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      Manipulating Google’s Knowledge Graph Box to Counter Biased Information Processing During an Online Search on Vaccination: Application of a Technological Debiasing Strategy

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          Abstract

          Background

          One of people’s major motives for going online is the search for health-related information. Most consumers start their search with a general search engine but are unaware of the fact that its sorting and ranking criteria do not mirror information quality. This misconception can lead to distorted search outcomes, especially when the information processing is characterized by heuristic principles and resulting cognitive biases instead of a systematic elaboration. As vaccination opponents are vocal on the Web, the chance of encountering their non‒evidence-based views on immunization is high. Therefore, biased information processing in this context can cause subsequent impaired judgment and decision making. A technological debiasing strategy could counter this by changing people’s search environment.

          Objective

          This study aims at testing a technological debiasing strategy to reduce the negative effects of biased information processing when using a general search engine on people’s vaccination-related knowledge and attitudes. This strategy is to manipulate the content of Google’s knowledge graph box, which is integrated in the search interface and provides basic information about the search topic.

          Methods

          A full 3x2 factorial, posttest-only design was employed with availability of basic factual information (comprehensible vs hardly comprehensible vs not present) as the first factor and a warning message as the second factor of experimental manipulation. Outcome variables were the evaluation of the knowledge graph box, vaccination-related knowledge, as well as beliefs and attitudes toward vaccination, as represented by three latent variables emerged from an exploratory factor analysis.

          Results

          Two-way analysis of variance revealed a significant main effect of availability of basic information in the knowledge graph box on participants’ vaccination knowledge scores ( F 2,273=4.86, P=.01), skepticism/fear of vaccination side effects ( F 2,273=3.5, P=.03), and perceived information quality ( F 2,273=3.73, P=.02). More specifically, respondents receiving comprehensible information appeared to be more knowledgeable, less skeptical of vaccination, and more critical of information quality compared to participants exposed to hardly comprehensible information. Although, there was no significant interaction effect between the availability of information and the presence of the warning, there was a dominant pattern in which the presence of the warning appeared to have a positive influence on the group receiving comprehensible information while the opposite was true for the groups exposed to hardly comprehensible information and no information at all. Participants evaluated the knowledge graph box as moderately to highly useful, with no significant differences among the experimental groups.

          Conclusion

          Overall, the results suggest that comprehensible information in the knowledge graph box positively affects participants’ vaccination-related knowledge and attitudes. A small change in the content retrieval procedure currently used by Google could already make a valuable difference in the pursuit of an unbiased online information search. Further research is needed to gain insights into the knowledge graph box’s entire potential.

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          Most cited references49

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          In Google We Trust: Users’ Decisions on Rank, Position, and Relevance

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            Impact of anti-vaccine movements on pertussis control: the untold story

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              Antivaccination activists on the world wide web.

              To determine the likelihood of finding an antivaccination site on the world wide web and to characterise their explicit claims and rhetorical appeals. Using "vaccination" and "immunisation", examining the first 10 sites displayed on seven leading search engines. Detailed examination of content of 100 antivaccination sites found on Google. 43% of websites were antivaccination (all of the first 10 on Google). Main rhetorical appeals involve themes of the scientific veracity of antivaccination argument; rapport with parents seeking to protect their children from harm; and alleged collusion between doctors, the pharmaceutical industry, and government to deny vaccine harm. There is a high probability that parents will encounter elaborate antivaccination material on the world wide web. Factual refutational strategies alone are unlikely to counter the highly rhetorical appeals that shape these sites.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                June 2016
                02 June 2016
                : 18
                : 6
                : e137
                Affiliations
                [1] 1Institute of Communication and Health Faculty of Communication Sciences University of Lugano (Università della Svizzera italiana) LuganoSwitzerland
                [2] 2Department of Pathology Yale University School of Medicine New Haven, CTUnited States
                Author notes
                Corresponding Author: Ramona Ludolph ramona.alexandra.ludolph@ 123456usi.ch
                Author information
                http://orcid.org/0000-0003-4662-0240
                http://orcid.org/0000-0003-0871-1977
                http://orcid.org/0000-0002-0405-2284
                Article
                v18i6e137
                10.2196/jmir.5430
                4911515
                27255736
                fb7a1cd0-a2e1-44fb-8697-0972e1ebddcc
                ©Ramona Ludolph, Ahmed Allam, Peter J Schulz. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.06.2016.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 10 December 2015
                : 7 January 2016
                : 17 February 2016
                : 21 March 2016
                Categories
                Original Paper
                Original Paper

                Medicine
                search engine,online health information search,vaccination,debiasing,search behavior,health communication,information processing,information seeking

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