Promoting Social Distancing and COVID-19 Vaccine Intentions to Mothers: Randomized Comparison of Information Sources in Social Media Messages

Abstract

Background Social media disseminated information and spread misinformation during the COVID-19 pandemic that affected prevention measures, including social distancing and vaccine acceptance. Objective In this study, we aimed to test the effect of a series of social media posts promoting COVID-19 nonpharmaceutical interventions (NPIs) and vaccine intentions and compare effects among 3 common types of information sources: government agency, near-peer parents, and news media. Methods A sample of mothers of teen daughters (N=303) recruited from a prior trial were enrolled in a 3 (information source) × 4 (assessment period) randomized factorial trial from January to March 2021 to evaluate the effects of information sources in a social media campaign addressing NPIs (ie, social distancing), COVID-19 vaccinations, media literacy, and mother–daughter communication about COVID-19. Mothers received 1 social media post per day in 3 randomly assigned Facebook private groups, Monday-Friday, covering all 4 topics each week, plus 1 additional post on a positive nonpandemic topic to promote engagement. Posts in the 3 groups had the same messages but differed by links to information from government agencies, near-peer parents, or news media in the post. Mothers reported on social distancing behavior and COVID-19 vaccine intentions for self and daughter, theoretic mediators, and covariates in baseline and 3-, 6-, and 9-week postrandomization assessments. Views, reactions, and comments related to each post were counted to measure engagement with the messages. Results Nearly all mothers (n=298, 98.3%) remained in the Facebook private groups throughout the 9-week trial period, and follow-up rates were high (n=276, 91.1%, completed the 3-week posttest; n=273, 90.1%, completed the 6-week posttest; n=275, 90.8%, completed the 9-week posttest; and n=244, 80.5%, completed all assessments). In intent-to-treat analyses, social distancing behavior by mothers (b=–0.10, 95% CI –0.12 to –0.08, P<.001) and daughters (b=–0.10, 95% CI –0.18 to –0.03, P<.001) decreased over time but vaccine intentions increased (mothers: b=0.34, 95% CI 0.19-0.49, P<.001; daughters: b=0.17, 95% CI 0.04-0.29, P=.01). Decrease in social distancing by daughters was greater in the near-peer source group (b=–0.04, 95% CI –0.07 to 0.00, P=.03) and lesser in the government agency group (b=0.05, 95% CI 0.02-0.09, P=.003). The higher perceived credibility of the assigned information source increased social distancing (mothers: b=0.29, 95% CI 0.09-0.49, P<.01; daughters: b=0.31, 95% CI 0.11-0.51, P<.01) and vaccine intentions (mothers: b=4.18, 95% CI 1.83-6.53, P<.001; daughters: b=3.36, 95% CI 1.67-5.04, P<.001). Mothers’ intentions to vaccinate self may have increased when they considered the near-peer source to be not credible (b=–0.50, 95% CI –0.99 to –0.01, P=.05). Conclusions Decreasing case counts, relaxation of government restrictions, and vaccine distribution during the study may explain the decreased social distancing and increased vaccine intentions. When promoting COVID-19 prevention, campaign planners may be more effective when selecting information sources that audiences consider credible, as no source was more credible in general. Trial Registration ClinicalTrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807

The Process of Responding to COVID-19 Misinformation in a Social Media Feed

“…Mothers were middle-aged (mean = 42.8 years), majority White (87.1%), college-educated (55.7%), and affluent (68.8% annual incomes >$60 000) but diverse politically (24.4% conservative, 50.2% middle-of-the-road, 25.4% liberal). Of the 135 posts total (n = 45 per group; on average, mothers viewed more than 35 posts per group 9 ), 17 (13%) posts received comments containing misinformation (n = 54 [3.3%] out of 1617 comments total) from 20 unique mothers (6.6% of sample; range = 1-7 misinformation comments per mother). Misinformation took a number of forms (eg, see the Table ).…”

“…Posts were delivered in 3 Facebook private groups from January to March, 2021-45 experimental posts plus 12 posts on study procedures or to attract engagement per group. Text for posts was written by the researchers and were nearly identical across groups, except that mothers were randomly assigned to receive links to different information sources in the posts-government agencies (n = 100), near-peer parents (n = 99), or news media (n = 104)-in the 3 groups (a detailed description was published previously 9 ). Randomization should have balanced exposure to these information sources outside of the study.…”

“…Randomization should have balanced exposure to these information sources outside of the study. Mothers were posttested at 3 weeks, 6 weeks, and 9 weeks postrandomization on NPIs, vaccination intentions, media literacy, family communication, and theoretic mediators (results reported elsewhere 9 ). Most mothers (98.3%) stayed in the Facebook groups for all 9 weeks; 80.5% completed all assessments.…”

“…They recommended that responses start with acknowledging participants and their uncertainty, confusion, or motivation, to convey empathy, prevent defensiveness, and/or maintain trust among participants,4 before debunking the misinformation using various techniques (eg, fact-checking, coherence appeals, reframing, safety/efficacy information, resistance-to-persuasion tactics, and stories with statistical content5–8). In 2021, as COVID-19 vaccines were initially distributed, the authors conducted a 9-week social media campaign on COVID-19 prevention 9. Here, we describe experiences deploying a protocol to respond to misinformation in comments by users.…”

“…In 2021, as COVID-19 vaccines were initially distributed, the authors conducted a 9-week social media campaign on COVID-19 prevention. 9 Here, we describe experiences deploying a protocol to respond to misinformation in comments by users.…”