Digital Health Literacy, Health Communication, Health Misinformation, Misinformation
Conditions
Keywords
Inoculation theory, Cognitive inoculation, Emotional inoculation, Nutrition misinformation, Misinformation, Young adults, Social media, Health literacy
Brief summary
This study aims to examine the effects of cognitive and emotional inoculation interventions on young adults' ability to identify and respond to nutrition-related misinformation on social media. The study will compare two game-based inoculation approaches-a cognitive inoculation intervention and an emotional inoculation intervention-with a control condition. Outcomes will be assessed at baseline, immediately after the intervention, and 2 weeks later.
Detailed description
Nutrition-related misinformation is increasingly disseminated through social media and may influence how young adults perceive and make decisions about food, diet, and health. Such misinformation may rely not only on inaccurate or unsupported claims but also on persuasive communication techniques, including appeals to authority, unrealistic promises, fear appeals, conspiracy narratives, and absolute or dichotomous framing. These techniques may influence judgments by eliciting trust, desire, anxiety, anger, or decision-related pressure. This three-arm randomized controlled trial will compare two game-based inoculation interventions-a cognitive inoculation intervention and an emotional inoculation intervention-with a control condition. Participants will encounter common persuasive techniques used in nutrition-related misinformation and receive condition-specific feedback. The cognitive intervention is designed to promote recognition of misleading techniques and verification of supporting evidence. The emotional intervention is designed to promote recognition of emotional cues associated with manipulative messages and reflection on how such cues may influence judgment. The study will assess participants' responses to nutrition-related social media posts at baseline, immediately after the intervention, and 2 weeks later to examine both immediate and sustained effects.
Interventions
BEHAVIORALCognitive Game-Based Inoculation.
Participants will complete a five-level interactive game designed to build resistance to nutrition-related misinformation on social media. In each level, participants act as a health-content creator and choose between an original social media post and alternative titles that may use misleading persuasive techniques. The game addresses five techniques: fake authority, impossible expectations, fear appeals, conspiracy framing, and false dichotomies. After each decision, participants receive cognitive feedback explaining how the misleading technique operates, the linguistic cues that may indicate its use, and how to evaluate whether the claim is supported by verifiable evidence.
BEHAVIORALEmotional Game-Based Inoculation.
Participants will complete a five-level interactive game designed to build resistance to nutrition-related misinformation on social media. The game uses the same scenarios and addresses the same five misleading techniques as the cognitive inoculation intervention: fake authority, impossible expectations, fear appeals, conspiracy framing, and false dichotomies. After each decision, participants receive emotional feedback designed to help them recognize and reflect on the emotional cues triggered by manipulative messages, including unwarranted reassurance, desire, anxiety, anger, and pressure to make extreme choices. The feedback explains how these emotional responses may influence judgment of nutrition-related information.
BEHAVIORALGeneral Nutrition Health Education.
Participants will read eight brief sections of general nutrition health education adapted from the Chinese Dietary Guidelines (2022). This condition provides credible healthy-diet information without instruction about nutrition-related misinformation, persuasive techniques, evidence verification, fact-checking, or emotional manipulation cues. The sections cover dietary variety; energy balance and physical activity; fruit and vegetable intake; animal-source foods; limiting salt, oil, sugar, and alcohol; regular meals and adequate hydration; food selection, label reading, and food hygiene; and sustainable dietary practices.
Sponsors
Beijing Normal University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
No
Inclusion criteria
1. Aged 18 to 30 years. 2. Able to read and understand Chinese. 3. Able to access and independently complete the online intervention game and study questionnaires. 4. Has access to WeChat for study communication and follow-up reminders. 5. Provides electronic informed consent.
Exclusion criteria
1. Younger than 18 years or older than 30 years. 2. Unable to read Chinese or independently complete the online study procedures. 3. Does not provide electronic informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Perceived Credibility of Nutrition-Related Misinformation | Baseline (T0), immediate post-intervention (T1), and 2-week follow-up (T2). | Change from baseline in perceived credibility of nutrition-related misinformation will be assessed using simulated social-media posts about diet and health. Participants will rate the perceived credibility of each post using a 7-point Likert scale ranging from 1 (not at all credible) to 7 (extremely credible). Higher scores indicate greater perceived credibility of nutrition-related misinformation, representing a worse outcome. Lower scores indicate lower perceived credibility of nutrition-related misinformation. |
| Manipulation-Technique Recognition Accuracy | Baseline (T0), immediate post-intervention (T1), and 2-week follow-up (T2). | Change from baseline in the accuracy of recognizing manipulation techniques in nutrition-related social-media information will be assessed using simulated posts containing both misleading and accurate content. Participants will identify the persuasion or manipulation technique used in each post, or indicate that no misleading technique is present. Higher scores indicate better recognition accuracy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intention to Share Nutrition-Related Misinformation | Baseline (T0), immediate post-intervention (T1), and 2-week follow-up (T2). | Change from baseline in willingness to share nutrition-related misinformation will be assessed using simulated social-media posts about diet and health. Participants will rate their willingness to share the information with others on a 7-point Likert scale ranging from 1 (very unlikely) to 7 (very likely). Higher scores indicate greater intention to share nutrition-related misinformation and represent a worse outcome. |
| Intention to Fact-Check Nutrition-Related Information | Baseline (T0), immediate post-intervention (T1), and 2-week follow-up (T2). | Change from baseline in intention to verify nutrition-related information will be assessed using simulated social-media posts about diet and health. Participants will rate the extent to which they would check whether the information is accurate or supported by reliable evidence on a 7-point Likert scale ranging from 1 (very unlikely) to 7 (very likely). Higher scores indicate greater intention to fact-check nutrition-related information and represent a better outcome. |
| Perceived Manipulativeness | Baseline (T0), immediate post-intervention (T1), and 2-week follow-up (T2). | Change from baseline in perceived manipulativeness will be assessed by participants' ratings of the extent to which nutrition-related social-media posts are perceived as deliberately attempting to influence or guide their judgment. Ratings will be made on a 7-point Likert scale ranging from 1 (not at all manipulative) to 7 (extremely manipulative). Higher scores indicate greater perceived manipulativeness. |
| Perceived Emotional Manipulation | Baseline (T0), immediate post-intervention (T1), and 2-week follow-up (T2). | Change from baseline in perceived emotional manipulation will be assessed in response to nutrition-related social-media posts. Participants will rate the extent to which the posts rely on emotional appeals rather than factual information.Ratings will be made on 7-point Likert scale ranging from 1 (not at all) to 7 (extremely). Higher scores indicate greater perceived emotional manipulation. |
| Perceived Threat | Baseline (T0), immediate post-intervention (T1), and 2-week follow-up (T2). | Change from baseline in perceived threat will be assessed in response to nutrition-related social-media posts. Participants will rate the extent to which the posts evoke concerns about personal health.Ratings will be made on 7-point Likert scale ranging from 1 (not at all) to 7 (extremely).Higher scores indicate greater perceived threat. |
| Counterarguing in Response to Nutrition-Related Misinformation | Baseline (T0), immediate post-intervention (T1), and 2-week follow-up (T2). | Change from baseline in counterarguing will be assessed by participants' self-reported tendency to generate thoughts that question, challenge, or critically evaluate the claims made in nutrition-related social-media posts. Responses will be rated on a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). Higher scores indicate greater counterarguing and represent a better outcome. |
| Misinformation-Detection Self-Efficacy | Baseline (T0) and 2-week follow-up (T2). | Change from baseline in confidence in detecting false, exaggerated, or insufficiently supported nutrition-related information and in verifying its source will be assessed using self-report items rated on 7-point Likert scale ranging from 1 (not at all confident) to 7 (extremely confident). Higher scores indicate greater misinformation-detection self-efficacy. |
Countries
China
Contacts
CONTACTXue Weng
PRINCIPAL_INVESTIGATORXue Weng
Beijing Normal University
Outcome results
None listed