TRUTH, FEAR, AND VIRALITY: A CROSS-PLATFORM CONTENT ANALYSIS OF HEALTH MISINFORMATION NARRATIVES ON SOCIAL MEDIA

Abstract

Social media platforms have emerged as dominant conduits for health information, yet they simultaneously facilitate the accelerated diffusion of health misinformation with demonstrable consequences for public health outcomes. Despite a growing body of scholarship on the spread of misinformation, the mechanisms by which narrative and emotional content interact with platform-level algorithmic structures to produce differential virality remain undertheorized. This study addresses that gap through a systematic, cross-platform content analysis of 1,000 posts sampled from Twitter/X (n = 250), Facebook (n = 250), TikTok (n = 250), and YouTube (n = 250). Drawing on emotional contagion theory (Hatfield et al., 1993), algorithmic amplification frameworks (Gillespie, 2014), and misinformation diffusion models (Vosoughi et al., 2018), a theoretically grounded coding scheme was applied to assess misinformation typology, emotional tone, narrative framing, source credibility, and engagement metrics. Intercoder reliability was established at Cohen's κ = .82. Findings reveal that 48% of sampled content contained misinformation, with the highest prevalence on TikTok and Facebook. Fear-based narratives accounted for 62% of misinformation posts and generated 2.3 times as many shares and 1.8 times as many comments as equivalent factual content. Approximately 70% of misinformation originated from non-expert influencers, while medically credentialed sources contributed fewer than 15% of total posts. These patterns confirm that virality is not incidental but is structurally produced through the interaction of emotionally charged narrative content and engagement-optimizing algorithmic systems. The study contributes an integrated cross-platform analytical model to misinformation research and advances empirically grounded recommendations for platform governance, emotion-aware public health communication, and digital health literacy interventions.