COVID-19 vaccine misinformation contributed to vaccine hesitancy and preventable illness.This study tested whether a brief online game helps Canadian adults identify COVID-19vaccine misinformation, and whether effects last one month. In the game, participantsjudged whether statements about COVID-19 vaccines were true or false and immediatelyreceived the correct answer with a brief evidence-based explanation, delivered in agame-like format with points, ranks, and feedback. Adults from a national non-probabilityonline panel (n = 4,071) were randomized to the game, to the identical corrective contentpresented as a static blog post, or to a no-activity control. The game and blog groupswere assessed immediately after the activity; all three groups were reassessedapproximately one month later. The hypothesis was that gamified corrective informationwould produce more accurate knowledge than the same information presented as a staticblog post and, at one month, than no activity. The primary outcome was accuracy inidentifying true and false claims; vaccination intention, vaccine confidence, andself-reported vaccination were secondary outcomes. This is the fourth study in a researchprogram whose first three trials are registered in a companion record.
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.
Behavioral: Gamified misinformation refutation quiz
Single-session online game in which participants judged a larger set of true/false
statements about COVID-19 vaccines. Immediately after each response, participants
received the correct answer and a brief evidence-based refutation within a gamified
interface featuring points, ranks, and affective feedback. The game was administered in
English or French. Six selected items from the game content were used in the survey-based
knowledge outcome measure.
Behavioral: Refutational text blog post (active control)
Identical refutational content delivered as a static blog post with no game elements.
Administered in English or French.
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
Online
Columbia, South Carolina, United States
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