Testing the Efficacy of Attitudinal Inoculation Videos to Enhance COVID-19 Vaccine Acceptance: Quasi-Experimental Intervention Trial

Abstract

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Over the course of the COVID-19 pandemic, a variety of COVID-19 related misinformation has spread and been amplified online. The spread of misinformation can influence COVID-19 beliefs and protective actions including vaccine hesitancy. Belief in vaccine misinformation is associated with lower vaccination rates and higher vaccine resistance. Attitudinal inoculation is a preventative approach to combating misinformation and disinformation which leverages the power of narrative, rhetoric, values, and emotion. Objective: This study seeks to test inoculation messages in the form of short video messages to promote resistance against persuasion by COVID-19 vaccine misinformation. Methods: We designed a series of 30-second inoculation videos and conducted a quasi-experimental study to test the use of attitudinal inoculation in a population of individuals who were unvaccinated. The three intervention videos were distinguished by their script design- with Intervention Video 1 focusing on narrative/rhetorical (“Narrative”) presentation of information, Intervention Video 2 focusing on delivering a fact-based information (“Fact”), and Intervention Video 3 using a hybrid design (“Hybrid”). Analysis of covariance (ANCOVA) models were used to compare the main effect of intervention group on the three outcome variables: ability to recognize misinformation tactics (“Recognize”, willingness to share misinformation (“Share”), and willingness to take the COVID-19 vaccine (“Willingness”). Results: There were significant effects across all three outcome variables comparing inoculation intervention groups to controls. For the Recognize outcome, the ability to recognize rhetorical strategies, there was a significant intervention group effect (F(3,1929)=8.5, p<0.0001). For the Share outcome, support for sharing the mis-disinformation, the intervention group main effect was statistically significant (F(3,1928)=3.4, p=0.0168). For the Willingness outcome, there was a significant intervention group effect; intervention groups were more willing to get the COVID-19 vaccine compared to controls (F(3,1929)=4.1, p=0.0064). Conclusions: Across all intervention groups, inoculated individuals showed greater resistance to misinformation than their non-inoculated counterparts. Relative to those who were not inoculated, inoculated participants showed significantly greater ability to recognize and identify rhetorical strategies used in misinformation, were less likely to share false information, and had greater willingness to get the COVID-19 vaccine. Attitudinal inoculation delivered through short video messages should be tested in public health messaging campaigns to counter mis-disinformation