Leveraging Digital Tools to Increase COVID-19 Vaccine Adoption
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of South Carolina
- Enrollment
- 4,071
- Locations
- 1
- Primary Endpoint
- Mean Knowledge Accuracy Score - Immediate
Study Overview
Brief Summary
COVID-19 vaccine misinformation contributed to vaccine hesitancy and preventable illness. This study tested whether a brief online game helps Canadian adults identify COVID-19 vaccine misinformation, and whether effects last one month. In the game, participants judged whether statements about COVID-19 vaccines were true or false and immediately received the correct answer with a brief evidence-based explanation, delivered in a game-like format with points, ranks, and feedback. Adults from a national non-probability online panel (n = 4,071) were randomized to the game, to the identical corrective content presented as a static blog post, or to a no-activity control. The game and blog groups were assessed immediately after the activity; all three groups were reassessed approximately one month later. The hypothesis was that gamified corrective information would produce more accurate knowledge than the same information presented as a static blog post and, at one month, than no activity. The primary outcome was accuracy in identifying true and false claims; vaccination intention, vaccine confidence, and self-reported vaccination were secondary outcomes. This is the fourth study in a research program whose first three trials are registered in a companion record.
Detailed Description
This randomized controlled trial was the fourth study in a research program evaluating digital educational interventions to counter COVID-19 misinformation. The first three studies were conducted under a separate exempt determination from the University of South Carolina Institutional Review Board (Pro00099400) before participant enrollment and are registered in a companion record. This trial received a separate exempt determination (Pro00122534). This record retrospectively registers the completed trial.
The trial used the same intervention platform as the earlier studies: a true/false quiz covering a larger set of circulating COVID-19 vaccine misinformation items, with each response followed immediately by item-level refutational feedback (the correct answer plus a brief evidence-based explanation) embedded in a gamified interface with points, ranks, and affective feedback. A six-item subset was administered in the study surveys to measure knowledge accuracy.
Participants (N = 4,071) were recruited from a national non-probability online panel in Canada (Prodege, fielded by Nanos Research) and randomized to three arms: Game (n = 1,168), Text - the identical refutational content texts as a static blog post (n = 1,288), or no-activity Control (n = 1,615). The questionnaire was administered in English and French nationwide, including Quebec. All arms completed a Wave 1 baseline (fielded December 8-30, 2022); Game and Text then received their assigned activity and an immediate posttest; the Control arm received no activity and, by design, no immediate assessment. All three arms were reassessed at Wave 2, approximately one month later (January 23-February 13, 2023); 2,079 of 4,071 (51.1%) were retained.
Two contrasts were confirmatory: Game versus Text (incremental effect of gamified delivery; evaluated immediately and at one month) and Game versus Control (total intervention effect; one-month horizon, as the Control arm had no immediate assessment). Text versus Control was descriptive. Immediate analyses included all 2,456 participants randomized to the Game and Text arms. No post-randomization data-quality exclusions were applied. One-month analyses included all 2,079 participants who completed Wave 2; nonparticipation at Wave 2 was treated as loss to follow-up rather than an analytic exclusion.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Other
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Canadian residents aged 18 or older
- •Internet access
- •Able to complete the questionnaire in English or French (fielded nationwide, including Quebec)
Exclusion Criteria
- •Employment in market research, advertising, media, or by a political party
Arms & Interventions
Text
Identical refutational content delivered as a static blog post text, followed by immediate post-intervention assessments and one-month follow-up.
Intervention: Refutational text blog post (active control) (Behavioral)
Game
Gamified refutation quiz covering COVID-19 vaccine misinformation items, with immediate per-item corrective feedback, followed by immediate post-intervention assessments and one-month follow-up.
Intervention: Gamified misinformation refutation quiz (Behavioral)
Control
No activity. Completed the Wave 1 baseline and the one-month follow-up only; no immediate assessment by design.
Outcomes
Primary Outcomes
Mean Knowledge Accuracy Score - Immediate
Time Frame: Immediately post-intervention, Day 1 (Game and Text arms only; the Control arm has no immediate assessment by design)
Mean score across 6 true/false COVID-19 vaccine misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy; "Unsure" responses received 0.5 points.
Mean Knowledge Accuracy Score - One Month
Time Frame: Approximately 1 month post-intervention (Wave 2), all arms.
Mean score across 6 true/false COVID-19 vaccine misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy; "Unsure" responses received 0.5 points.
Secondary Outcomes
- Mean Vaccination Intention Score(Baseline (Wave 1); immediately post-intervention (Game and Text arms, Wave 1); approximately 1 month later (all arms, Wave 2))
- Mean COVID-19 Vaccine Confidence(Immediately post-intervention (Game and Text arms, Wave 1); approximately 1 month later (all arms, Wave 2))
- Percentage of Participants Reporting Receipt of a COVID-19 Vaccination or Booster in the Past 30 Days(Approximately 1 month post-intervention (Wave 2 only), all arms.)
Investigators
Gregory Trevors
Associate Professor
University of South Carolina