COVID-19 Messaging for Vaccination

NCT ID: NCT05182554

Last Updated: 2023-08-25

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

6 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-12-22

Study Completion Date

2022-01-27

Brief Summary

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This study will distribute videos of health professionals encouraging Covid-19 vaccination to a large sample of Facebook users, and will test the most effective ways to maximize diffusion of this vaccine-related content to increase vaccination rates. The study sample will be U.S. states where vaccination rates remained low in fall 2021. The experimental design is an RCT with 4 groups, randomized at the county level: 1) a control group which receives no intervention, 2) a treatment group in which Facebook users receive ads which include videos of health professionals telling them to get vaccinated, 3) a treatment group in which Facebook users receive ads which include videos of health professionals encouraging them to help their friends to get vaccinated, and 4) a treatment group in which Facebook users receive ads which include videos of health professionals encouraging them to get their most influential friends to help their friends get vaccinated. In treatments 3 and 4, participants will have the option to sign up to be a "vaccine ambassador," in which case they will get notifications when the study team posts new vaccine-related content, and will receive reminders about encouraging their friends to be vaccinated. The vaccine ambassadors will also be entered into a lottery to win prizes. The study team is building a website to host the videos of health professionals which answer common questions about Covid-19 vaccination. The investigators will measure engagement with the vaccine-related content as well as assess effects on vaccination rates at the county level.

Detailed Description

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The study will have three treatment arms and a control group. Each of the treatments will be randomized at the county level and will be initiated through a Facebook ad campaign.

Experimental Sample: The experimental sample includes all states where less than 60% of the total population had received a first dose of Covid-19 vaccine by October 21, 2021. There are 1402 counties in the 19 states satisfying those criteria (Alabama, Alaska, Arkansas, Georgia, Idaho, Iowa, Indiana, Louisiana, Michigan, Mississippi, Missouri, Montana, North Dakota, Ohio, Oklahoma, South Carolina, Tennessee, West Virginia, Wyoming). Excluding the five counties with missing data, there are 1,397 counties in the experiment, of which there are 468 counties in the control group, 310 counties in T1 ("direct" messaging) treatment, 309 counties in T2 ("friends" messaging), and 310 counties in T3 ("gossips" messaging).

The following procedures will be used:

* Treatment Group 1 ("Direct" messaging): The investigators will conduct a Facebook ad campaign to show content about COVID-19 vaccination to a large number of Facebook users. Facebook will allocate ad credits across users in treatment areas. The ads will be displayed twice per week for 3-4 weeks. Like for any Facebook ad, individuals can choose to whether or not to watch the video and can close the ad at any time. If individuals wish, they can also share any of the content with others. The videos shown in the ads will be hosted on our project Facebook page "Doctors for Coronavirus Prevention." As in previous projects by the investigators, a health professional (normally wearing a white coat or scrubs) will read very short scripts directly onto the camera (see eg. https://www.facebook.com/doctors4covidprevention/posts/104965558099200 for an example).
* Treatment Group 2 ("Friends" messaging): For this group, the Facebook ad campaign will recruit individuals to become "vaccine ambassadors" to help spread the word about vaccination to their friends, families and communities. Recruitment ads will be disseminated in a similar manner to the content in T1. Individuals will be able to share the ad with others. Individuals interested in learning more can click through a link in the ad to the vaccine ambassador webpage. Participants can consume or share any of the information on the webpage. Interested individuals can also enroll formally as vaccine ambassadors. They can share their contact information with the study to a) be entered into prize lotteries, b) receive reminders to share content with others, c) be contacted in the future for possible follow-up surveys. They will be asked to give their informed consent at this time and will be screened based on whether they live in a treated county and whether they are 18 years or older.
* Treatment Group 3 ("Gossips" messaging): This treatment looks the same as Treatment Group 2, except the recruitment ads will differ slightly. If the individual clicks through to learn more about vaccine ambassadors, they will also be reminded to share the invitation with people they know who are often the source of important news or information.
* Control: individuals in these counties will receive no intervention and will never be contacted by members of the study team.

Treatment and control status at the county level will be merged with aggregated and de-identified datasets to measure COVID vaccinations, COVID symptoms, and cases, and engagement with the vaccine ambassador content.

The study team will create a series of websites with materials that the vaccine ambassadors can share with friends, family and others in their communities. This same content will be disseminated through sponsored Facebook ads in T1. On the website, the framing of the vaccine-related videos with either a "fact" or "myth" frame will be randomized. The purpose is to study which framing is more effective at engaging users.

Conditions

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Vaccination Refusal COVID-19 Pandemic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

There are four arms in the study which geographic areas are assigned to in parallel. The geographic areas in the three treatment arms will receive a Facebook ad campaign over the same time period to one another.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Control

No intervention in this arm; the study team will examine publicly available county- and zip code-level outcomes in this group.

Group Type NO_INTERVENTION

No interventions assigned to this group

Treatment 1: Direct

Facebook users in the area receive ads which include videos of health professionals telling them to get vaccinated. The health professionals answer common questions about Covid-19 vaccines (e.g. are they safe / are they free).

Group Type EXPERIMENTAL

Doctor Videos

Intervention Type BEHAVIORAL

Receive ads on Facebook or through our website with videos in which health professionals tell people to get the Covid-19 vaccine. The health professionals answer common questions about the Covid-19 vaccine, such as how mRNA vaccines work, and what types of side effects to expect.

Treatment 2: Friends

Facebook users in the area receive ads which include videos of health professionals encouraging them to help their friends to get vaccinated. There is also a link in the ad to a website build by the study team. This website hosts videos which answer common questions about vaccination (the same videos which are directly served to Facebook users in Treatment 1).

Group Type EXPERIMENTAL

Doctor Videos

Intervention Type BEHAVIORAL

Receive ads on Facebook or through our website with videos in which health professionals tell people to get the Covid-19 vaccine. The health professionals answer common questions about the Covid-19 vaccine, such as how mRNA vaccines work, and what types of side effects to expect.

Sharing Videos

Intervention Type BEHAVIORAL

Receive ads on Facebook with videos in which health professionals tell people to encourage their unvaccinated friends to get the Covid-19 vaccine.

Vaccine Ambassador

Intervention Type BEHAVIORAL

Adults in participating geographic areas can sign up to be a "vaccine ambassador" on a website that the study team has built. The study team will send updates to vaccine ambassadors when new content has been posted to the website (e.g. a new video) and/or to remind the vaccine ambassadors to encourage their friends to get vaccinated. The study team will incentivize vaccine ambassadors by entering participating ambassadors into a lottery for a prize.

Video framing

Intervention Type BEHAVIORAL

The same videos will be displayed using two different frames: a "myth" frame and a "fact" frame. Visitors to the vaccine content website will randomly receive one framing of each video.

Video order

Intervention Type BEHAVIORAL

The order in which videos appear on the vaccine content website will be randomized.

Treatment 3: Gossips

Facebook users in the area receive ads which include videos of health professionals encouraging them to nominate their most influential friends to help their friends get vaccinated. The difference from Treatment 2 is that the health professionals call on Facebook users to get their most influential friends to do the convincing about the vaccine. There is also a link in the ad to a website built by the study team. This website hosts videos which answer common questions about vaccination (the same videos that are directly served to Facebook users in Treatment 1).

Group Type EXPERIMENTAL

Doctor Videos

Intervention Type BEHAVIORAL

Receive ads on Facebook or through our website with videos in which health professionals tell people to get the Covid-19 vaccine. The health professionals answer common questions about the Covid-19 vaccine, such as how mRNA vaccines work, and what types of side effects to expect.

Sharing Videos (Influencers)

Intervention Type BEHAVIORAL

Receive ads on Facebook with videos in which health professionals tell people to get their most influential friends to encourage their unvaccinated friends to get the Covid-19 vaccine.

Vaccine Ambassador

Intervention Type BEHAVIORAL

Adults in participating geographic areas can sign up to be a "vaccine ambassador" on a website that the study team has built. The study team will send updates to vaccine ambassadors when new content has been posted to the website (e.g. a new video) and/or to remind the vaccine ambassadors to encourage their friends to get vaccinated. The study team will incentivize vaccine ambassadors by entering participating ambassadors into a lottery for a prize.

Video framing

Intervention Type BEHAVIORAL

The same videos will be displayed using two different frames: a "myth" frame and a "fact" frame. Visitors to the vaccine content website will randomly receive one framing of each video.

Video order

Intervention Type BEHAVIORAL

The order in which videos appear on the vaccine content website will be randomized.

Interventions

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Doctor Videos

Receive ads on Facebook or through our website with videos in which health professionals tell people to get the Covid-19 vaccine. The health professionals answer common questions about the Covid-19 vaccine, such as how mRNA vaccines work, and what types of side effects to expect.

Intervention Type BEHAVIORAL

Sharing Videos

Receive ads on Facebook with videos in which health professionals tell people to encourage their unvaccinated friends to get the Covid-19 vaccine.

Intervention Type BEHAVIORAL

Sharing Videos (Influencers)

Receive ads on Facebook with videos in which health professionals tell people to get their most influential friends to encourage their unvaccinated friends to get the Covid-19 vaccine.

Intervention Type BEHAVIORAL

Vaccine Ambassador

Adults in participating geographic areas can sign up to be a "vaccine ambassador" on a website that the study team has built. The study team will send updates to vaccine ambassadors when new content has been posted to the website (e.g. a new video) and/or to remind the vaccine ambassadors to encourage their friends to get vaccinated. The study team will incentivize vaccine ambassadors by entering participating ambassadors into a lottery for a prize.

Intervention Type BEHAVIORAL

Video framing

The same videos will be displayed using two different frames: a "myth" frame and a "fact" frame. Visitors to the vaccine content website will randomly receive one framing of each video.

Intervention Type BEHAVIORAL

Video order

The order in which videos appear on the vaccine content website will be randomized.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Facebook user
* Over 18 years old
* In a geographic area targeted by the study

Exclusion Criteria

\-
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Facebook, Inc.

OTHER

Sponsor Role collaborator

Code3

INDUSTRY

Sponsor Role collaborator

Stanford University

OTHER

Sponsor Role collaborator

Harvard University

OTHER

Sponsor Role collaborator

Yale University

OTHER

Sponsor Role collaborator

Johns Hopkins University

OTHER

Sponsor Role collaborator

Massachusetts General Hospital

OTHER

Sponsor Role collaborator

Ludwig-Maximilians - University of Munich

OTHER

Sponsor Role collaborator

National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

Massachusetts Institute of Technology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Esther Duflo, PhD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts Institute of Technology

Ben Olken, PhD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts Institute of Technology

Abhijit Banerjee, PhD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts Institute of Technology

Marcella Alsan, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Harvard Kennedy School

Arun Chandrasekhar, PhD

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Emily Breza, PhD

Role: PRINCIPAL_INVESTIGATOR

Harvard University

Paul Goldsmith-Pinkham, PhD

Role: PRINCIPAL_INVESTIGATOR

Yale University

Emily Hoppe, PhD Student

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins School of Nursing

Pierre-Luc Vautrey, PhD Student

Role: PRINCIPAL_INVESTIGATOR

Massachusetts Institute of Technology

Lisa Ho, PhD Student

Role: PRINCIPAL_INVESTIGATOR

Massachusetts Institute of Technology

Lucy Ogbu-Nwobodo, MD

Role: PRINCIPAL_INVESTIGATOR

MGH/McLean Harvard Psychiatry Program

Erica Warner, ScD, MPH

Role: PRINCIPAL_INVESTIGATOR

Harvard Medical School & Massachusetts General Hospital

Carlos Torres, MD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts General Hospital

Fatima Stanford, MD, MPH, MPA

Role: PRINCIPAL_INVESTIGATOR

Harvard Medical School & Massachusetts General Hospital

Sarah Eichmeyer, PhD

Role: PRINCIPAL_INVESTIGATOR

Ludwig-Maximilians - University of Munich

Locations

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Massachusetts Institute of Technology

Cambridge, Massachusetts, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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2106000397

Identifier Type: -

Identifier Source: org_study_id

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