The Efficacy of a Brief, Altruism-Eliciting Video Intervention in Enhancing COVID-19 Vaccination Intentions Among a Population-Based Sample of Younger Adults: Randomized Controlled Trial
High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have demonstrated lower levels of vaccine uptake compared to older adults, while being more likely to transmit the virus due to a higher number of social con...
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| Published in | JMIR public health and surveillance Vol. 8; no. 5; p. e37328 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Canada
JMIR Publications
30.05.2022
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| Abstract | High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have demonstrated lower levels of vaccine uptake compared to older adults, while being more likely to transmit the virus due to a higher number of social contacts. Consequently, this age group has been identified by public health authorities as a key target for vaccine uptake. Previous research has demonstrated that altruistic messaging and motivation is associated with vaccine acceptance.
This study had 2 objectives: (1) to evaluate the within-group efficacy of an altruism-eliciting short, animated video intervention in increasing COVID-19 vaccination intentions amongst unvaccinated Canadian younger adults and (2) to examine the video's efficacy compared to a text-based intervention focused exclusively on non-vaccine-related COVID-19 preventive health measures.
Using a web-based survey in a pre-post randomized control trial (RCT) design, we recruited Canadians aged 20-39 years who were not yet vaccinated against COVID-19 and randomized them in a 1:1 ratio to receive either the video intervention or an active text control. The video intervention was developed by our team in collaboration with a digital media company. The measurement of COVID-19 vaccination intentions before and after completing their assigned intervention was informed by the multistage Precaution Adoption Process Model (PAPM). The McNemar chi-square test was performed to evaluate within-group changes of vaccine intentions. Exact tests of symmetry using pairwise McNemar tests were applied to evaluate changes in multistaged intentions. Between-group vaccine intentions were assessed using the Pearson chi-square test postintervention.
Analyses were performed on 1373 participants (n=686, 50%, in the video arm, n=687, 50%, in the text arm). Within-group results for the video intervention arm showed that there was a significant change in the intention to receive the vaccine (χ
=20.55, P<.001). The between-group difference in postintervention intentions (χ
=1.70, P=.64) was not significant. When administered the video intervention, we found that participants who had not thought about or were undecided about receiving a COVID-19 vaccine were more amenable to change than participants who had already decided not to vaccinate.
Although the video intervention was limited in its effect on those who had firmly decided not to vaccinate, our study demonstrates that prosocial and altruistic messages could increase COVID-19 vaccine uptake, especially when targeted to younger adults who are undecided or unengaged regarding vaccination. This might indicate that altruistic messaging provides a "push" for those who are tentative toward, or removed from, the decision to receive the vaccine. The results of our study could also be applied to more current COVID-19 vaccination recommendations (eg, booster shots) and for other vaccine-preventable diseases.
ClinicalTrials.gov NCT04960228; https://clinicaltrials.gov/ct2/show/NCT04960228. |
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| AbstractList | Background
High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have demonstrated lower levels of vaccine uptake compared to older adults, while being more likely to transmit the virus due to a higher number of social contacts. Consequently, this age group has been identified by public health authorities as a key target for vaccine uptake. Previous research has demonstrated that altruistic messaging and motivation is associated with vaccine acceptance.
Objective
This study had 2 objectives: (1) to evaluate the within-group efficacy of an altruism-eliciting short, animated video intervention in increasing COVID-19 vaccination intentions amongst unvaccinated Canadian younger adults and (2) to examine the video’s efficacy compared to a text-based intervention focused exclusively on non-vaccine-related COVID-19 preventive health measures.
Methods
Using a web-based survey in a pre-post randomized control trial (RCT) design, we recruited Canadians aged 20-39 years who were not yet vaccinated against COVID-19 and randomized them in a 1:1 ratio to receive either the video intervention or an active text control. The video intervention was developed by our team in collaboration with a digital media company. The measurement of COVID-19 vaccination intentions before and after completing their assigned intervention was informed by the multistage Precaution Adoption Process Model (PAPM). The McNemar chi-square test was performed to evaluate within-group changes of vaccine intentions. Exact tests of symmetry using pairwise McNemar tests were applied to evaluate changes in multistaged intentions. Between-group vaccine intentions were assessed using the Pearson chi-square test postintervention.
Results
Analyses were performed on 1373 participants (n=686, 50%, in the video arm, n=687, 50%, in the text arm). Within-group results for the video intervention arm showed that there was a significant change in the intention to receive the vaccine (χ21=20.55, P<.001). The between-group difference in postintervention intentions (χ23=1.70, P=.64) was not significant. When administered the video intervention, we found that participants who had not thought about or were undecided about receiving a COVID-19 vaccine were more amenable to change than participants who had already decided not to vaccinate.
Conclusions
Although the video intervention was limited in its effect on those who had firmly decided not to vaccinate, our study demonstrates that prosocial and altruistic messages could increase COVID-19 vaccine uptake, especially when targeted to younger adults who are undecided or unengaged regarding vaccination. This might indicate that altruistic messaging provides a “push” for those who are tentative toward, or removed from, the decision to receive the vaccine. The results of our study could also be applied to more current COVID-19 vaccination recommendations (eg, booster shots) and for other vaccine-preventable diseases.
Trial Registration
ClinicalTrials.gov NCT04960228; https://clinicaltrials.gov/ct2/show/NCT04960228 High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have demonstrated lower levels of vaccine uptake compared to older adults, while being more likely to transmit the virus due to a higher number of social contacts. Consequently, this age group has been identified by public health authorities as a key target for vaccine uptake. Previous research has demonstrated that altruistic messaging and motivation is associated with vaccine acceptance. This study had 2 objectives: (1) to evaluate the within-group efficacy of an altruism-eliciting short, animated video intervention in increasing COVID-19 vaccination intentions amongst unvaccinated Canadian younger adults and (2) to examine the video's efficacy compared to a text-based intervention focused exclusively on non-vaccine-related COVID-19 preventive health measures. Using a web-based survey in a pre-post randomized control trial (RCT) design, we recruited Canadians aged 20-39 years who were not yet vaccinated against COVID-19 and randomized them in a 1:1 ratio to receive either the video intervention or an active text control. The video intervention was developed by our team in collaboration with a digital media company. The measurement of COVID-19 vaccination intentions before and after completing their assigned intervention was informed by the multistage Precaution Adoption Process Model (PAPM). The McNemar chi-square test was performed to evaluate within-group changes of vaccine intentions. Exact tests of symmetry using pairwise McNemar tests were applied to evaluate changes in multistaged intentions. Between-group vaccine intentions were assessed using the Pearson chi-square test postintervention. Analyses were performed on 1373 participants (n=686, 50%, in the video arm, n=687, 50%, in the text arm). Within-group results for the video intervention arm showed that there was a significant change in the intention to receive the vaccine (χ =20.55, P<.001). The between-group difference in postintervention intentions (χ =1.70, P=.64) was not significant. When administered the video intervention, we found that participants who had not thought about or were undecided about receiving a COVID-19 vaccine were more amenable to change than participants who had already decided not to vaccinate. Although the video intervention was limited in its effect on those who had firmly decided not to vaccinate, our study demonstrates that prosocial and altruistic messages could increase COVID-19 vaccine uptake, especially when targeted to younger adults who are undecided or unengaged regarding vaccination. This might indicate that altruistic messaging provides a "push" for those who are tentative toward, or removed from, the decision to receive the vaccine. The results of our study could also be applied to more current COVID-19 vaccination recommendations (eg, booster shots) and for other vaccine-preventable diseases. ClinicalTrials.gov NCT04960228; https://clinicaltrials.gov/ct2/show/NCT04960228. BackgroundHigh COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have demonstrated lower levels of vaccine uptake compared to older adults, while being more likely to transmit the virus due to a higher number of social contacts. Consequently, this age group has been identified by public health authorities as a key target for vaccine uptake. Previous research has demonstrated that altruistic messaging and motivation is associated with vaccine acceptance. ObjectiveThis study had 2 objectives: (1) to evaluate the within-group efficacy of an altruism-eliciting short, animated video intervention in increasing COVID-19 vaccination intentions amongst unvaccinated Canadian younger adults and (2) to examine the video’s efficacy compared to a text-based intervention focused exclusively on non-vaccine-related COVID-19 preventive health measures. MethodsUsing a web-based survey in a pre-post randomized control trial (RCT) design, we recruited Canadians aged 20-39 years who were not yet vaccinated against COVID-19 and randomized them in a 1:1 ratio to receive either the video intervention or an active text control. The video intervention was developed by our team in collaboration with a digital media company. The measurement of COVID-19 vaccination intentions before and after completing their assigned intervention was informed by the multistage Precaution Adoption Process Model (PAPM). The McNemar chi-square test was performed to evaluate within-group changes of vaccine intentions. Exact tests of symmetry using pairwise McNemar tests were applied to evaluate changes in multistaged intentions. Between-group vaccine intentions were assessed using the Pearson chi-square test postintervention. ResultsAnalyses were performed on 1373 participants (n=686, 50%, in the video arm, n=687, 50%, in the text arm). Within-group results for the video intervention arm showed that there was a significant change in the intention to receive the vaccine (χ21=20.55, P<.001). The between-group difference in postintervention intentions (χ23=1.70, P=.64) was not significant. When administered the video intervention, we found that participants who had not thought about or were undecided about receiving a COVID-19 vaccine were more amenable to change than participants who had already decided not to vaccinate. ConclusionsAlthough the video intervention was limited in its effect on those who had firmly decided not to vaccinate, our study demonstrates that prosocial and altruistic messages could increase COVID-19 vaccine uptake, especially when targeted to younger adults who are undecided or unengaged regarding vaccination. This might indicate that altruistic messaging provides a “push” for those who are tentative toward, or removed from, the decision to receive the vaccine. The results of our study could also be applied to more current COVID-19 vaccination recommendations (eg, booster shots) and for other vaccine-preventable diseases. Trial RegistrationClinicalTrials.gov NCT04960228; https://clinicaltrials.gov/ct2/show/NCT04960228 Background: High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have demonstrated lower levels of vaccine uptake compared to older adults, while being more likely to transmit the virus due to a higher number of social contacts. Consequently, this age group has been identified by public health authorities as a key target for vaccine uptake. Previous research has demonstrated that altruistic messaging and motivation is associated with vaccine acceptance. Objective: This study had 2 objectives: (1) to evaluate the within-group efficacy of an altruism-eliciting short, animated video intervention in increasing COVID-19 vaccination intentions amongst unvaccinated Canadian younger adults and (2) to examine the video’s efficacy compared to a text-based intervention focused exclusively on non-vaccine-related COVID-19 preventive health measures. Methods: Using a web-based survey in a pre-post randomized control trial (RCT) design, we recruited Canadians aged 20-39 years who were not yet vaccinated against COVID-19 and randomized them in a 1:1 ratio to receive either the video intervention or an active text control. The video intervention was developed by our team in collaboration with a digital media company. The measurement of COVID-19 vaccination intentions before and after completing their assigned intervention was informed by the multistage Precaution Adoption Process Model (PAPM). The McNemar chi-square test was performed to evaluate within-group changes of vaccine intentions. Exact tests of symmetry using pairwise McNemar tests were applied to evaluate changes in multistaged intentions. Between-group vaccine intentions were assessed using the Pearson chi-square test postintervention. Results: Analyses were performed on 1373 participants (n=686, 50%, in the video arm, n=687, 50%, in the text arm). Within-group results for the video intervention arm showed that there was a significant change in the intention to receive the vaccine (χ21=20.55, P<.001). The between-group difference in postintervention intentions (χ23=1.70, P=.64) was not significant. When administered the video intervention, we found that participants who had not thought about or were undecided about receiving a COVID-19 vaccine were more amenable to change than participants who had already decided not to vaccinate. Conclusions: Although the video intervention was limited in its effect on those who had firmly decided not to vaccinate, our study demonstrates that prosocial and altruistic messages could increase COVID-19 vaccine uptake, especially when targeted to younger adults who are undecided or unengaged regarding vaccination. This might indicate that altruistic messaging provides a “push” for those who are tentative toward, or removed from, the decision to receive the vaccine. The results of our study could also be applied to more current COVID-19 vaccination recommendations (eg, booster shots) and for other vaccine-preventable diseases. Trial Registration: ClinicalTrials.gov NCT04960228; https://clinicaltrials.gov/ct2/show/NCT04960228 BACKGROUNDHigh COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have demonstrated lower levels of vaccine uptake compared to older adults, while being more likely to transmit the virus due to a higher number of social contacts. Consequently, this age group has been identified by public health authorities as a key target for vaccine uptake. Previous research has demonstrated that altruistic messaging and motivation is associated with vaccine acceptance. OBJECTIVEThis study had 2 objectives: (1) to evaluate the within-group efficacy of an altruism-eliciting short, animated video intervention in increasing COVID-19 vaccination intentions amongst unvaccinated Canadian younger adults and (2) to examine the video's efficacy compared to a text-based intervention focused exclusively on non-vaccine-related COVID-19 preventive health measures. METHODSUsing a web-based survey in a pre-post randomized control trial (RCT) design, we recruited Canadians aged 20-39 years who were not yet vaccinated against COVID-19 and randomized them in a 1:1 ratio to receive either the video intervention or an active text control. The video intervention was developed by our team in collaboration with a digital media company. The measurement of COVID-19 vaccination intentions before and after completing their assigned intervention was informed by the multistage Precaution Adoption Process Model (PAPM). The McNemar chi-square test was performed to evaluate within-group changes of vaccine intentions. Exact tests of symmetry using pairwise McNemar tests were applied to evaluate changes in multistaged intentions. Between-group vaccine intentions were assessed using the Pearson chi-square test postintervention. RESULTSAnalyses were performed on 1373 participants (n=686, 50%, in the video arm, n=687, 50%, in the text arm). Within-group results for the video intervention arm showed that there was a significant change in the intention to receive the vaccine (χ21=20.55, P<.001). The between-group difference in postintervention intentions (χ23=1.70, P=.64) was not significant. When administered the video intervention, we found that participants who had not thought about or were undecided about receiving a COVID-19 vaccine were more amenable to change than participants who had already decided not to vaccinate. CONCLUSIONSAlthough the video intervention was limited in its effect on those who had firmly decided not to vaccinate, our study demonstrates that prosocial and altruistic messages could increase COVID-19 vaccine uptake, especially when targeted to younger adults who are undecided or unengaged regarding vaccination. This might indicate that altruistic messaging provides a "push" for those who are tentative toward, or removed from, the decision to receive the vaccine. The results of our study could also be applied to more current COVID-19 vaccination recommendations (eg, booster shots) and for other vaccine-preventable diseases. TRIAL REGISTRATIONClinicalTrials.gov NCT04960228; https://clinicaltrials.gov/ct2/show/NCT04960228. |
| Author | Tunis, Matthew Griffin-Mathieu, Gabrielle Perez, Samara Dubé, Ève Tatar, Ovidiu Haward, Ben Rosberger, Zeev Zhu, Patricia Zimet, Gregory |
| AuthorAffiliation | 5 Department of Oncology McGill University Montreal, QC Canada 9 Department of Psychology McGill University Montreal, QC Canada 8 Faculty of Social Sciences; Anthropology University of Laval Québec, QC Canada 1 Lady Davis Institute for Medical Research Jewish General Hospital Montreal, QC Canada 2 Department of Psychiatry McGill University Montreal, QC Canada 7 National Advisory Committee on Immunization Secretariat Centre for Immunization Readiness Public Health Agency of Canada Ottawa, ON Canada 3 Research Center Centre Hospitalier de l’Université de Montréal Montreal, QC Canada 4 Cedars Cancer Center McGill University Health Center Montreal, QC Canada 6 Division of Adolescent Medicine Indiana University School of Medicine Indianapolis, IN United States |
| AuthorAffiliation_xml | – name: 4 Cedars Cancer Center McGill University Health Center Montreal, QC Canada – name: 2 Department of Psychiatry McGill University Montreal, QC Canada – name: 5 Department of Oncology McGill University Montreal, QC Canada – name: 3 Research Center Centre Hospitalier de l’Université de Montréal Montreal, QC Canada – name: 1 Lady Davis Institute for Medical Research Jewish General Hospital Montreal, QC Canada – name: 8 Faculty of Social Sciences; Anthropology University of Laval Québec, QC Canada – name: 9 Department of Psychology McGill University Montreal, QC Canada – name: 6 Division of Adolescent Medicine Indiana University School of Medicine Indianapolis, IN United States – name: 7 National Advisory Committee on Immunization Secretariat Centre for Immunization Readiness Public Health Agency of Canada Ottawa, ON Canada |
| Author_xml | – sequence: 1 givenname: Patricia orcidid: 0000-0001-6549-3668 surname: Zhu fullname: Zhu, Patricia organization: Department of Psychiatry, McGill University, Montreal, QC, Canada – sequence: 2 givenname: Ovidiu orcidid: 0000-0003-1886-6390 surname: Tatar fullname: Tatar, Ovidiu organization: Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada – sequence: 3 givenname: Gabrielle orcidid: 0000-0002-6169-2747 surname: Griffin-Mathieu fullname: Griffin-Mathieu, Gabrielle organization: Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada – sequence: 4 givenname: Samara orcidid: 0000-0002-4849-8616 surname: Perez fullname: Perez, Samara organization: Department of Oncology, McGill University, Montreal, QC, Canada – sequence: 5 givenname: Ben orcidid: 0000-0002-6119-5767 surname: Haward fullname: Haward, Ben organization: Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada – sequence: 6 givenname: Gregory orcidid: 0000-0003-3835-937X surname: Zimet fullname: Zimet, Gregory organization: Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, United States – sequence: 7 givenname: Matthew orcidid: 0000-0003-2092-9143 surname: Tunis fullname: Tunis, Matthew organization: National Advisory Committee on Immunization Secretariat, Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, ON, Canada – sequence: 8 givenname: Ève orcidid: 0000-0003-1336-1510 surname: Dubé fullname: Dubé, Ève organization: Faculty of Social Sciences; Anthropology, University of Laval, Québec, QC, Canada – sequence: 9 givenname: Zeev orcidid: 0000-0003-4248-1909 surname: Rosberger fullname: Rosberger, Zeev organization: Department of Psychology, McGill University, Montreal, QC, Canada |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35544437$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | Patricia Zhu, Ovidiu Tatar, Gabrielle Griffin-Mathieu, Samara Perez, Ben Haward, Gregory Zimet, Matthew Tunis, Ève Dubé, Zeev Rosberger. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 30.05.2022. 2022. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Patricia Zhu, Ovidiu Tatar, Gabrielle Griffin-Mathieu, Samara Perez, Ben Haward, Gregory Zimet, Matthew Tunis, Ève Dubé, Zeev Rosberger. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 30.05.2022. 2022 |
| Copyright_xml | – notice: Patricia Zhu, Ovidiu Tatar, Gabrielle Griffin-Mathieu, Samara Perez, Ben Haward, Gregory Zimet, Matthew Tunis, Ève Dubé, Zeev Rosberger. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 30.05.2022. – notice: 2022. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: Patricia Zhu, Ovidiu Tatar, Gabrielle Griffin-Mathieu, Samara Perez, Ben Haward, Gregory Zimet, Matthew Tunis, Ève Dubé, Zeev Rosberger. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 30.05.2022. 2022 |
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| Keywords | vaccine hesitancy health intervention younger adults web survey health promotion health information digital intervention youth randomized controlled trial COVID-19 video intervention digital health online health altruism public health prosocial motives vaccination |
| Language | English |
| License | Patricia Zhu, Ovidiu Tatar, Gabrielle Griffin-Mathieu, Samara Perez, Ben Haward, Gregory Zimet, Matthew Tunis, Ève Dubé, Zeev Rosberger. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 30.05.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on https://publichealth.jmir.org, as well as this copyright and license information must be included. |
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| Snippet | High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have... Background High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have... Background: High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have... BACKGROUNDHigh COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have... BackgroundHigh COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have... |
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| SubjectTerms | Age groups Aged Altruism Bias Canada Coronaviruses COVID-19 COVID-19 - epidemiology COVID-19 - prevention & control COVID-19 Vaccines Data collection Design Disease transmission Health surveillance Humans Immunization Intention Intervention Older people Original Paper Pandemics Population density Public health SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Vaccination Vaccines Young adults |
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| Title | The Efficacy of a Brief, Altruism-Eliciting Video Intervention in Enhancing COVID-19 Vaccination Intentions Among a Population-Based Sample of Younger Adults: Randomized Controlled Trial |
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