Constituents' Inferences of Local Governments' Goals and the Relationship Between Political Party and Belief in COVID-19 Misinformation: Cross-sectional Survey of Twitter Followers of State Public Health Departments.

Background: Amid the COVID-19 pandemic, social media have influenced the circulation of health information. Public health agencies often use Twitter to disseminate and amplify the propagation of such information. Still, exposure to local government-endorsed COVID-19 public health information does not make one immune to believing misinformation. Moreover, not all health information on Twitter is accurate, and some users may believe misinformation and disinformation just as much as those who endorse more accurate information. This situation is complicated, given that elected officials may pursue a political agenda of re-election by downplaying the need for COVID-19 restrictions. The politically polarized nature of information and misinformation on social media in the United States has fueled a COVID-19 infodemic. Because pre-existing political beliefs can both facilitate and hinder persuasion, Twitter users' belief in COVID-19 misinformation is likely a function of their goal inferences about their local government agencies' motives for addressing the COVID-19 pandemic.

Objective: We shed light on the cognitive processes of goal understanding that underlie the relationship between partisanship and belief in health misinformation. We investigate how the valence of Twitter users' goal inferences of local governments' COVID-19 efforts predicts their belief in COVID-19 misinformation as a function of their political party affiliation.

Methods: We conducted a web-based cross-sectional survey of US Twitter users who followed their state's official Department of Public Health Twitter account (n=258) between August 10 and December 23, 2020. Inferences about local governments' goals, demographics, and belief in COVID-19 misinformation were measured. State political affiliation was controlled.

Results: Participants from all 50 states were included in the sample. An interaction emerged between political party affiliation and goal inference valence for belief in COVID-19 misinformation (∆R ²=0.04; F _8,249=4.78; P<.001); positive goal inference valence predicted increased belief in COVID-19 misinformation among Republicans (β=.47; t ₂₄₉=2.59; P=.01) but not among Democrats (β=.07; t ₂₄₉=0.84; P=.40).

Conclusions: Our results reveal that favorable inferences about local governments' COVID-19 efforts can accelerate belief in misinformation among Republican-identifying constituents. In other words, accurate COVID-19 transmission knowledge is a function of constituents' sentiment toward politicians rather than science, which has significant implications on public health efforts for minimizing the spread of the disease, as convincing misinformed constituents to practice safety measures might be a political issue just as much as it is a health one. Our work suggests that goal understanding processes matter for misinformation about COVID-19 among Republicans. Those responsible for future COVID-19 public health messaging aimed at increasing belief in valid information about COVID-19 should recognize the need to test persuasive appeals that address partisans' pre-existing political views in order to prevent individuals' goal inferences from interfering with public health messaging.