetoric of the COVID-19 pandemic on the social network Twitter","volume":"17","author":"Fernandes","year":"2022","journal-title":"Braz. J. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1080\/17441692.2021.1945123","article-title":"Political discourse, denialism and leadership failure in Brazil\u2019s response to COVID-19","volume":"16","author":"Nattrass","year":"2021","journal-title":"Glob. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Cervi, L., Garc\u00eda, F., and Mar\u00edn-Llad\u00f3, C. (2021). Populism, Twitter, and COVID-19: Narrative, Fantasies, and Desires. Soc. Sci., 10.","DOI":"10.3390\/socsci10080294"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e5317","DOI":"10.18617\/liinc.v16i2.5317","article-title":"A P\u00f3s-verdade em tempos de COVID 19: O negacionismo no discurso de Jair Bolsonaro no Instagram","volume":"16","author":"Fernandes","year":"2020","journal-title":"Liinc Em Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/S0140-6736(20)31681-0","article-title":"Political and institutional perils of Brazil\u2019s COVID-19 crisis","volume":"396","author":"Barberia","year":"2020","journal-title":"Lancet"},{"key":"ref_26","first-page":"77","article-title":"Os caminhos da corrup\u00e7\u00e3o: Uma vis\u00e3o sist\u00eamica","volume":"17","author":"Dowbor","year":"2012","journal-title":"Econ. Glob. E Gest\u00e3o"},{"key":"ref_27","unstructured":"Mari, A. (2022, March 16). Fake News Probe in Brazil Exposes \u201cOffice of Hate\u201d within Government. Available online: https:\/\/www.zdnet.com\/article\/fake-news-probe-in-brazil-exposes-office-of-hate-within-government\/."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1186\/s13063-019-3714-8","article-title":"Sustainable, healthy cities: Protocol of a mixed methods evaluation of a cluster randomized controlled trial for Aedes control in Brazil using a community mobilization approach","volume":"21","author":"Zinszer","year":"2020","journal-title":"Trials"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.1038\/s41467-021-22921-7","article-title":"Lying in wait: The resurgence of dengue virus after the Zika epidemic in Brazil","volume":"12","author":"Brito","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_30","unstructured":"Guti\u00e9rrez, L.A. (2022, January 13). Reported Cases of Dengue Fever in the Americas. Available online: https:\/\/www3.paho.org\/data\/index.php\/en\/mnu-topics\/indicadores-dengue-en\/dengue-nacional-en\/252-dengue-pais-ano-en.html."},{"key":"ref_31","unstructured":"Sistema de Monitoramento Di\u00e1rio de Agravos (SIMDA) (2019). Distribui\u00e7\u00e3o de Casos Confirmados e Taxa de Incid\u00eancia de Dengue, Fortaleza 2018\u20132019, Secretaria Munipal de Saude, Prefeitura de Fortaleza."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1177\/07340168211038043","article-title":"Concentration of Urban Violence in Fortaleza and Strategies for Crime Prevention","volume":"46","author":"Dantas","year":"2021","journal-title":"Crim. Justice Rev."},{"key":"ref_33","first-page":"147","article-title":"Violence and Local Development in Fortaleza, Brazil: A Spatial Regression Analysis","volume":"12","author":"Carvalho","year":"2019","journal-title":"Appl. Spat. Anal."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/s40249-020-00772-6","article-title":"Spatiotemporal dynamics, risk areas and social determinants of dengue in Northeastern Brazil, 2014\u20132017: An ecological study","volume":"9","author":"Pastor","year":"2020","journal-title":"Infect. Dis. Poverty"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"h3267","DOI":"10.1136\/bmj.h3267","article-title":"Evidence based community mobilization for dengue prevention in Nicaragua and Mexico (Camino Verde, the Green Way): Cluster randomized controlled trial","volume":"351","author":"Andersson","year":"2015","journal-title":"BMJ"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Ledogar, R.J., Arostegu\u00ed, J., Hern\u00e1ndez-Alvarez, C., Morales-Perez, A., Nava-Aguilera, E., Legorreta-Soberanis, J., Suazo-Laguna, H., Belli, A., Laucirica, J., and Coloma, J. (2017). Mobilising communities for Aedes aegypti control: The SEPA approach. BMC Public Health, 17.","DOI":"10.1186\/s12889-017-4298-4"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Morales-Perez, A., Nava-Aguilera, E., Legorreta-Soberanis, J., Paredes-Sol\u00eds, S., Balanzar-Mart\u00ednez, A., Serrano-de los Santos, F.R., R\u00edos-Rivera, C.E., Garc\u00eda-Leyva, J., Ledogar, R.J., and Cockcroft, A. (2017). Which green way: Description of the intervention for mobilising against Aedes aegypti under difficult security conditions in southern Mexico. BMC Public Health, 17.","DOI":"10.1186\/s12889-017-4300-1"},{"key":"ref_38","first-page":"92","article-title":"Political Realignment in Brazil: Jair Bolsonaro and the Right Turn","volume":"69","year":"2019","journal-title":"Rev. De Estud. Soc."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1080\/25729861.2019.1708606","article-title":"Science is a war zone: Some comments on Brazil","volume":"3","author":"Monteiro","year":"2020","journal-title":"Tapuya Lat. Am. Sci. Technol. Soc."},{"key":"ref_40","unstructured":"Kaiser, A.J. (Guardian, 2019). \u201cIt\u2019s complete chaos\u201d: Brazilian state overwhelmed by rash of gang violence, Guardian."},{"key":"ref_41","unstructured":"Cowie, S. (Guardian, 2020). Brazil sends armed forces to north-east to quell violence from police strike, Guardian."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1080\/10410236.2017.1331312","article-title":"See Something, Say Something: Correction of Global Health Misinformation on Social Media","volume":"33","author":"Bode","year":"2018","journal-title":"Health Commun."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e320","DOI":"10.1016\/S2214-109X(21)00563-5","article-title":"COVID-19 vaccine hesitancy in Africa: A call to action","volume":"10","author":"Mutombo","year":"2022","journal-title":"Lancet Glob. Health"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3389\/fcomm.2020.00045","article-title":"Rising Above Misinformation or Fake News in Africa: Another Strategy to Control COVID-19 Spread","volume":"5","author":"Ahinkorah","year":"2020","journal-title":"Front. Commun."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1146\/annurev-publhealth-040119-094127","article-title":"Public Health and Online Misinformation: Challenges and Recommendations","volume":"41","author":"Lazer","year":"2020","journal-title":"Annu. Rev. Public Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e24756","DOI":"10.2196\/24756","article-title":"Knowledge About COVID-19 in Brazil: Cross-Sectional Web-Based Study","volume":"7","author":"Cassiano","year":"2021","journal-title":"JMIR Public Health Surveill."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"137","DOI":"10.34172\/hpp.2021.18","article-title":"Risk communication and community engagement strategies for COVID-19 in 13 African countries","volume":"11","author":"Adebisi","year":"2021","journal-title":"Health Promot. Perspect."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"355","DOI":"10.9745\/GHSP-D-21-00031","article-title":"Real-Time Tracking of COVID-19 Rumors Using Community-Based Methods in C\u00f4te d\u2019Ivoire","volume":"9","author":"Tibbels","year":"2021","journal-title":"Glob. Health Sci. Pract."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3523","DOI":"10.2147\/RMHP.S317517","article-title":"How to Make Health and Risk Communication on Social Media More \u201cSocial\u201d; During COVID-19","volume":"14","year":"2021","journal-title":"RMHP"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/7\/5299\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:05:26Z","timestamp":1760123126000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/7\/5299"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,28]]},"references-count":49,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["ijerph20075299"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20075299","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,28]]}}}