Official Title
Leveraging Digital Tools to Increase COVID-19 Vaccine Adoption
Brief Summary

COVID-19 misinformation contributed to vaccine hesitancy and preventable illness. Thisrecord covers three sequential randomized studies (conducted in Canada and the UnitedStates, November-December 2020) testing whether a brief online game helps adults identifyCOVID-19 and vaccine misinformation. In the game, participants judged whether statementsabout COVID-19 or COVID-19 vaccines were true or false and immediately received thecorrect answer with a brief evidence-based explanation, delivered in a game-like formatwith points, ranks, and feedback. Study 1 (Canada, n = 2,018) randomized participants tocomplete the knowledge assessment either before playing the game or immediately afterplaying it. Studies 2 (U.S., n = 822) and 3 (U.S., n = 797) compared the game against theidentical corrective content presented as plain text, for general COVID-19 misinformationand vaccine-specific misinformation, respectively. The hypothesis was that gamifiedcorrective information produces more accurate knowledge than non-gamified information.The primary outcome was accuracy in identifying true and false claims; vaccinationintention was a secondary outcome.

Detailed Description

This protocol comprised three sequential randomized controlled studies evaluating digital
educational interventions to counter COVID-19 misinformation, conducted under a single
IRB approval (University of South Carolina, Pro00099400) with study specific amendments.
The University of South Carolina Institutional Review Board determined the study to be
exempt before participant enrollment. A fourth study in the research program, conducted
under a separate IRB approval (Pro00122534), is registered separately. Study 1 enrolled a
national non-probability online panel sample in Canada (Nanos Research); Study 2 enrolled
a U.S. MTurk sample on general COVID-19 misinformation; Study 3 enrolled a U.S. MTurk
sample on vaccine misinformation. This record registers the three completed trials
retrospectively. All three trials used the same intervention platform: a true/false quiz
over circulating misinformation items, each response followed immediately by item-level
refutational feedback (correct answer plus brief evidence-based explanation) embedded in
a gamified interface (points, ranks, response-contingent feedback).

Trial 1 (Canada, N = 2,018; non-probability online panel fielded by Nanos Research,
December 4-14, 2020; general COVID-19 content, 6 items): both arms received identical
quiz-and-game content; arms differed in timing of the knowledge assessment within the
single session (in Control assessed before playing, in Game immediately after).

Trial 2 (United States, N = 822; Amazon Mechanical Turk, November-December 2020; general
COVID-19 content, 19 items): Game versus active-text control receiving the identical
refutational content as a static text.

Trial 3 (United States, N = 797; Amazon Mechanical Turk, November-December 2020;
vaccine-specific content, 17 items): same two-arm design as Trial 2.

All trials were single session. Knowledge accuracy was the primary outcome; vaccination
intention was secondary. Data quality exclusions were applied at analysis: item-level
missingness on the knowledge scale (Trial 1) and duplicate/non-U.S. IP screening plus, in
the Game arm, completion code validation (Trials 2 and 3).

Completed
COVID-19
Vaccine Hesitancy
Health Misinformation
Communication

Behavioral: Gamified misinformation refutation quiz

Single-session online game: participants judge true/false statements about COVID-19
(Trials 1-2) or COVID-19 vaccines (Trial 3) and immediately after each response receive
the correct answer with a brief evidence-based refutation, within a gamified interface
(points, ranks, feedback). 6-19 knowledge items depending on trial.

Behavioral: Refutational text (active control)

Identical evidence-based refutational content presented as a single static text block
without game elements or item-level feedback. Participants confirmed reading the text
before completing the post-intervention assessments.

Eligibility Criteria

Inclusion Criteria:

- Adults aged 18 or older

- Trial 1: Canadian residents residing outside Quebec, with internet access, able to
complete the questionnaire in English

- Trials 2-3: Amazon Mechanical Turk workers located in the United States, with a HIT
approval rate of at least 95% and more than 100 approved HITs.

Exclusion Criteria:

- Trial 1: employment in market research, advertising, media, or by a political party

Eligibility Gender
All
Eligibility Age
Minimum: 18 Years ~ Maximum: N/A
Countries
United States
Locations

Online
Columbia, South Carolina, United States

Not Provided

University of South Carolina
NCT Number
Keywords
Misinformation
refutation
gamification
serious games
health education
Vaccine Hesitancy
infodemic
belief change
debunking
online intervention
MeSH Terms
COVID-19
Vaccination Hesitancy
Communication
Health Education