Eight-Element Communication Model for Internet Health Rumors: A New Exploration of Lasswell’s “5W Communication Model”

(1) Background: Rumors are a special type of information. Based on the classic theory of the communication of information, the “5W” communication model, this article aims to build a new model and thus explains the generation and communication of Internet health rumors. (2) Methods: The authors selected 50 Internet health rumors, which were widely spread in widely used websites and social media in China, then grounded theory is used to perform the qualitative analysis of the Internet health rumors. (3) Results: Three Core Concepts are abstracted after qualitative analysis. An internal dynamic mutual assistance mechanism of the communication of rumors is built and illustrated. Based on Lasswell’s “5W” communication model, the authors develop an eight-element communication model for Internet health rumors to illustrate the generation and communication of Internet health rumors. (4) Conclusions: By removing one or several elements of this new model, the chain of the communication of Internet health rumors could be cut off, which is valuable information for the government or websites to manage communication of Internet health rumors.


Introduction
We are surrounded by health rumors. When a pandemic rages, health rumors spread even more rapidly. The COVID-19 pandemic is the most recent example. Compared with traditional rumors, Internet rumors are characterized by faster spreading, wider influence, greater social harm, higher professionalism, greater concealment, and larger temptation. The Internet is gradually becoming an important platform for people to gain health information that is easily made up and spread. Against the backdrop of the "Healthy China" strategy, the governance of Internet health rumors has become one of the difficult problems faced by the Chinese government. The Chinese government has strengthened the governance of Internet rumors, but there are many problems with rumor control.
This study focuses on the micro-level of Internet health rumors to profoundly explore the flexibility and applicability of the 5W communication model based on three questions, "How are Internet health rumors generated?" "How are Internet health rumors spread?", and "How do elements of the generation and communication of Internet health rumors interact with each other?" A new theoretical communication model is constructed to answer the questions about Internet health rumors.

Literature Review
As stated in Webster's Dictionary of the English Language, rumor refers to gossip, talk, or opinion without a discernible source or known authority for its truth. With rumors in Massachusetts as the case, Knapp initially studied the causes, consequences, and control strategies of rumors [1]. The process of rumor spreading was concisely described by formulas and models by several scholars. Allport believes that rumor = importance (event) × fuzziness (event), empirical data. According to the generation mechanism of these text materials, it is possible to explain the mechanism and pattern of generation and dissemination of Internet rumors.
The information for 50 Internet health rumors is in Appendix A, including title of rumor, name of the lists, the platforms, and website addresses.

Coding Procedure
This qualitative study is based on text materials. With the coding technology of the grounded theory, the Nvivo12.0 software is used to encode the data step by step, until it reaches theoretical saturation when there is no new concept. The grounded theory requires researchers to carry out two parts of work. (1) Open coding is the initial stage of constant comparative analysis, before delimiting the coding to a core category and its properties [15].
(2) Selective coding means that "the analyst delimits coding to only those variables that relate to the core variable in sufficiently significant ways to be used in a parsimonious theory" [16].
In this study, the coding technology of the grounded theory is applied in two aspects. First of all, open coding is conducted by labeling the content related to the basic theme in the text materials and recording the feelings after reading the text materials. Secondly, selective coding is to sort and classify the labels, refine the key factors of the generation and dissemination of Internet health rumors, and summarize the internal relationships among the key factors.

Reliability and Validity
A unified standard improves the validity of qualitative research. The research team formulated a detailed coding guideline through discussion and selected two analysts to code separately by following the coding guideline. The cross-validation shows that 90% of the nodes coded by the two analysts are consistent. Code comparison verifies the reliability of the qualitative study. The coding nodes achieved full coverage of the 50 Internet health rumors from 2014 to 2019, and no new nodes appeared, which indicated high validity of the coding results.

Results of Coding of Text Materials
After open coding, the text materials are summarized as 55 Primary Concepts (see Table 1). The grounded theory requires the researchers to conduct selective coding to generalize the Primary Concepts to Core Concepts. During the process of the first selective coding, the team classified the Primary Concepts into nine Category Concepts (See Table 2). For the second selective coding, nine Category Concepts are generalized into three Core Concepts, that is, Correlation, Credibility, and Communication (See Table 3).  After 12 days of experiment, the seeds germinated and thrived in the room without router, while most of the seeds of cress and pea died in the room with router! A22 Chronic diseases 9 24 The ancient prescription of dredging blood vessels would work no matter how serious it is! A23 Media reports 12 19 Foreign media reported that Ebola virus evolved into zombie virus.

A24
Fabricating the case for a specific person 9 16 John Di Carlo, a 72-year-old man, suffered from leukemia. He used dandelion to make tea and drink it every day. Only four months later, his condition began to improve.

A25
Women's health 10 15 The radiation of high-speed railways is heavy. It would do harm to unmarried women. So unmarried women do not take them frequently! (Author: this rumor means that the radiation of high-speed railway may cause infertility of unmarried women.) Many countries, such as France, Germany, and Japan have developed the technology of reducing radiation. The railway research institution of China also develops this technology, but the Ministry of Railways has no plans to use it.

A30
Authoritative journal 8 11 Environmental Research Journal shows that 90% of receipts use thermal paper containing bisphenol A(BPA), which can lead to hormone-dependent cancer.

A31
Skin beauty 3 9 The secret of the three effects of enzyme beauty, which makes you 10 years younger!

A32
The health of the elderly 8 9 The old lady's cancer was cured by drinking wheat seedling juice.

A33
Inside information 6 9 Warm reminder from the hospital: The pathogens caused by haze mainly aim at children under 12 years old.

A34
False science communication 5 8 The persistent haze in North China belongs to nuclear smog.

A36
Taking advantage of celebrity 5 7 In the speech, Zhong Nanshan (a famous expert in the area of contagion) quoted the relevant statistics of China Environmental Protection Association: For the children with leukemia, 90% of them have had luxurious decoration in their homes. About 2.1 million children die from luxurious decoration every year.

A37
Fawning on foreigners 2 7 Crayfish is a kind of insect that is used to process corpses, and foreigners never eat this food.

A38
Fear of AIDS 1 7 Hong Kong University's new drug to eliminate AIDS is simply too powerful.

A39
Traditional culture 2 6 Look at the word "rice". "Food + anti = rice" (in the context of Chinese Character) means the sequence of eating is wrong! A40 Spread of the virus 1 5 Transgenic mosquitoes may be the chief cause of the outbreak of Zika virus.

A41
Oral health 1 5 It is the correct brushing posture to brush toothpaste directly without touching water.

A42
Historical event 3 5 Japanese biochemical troops used crayfish to dispose of a large number of corpses.

A43
Video commentary 4 5 The photographer said: "This is Toxoplasma gondii (a kind of parasite). It can't be killed even when the temperature is at 260 • C. It must be cured with selenium." Geothermal heating affects the human reproductive system, which is mainly manifested by the decrease of male sperm quality.

A46
Mental health 3 3 Stan said: "If you eat too much corn oil or sunflower oil, the lack of Omega-3 may lead to mental health or aphasia."

A47
Policy suggestion 3 3 China should formulate a unified national standard for safety of geothermal heating radiation as soon as possible.

A48
False theory 2 3 Cut 2-3 slices of lemon and put it in the hot water, which will turn into alkaline water. It is good to drink it every day.

A49
Educational video 3 3 The video shows that the workers put the plastic into the machine and the machine produces the white particles. The worker also put these white particles into a woven bag originally used for containing rice. (This rumor let people believe that the white particles are the white rice and they would be sold on the market) A user majoring in chemistry also questioned that the heat resistance of polyester material used to make beverage bottles is 70 • C, but "the temperature in cars cannot reach 70 • C"! "Attracting public attention" plays a critical role in promoting the generation and communication of Internet health rumors, with the eight primary concepts, e.g., "eye-catching headline" and "pretending to be surprised", being the important means of "attracting public attention".
Pretending to be surprised Media reports With real information in ten aspects mixed with fake information, the public finds it difficult to distinguish the genuine from fake. There is a process relationship between "faking real information" and "attracting public attention"; that is, Internet health rumors generally attract public attention first, which then makes it hard for the public to distinguish the faked real information, thereby interfering with the cognition and judgment of the public. The fuzzy truth in the field of Internet health rumors has the following features: being close to life, twisting the truth, false science communication, false theory, and pretending to raise questions. As a result, the public is unable to clearly recognize the truth about health and will be constantly trapped by the "cage" of Internet health rumors.
Twisting the truth   Regarding the fields of the health issue involved, the highest response frequency was found in Internet health rumors about food safety, with such rumors being encoded 65 times among the 17 text materials (Figure 1). The frequent occurrence of Internet health rumors concerning children's health and food safety is associated with the psychology of caring for children by parents and the concern about the food. In addition, when fabricating a fictitious person or place in a vivid context, Internet health rumors are becoming seemingly authentic. Hence, Internet health rumors have been closely related to the health issues of different groups of people. Hence, the rumors attract different groups of people to read and focus on.
"Correlation" is the prerequisite for the generation of Internet health rumors. The public's actual demands for health information have led to the generation of Internet health rumors. Based on the results of open coding, regarding the groups of people that are targeted, Internet health rumors related to children's health are responded to most frequently, with such rumors being encoded 45 times among the 13 text materials. Regarding the fields of the health issue involved, the highest response frequency was found in Internet health rumors about food safety, with such rumors being encoded 65 times among the 17 text materials (Figure 1). The frequent occurrence of Internet health rumors concerning children's health and food safety is associated with the psychology of caring for children by parents and the concern about the food. In addition, when fabricating a fictitious person or place in a vivid context, Internet health rumors are becoming seemingly authentic. Hence, Internet health rumors have been closely related to the health issues of different groups of people. Hence, the rumors attract different groups of people to read and focus on. "Credibility" guarantees the generation of Internet health rumors. The Category Concept "Faking real information" is a common trick for generating Internet health rumors, the Category Concept "fuzzy truth" is a necessary condition for generating Internet health rumors, and the Category Concept "Claiming as reliable information" makes Internet health rumors more mysterious. As early as 1947, the generation of rumors was proportional to the importance and fuzziness of events. Credibility directly determines the "quality" of Internet health rumors.

Communication by Duplication and Variation
The ultimate goal of rumor mongers is to spread Internet health rumors. From the selective coding results, the Core Concept "Communication" involved 49 text materials and is encoded 713 times as the most frequently encoded core category. Moreover, according to the coding frequency of 50 text materials in the core category matrix, except for "Claiming as reliable information", Core Concepts "Correlation" and "Credibility" highly frequently respond to the concept "Communication" as shown in Table 4. "Credibility" guarantees the generation of Internet health rumors. The Category Concept "Faking real information" is a common trick for generating Internet health rumors, the Category Concept "fuzzy truth" is a necessary condition for generating Internet health rumors, and the Category Concept "Claiming as reliable information" makes Internet health rumors more mysterious. As early as 1947, the generation of rumors was proportional to the importance and fuzziness of events. Credibility directly determines the "quality" of Internet health rumors.

Communication by Duplication and Variation
The ultimate goal of rumor mongers is to spread Internet health rumors. From the selective coding results, the Core Concept "Communication" involved 49 text materials and is encoded 713 times as the most frequently encoded core category. Moreover, according to the coding frequency of 50 text materials in the core category matrix, except for "Claiming as reliable information", Core Concepts "Correlation" and "Credibility" highly frequently respond to the concept "Communication" as shown in Table 4. The spread of Internet health rumors mainly refers to duplication and variation. First of all, duplication needs to attract the attention of the public, with the eye-catching headline being the most representative approach. Secondly, it is necessary to meet psychology of the public. When people are anxious about topics related to themselves, they create and spread rumors [17]. Fear of cancer and curiosity are the main psychological motivation for the public to spread Internet health rumors. Thirdly, to extensively spread Internet health rumors, secondary transmission is induced. It is manifested in different ways. For example, the Primary Concept of "moral kidnapping" means the health rumors are connected it to the receivers' families (e.g., "Just spread it out, simply for the health of your family"). Videos' commentary makes rumors incendiary. Taking advantage of rumor's derivatives is the way that using another rumor to verify the original rumor which makes them more credible. Economic benefits are used as the bait to spread the rumors (e.g., rumor mongers distribute a small amount of money in a chatting room in "WeChat" to stimulate spreading). The key factor "acquaintances" induce the varied communication of Internet health rumors. Rumors do not come from strangers, but from our acquaintances [18]. For example, the function "Moments" of social media is the best place for posting articles, pictures and videos. Internet health rumors are shared and posted there and are easily shared by other friends with a simple click. The spread of Internet health rumors is intensified by the promotion of "acquaintances". Even health issues that originally have little to do with people become closer to life simply due to the recommendation, comments, or spread by acquaintances. They are particularly able to stimulate, trigger, or arouse people's attention even if it is only browsing [19].

Internal Dynamic Mutual Assistance Mechanism
Correlation, Credibility, and Communication are the three key factors of the generation and communication of Internet health rumors. Correlation, as the source power, triggers Credibility if people have great demands for health information but insufficient knowledge about health. Credibility promotes communication. Studies have shown that high credibility increases trust and the intention to share rumors [20]. Credibility makes rumors more persuasive, especially for Internet users who lack the motivation to process information [21]. Moreover, communication also affects credibility. According to the spiral of silence theory, when people holding certain opinions are in the "minority", they tend to remain silent so as not to be isolated [22]. In the Internet environment, people who hold minority opinions tend to remain silent or even join the majority to protect themselves from cyber violence. Consequently, recurrent rumors are reinforced and become credible, because people do not spread rumors that they do not believe. They only believe what they choose to believe. Spreading dreadful rumors verify their prejudices to share feelings of fear and reduce discomfort [23]. Therefore, when rumors are spread to a certain degree, their correlation and credibility will be strengthened, as shown in Table 4. Figure 2 shows the relationship among Correlation, Credibility, and Communication and the process of the formation of Core Concepts from Primary Concepts. selves from cyber violence. Consequently, recurrent rumors are reinforced and become credible, because people do not spread rumors that they do not believe. They only believe what they choose to believe. Spreading dreadful rumors verify their prejudices to share feelings of fear and reduce discomfort [23]. Therefore, when rumors are spread to a certain degree, their correlation and credibility will be strengthened, as shown in Table 4. Figure  2 shows the relationship among Correlation, Credibility, and Communication and the process of the formation of Core Concepts from Primary Concepts.

Figure 2.
Internal dynamic mutual assistance mechanism (relationship among Correlation, Credibility, and Communication).

Eight-Element Communication Model for Internet Health Rumors
The Internet environment diversifies the elements of the generation and communication of Internet health rumors. Internet health rumors cannot exist independently in Internet environment, and their generation and communication are deeply influenced by the external environment, especially in the era of "new media". The 5W communication model provides the theoretical basis for the communication of Internet health rumors. Harold Lasswell proposed the "5W" communication model in his book The Structure and Function of Communication in Society. "5W" represents "Who", "What", "In Which Channel", "To Whom", and "With What Effect" (Figure 3). The 5W communication model has the value of application and the room for extension. The application to the area of Internet health rumors is worth exploring.

Eight-Element Communication Model for Internet Health Rumors
The Internet environment diversifies the elements of the generation and communication of Internet health rumors. Internet health rumors cannot exist independently in Internet environment, and their generation and communication are deeply influenced by the external environment, especially in the era of "new media". The 5W communication model provides the theoretical basis for the communication of Internet health rumors. Harold Lasswell proposed the "5W" communication model in his book The Structure and Function of Communication in Society. "5W" represents "Who", "What", "In Which Channel", "To Whom", and "With What Effect" (Figure 3). The 5W communication model has the value of application and the room for extension. The application to the area of Internet health rumors is worth exploring. "Who" is expanded to rumor mongers and refuters, and "What" is enlarged to Internet health rumor information, rumor-dispelling information, and hot events. To release their stress and tension [24] and take revenge on the society [25], rumor mongers make up Internet health rumors. The Internet environment is thereby filled with health rumors. Internet rumors severely endanger national political security, social stability, economic security, and social order [26]. Therefore, the government, authoritative media, and other "Who" is expanded to rumor mongers and refuters, and "What" is enlarged to Internet health rumor information, rumor-dispelling information, and hot events. To release their stress and tension [24] and take revenge on the society [25], rumor mongers make up Internet health rumors. The Internet environment is thereby filled with health rumors. Internet rumors severely endanger national political security, social stability, economic security, and social order [26]. Therefore, the government, authoritative media, and other rumor refuters do not allow the generation and communication of Internet health rumors.
Rumor refuters and mongers fight against each other, and rumor-dispelling information released by rumor refuters compete with Internet health rumors on the Internet. For example, the original text of Internet health rumors in some of the 50 samples are hardly found on the Internet because these rumors are dispelled by the government, scientific research institutions, authoritative media, and social media platforms. For these rumors, they are seen in the text of rumor-dispelling information as objects of analysis. Therefore, only rumor-dispelling information is shown to the public and the communication chain of the rumors is cut off. Thus, rumor refuter and rumor-dispelling information as new elements are necessarily added in the new communication model.
Hot events are likely to induce the public to emotionally spread Internet rumor information based on their prior experience [27]. Hot events have a weighted effect on the generation and communication of Internet health rumors. In this study, Internet health rumors which are widely spread are caused by hot events related to food safety, drug safety, disease, environment, and psychology. The hot events are closed to quality of life, health, and life, so it easily triggers the emotion of the public and leads to virus-like dissemination. For instance, due to the frequent occurrence of hot events related to food safety, the Internet health rumor that "spotted eggs are poisonous" in 2018 was highly similar to a short video popular in 2015. Thus, hot events is brought into the new communication model as a new element.
"In Which Channel" refers to the diversification of media channels. In the Internet environment, the media that spread Internet health rumors include websites, post-bars, BBS, Weibo, blogs, WeChat, instant messaging, and e-mail in diversified forms ranging from text to picture, sound, and video. Concerning the 50 Internet health rumors, they are from websites and social media, and the content are shown by texts, pictures, and short videos. It is more difficult to prevent Internet health rumors from spreading in multiple forms and via multiple media channels. Moreover, the evolution of media has not only affected the way of information transmission between people but also have brought a new impact on the "special information", rumors.
"To Whom" indicates the diversification of receivers. The elderly, children, and women are the receivers accurately targeted by Internet health rumors. The Analysis Report of Population Vulnerable to Rumors released by Tencent Company in 2017 also shows that the elderly are most vulnerable to the spread of Internet rumors, and health rumors account for the highest proportion of rumors spread among the elderly (The report is released by Tencent Truth Platform in 2017). In addition, mutual confirmation between receivers is another factor that promotes the extensive spread of rumors. Apart from arousing the attention of receivers, Internet health rumors also have to make themselves convincing among the targeted receivers to achieve the purpose of communication. As pointed out by Kapferer, there are three conditions for rumors to be convincing: a) the source of information is reliable, b) the information should be what people expect and want to know, and c) the information should sound real [28]. The Category Concepts such as "faking real information", "fuzzy truth", "claiming as reliable information", and "meeting the psychology of the public" in the coded materials exactly reveal the above viewpoints.
"With What Effect" is the effect or result of the generation and communication of Internet health rumors. A specific scenario is that the receiver reads (or does not read), believes (or does not believe), and spreads (or does not spread) the Internet health rumors. Based on the result of this study, Core Concepts are abstracted, namely, Correlation, Credibility, and Communication. Whether people read, believe, and spread an Internet health rumor is based on the three Core Concepts. These three Core Concepts constitute an internal dynamic mutual assistance mechanism for the generation and communication of Internet health rumors, which explains the generation and communication of Internet health rumors.
Therefore, Rumor Mongers, Rumor Refuters, Internet Health Rumors, Rumor-Dispelling Information, Hot Events, Media Channels, Receivers, and Effect constitute the eight elements throughout the generation and communication of Internet health rumors as shown in Table 5. Among them, rumor refuters, rumor-dispelling information, and hot events are three new elements added based on the 5W communication model; "Who", "What" "In Which Channel", "To Whom" and "With What Effect" have also been given new meanings in the context of the Internet environment.

Relationships among Eight-Element Communication Model
Coupling refers to the phenomenon that two or more systems or two forms of motion influence each other and even unite through interaction [29]. The key to coupling is to break the boundaries of the original system and recombine the related elements according to the natural association of the elements and the free flow of information and form a "living" subject system with self-organizing structure and dynamic elements in the system [30]. Based on the 5W communication model, we proposed the eight elements of the generation and communication of Internet health rumors. The coupling of Internet health rumors refers to the interaction and unification of rumor mongers, rumor refuters, rumor information, rumor-dispelling information, hot events, media channels, receivers, and effects through various ways and forms during the generation and communication of Internet health rumors. From different perspectives, the eight elements of the generation and communication of Internet health rumors have different combination forms to explain the process and mechanism of the generation and communication of Internet health rumors. The relationships are shown in Figure 4.  From the perspective of the system boundary, the eight-element communication model includes internal and external coupling. The internal coupling refers to the internal dynamic mutual assistance mechanism mentioned above among the three elements, namely correlation, reliability, and communication. Internet health rumors are "time bombs". Once rumors are contacted by the receivers, the internal dynamic mutual assis- From the perspective of the system boundary, the eight-element communication model includes internal and external coupling. The internal coupling refers to the internal dynamic mutual assistance mechanism mentioned above among the three elements, namely correlation, reliability, and communication. Internet health rumors are "time bombs". Once rumors are contacted by the receivers, the internal dynamic mutual assistance mechanism of Internet health rumors starts to work, and the receivers make the following choices: (a) unrelated → filter, (b) related → unreliable → filter → rumors memo, (c) related → reliable → not to spread → filter → rumors memo, and (d) related → reliable → spread → related. External coupling refers to how the seven elements interact with each other and with an internal mutual dynamic assistance mechanism. Whether people read (or do not read), believe (or do not believe), and spread (or do not spread) is determined by correlation, credibility, and communication, respectively. Therefore, the eight-element communication model is illustrated as follows: (a) rumor mongers → Internet health rumors → receivers → not to read, (b) rumor mongers → Internet health rumors → receivers → read → not to believe ← rumor-dispelling information ← rumor refuters, (c) rumor mongers → Internet health rumors → receivers → read → believe → not to spread ← rumor-dispelling information ← rumor refuters, and (d) rumor mongers → Internet health rumors → receivers → read → believe → spread ← rumor-dispelling information ← rumor refuters. The relationships are shown in Figure 4.
From the perspective of the development process, the eight-element coupling model includes the prelude to coupling, the occurrence of coupling, and removing coupling. Prelude to coupling refers to the stage in which the Internet health rumors made up by rumor mongers have not reached the receivers, that is, rumor mongers → Internet health rumors. At this stage, there is no coupling effect among the eight elements. The coupling effect is imminent because they aim at specific populations such as kids, women, or elders. Once rumors reach the receivers, the coupling effect occurs. The occurrence of coupling is the stage in which the Internet health rumors made up by rumor mongers have reached the receivers and produced certain effects, that is, rumor mongers → Internet health rumors → receivers → effect. The coupling effect is manifested as reading, believing, and spreading. According to the influence of the coupling effect, rumor refuters fight against rumor mongers and Internet health rumors by releasing them at different degrees. Removing coupling refers to the rumor-dispelling information. From the perspective of development, the three stages of the eight-element coupling model can be summarized and simplified as rumor mongers → Internet health rumors → receivers → effect ← rumor-dispelling information ← rumor refuters ( Figure 4).
From the perspective of the number of elements, the eight-element coupling model includes weak coupling, regular coupling, and strong coupling. Weak coupling refers to the coupling phenomenon with incomplete main elements (rumor mongers, receivers, and rumor refuters) and the incomplete relationship between elements without intervention elements (hot events and media channels), e.g., rumor mongers → Internet health rumors → receivers → effect. Regular coupling refers to the coupling phenomenon with complete main elements (rumor mongers, receivers, and rumor refuters) and complete relationship between elements but without intervention elements (hot events and media channels), e.g., rumor mongers → Internet health rumors → receivers → effect ← rumor-dispelling information ← rumor refuters. Strong coupling refers to the coupling phenomenon with complete main elements (rumor mongers, receivers, and rumor refuters), the complete relationship between elements, and intervention elements (hot events and media channels), as shown in Figure 4.
In summary, the relationships among this eight-element communication model from three perspectives are illustrated. Based on this, the research team proposed the idea that the approach to the governance of Internet health rumors is to break the relationship among the eight elements.

From the Perspective of Rumor Mongers and the Channels: Controlling the Publishing and Spreading of Internet Health Rumors
Information source determines the origin of rumors, and also becomes a key factor in evaluating the credibility of Internet health rumors, which has a significant impact on the popularity and duration of Internet rumors of public events. The professionalism of the rumor monger and the authority of the platform for Internet health rumors directly affect whether the Internet health rumors would be read, believed, and spread. Therefore, only by tracking the information source and taking targeted measures can the Internet health rumors be effectively eliminated or reduced. At the same time, the government should pay close attention to hot issues in the health field to avoid or reduce the generating and spreading of health rumors on the Internet. For example, new Internet health rumors have surged since 2020, such as COVID-19, related medicine, and related vaccine. Regarding channels for communication of Internet health rumors, news media, social media, and other platforms should be hold accountable if they have no policy or actions for controlling Internet health rumors. The spread of some Internet health rumors could be cut off by those channels. The government should strictly monitor and control the channels and media for releasing and disseminating Internet health information, establish a regular governance mechanism, and conduct emergency management for the possible wrong and misleading public Internet health information.

From the Perspective of Rumor Refuter: Improving the Governance Ability of Internet Health Rumors
The government often plays the key role of "rumor refuter" in rumor control, and the credibility of the government is the key to effectively dispel rumors. If the government's credibility is vulnerable, it may fall into the "Tacitus trap" (Tacitus trap: a political theory named after Roman historian Tacitus, which describes a situation where an unpopular government is hated no matter what it does and whether it is right or wrong), in the process of releasing refuting rumors on the Internet. In the field of health information communication, the credibility of the government is mainly reflected in the timeliness and transparency of Internet health information. In order to avoid falling into the "Tacitus trap", the government should actively build professional Internet-health-rumor-refuting think tanks and platforms to timely and effectively popularize correct health information. It is essential to take advice from professional scientific research institutions and acquire assistance from news media, so that the Internet health information would be professional, authoritative, and timely. Only a combination of multiple ways can prevent the growth and spread of Internet health rumors to the greatest extent.

From the Perspective of Receiver: Improving Literacy of Health Information of the Public
Improving literacy of health information of the public can enhance their immunity to Internet health rumors, so that it would fundamentally reduce the credibility and block dissemination of Internet health rumors.
Especially, it is necessary to enhance the scientific communication for vulnerable groups, such as children, women, and the elderly. Additionally, scientific communication should specifically aim at the key health issues, that is, food safety, environment issues, and diseases.
In addition, "minority" opinions of Internet health information communication should also be taken into account. The spiral theory of silence holds that when people's opinions belong to "minority" opinions in the public opinion, they tend to keep silent to avoid isolation. In the field of health information communication, opinions of "minorities", especially those of professionals, cannot be ignored. How to make professional Internet health information become "dominant opinions" is also a problem worth further consideration.

Conclusions
By analyzing 50 text materials of Internet health rumors based on grounded theory, three Core Concepts are abstracted, that is, Correlation, Credibility, and Communication. The internal dynamic mutual assistance mechanism among these three concepts is illustrated. Based on the feature, changes, and trends of the Internet, Lasswell's 5W communication model needs to be reexamined and expanded. Thus, five elements are expanded to eight elements, namely, rumor mongers, rumor refuters, Internet health rumors, rumor-dispelling information, hot events, media channels, receivers, and effect. The eight elements are combined in different forms. The eight-element communication model is viewed from three perspectives. The relationships among eight elements are explained and illustrated to reveal the complicated process and internal mechanism of the generation and communication of Internet health rumors.
Compared with the linear mechanism of the 5W communication model, this model develops the process of generation and communication of Internet health rumors. In addition, it is the application of the 5W communication model at the micro level. The significance of this study is that cutting off the chain among these eight elements may eliminate or weaken the harm and impact of Internet health rumors. Thus, it provides the practical reference value for the government to control Internet health rumors. This article also proposes three strategies for governing Internet health rumors from three perspectives, that is, rumor mongers and the channels, rumor refuters, and rumor receivers. By governing the Internet health rumors from multiple ways, Internet health rumors could be reduced or blocked timely and effectively in the future.