Beliefs
Conditions
Brief summary
This study seeks to assess the efficacy of educational messages to correct misperceptions. People hold a number of misperceptions that are relevant to public health, including misperceptions regarding COVID vaccines. Some people incorrectly think the COVID vaccines authorized by FDA are not safe or effective. These misperceptions can reduce adherence to public health recommendations and result in continued spread of COVID. This study will test if humor and different types of framing increase the efficacy of messages to correct misperceptions about FDA's authorized coronavirus vaccine safety and effectiveness. The frames tested will include: framing the vaccine as a way to boost economic recovery and framing the vaccine as a way to increase freedom to choose how to behave. The addition of humor will also be tested. Message efficacy will be measured via improved accuracy of beliefs after being exposed to the message. In other words, participants will be asked how safe and effective FDA authorized COVID vaccines are before seeing a message, then they will see a message about why the COVID vaccines are safe and effective, and then they will again be asked how safe and effective they think the vaccines are. This study will also assess the accuracy of inferential beliefs. This will be accomplished by asking participants questions about other vaccines that either are or are not authorized by FDA. If participants have understood the messages and updated their mental models of how FDA evaluates vaccines, they should be able to infer if other vaccines are safe and effective based on their FDA authorization status. Hypotheses H1: Participants who are exposed to A.) a message with humor, B.) a message with an economic recovery fame, or C.) a message with a freedom frame will be more likely to increase their agreement with the statement that the FDA will only authorize coronavirus vaccines that are safe and effective after message exposure than participants exposed to the control condition. H2: Participants who are exposed to A.) a message with humor, B.) a message with an economic recovery fame, or C.) a message with a freedom frame will agree more strongly with the statement that the FDA approved flu vaccine is safe and effective after message exposure than participants exposed to the control condition. H3. Participants who are exposed to A.) a message with humor, B.) a message with an economic recovery fame, or C.) a message with a freedom frame will agree more strongly with the statement that the ResVax vaccine, which was not approved by the FDA for the treatment of RSV, is a safe and effective after message exposure than participants exposed to the control condition. H4. Participants who are exposed to A.) a message with humor, B.) a message with an economic recovery fame, or C.) a message with a freedom frame will be more likely to increase behavioral intentions to get an FDA authorized COVID vaccine after message exposure than participants exposed to the control condition.
Interventions
BEHAVIORALCorrective message framing and humor
The main content of the messages will be the same. Experimental conditions (arms 2-4) will additionally include consequent framing as a result of getting vaccinated (e.g. economic recovery for arm 2 and freedom for arm 3) and humor for arm 4. Participants will be randomized to view one of the four messages.
Sponsors
Johns Hopkins Bloomberg School of Public Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Intervention model description
Model Description: Participants will be randomized to view one of four messages. The control message explains why people are hesitant to accept the FDA authorized COVID vaccines are safe and effective and how they are evaluated. Arm 2 additionally includes consequent framing regarding economic recovery (e.g. If everyone gets vaccinated, we can keep schools, stores, and other businesses open so more Americans can keep working and supporting their families. With a picture of an open for business sign), arm 3 includes consequent framing regarding freedom to behave as one chooses (e.g. Everyone getting vaccinated is the key to freedom! A vaccine can give us the freedom to hang out with friends, shop, and worship together again safely. With a picture of an American flag), and arm 4 includes humor (e.g. Unfortunately, everyone getting vaccinated means leaving the house again.).
Eligibility
Sex/Gender
ALL
Age
21 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Are 21 years of age or older. * Have not participated in the cognitive interview. * Have not yet received a COVID vaccine. * Are registered with MTurk in the United States. * Have completed \>= 5,000 HIITs within the MTurk system * Have a HIIT approval rating of \>= 97% * Rate their agreement with the following statement as less than or equal to 50 out of 100: To what extent do you agree with the following: The FDA only authorizes COVID vaccines that are safe and effective.
Exclusion criteria
* Are younger than 21 years of age * Participated in the cognitive interviews * Have already received a COVID vaccine. * Are not registered with MTurk in the US * Have completed \< 5,000 HIITS * Have a HIIT approval rating of \<97% * Rate their agreement with the following statement as greater than 50 out of 100: To what extent do you agree with the following: The FDA only authorizes COVID vaccines that are safe and effective.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Accuracy of the Belief That FDA Authorized COVID-19 Vaccines Are Safe and Effective | Baseline and up to 5 minutes after receiving the corrective message | Assessed by change in response to the question To what extent do you agree or disagree with the following statement: The FDA has only authorized COVID vaccines that are safe and effective; with response options on a continuous scale from 0 I do not agree at all to 100, I completely agree. |
| Accuracy of Inferential Belief That the FDA Authorized Flu Vaccine is Safe and Effective | Up to 5 minutes after receiving the corrective message | Assessed by response to the question To what extent do you agree with the following: The FDA authorized flu vaccine is safe and effective.; with response options on a continuous scale from 0 I do not agree at all to 100, I completely agree. |
| Accuracy of Inferential Belief That RexVax is Safe and Effective | Up to 5 minutes after receiving the corrective message | Assessed by response to the question, The FDA recommended more testing of ResVax and did NOT authorize the vaccine because it did not prevent enough RSV infections. To what extent do you agree with the following: ResVax is safe and effective; with response options on a continuous scale from 0 I do not agree at all to 100, I completely agree. |
| Change in Intention to Get a COVID-19 Vaccine | Baseline and up to 5 minutes after receiving the corrective message | Assessed by change in response to the statement: I plan on getting an FDA authorized coronavirus vaccine; with response options on a continuous scale from 0 I do not agree at all to 100, I completely agree. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Vaccine Corrective Control A message that explains why people are hesitant to accept the FDA authorized COVID vaccines are safe and effective and how the vaccines are evaluated as safe and effective by FDA.
Corrective message framing and humor: The main content of the messages will be the same. Experimental conditions (arms 2-4) will additionally include consequent framing as a result of getting vaccinated (e.g. economic recovery for arm 2 and freedom for arm 3) and humor for arm 4. Participants will be randomized to view one of the four messages. | 27 |
| Vaccine Corrective With Economic Recovery Framing The content of the control message with the addition of the text, If everyone gets vaccinated, we can keep schools, stores, and other businesses open so more Americans can keep working and supporting their families. The message will also include a picture of an open for business sign.
Corrective message framing and humor: The main content of the messages will be the same. Experimental conditions (arms 2-4) will additionally include consequent framing as a result of getting vaccinated (e.g. economic recovery for arm 2 and freedom for arm 3) and humor for arm 4. Participants will be randomized to view one of the four messages. | 27 |
| Vaccine Corrective With Freedom Framing The content of the control message with the addition of the text, Everyone getting vaccinated is the key to freedom! A vaccine can give us the freedom to hang out with friends, shop, and worship together again safely. The message will also include a picture of an American flag.
Corrective message framing and humor: The main content of the messages will be the same. Experimental conditions (arms 2-4) will additionally include consequent framing as a result of getting vaccinated (e.g. economic recovery for arm 2 and freedom for arm 3) and humor for arm 4. Participants will be randomized to view one of the four messages. | 24 |
| Vaccine Corrective With Humor The content of the control message with the addition of the text, Unfortunately, everyone getting vaccinated means leaving the house again. The message will include a meme of a cat being pulled/rescued from a window with text boxes labeling the cat as People at home working in sweatpants and the rescuer as COVID Vaccines.
Corrective message framing and humor: The main content of the messages will be the same. Experimental conditions (arms 2-4) will additionally include consequent framing as a result of getting vaccinated (e.g. economic recovery for arm 2 and freedom for arm 3) and humor for arm 4. Participants will be randomized to view one of the four messages. | 22 |
| Total | 100 |
Baseline characteristics
| Characteristic | Vaccine Corrective Control | Vaccine Corrective With Economic Recovery Framing | Vaccine Corrective With Freedom Framing | Vaccine Corrective With Humor | Total |
|---|---|---|---|---|---|
| Age, Continuous | 39 years STANDARD_DEVIATION 9.9 | 41.4 years STANDARD_DEVIATION 11.9 | 43.3 years STANDARD_DEVIATION 9.2 | 40.8 years STANDARD_DEVIATION 9.7 | 41.1 years STANDARD_DEVIATION 10.3 |
| Political affiliation Conservative | 11 Participants | 18 Participants | 16 Participants | 13 Participants | 58 Participants |
| Political affiliation Liberal | 3 Participants | 4 Participants | 6 Participants | 3 Participants | 16 Participants |
| Political affiliation Moderate | 13 Participants | 5 Participants | 2 Participants | 6 Participants | 26 Participants |
| Race/Ethnicity, Customized Race/ethnicity Non-Hispanic White | 19 Participants | 24 Participants | 20 Participants | 16 Participants | 79 Participants |
| Race/Ethnicity, Customized Race/ethnicity Racial/ethnic minority | 8 Participants | 3 Participants | 4 Participants | 6 Participants | 21 Participants |
| Sex: Female, Male Female | 8 Participants | 15 Participants | 10 Participants | 9 Participants | 42 Participants |
| Sex: Female, Male Male | 19 Participants | 12 Participants | 14 Participants | 13 Participants | 58 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 27 | 0 / 27 | 0 / 24 | 0 / 22 |
| other Total, other adverse events | 0 / 27 | 0 / 27 | 0 / 24 | 0 / 22 |
| serious Total, serious adverse events | 0 / 27 | 0 / 27 | 0 / 24 | 0 / 22 |
Outcome results
Primary
Accuracy of Inferential Belief That RexVax is Safe and Effective
Assessed by response to the question, The FDA recommended more testing of ResVax and did NOT authorize the vaccine because it did not prevent enough RSV infections. To what extent do you agree with the following: ResVax is safe and effective; with response options on a continuous scale from 0 I do not agree at all to 100, I completely agree.
Time frame: Up to 5 minutes after receiving the corrective message
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Vaccine Corrective Control | Accuracy of Inferential Belief That RexVax is Safe and Effective | 14.923077 units on a scale | Standard Deviation 20.853629 |
| Vaccine Corrective With Economic Recovery Framing | Accuracy of Inferential Belief That RexVax is Safe and Effective | 14.24 units on a scale | Standard Deviation 23.502269 |
| Vaccine Corrective With Freedom Framing | Accuracy of Inferential Belief That RexVax is Safe and Effective | 12.47619 units on a scale | Standard Deviation 17.28473 |
| Vaccine Corrective With Humor | Accuracy of Inferential Belief That RexVax is Safe and Effective | 23.863636 units on a scale | Standard Deviation 28.782097 |
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.99495% CI: [-16.98852, 14.07451]ANCOVA
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.99895% CI: [-17.34491, 15.14973]ANCOVA
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.44795% CI: [-7.110771, 24.96315]ANCOVA
Primary
Accuracy of Inferential Belief That the FDA Authorized Flu Vaccine is Safe and Effective
Assessed by response to the question To what extent do you agree with the following: The FDA authorized flu vaccine is safe and effective.; with response options on a continuous scale from 0 I do not agree at all to 100, I completely agree.
Time frame: Up to 5 minutes after receiving the corrective message
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Vaccine Corrective Control | Accuracy of Inferential Belief That the FDA Authorized Flu Vaccine is Safe and Effective | 37.074074 score on a 0-100 scale | Standard Deviation 33.546668 |
| Vaccine Corrective With Economic Recovery Framing | Accuracy of Inferential Belief That the FDA Authorized Flu Vaccine is Safe and Effective | 44.666667 score on a 0-100 scale | Standard Deviation 31.619128 |
| Vaccine Corrective With Freedom Framing | Accuracy of Inferential Belief That the FDA Authorized Flu Vaccine is Safe and Effective | 49.583333 score on a 0-100 scale | Standard Deviation 35.808569 |
| Vaccine Corrective With Humor | Accuracy of Inferential Belief That the FDA Authorized Flu Vaccine is Safe and Effective | 50.954545 score on a 0-100 scale | Standard Deviation 35.18993 |
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.81395% CI: [-14.39448, 28.39899]ANCOVA
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.26895% CI: [-6.938055, 37.18234]ANCOVA
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.3395% CI: [-8.218891, 37.0253]ANCOVA
Primary
Change in Accuracy of the Belief That FDA Authorized COVID-19 Vaccines Are Safe and Effective
Assessed by change in response to the question To what extent do you agree or disagree with the following statement: The FDA has only authorized COVID vaccines that are safe and effective; with response options on a continuous scale from 0 I do not agree at all to 100, I completely agree.
Time frame: Baseline and up to 5 minutes after receiving the corrective message
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Vaccine Corrective Control | Change in Accuracy of the Belief That FDA Authorized COVID-19 Vaccines Are Safe and Effective | 20.1 score on a 0-100 scale | Standard Deviation 23.8 |
| Vaccine Corrective With Economic Recovery Framing | Change in Accuracy of the Belief That FDA Authorized COVID-19 Vaccines Are Safe and Effective | 22.8 score on a 0-100 scale | Standard Deviation 24 |
| Vaccine Corrective With Freedom Framing | Change in Accuracy of the Belief That FDA Authorized COVID-19 Vaccines Are Safe and Effective | 24.2 score on a 0-100 scale | Standard Deviation 26.9 |
| Vaccine Corrective With Humor | Change in Accuracy of the Belief That FDA Authorized COVID-19 Vaccines Are Safe and Effective | 22.7 score on a 0-100 scale | Standard Deviation 24.1 |
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.99895% CI: [-9.463627, 10.71961]ANCOVA
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.72595% CI: [-6.416608, 14.505]ANCOVA
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.9895% CI: [-12.25295, 9.179834]ANCOVA
Primary
Change in Intention to Get a COVID-19 Vaccine
Assessed by change in response to the statement: I plan on getting an FDA authorized coronavirus vaccine; with response options on a continuous scale from 0 I do not agree at all to 100, I completely agree.
Time frame: Baseline and up to 5 minutes after receiving the corrective message
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Vaccine Corrective Control | Change in Intention to Get a COVID-19 Vaccine | 15.925926 score on a 0-100 scale | Standard Deviation 24.935187 |
| Vaccine Corrective With Economic Recovery Framing | Change in Intention to Get a COVID-19 Vaccine | 9.4814815 score on a 0-100 scale | Standard Deviation 16.032108 |
| Vaccine Corrective With Freedom Framing | Change in Intention to Get a COVID-19 Vaccine | 9.625 score on a 0-100 scale | Standard Deviation 21.906546 |
| Vaccine Corrective With Humor | Change in Intention to Get a COVID-19 Vaccine | 12.863636 score on a 0-100 scale | Standard Deviation 20.2797 |
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.11395% CI: [-8.985328, 0.6761041]ANCOVA
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.47395% CI: [-7.6609, 2.289114]ANCOVA
Comparison: Note that analyses are underpowered due to administrative issues with funding that halted recruitment early.p-value: 0.00895% CI: [-11.58151, -1.358358]ANCOVA