Improving Health Equity for COVID-19 Vaccination for At-risk Populations Using Online Social Networks

Covid19 Clinical Trial

Official title:

Improving Health Equity for COVID-19 Vaccination and Related Health Behaviors for At-risk Populations Using Online Social Networks

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT04779827
• Other study ID #: 827141
• Status: Active, not recruiting
• Phase: N/A
• Start date: May 4, 2021
• Est. completion date: January 30, 2025

Study information

• Verified date: January 2024
• Source: University of Pennsylvania
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Social technologies for health have already become essential means for providing underserved populations greater social connectedness and increased access to novel health information. However, these technologies have also had negative unintended consequences. The resulting digital divide in social technology takes many forms - from explicit racism that excludes African American and Latinx populations from the resources enjoyed by White and Asian members of online communities, to self-segregation for the purposes of identity preservation and community-building that unintentionally results in limited informational diversity in underserved communities. The result is an often unnoticed, but highly consequential compounding of inequities.

This research seeks to use an online social network approach to address these challenges, in which the investigators demonstrate how reducing the online levels of network centralization and network homophily among African American community members directly increases their productive engagement with health-promoting information.

Description:

To investigate the causal effects of network structure and composition on the acceptance of new or unfamiliar behavior-relevant health information, the investigators propose a randomized controlled experiment that compares several independent populations to identify and address participants' endorsement of biased information, and engagement with novel behavior relevant information (e.g., regarding COVID-19 vaccination). Each population will have its own network structure (i.e., level of centralization) and composition (i.e., level of homophily).

To run each experimental trial, the investigators will recruit 240 African American participants, aged 18 to 40, collectively to answer behavior-relevant questions over a period of no greater than 8 minutes. Participants can respond asynchronously - i.e., when the participants' time permits. As with previous studies, the technical infrastructure will manage participants' progress through the study to ensure that all participants have the relevant information about each other's responses.

To ensure causal identification, each network graph will constitute a single observation of how individual decisions change under conditions of interdependent social information. Thus, each trial of 240 people (6 networks x 40 participants per network) produces 6 observations of a community-level social learning process. Power calculations indicate that 8 independent trials are sufficient to produce results of p<0.05 with 85% power, resulting in a desired population of 1920 participants for each health topic (e.g., COVID-19 vaccination is a single "health topic"), producing 48 independent observations of collective decision making per health topic.

The studies will target health topics for which there is substantial racial disparity in outcomes and behavior, such as acceptance of COVID-19 vaccination, and spreading of various categories of COVID-19 misinformation (e.g. beliefs related to assessment of personal risk, effectiveness of protective behaviors, methods of transmission, disease prevention, treatment, origins of the virus) and related health practices (e.g. choice of appropriate contraceptive methods, value of heart disease screenings, etc.).

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 4476
• Est. completion date: January 30, 2025
• Est. primary completion date: March 30, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Having internet access

• Aged 18 and above

• Living in the United States

Exclusion Criteria:

• Having no internet access

• Aged below 18

• Living outside of the United States

Related Conditions & MeSH terms

• COVID-19
• Covid19
• Heart Diseases
• Vaccination Refusal

Intervention

Behavioral:
• Online Social Network and Collective Intelligence Intervention
The online network intervention aims to use different configurations of online social networks to optimize the impacts of collective intelligence process to improve individuals' understanding, beliefs, and behavioral choices regarding a variety of health behaviors. Participants will be put into different online networks and respond to health questions while receiving feedback from their network members.
• Independent Control
Independent control aims to test the baseline of population understanding of health behaviors and choices. Participants will respond to health questions independently without getting any feedback from others.

Locations

Country	Name	City	State
United States	Annenberg School for Communication	Philadelphia	Pennsylvania

Sponsors (4)

Lead Sponsor	Collaborator
University of Pennsylvania	University of California, Berkeley, University of California, Davis, University of California, San Francisco

Country where clinical trial is conducted

United States, 

References & Publications (2)

Guilbeault D, Becker J, Centola D. Social learning and partisan bias in the interpretation of climate trends. Proc Natl Acad Sci U S A. 2018 Sep 25;115(39):9714-9719. doi: 10.1073/pnas.1722664115. Epub 2018 Sep 4. — View Citation

Guilbeault D, Centola D. Networked collective intelligence improves dissemination of scientific information regarding smoking risks. PLoS One. 2020 Feb 6;15(2):e0227813. doi: 10.1371/journal.pone.0227813. eCollection 2020. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	COVID-19 vaccination attitude	COVID-19 vaccination attitude scale, which is a self-reported scale measuring participants' attitudes toward COVID-19 vaccination. The scale is consisted of 5 questions (e.g., "How much confidence do you have that the COVID-19 vaccine in the U.S. is safe and effective?") with responses ranging from 1 (No confidence at all) to 5 (A great deal of confidence); a higher average score means a more positive attitude in favor of COVID-19 vaccination.	Immediate after intervention
Primary	COVID-19 vaccination intention	COVID-19 vaccination intention scale, which is a self-reported scale measuring participants' intention toward COVID-19 vaccination. The scale is consisted of 5 questions (e.g., "Would you get a COVID-19 vaccine when it is available to you?") with responses ranging from 1 (Definitely Not) to 5 (Definitely); a higher average score means a stronger intention to receive the COVID-19 vaccine.	Immediate after intervention
Primary	COVID-19 vaccine safety perception	One question asks participant's estimation of one potential side effect from the COVID-19 vaccine. The question asks "According to the most recent data, for every 10 million people in the US vaccinated for COVID-19, how many experienced a severe allergic reaction (anaphylaxis)? Answer must be between 0 and 10,000."	Immediate after intervention
Secondary	COVID-19 vaccine belief	COVID-19 vaccine belief scale, which is a self-reported scale measuring participants' knowledge and belief (including misbelief) about the COVID-19 vaccine safety and effectiveness. The scale is consisted of 12 items (e.g., "A COVID-19 vaccine will not alter my DNA") with responses ranging from 1 (completely disagree) to 5 (completely agree); a higher average score means more accurate knowledge and belief towards the COVID-19 vaccine.	Immediate after intervention