Social media has accelerated the spread of vaccine misinformation leading to decreased
immunization rates and increased preventable deaths in the US and globally. The health
impact of misinformation is particularly critical to understand and address when
considering the lives of minoritized racial and ethnic groups who are often the target of
misinformation campaigns or who may not have easy access to culturally relevant and
language-concordant reputable sources. Although access to vaccines remains a significant
barrier, vaccine safety confidence is a significant predictor of influenza and COVID
vaccination in Hispanic adults. Yet, little is known about how misinformation narratives
emerge specifically in relation to Hispanic communities, how they are disseminated, and
how they ultimately affect people's decision to get vaccinated.

Social media posts that include personal narratives are more effective at communicating
reliable health recommendations, especially those that come from a trusted peer.
Therefore, communication strategies that leverage community and interpersonal
relationships can prove extremely effective at debunking misinformation about vaccines.
Promotores de salud are trusted community members who serve as links between
health/social services and a community to improve access to health services and quality
of service delivery. Promotores can diffuse and address misinformation in their
communities and can be essential to debunk myths, increase trust, and improve health
outcomes. Promotores have been at the forefront of addressing disparities in COVID
testing and vaccine uptake. Promotores de salud are uniquely positioned as trusted
messengers to debunk vaccine misinformation through strategic use of social media and
infodemiology principles.

Dime La VerDAD (Verify, Debunk, and Disseminate) is an innovative social media
capacity-building program based on theoretical frameworks related to health communication
that empowers promotores de salud to debunk vaccine misinformation through the use of
personal narratives on social media. To date, there has been no evaluation of whether
training promotores de salud to identify and debunk misinformation on social media can
improve uptake of accurate scientific information. Dime La VerDAD (Verify, Debunk, and
Disseminate) will evaluate how debunking misinformation is perceived on social media, and
discern how these can lead to changes in opinions and behavior. The proposed work will
use a rigorous stepped wedge design to:

1. Identify and evaluate promotores' use of social media to disseminate vaccine
information in the Hispanic community. Investigators will conduct focus groups and
key informant interviews with promotores de salud recruited through Illinois Unidos
partnerships to verify their peers' information sources about vaccines,
vaccine-related misbeliefs, perceptions of vaccine safety, and personal plans to get
vaccinated.

2. Engage Promotores de Salud as community champions in an adapted science
communication curriculum so they can learn to identify and debunk misinformation.
Participants will learn how to make their own infographics to debunk misinformation
as well as incorporate their personal narratives into posts. Promotores will also
recruit members of their social media circles to participate as subjects to test the
effectiveness of their posts.

3. Test effectiveness of personal-narrative posts versus resharing of standardized
debunking content shared by promotores de salud to their social networks. Using a
stepped-wedge approach, members of promotores' social media circles will be surveyed
to measure the reach and effectiveness of various types of social media posts.
Investigators hypothesize that community champions will be viewed as trusted
messengers within their social circles and that debunking posts with personal
narrative using principles from the training program will be disseminated, viewed,
and recalled more often as compared to a standard post without personal narrative
and lead to increased COVID and influenza vaccination uptake.

This work will test a model of community engagement and empowerment while providing
greater knowledge of how credible scientific information can be shared and effect
positive changes in opinions and behavior.