Author's School

Brown School

Author's Department

Social Work

Language

English (en)

Date of Award

Fall 9-2025

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

Jenine Harris

Committee Members

Douglas Luke; Matthew Kreuter; Raven Maragh-Lloyd; Ruopeng An

Abstract

Growing evidence suggests that health misinformation has the potential to proliferate on social media. However, our understanding of the problem’s magnitude continues to evolve. Despite several studies on health misinformation and Black communities in the United States (U.S.), few of these studies characterize misinformation within digital settings. This dissertation seeks to address this gap by: 1) synthesizing the literature on health misinformation and Black communities to identify prevalent misinformation topics and claims, characteristics of exposure to and belief in these topics and claims, and successful intervention strategies; 2) quantifying and characterizing the volume of COVID-19 misinformation on Black Twitter during the initial weeks of the pandemic; and (3) advancing our understanding of the network of accounts that shared COVID-19 misinformation on Black Twitter during the initial weeks of the pandemic. Regarding the first aim, a scoping review provides important context for Aims 2 and 3. It suggests that misinformation beliefs in Black communities are common and consistently themed across vastly different health topics (e.g., HIV/AIDS, COVID-19, and reproductive health), misinformation topics (e.g., origins, transmission, treatment), and over time, suggesting deeply entrenched frames of government and medical mistrust. Furthermore, the results of this review demonstrate that specific subgroups may be more susceptible to misinformation than their counterparts, suggesting the importance of tailoring interventions to specific audiences. However, among the gaps identified by this scoping review, few studies examine Black communities in digital settings, despite several studies referencing social media as a source of misinformation. Regarding the second and third aims, a case study extends existing research by characterizing discourse about COVID-19 on Black Twitter, one of many U.S.-centric Black digital communities, during the initial weeks of the pandemic. To achieve this, a large sample of tweets referring to COVID-19 as “the Rona,” #Rona, or #theRona—a colloquialism widely used among Black communities in the U.S. during the pandemic—was described using traditional approaches and social network analysis. A descriptive analysis of misinformation volume and themes reveals that COVID-19 misinformation was plentiful but less prevalent than other COVID-19 information on Black Twitter; however, misinformation received more retweets. Misinformation claims overlapped with mainstream media and misinformation but were often spun in ways that were specific to Black experiences and culture. Moreover, a close reading of tweets revealed that specific claims and frames (e.g., government and medical mistrust) overlapped those described in the Aim 1 scoping review, which largely correspond to offline settings. Social network analysis demonstrated that, during most weeks, the retweet network that shared COVID-19 misinformation and the retweet network that shared other COVID-19 information were both fragmented. These networks consisted of several hubs, where many others retweeted a single account, and several smaller fragments involving two or more accounts. Among these networks, a sizable proportion of accounts questioned or opposed misinformation, and involvement of accounts with relatively large followings promoted tweet diffusion. The empirical studies in this dissertation align variably with existing literature on health misinformation and social media, contributing to a more nuanced understanding of the health misinformation landscape within Black communities in the U.S. In combination with future research, insights from these studies may inform the development and evaluation of tailored, culturally relevant interventions designed to reduce misinformation diffusion, exposure, and acceptance, and to better reach Black digital communities with accurate health information.

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