Animated, video entertainment-education to improve vaccine confidence globally during the COVID-19 pandemic: an online randomized controlled experiment with 24,000 participants

Chen, Simiao; Förster, Sebastian; Yang, Juntao; Yu, Fengyun; Jiao, Lirui; Gates, Jennifer; Wang, Zhuoran; Chen, Qiushi; Geldsetzer, Pascal; Wu, Peixin; Wang, Chen; McMahon, Shannon A.; Bärnighausen, Till; Adam, Maya

doi:10.1186/s13063-022-06067-5

Cited by 10 publications

(10 citation statements)

References 28 publications

(29 reference statements)

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“…This finding contrasts with the significantly higher grand mean hope score observed across a similar number of adult participants (N = 12,000) in China, who were involved in the parallel sister trial. 20 The mean hope score in this parallel study population fell within the medium hope score range. (F. Yu, personal communication, December 2021).…”

Section: Discussionmentioning

confidence: 71%

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Hope as a predictor for COVID-19 vaccine uptake in the US: a cross-sectional survey of 11,955 adults

Adam

Mohan

Förster

et al. 2022

Human Vaccines & Immunotherapeutics

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Widespread vaccine uptake is critical for ending the COVID-19 pandemic. As public health officials focus on overcoming vaccine hesitancy, simultaneously boosting hope may be equally important in the US. We analyzed data from an online cross-sectional survey conducted in June 2021. Participants were 11,955 US adults (ages 18–83) of various ethnicities, living in urban and rural settings. Of these, 71.3% had some college education. Mean age was 32.3 years and 72.4% reported being vaccinated against COVID-19. Main measures were COVID-19 self-reported vaccination status (vaccine uptake), vaccine hesitancy (Adult Vaccine Hesitancy Scale), and hope (Adult Hope Scale). The US grand mean hope score fell within the low-hope range. COVID-19 vaccine uptake was positively associated with hope, even after adjusting for vaccine hesitancy, gender, age, ethnicity, income, and urban vs. rural residence. The strong relationship between hope, vaccine confidence and vaccine uptake persisted across US populations at risk for low vaccine uptake. Our mediation analysis revealed that, for every unit increase in hope, the probability of being vaccinated went up by 5% points. Of this association, 52% was not mediated by vaccine hesitancy, but rather through a direct pathway from hope to vaccine uptake. Mediation analyses of US populations at risk of low vaccine uptake revealed similar findings. Hope may play an important role in vaccine uptake by reducing vaccine hesitancy and by directly enhancing vaccine uptake. Especially in populations at risk of low vaccine uptake, vaccine interventions that boost hope may augment public health efforts to increase US vaccination rates.

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Section: Discussionmentioning

confidence: 71%

“…Our survey was nested within a randomized controlled trial, described elsewhere. 20 The trial aimed to explore the effect of vaccine promotion media on vaccine hesitancy.…”

Section: Methodsmentioning

confidence: 99%

Hope as a predictor for COVID-19 vaccine uptake in the US: a cross-sectional survey of 11,955 adults

Adam

Mohan

Förster

et al. 2022

Human Vaccines & Immunotherapeutics

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“…Prior studies have shown high potential of entertainment-focused educational media as a powerful tool for promoting healthy behaviors ( 41 – 43 ). However, only a few studies have explored the potential of SAS videos in tackling vaccine hesitancy ( 44 , 45 ). In a systematic review, Shen and Han ( 46 ) concluded that techniques for measuring the impact of entertainment-focused instructional media are lacking, and they advocated conducting controlled studies to determine what features may result in desirable effects.…”

Section: Discussionmentioning

confidence: 99%

“…We define the difference between the SAS intervention videos and the control as the total effect, the difference between the SAS intervention videos and the APC video as the content effect, and the difference between the APC video and the control as the attention effect. There have been several entertainment-education studies that have employed an experimental approach to assess the effect of an intervention video in this way ( 47 – 51 ), but only few on COVID-19 ( 44 , 45 , 52 ).…”

Section: Discussionmentioning

confidence: 99%

The effect of a short, animated story-based video on COVID-19 vaccine hesitancy: A study protocol for an online randomized controlled trial

Barteit

Hachaturyan

Beleites

et al. 2022

Front. Public Health

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IntroductionExposure to a high volume of vaccine misinformation on social media can have a negative effect on vaccine confidence and rates. To counteract misinformation, we designed a collage of three short, animated story-based (SAS) videos to convey scientifically informed and accessible information about COVID-19 vaccine applicable to a social media context.Methods and analysisWe will conduct an online randomized controlled trial primarily to: (1) determine the effectiveness of SAS videos in improving COVID-19 vaccine knowledge; (2) evaluate the effectiveness of SAS videos in increasing behavioral intent for COVID-19 vaccination; and (3) quantify people's interest in watching SAS videos about the COVID-19 vaccine. We also aim to identify barriers and facilitators to COIVD-19 vaccinations that have been shown to minimize vaccine hesitancy between vaccinated and unvaccinated populations. Using a web-based recruitment platform, a total of 10,000 adults from the United States will be recruited and randomly assigned to (1) a SAS video collage arm, (2) an attention placebo control video arm, or (3) no intervention arm (1:1:1). Furthermore, we will measure behavioral intent to obtain information on vaccination regarding COVID-19. At the end of the trial, participants randomized to arm 2 and arm 3 will be given the option of watching one of the intervention videos voluntarily to assess participant engagement with SAS videos. Finally, we will assess individual factors associated with vaccine hesitancy - hope, optimism, COVID-19 perceived risks and benefits, self-efficacy, perceived social norms, and trust - and compare vaccinated and unvaccinated participants across the three arms.DiscussionsEvidence-based information from official channels can be complex and inaccessible to the general public, whereas false information on social media is frequently shared in brief postings, images, or videos that can easily reach the general public, thereby rapidly disseminating (mis-)information. To avoid the spread of misinformation, social media may be used to deliver evidence-based and emotionally compelling information in a readily accessible format in order to pre-empt misinformation. Our findings may help inform future SAS efforts addressing COVID-19 and other important public health challenges.Ethics and disseminationThe study was approved by the Heidelberg University Hospital's Ethics Committee (S-163/2022). The trial was registered with German Clinical Trials Register (www.drks.de) on 5 January 2022: number DRKS00027938. Findings of the study will be published in peer-reviewed scientific publications and possibly presented at scientific conferences.

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“…Although the humorous message shown to participants in this study performed poorly, humor is increasingly used to reach social media audiences otherwise disengaged from a public health topic and promote widespread sharing [66][67][68]. Friendly, self-deprecating humor as seen in popular voice assistant bots may be a better choice for one-to-one anonymous conversations with a chatbot than meme-style humor [69].…”

Section: Principal Findingsmentioning

confidence: 99%

Chatbot-Delivered COVID-19 Vaccine Communication Message Preferences of Young Adults and Public Health Workers in Urban American Communities: Qualitative Study (Preprint)

Weeks¹,

Cooper²,

Sangha³

et al. 2022

Preprint

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BACKGROUND Automated conversational agents, or chatbots, have a role in reinforcing evidence-based guidance delivered through other media and offer an accessible, individually tailored channel for public health guidance. In early-to-mid-2021, young adults and Black and Hispanic community members in the U.S. were more likely to be hesitant toward COVID-19 vaccines, citing concerns regarding vaccine safety and effectiveness. Successful chatbot communication requires purposive understanding of user needs, and little is known about how vaccine messaging should be delivered by educational chatbots in health contexts. OBJECTIVE We sought to review the acceptability of messages to be delivered by a chatbot named VIRA from Johns Hopkins University. The study investigated which message styles were preferred by young, urban-dwelling Americans as well as public health workers, since we anticipated the chatbot would be used by the latter as a job aid. METHODS We conducted four virtual focus groups with 20 racially and ethnically diverse adults 18-61 years old living in or near eastern U.S. cities. We tested six message styles, asking participants to select a preferred response style for a chatbot answering common questions about COVID-19 vaccines. We transcribed, coded, and categorized emerging themes within discussions of message content, style, and framing. RESULTS Participants overwhelmingly preferred responses that began with an empathetic reflection of a user concern and concluded with a straightforward, fact-supported response. Most participants disliked moralistic or reasoning-based appeals to get vaccinated, although a subset of public health workers felt such strong statements were warranted. Responses containing humor, testimonials, or unsympathetic phrases did not appeal. CONCLUSIONS To foster credibility, chatbots targeting young people should aim to build rapport with users by deploying empathic, reflective statements, followed by direct and comprehensive responses to user queries. Further studies are needed to inform the appropriate utilization of user-tailored testimonials and humor in the context of chatbot communication, since these strategies can effectively engage and influence users through social media and other digital communication media.

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Animated, video entertainment-education to improve vaccine confidence globally during the COVID-19 pandemic: an online randomized controlled experiment with 24,000 participants

Cited by 10 publications

References 28 publications

Hope as a predictor for COVID-19 vaccine uptake in the US: a cross-sectional survey of 11,955 adults

Hope as a predictor for COVID-19 vaccine uptake in the US: a cross-sectional survey of 11,955 adults

The effect of a short, animated story-based video on COVID-19 vaccine hesitancy: A study protocol for an online randomized controlled trial

Chatbot-Delivered COVID-19 Vaccine Communication Message Preferences of Young Adults and Public Health Workers in Urban American Communities: Qualitative Study (Preprint)

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