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.

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.

Effectiveness of a Video-Based Intervention on Reducing Perceptions of Fear, Loneliness, and Public Stigma Related to COVID-19: A Randomized Controlled Trial.

Objectives: During the first peak of the COVID-19 outbreak in the United States, we investigated the impact of digital interventions to reduce COVID-19 related fear, loneliness, and public stigma. Methods: We recruited and randomly assigned 988 United States residents to: 1) no intervention 2) informational sheet to learn about COVID-19, 3) (2) AND video encouraging digital social activity, 4) (2) AND video sensitizing to COVID-19 related stigma (registered in Clinicaltrials.gov). Surveys were conducted between April 2-16, 2020. We employed generalized linear mixed models to investigate intervention effects. Results: 10% of the participants reported not being afraid of people COVID-19+ and 32% reported not feeling lonely. Stigma and fear items reflected acute worries about the outbreak. Relative to the informational sheet only group, video groups led to greater reduction in perceptions of fear towards COVID-19+ (ORvideo.solo = 0.78, p-val<0.001; ORvideo.friend = 0.79, p-val<0.001) and of stigma (BETAvideo.solo = -0.50, p-val<0.001; BETAvideo.friend = -0.69, p-val<0.001). Conclusion: Video-based interventions lead to reductions in COVID-19-related fear and stigma. No difference in social activity among groups was found, potentially explaining lack of efficacy on loneliness.

The development of the 'COVID-19 Psychological Resilience Model' and its efficacy during the COVID-19 pandemic in China.

During the novel coronavirus disease 2019 (COVID-19) outbreak, traditional face-to-face psychological interventions have been suspended due to high risks of rapid transmission. Developing an effective online model of psychological intervention is deemed necessary to deal with the mental health challenges brought up by this disease. An integrated psychological intervention model coined 'COVID-19 Psychological Resilience Model' was developed in Chengdu, China including live media, 24-hour hotline consultations, online video intervention and on-site crisis intervention sessions to provide services to those in need. A total of 45 episodes of live media programs on COVID-19 outbreak-related psychological problems were broadcasted with over 10 million views. A total of 4,236 hotline consultations were completed. More than 50% of the clients had positive feedback about the hotline consultations. A total of 223 cases received online video intervention, of which 84.97% were redirected from the hotline consultation and 15.03% from COVID-19-designated hospital and community-based observation spots. Seventy one-on-one psychological interventions were conducted with 39 COVID-19 patients, and one-third were treated with medication. Additionally, 5 training sessions were conducted to 98 frontline medical staff. This 'COVID-19 Psychological Resilience Model' is proven effective to the general population during the COVID-19 pandemic. We have greatly improved the overall mental health of our target population during the COVID-19 pandemic. This model could provide valuable experiences and serve as a reference guide for other countries to offer effective psychological intervention, and reduce detrimental negative mental health outcomes in public health emergency.