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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vaccine Corrective Control | Active Comparator | 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. |
|
| Vaccine corrective with economic recovery framing | Experimental | 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. |
|
| Vaccine corrective with freedom framing | Experimental | 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. |
|
| Vaccine corrective with humor | Experimental | 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." |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Corrective message framing and humor | Behavioral | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| 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." | Baseline and up to 5 minutes after receiving the corrective message |
| 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." | Up to 5 minutes after receiving the corrective message |
| 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." | Up to 5 minutes after receiving the corrective message |
| 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." | Baseline and up to 5 minutes after receiving the corrective message |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Meghan Moran, PhD | Johns Hopkins Bloomberg School of Public Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Johns Hopkins Bloomberg School of Public Health | Baltimore | Maryland | 21205 | United States |
Upon request, deidentified participant data collected during the study may be shared. Upon request, we may also share the study protocol, survey, and informed consent form. Data will be made available upon request beginning 3 months following publication of the final article from this study, with no end date. Data will be made available for analyses deemed appropriate by the study PI. Proposals should be directed to mmoran22@jhu.edu. Data requestors will need to sign a data access agreement.
Starting 3 months following publication of the final article from this study, with no end date.
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| ID | Title | Description |
|---|---|---|
| FG000 | 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. |
| FG001 | 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. |
| FG002 | 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. |
| FG003 | 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. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | 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. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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." | Posted | Mean | Standard Deviation | score on a 0-100 scale | Baseline and up to 5 minutes after receiving the corrective message |
|
up to 3 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | 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. |
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Limitations include the ANCOVAs being underpowered. Failure to reject the null offers limited value because there's not strong support for lack of effect. Beliefs were also measured on a continuous scales, which can detect even small effects.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Caitlin Weiger | Johns Hopkins Bloomberg School of Public Health | 301-712-8357 | cweiger2@jhmi.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Aug 4, 2021 | Jul 28, 2023 | Prot_SAP_000.pdf |
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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.").
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|
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| BG001 | 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. |
| BG002 | 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. |
| BG003 | 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. |
| BG004 | Total | Total of all reporting groups |
| years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Political affiliation | Count of Participants | Participants |
|
| OG001 | 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. |
| OG002 | 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. |
| OG003 | 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. |
|
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| 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." | Posted | Mean | Standard Deviation | score on a 0-100 scale | Up to 5 minutes after receiving the corrective message |
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| 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." | Posted | Mean | Standard Deviation | units on a scale | Up to 5 minutes after receiving the corrective message |
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| 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." | Posted | Mean | Standard Deviation | score on a 0-100 scale | Baseline and up to 5 minutes after receiving the corrective message |
|
|
|
|
| 0 |
| 27 |
| 0 |
| 27 |
| 0 |
| 27 |
| EG001 | 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. | 0 | 27 | 0 | 27 | 0 | 27 |
| EG002 | 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. | 0 | 24 | 0 | 24 | 0 | 24 |
| EG003 | 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. | 0 | 22 | 0 | 22 | 0 | 22 |
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| Note that analyses are underpowered due to administrative issues with funding that halted recruitment early. | ANCOVA | DF = 6 | 0.268 | Sidak's adjusted p-value for multiple comparisons | Mean Difference (Final Values) | 15.12214 | Standard Error of the Mean | 9.07444 | 2-Sided | 95 | -6.938055 | 37.18234 | Freedom - control | Superiority |
| Note that analyses are underpowered due to administrative issues with funding that halted recruitment early. | ANCOVA | DF = 6 | 0.330 | Sidak's adjusted p-value for multiple comparisons | Mean Difference (Final Values) | 14.4032 | Standard Error of the Mean | 9.305576 | 2-Sided | 95 | -8.218891 | 37.0253 | Humor - Control | Superiority |
| Note that analyses are underpowered due to administrative issues with funding that halted recruitment early. | ANCOVA | DF = 5 | 0.998 | Sidak's adjusted p-value for multiple comparisons | Mean Difference (Final Values) | -1.097586 | Standard Error of the Mean | 6.675066 | 2-Sided | 95 | -17.34491 | 15.14973 | Freedom - control | Superiority |
| Note that analyses are underpowered due to administrative issues with funding that halted recruitment early. | ANCOVA | DF = 5 | 0.447 | Sidak's adjusted p-value for multiple comparisons | Mean Difference (Final Values) | 8.926191 | Standard Error of the Mean | 6.588643 | 2-Sided | 95 | -7.110771 | 24.96315 | Humor - Control | Superiority |
| Note that analyses are underpowered due to administrative issues with funding that halted recruitment early. | ANCOVA | DF = 6 | 0.473 | Sidak's adjusted p-value for multiple comparisons | Mean Difference (Final Values) | -2.685896 | Standard Error of the Mean | 2.046067 | 2-Sided | 95 | -7.66090 | 2.289114 | Freedom - control | Superiority |
| Note that analyses are underpowered due to administrative issues with funding that halted recruitment early. | ANCOVA | DF = 6 | 0.008 | Sidak's adjusted p-value for multiple comparisons | Mean Difference (Final Values) | -6.469932 | Standard Error of the Mean | 2.102231 | 2-Sided | 95 | -11.58151 | -1.358358 | Humor - control | Superiority |