Online Games to Help Canadian and U.S. Adults Identify COVID-19 and Vaccine Misinformation: Three Sequential Randomized Studies

Communication, COVID-19, Health Misinformation, Vaccine Hesitancy

misinformation, refutation, gamification, serious games, health education, vaccine hesitancy, infodemic, belief change, debunking, online intervention

COVID-19 misinformation contributed to vaccine hesitancy and preventable illness. This record covers three sequential randomized studies (conducted in Canada and the United States, November-December 2020) testing whether a brief online game helps adults identify COVID-19 and vaccine misinformation. In the game, participants judged whether statements about COVID-19 or 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. Study 1 (Canada, n = 2,018) randomized participants to complete the knowledge assessment either before playing the game or immediately after playing it. Studies 2 (U.S., n = 822) and 3 (U.S., n = 797) compared the game against the identical corrective content presented as plain text, for general COVID-19 misinformation and vaccine-specific misinformation, respectively. The hypothesis was that gamified corrective information produces more accurate knowledge than non-gamified information. The primary outcome was accuracy in identifying true and false claims; vaccination intention was a secondary outcome.

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).

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