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Completed

NCT Number: NCT07758309

Online Games to Help Canadian and U.S. Adults Identify COVID-19 and Vaccine Misinformation: Three Sequential Randomized Studies

COVID-19 misinformation contributed to vaccine hesitancy and preventable illness. This record covers three sequential randomized studies (conducted in Canada and the United States, November-December 2020) testing whether a brief online game helps adults identify COVID-19 and vaccine misinformation. In the game, participants judged whether statements about COVID-19 or 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. Study 1 (Canada, n = 2,018) randomized participants to complete the knowledge assessment either before playing the game or immediately after playing it. Studies 2 (U.S., n = 822) and 3 (U.S., n = 797) compared the game against the identical corrective content presented as plain text, for general COVID-19 misinformation and vaccine-specific misinformation, respectively. The hypothesis was that gamified corrective information produces more accurate knowledge than non-gamified information. The primary outcome was accuracy in identifying true and false claims; vaccination intention was a secondary outcome.

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Key information

Conditions

COVID-19 Adherence Interventions Behavior Communication Coronaviridae Infections Coronavirus Infections Health Behavior Health Education Health Misinformation Infections Lung Diseases Medication Adherence Nidovirales Infections Patient Acceptance of Health Care Patient Compliance Pneumonia Pneumonia, Viral RNA Virus Infections Respiratory Tract Diseases Respiratory Tract Infections Treatment Adherence and Compliance Treatment Refusal Vaccination Hesitancy Vaccination Refusal Vaccine Hesitancy Virus Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Online

Columbia, South Carolina, 29208, United States

About this study

This protocol comprised three sequential randomized controlled studies evaluating digital educational interventions to counter COVID-19 misinformation, conducted under a single IRB approval (University of South Carolina, Pro00099400) with study specific amendments. The University of South Carolina Institutional Review Board determined the study to be exempt before participant enrollment. A fourth study in the research program, conducted under a separate IRB approval (Pro00122534), is registered separately. Study 1 enrolled a national non-probability online panel sample in Canada (Nanos Research); Study 2 enrolled a U.S. MTurk sample on general COVID-19 misinformation; Study 3 enrolled a U.S. MTurk sample on vaccine misinformation. This record registers the three completed trials retrospectively. All three trials used the same intervention platform: a true/false quiz over circulating misinformation items, each response followed immediately by item-level refutational feedback (correct answer plus brief evidence-based explanation) embedded in a gamified interface (points, ranks, response-contingent feedback).

Trial 1 (Canada, N = 2,018; non-probability online panel fielded by Nanos Research, December 4-14, 2020; general COVID-19 content, 6 items): both arms received identical quiz-and-game content; arms differed in timing of the knowledge assessment within the single session (in Control assessed before playing, in Game immediately after).

Trial 2 (United States, N = 822; Amazon Mechanical Turk, November-December 2020; general COVID-19 content, 19 items): Game versus active-text control receiving the identical refutational content as a static text.

Trial 3 (United States, N = 797; Amazon Mechanical Turk, November-December 2020; vaccine-specific content, 17 items): same two-arm design as Trial 2.

All trials were single session. Knowledge accuracy was the primary outcome; vaccination intention was secondary. Data quality exclusions were applied at analysis: item-level missingness on the knowledge scale (Trial 1) and duplicate/non-U.S. IP screening plus, in the Game arm, completion code validation (Trials 2 and 3).

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adults aged 18 or older
  • Trial 1: Canadian residents residing outside Quebec, with internet access, able to complete the questionnaire in English
  • Trials 2-3: Amazon Mechanical Turk workers located in the United States, with a HIT approval rate of at least 95% and more than 100 approved HITs.

Exclusion criteria

  • Trial 1: employment in market research, advertising, media, or by a political party

Treatment and study plan

Gamified misinformation refutation quiz

Behavioral

Single-session online game: participants judge true/false statements about COVID-19 (Trials 1-2) or COVID-19 vaccines (Trial 3) and immediately after each response receive the correct answer with a brief evidence-based refutation, within a gamified interface (points, ranks, feedback). 6-19 knowledge items depending on trial.

Refutational text (active control)

Behavioral

Identical evidence-based refutational content presented as a single static text block without game elements or item-level feedback. Participants confirmed reading the text before completing the post-intervention assessments.

Primary outcomes

  1. Mean Knowledge Accuracy Score

    Time frame: Single session (Day 1). Assessed immediately post-intervention in all intervention and text-control arms; in Trial 1's assessment-first control arm, assessed at the start of the session before game exposure.

    Mean score across true/false misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy. Trial 1 included 6 items, Trial 2 included 19 items, and Trial 3 included 17 items. In Trials 1 and 2, "Unsure" responses received 0.5 points; Trial 3 used forced-choice true/false responses.

Secondary outcomes

  1. Vaccination Intention Score - Trial 1

    Time frame: Immediately post-intervention (single session, Day 1); control arm assessed at session start before game exposure.

    Single self-report item scored from 1 to 4, with higher scores indicating greater intention to receive a COVID-19 vaccine.

    "Are you interested, somewhat interested, somewhat not interested or not interested in receiving a vaccine for COVID-19 when it is available in Canada?" [Interested / Somewhat interested / Somewhat not interested / Not interested]

  2. Vaccination Intention Score - Trial 2

    Time frame: Immediately post-intervention (single session, Day 1).

    Single self-report item scored from 1 to 4, with higher scores indicating greater intention to receive a COVID-19 vaccine.

    "How likely or unlikely are you to do the following actions in the future in response to the new coronavirus? - Receive a vaccine for COVID-19 when it is available in the US" [Not at all / Unlikely / Likely / Certain]

  3. Vaccination Intention Score - Trial 3

    Time frame: Baseline before randomization and immediately post-intervention during the single study session, Day 1.

    Single self-report item scored from 1 to 6, with higher scores indicating greater intention to receive a COVID-19 vaccine.

    "How likely or unlikely are you to receive a COVID-19 vaccine when one becomes available to you?" [Not at all likely / Very unlikely / Somewhat unlikely / Somewhat likely / Very likely / Extremely likely]

Sponsors and collaborators

Lead sponsor

University of South Carolina

Other

Collaborators

  • Canadian Heritage
  • Digital Public Square
  • U.S. National Science Foundation

Registry information

Official study title

Leveraging Digital Tools to Increase COVID-19 Vaccine Adoption

Important dates

Study start
2020
Primary completion
2020
Study completion
2020
First posted
Aug 11, 2026
Registry last updated
Aug 11, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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