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What If Information Is Not the Problem?

Updated: 7 days ago


One question has followed me throughout my career: Why do people engage with health

interventions - or choose not to? I have explored that question in nutrition, public health, media psychology, and now digital mental health. Although the settings have changed, one observation has remained remarkably consistent.


People often know what they should do. They know what constitutes a healthy diet. They

understand the benefits of physical activity. They know vaccines prevent disease. They recognize when mental health support could improve their wellbeing. Yet knowledge alone does not consistently translate into action.


For decades, many health interventions have been built around a simple assumption: people make poor health decisions because they lack information. If that is true, the solution is straightforward-educate, inform, and improve health literacy. Education matters. Evidence matters. But behavior is more complicated than information alone.


That became especially clear while studying vaccine hesitancy among more than 4,700

university students in conflict-affected Syria. We expected to find important gaps in knowledge. Instead, many participants reported actively seeking information and relying on official sources. They were informed, yet information alone did not explain why some chose to vaccinate while others remained hesitant.


As I reflected on those findings, I was reminded of earlier work examining public health

implementation across Africa and other low- and middle-income countries. Despite very

different contexts, I encountered the same lesson. The initiatives that achieved the greatest

engagement were not necessarily those that provided the most information. They were the ones that partnered with communities, worked through trusted local leaders, and communicated in ways that reflected people's lived realities.


Different health challenges. Different continents. The same lesson.


Looking back, I realized this was not unique to vaccination-or even to public health. It was

something I had seen repeatedly throughout my work in nutrition and health behavior.

Information is essential, but it is only one part of a much larger picture. People's decisions are shaped by trust, relationships, culture, identity, emotions, competing priorities, and the environments in which they live.


Today, we have unprecedented opportunities to expand access to nutrition and mental health support through digital therapeutics, mobile applications, and artificial intelligence. Yet many of these innovations continue to reflect the assumption that if we make evidence-based information more accessible, engagement will naturally follow.


Media psychology suggests otherwise. People do not engage with information in isolation. They interpret it through their experiences, relationships, values, and social contexts. Before using digital mental health or a digital nutrition tool, they are often asking questions that extend well beyond the quality of the information itself: Can I trust this? Does it understand someone like me? Does it fit my life? These questions shape engagement just as much as the evidence behind the technology.


This research has not led me to conclude that information is unimportant. Quite the opposite. Evidence remains the foundation of effective health interventions. But it has reminded me of something I first learned in nutrition, saw again in public health, and now encounter in digital mental health: Information has never been the whole story.


Further Reading


  • El-Kour, T. (2026). From Information to Trust: Cross-Regional Lessons for Digital Mental

    Health Engagement in Underserved Populations. Society for Digital Mental Health Annual Conference (Conference Abstract).


  • Razouk, A., Skotzke, P., Abdin, A. Y., Yeboah, P., Pitsch, W., Wakkaf, M., El-Kour, T., Rajab,

    M., Nasim, M. J., Jouma, M., & Jacob, C. (2025). Informed Yet Unvaccinated: Investigating COVID-19 Vaccine Hesitancy Among Syrian University Students Using the 5C Framework. COVID, 5(9), 159. https://doi.org/10.3390/covid5090159




  • Society for Digital Mental Health. (2025). Digital Mental Health Treatment Implementation Playbook: Successful Practices from Implementation Experiences in American Healthcare Organizations. https://doi.org/10.3389/fdgth.2025.1509387


 
 
 

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