Understanding and Overcoming the Racial/Ethnic Inequalities in COVID-19 Vaccination Acceptance

NCT05238428 | Completed

• 1 other identifier: ETH2122-0265
• Study Type: interventional
• Target: 4,039
• Locations: 1 country
• Sites: 1

Brief Summary

With the constant threat of new epidemic waves and the emergence of variants, COVID-19 resilience can only be attained when a sufficient level of immunity is achieved. Yet, in the US and the UK, COVID-19 vaccination campaigns have failed to secure consistent vaccination acceptance in racial/ethnic minority communities. Despite racial/ethnic minorities being more at risk from COVID-19, they are less vaccinated than the White majority. The investigators propose that current vaccination invitation messages are deemed less trustworthy by racial/ethnic minorities than the White majority and that this might partly explain reduced vaccination acceptance. To provide causal evidence of the role of trust and actionable insights, the investigators will experimentally assess the benefits of new invitation messages to receive the COVID-19 booster dose in large, racially/ethnically diverse samples in the US and the UK. Results will evidence how to increase message and source trustworthiness to foster trust and vaccination acceptance across racial/ethnic groups.

Conditions

Vaccine Refusal

Keywords

COVID-19 vaccination acceptance; vaccine hesitancy; trust; health inequality; racial/ethnicity

Outcome Measures

Primary Outcomes (2)

• Trust perception

  Perceived trustworthiness of the vaccine invitation. Participants will rate how trustworthy is the invitation message on a 5 point Likert scale (1: Untrustworthy 3: Not sure, 5: Trustworthy)

  immediately after intervention

• Vaccination appointment booking

  Likelihood to book a vaccination appointment via the message. Participants will report if they would use the link in the message to book their vaccination appointment on a 5 point Likert scale (1: No, I would not, 3: Not sure/maybe later, 5: Yes, I would)

  immediately after intervention

Study Arms (16)

Control sender + control content

NO INTERVENTION

Participants will read the following text in an online survey: You are invited to book your COVID-19 booster vaccination. Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Control sender + Low trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: You are invited to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Behavioral: Trust boost

Control sender + Medium trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: You are invited to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. Vaccines may cause side effects, but the benefits outweigh the risks. The most common side effects are very mild (e.g., sore arm, fever) and severe side effects are very rare (e.g., allergic reaction). Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Behavioral: Trust boost

Control sender+ high trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: You are invited to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. This vaccination is especially important for people who are at higher risk from COVID such as older individuals or those from ethnic minorities. Vaccines may cause side effects, but the benefits outweigh the risks. The most common side effects are very mild (e.g., sore arm, a fever) and severe side effects are very rare (e.g., allergic reaction). Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Behavioral: Trust boost

Low trust boost Sender + control content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP, I would like to invite you to book your COVID-19 booster vaccination. Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Behavioral: Trust boost

Low trust boost Sender + low trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP, I would like to invite you to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Behavioral: Trust boost

Low trust boost Sender + medium trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP, I would like to invite you to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. Vaccines may cause side effects, but the benefits outweigh the risks. The most common side effects are very mild (e.g., sore arm, fever) and severe side effects are very rare (e.g., allergic reaction). Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Behavioral: Trust boost

Low trust boost sender + high trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP, I would like to invite you to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. This vaccination is especially important for people who are at higher risk from COVID such as older individuals or those from ethnic minorities. Vaccines may cause side effects, but the benefits outweigh the risks. The most common side effects are very mild (e.g., sore arm, a fever) and severe side effects are very rare (e.g., allergic reaction). Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Behavioral: Trust boost

Medium trust boost Sender + control content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP and a health expert who cares for the local community, I would like to invite you to book your COVID-19 booster vaccination. Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Behavioral: Trust boost

Medium trust boost sender + low trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP and a health expert who cares for the local community, I would like to invite you to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Behavioral: Trust boost

Medium trust boost sender + Medium trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP and a health expert who cares for the local community, I would like to invite you to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. Vaccines may cause side effects, but the benefits outweigh the risks. The most common side effects are very mild (e.g., sore arm, fever) and severe side effects are very rare (e.g., allergic reaction). Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Behavioral: Trust boost

Medium trust boost Sender+ high trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP and a health expert who cares for the local community, I would like to invite you to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. This vaccination is especially important for people who are at higher risk from COVID such as older individuals or those from ethnic minorities. Vaccines may cause side effects, but the benefits outweigh the risks. The most common side effects are very mild (e.g., sore arm, a fever) and severe side effects are very rare (e.g., allergic reaction). Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5

Behavioral: Trust boost

High trust boost sender + control content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP and a health expert who cares for the local community, I would like to invite you to book your COVID-19 booster vaccination. Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5 Dr Sanjay Kumar

Behavioral: Trust boost

High trust boost sender + low trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP and a health expert who cares for the local community, I would like to invite you to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5 Dr Sanjay Kumar

Behavioral: Trust boost

High trust boost Sender + medium trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP and a health expert who cares for the local community, I would like to invite you to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. Vaccines may cause side effects, but the benefits outweigh the risks. The most common side effects are very mild (e.g., sore arm, fever) and severe side effects are very rare (e.g., allergic reaction). Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5 Dr Sanjay Kumar

Behavioral: Trust boost

High trust boost sender + high trust boost content

EXPERIMENTAL

Participants will read the following text in an online survey: As your local GP and a health expert who cares for the local community, I would like to invite you to book your COVID-19 booster vaccination. The vaccine reduces your chance of becoming infected and protects you against severe forms of the illness. It also protects your loved ones by reducing the risk that you infect others. COVID can be severe, don't risk it. This vaccination is especially important for people who are at higher risk from COVID such as older individuals or those from ethnic minorities. Vaccines may cause side effects, but the benefits outweigh the risks. The most common side effects are very mild (e.g., sore arm, a fever) and severe side effects are very rare (e.g., allergic reaction). Click here to book an appointment: accurx.thirdparty.nhs.uk/r/aafwaczmd5 Dr Sanjay Kumar

Behavioral: Trust boost

Interventions

Trust boost BEHAVIORAL

The investigators adapt the wording of the vaccination invitation to foster trust and increase vaccination acceptance.

Control sender + Low trust boost content; Control sender + Medium trust boost content; Control sender+ high trust boost content; High trust boost Sender + medium trust boost content; High trust boost sender + control content; High trust boost sender + high trust boost content; High trust boost sender + low trust boost content; Low trust boost Sender + control content; Low trust boost Sender + low trust boost content; Low trust boost Sender + medium trust boost content; Low trust boost sender + high trust boost content; Medium trust boost Sender + control content; Medium trust boost Sender+ high trust boost content; Medium trust boost sender + Medium trust boost content; Medium trust boost sender + low trust boost content

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may not qualify if:

• if participants complete the study in less than 5 minutes
• if participants complete the study without paying attention (as indicated by their answers to two attention check questions)

Sponsors & Collaborators

• University of Essex: lead
• University of Southern California: collaborator
• Department of Health and Social Care: collaborator
• Kingston University: collaborator

Study Sites (1)

Qualtrics. The data is gathered via an online platform.

London, United Kingdom

Location

MeSH Terms

Conditions

Vaccination Refusal; Vaccination Hesitancy

Condition Hierarchy (Ancestors)

Treatment Refusal; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Officials

• Marie Juanchich, PhD

  University of Essex

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Participants will read and evaluate 4 versions of the vaccination invitation. The condition will be selected randomly by the Qualtrics algorithm (with an even selection rate). The four invitations will be presented to each participant in a random order based on the Qualtrics randomisation algorithm.
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Reader/Associate Professor in Psychology

Model Details: In a 4 x 4 experimental design, the investigators will manipulate the content of the vaccination invitation message in within-subject and the message source in between-subjects. Each participant will hence read four versions of the COVID-19 booster vaccination invitation message sent by one of the four possible sources.

Study Record Dates

• First Submitted: February 1, 2022
• First Posted: February 14, 2022
• Study Start: February 3, 2022
• Primary Completion: February 28, 2022
• Study Completion: March 5, 2022
• Last Updated: May 24, 2022

Record last verified: 2022-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: The data and the study protocol will be shared after the main scientific output is accepted (possibly pending revision). The investigators anticipate this would be early 2023.
• Access Criteria: The data and study protocol will be free to access to the public

Locations

GB (1)