Creation, dissemination, and evaluation of videos to promote COVID-19 vaccination in India: A research protocol [version 2, peer review: 2 approved]

Background: Vaccine hesitancy is one of the greatest challenges to the success of coronavirus disease 2019 (COVID-19) vaccination campaigns. Videos promoting vaccines have a narrow scope focusing solely on facts, and less on the emotional and narrative elements of communication that can be equally persuasive. The role of humor, for example, has remained largely unexplored.   Objective: This study investigates whether theory-based videos can change people’s attitudes, beliefs, and intentions to receive the second COVID-19 vaccine. Our primary research question is: How do collectivistic and individualistic appeals, humor, and protagonist gender individually and jointly affect vaccination attitudes, beliefs, and intentions?   Methods: This project tapped into the underutilized Indian film industry—the world’s largest film producer—to promote vaccination messaging through short videos. Feedback from a community advisory board was utilized to inform the video scripts that were then shot by a production team. Eight videos were filmed and shared by adopting a 2 (appeal: individualistic or collectivistic) x 2 (tone: humor or non-humor) x 2 (protagonist gender: male or female) between-subjects design approach. Our sample includes Odia-speaking participants aged between 18 – 35 years old randomly assigned to watch one of the eight study videos. An online survey questionnaire, social media network analysis, and small group qualitative interviews will be utilized to explore how the entertainment-education videos can be used to reduce vaccine hesitancy.  Discussion: Vaccine messages do not fall into a cultural or cognitive vacuum. People process and make sense of information based on their prior experience, properties of the message, and their social environment. Yet, these considerations have taken secondary importance in vaccine communications. This research shows that it is possible to deliver high-caliber videos created in accordance with the audience's cultural and cognitive background.   Conclusions: This study will inform future health promotion messaging through brief videos on the internet.

Promoting Vaccination in India through Videos: The Role of Humor, Collectivistic Appeal and Gender.

Vaccination hesitancy is a barrier to India's efforts to control the COVID-19 pandemic. Considerable resources have been spent to promote COVID-19 vaccination, but evaluations of such efforts are sparse. Our objective was to determine how vaccine videos that manipulate message appeal (collectivistic versus individualistic), tone (humorous versus serious), and source (male versus female protagonist) toward vaccines and vaccination. We developed eight videos that manipulated the type of appeal (collectivistic or individualistic), tone of the message (humor or serious), and gender of the vaccine promoter (male or female) in a 2 × 2 × 2 between-subjects experiment. Participants (N = 2349) were randomly assigned to watch one of eight videos in an online experiment. Beliefs about vaccines and those about vaccination were obtained before and after viewing the video. Manipulation checks demonstrated that each of the three independent variables was manipulated successfully. After exposure to the video, beliefs about vaccines became more negative, while beliefs about vaccination became more positive. Humor reduced negative beliefs about vaccines. Collectivism and protagonist gender did not affect beliefs about vaccines or vaccination. Those able to remember the protagonist's gender (a measure of attention) were likely to develop favorable beliefs if they had also seen the humorous videos. These findings suggest that people distinguish beliefs about vaccines, which deteriorated after exposure to the videos, from beliefs about vaccination, which improved. We recommend using humor when appropriate and focusing on the outcomes of vaccination, rather than on the vaccines themselves.

Twitter and Facebook posts about COVID-19 are less likely to spread misinformation compared to other health topics.

The COVID-19 pandemic brought widespread attention to an "infodemic" of potential health misinformation. This claim has not been assessed based on evidence. We evaluated if health misinformation became more common during the pandemic. We gathered about 325 million posts sharing URLs from Twitter and Facebook during the beginning of the pandemic (March 8-May 1, 2020) compared to the same period in 2019. We relied on source credibility as an accepted proxy for misinformation across this database. Human annotators also coded a subsample of 3000 posts with URLs for misinformation. Posts about COVID-19 were 0.37 times as likely to link to "not credible" sources and 1.13 times more likely to link to "more credible" sources than prior to the pandemic. Posts linking to "not credible" sources were 3.67 times more likely to include misinformation compared to posts from "more credible" sources. Thus, during the earliest stages of the pandemic, when claims of an infodemic emerged, social media contained proportionally less misinformation than expected based on the prior year. Our results suggest that widespread health misinformation is not unique to COVID-19. Rather, it is a systemic feature of online health communication that can adversely impact public health behaviors and must therefore be addressed.

Not just conspiracy theories: Vaccine opponents and proponents add to the COVID-19 'infodemic' on Twitter.

In February 2020, the World Health Organization announced an 'infodemic' -- a deluge of both accurate and inaccurate health information -- that accompanied the global pandemic of COVID-19 as a major challenge to effective health communication. We assessed content from the most active vaccine accounts on Twitter to understand how existing online communities contributed to the 'infodemic' during the early stages of the pandemic. While we expected vaccine opponents to share misleading information about COVID-19, we also found vaccine proponents were not immune to spreading less reliable claims. In both groups, the single largest topic of discussion consisted of narratives comparing COVID-19 to other diseases like seasonal influenza, often downplaying the severity of the novel coronavirus. When considering the scope of the 'infodemic,' researchers and health communicators must move beyond focusing on known bad actors and the most egregious types of misinformation to scrutinize the full spectrum of information -- from both reliable and unreliable sources -- that the public is likely to encounter online.