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Interventions for combating COVID-19 misinformation: a systematic realist review

Dickinson, R., Makowski, D., van Marwijk, H., & Ford, E.

PLoS ONE, 2025

A realist systematic review of 35 studies covering eight kinds of intervention against COVID-19 misinformation. Game-type interventions come out best on the combination of impact and scalability, and nothing works well enough on its own — so the recommendation is packages of interventions tailored to context rather than a single fix.

Abstract

Misinformation is a growing concern worldwide, particularly in public health following the COVID-19 pandemic in which misinformation has been attributed to tens of thousands of unnecessary deaths. Therefore a search for effective interventions against misinformation is underway, with widely varying proposed interventions, measures of efficacy, and groups targeted for intervention. This realist systematic review of proposed interventions against COVID-19 misinformation assesses the studies themselves, the characteristics and effectiveness of the interventions proposed, the durability of effect, and the circumstances and contexts within which these interventions function. We searched several databases for studies testing interventions published from 2020 onwards. The search results were sorted by eligibility, with eligible studies then being coded by themes and assessed for quality. Thirty-five studies were included, representing eight types of intervention. The results are promising to the advantages of game-type interventions, with other types scoring poorly on either scalability or impact. Backfire effects and effects on subgroups were reported on intermittently in the included studies, showing the advantages of certain interventions for subgroups or contexts. No one intervention appears sufficient by itself, therefore this study recommends the creation of packages of interventions by policymakers, who can tailor the package for contexts and targeted groups. There was high heterogeneity in outcome measures and methods, making comparisons between studies difficult; this should be a focus in future studies. Additionally, the theoretical and intervention literatures need connecting for greater understanding of the mechanisms at work in the interventions. Lastly, there is a need for work more explicitly addressing political polarisation and its role in the belief and spread of misinformation. This study contributes toward the expansion of realist review approaches, understandings of COVID-19 misinformation interventions, and broader debates around the nature of politicisation in contemporary misinformation.

• DOI: 10.1371/journal.pone.0321818

Keywords: Misinformation

Cite

Dickinson, R., Makowski, D., van Marwijk, H., & Ford, E. (2025). Interventions for combating COVID-19 misinformation: a systematic realist review. PLoS ONE. https://doi.org/10.1371/journal.pone.0321818

See also

• Bad News: Testing Gamified Inoculation Against Misinformation — Dickinson, R., Makowski, D., Van Marwijk, H., & Ford, E. (2025)
• Exploring the Role of News Outlets in the Rise of a Conspiracy Theory: Hydroxychloroquine in the Early Days of COVID-19 — Dickinson, R., Makowski, D., van Marwijk, H., & Ford, E. (2024)
• Introducing the Choice-Confidence (CHOCO) Model for Bimodal Data from Subjective Ratings: Application to the Effect of Attractiveness on Reality Beliefs about AI-Generated Faces — Makowski, D., Neves, A., & Field, A. P. (2025)