An Online Game to Help Canadian Adults Identify COVID-19 Vaccine Misinformation With One-Month Follow-Up

NCT07758296 | Completed

• 2 other identifiers: Pro001225342122-HQ-000238
• Study Type: interventional
• Target: 4,071
• Locations: 1 country
• Sites: 1

Brief Summary

COVID-19 vaccine misinformation contributed to vaccine hesitancy and preventable illness. This study tested whether a brief online game helps Canadian adults identify COVID-19 vaccine misinformation, and whether effects last one month. In the game, participants judged whether statements about COVID-19 vaccines were true or false and immediately received the correct answer with a brief evidence-based explanation, delivered in a game-like format with points, ranks, and feedback. Adults from a national non-probability online panel (n = 4,071) were randomized to the game, to the identical corrective content presented as a static blog post, or to a no-activity control. The game and blog groups were assessed immediately after the activity; all three groups were reassessed approximately one month later. The hypothesis was that gamified corrective information would produce more accurate knowledge than the same information presented as a static blog post and, at one month, than no activity. The primary outcome was accuracy in identifying true and false claims; vaccination intention, vaccine confidence, and self-reported vaccination were secondary outcomes. This is the fourth study in a research program whose first three trials are registered in a companion record.

Conditions

COVID-19; Vaccination Hesitancy; Health Misinformation; Communication

Keywords

misinformation; refutation; gamification; serious games; health education; vaccine hesitancy; infodemic; belief change; debunking; online intervention

Outcome Measures

Primary Outcomes (2)

• Mean Knowledge Accuracy Score - Immediate

  Mean score across 6 true/false COVID-19 vaccine misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy; "Unsure" responses received 0.5 points.

  Immediately post-intervention, Day 1 (Game and Text arms only; the Control arm has no immediate assessment by design)

• Mean Knowledge Accuracy Score - One Month

  Mean score across 6 true/false COVID-19 vaccine misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy; "Unsure" responses received 0.5 points.

  Approximately 1 month post-intervention (Wave 2), all arms.

Secondary Outcomes (3)

• Mean Vaccination Intention Score

  Baseline (Wave 1); immediately post-intervention (Game and Text arms, Wave 1); approximately 1 month later (all arms, Wave 2)

• Mean COVID-19 Vaccine Confidence

  Immediately post-intervention (Game and Text arms, Wave 1); approximately 1 month later (all arms, Wave 2)

• Percentage of Participants Reporting Receipt of a COVID-19 Vaccination or Booster in the Past 30 Days

  Approximately 1 month post-intervention (Wave 2 only), all arms.

Study Arms (3)

Game

EXPERIMENTAL

Gamified refutation quiz covering COVID-19 vaccine misinformation items, with immediate per-item corrective feedback, followed by immediate post-intervention assessments and one-month follow-up.

Behavioral: Gamified misinformation refutation quiz

Text

ACTIVE COMPARATOR

Identical refutational content delivered as a static blog post text, followed by immediate post-intervention assessments and one-month follow-up.

Behavioral: Refutational text blog post (active control)

Control

NO INTERVENTION

No activity. Completed the Wave 1 baseline and the one-month follow-up only; no immediate assessment by design.

Interventions

Gamified misinformation refutation quiz BEHAVIORAL

Single-session online game in which participants judged a larger set of true/false statements about COVID-19 vaccines. Immediately after each response, participants received the correct answer and a brief evidence-based refutation within a gamified interface featuring points, ranks, and affective feedback. The game was administered in English or French. Six selected items from the game content were used in the survey-based knowledge outcome measure.

Game

Refutational text blog post (active control) BEHAVIORAL

Identical refutational content delivered as a static blog post with no game elements. Administered in English or French.

Text

Eligibility Criteria

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

You may qualify if:

• Canadian residents aged 18 or older
• Internet access
• Able to complete the questionnaire in English or French (fielded nationwide, including Quebec)

You may not qualify if:

• Employment in market research, advertising, media, or by a political party

Sponsors & Collaborators

• University of South Carolina: lead
• Digital Public Square: collaborator
• Public Health Agency of Canada (PHAC): collaborator

Study Sites (1)

Online

Columbia, South Carolina, 29208, United States

Location

MeSH Terms

Conditions

COVID-19; Vaccination Hesitancy; Communication; Health Education

Condition Hierarchy (Ancestors)

Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases; Vaccination Refusal; Treatment Refusal; Treatment Adherence and Compliance; Health Behavior; Behavior; Adherence Interventions; Medication Adherence; Patient Compliance; Patient Acceptance of Health Care

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Three-arm parallel randomized trial with baseline, immediate posttest (Game and Blog arms only), and one-month follow-up (all arms).

Study Record Dates

• First Submitted: July 31, 2026
• First Posted: August 11, 2026
• Study Start: December 8, 2022
• Primary Completion: February 13, 2023
• Study Completion: February 13, 2023
• Last Updated: August 11, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: ANALYTIC CODE
• Time Frame: Beginning upon publication of trial results; no end date.
• Access Criteria: Data shared with qualified researchers for verification or secondary analysis.

Locations

US (1)