Covid19NCT04644328

The Doctors for Coronavirus Prevention Project Thanksgiving / Christmas Messaging Campaign

A study testing Facebook Ads on the importance of staying safe during the Thanksgiving / Christmas holiday in people with Covid19, run by National Bureau of Economic Research, Inc. at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

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Trial summary

Facebook ads with physician-delivered videos were shown before the Thanksgiving and Christmas holidays and focused on staying safe during the COVID pandemic by limiting travel and mask-wearing. Read more about this study

Who is it for?: Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for: Covid19
What is being tested?: Facebook Ads on the importance of staying safe during the Thanksgiving / Christmas holiday
Type of treatment: Lifestyle or therapy programme
Could I receive a placebo?: No, everyone receives an active treatment
How many people: 820 participants
Where: 1 siteUnited States
Study dates: 12 Nov 2020to 11 Feb 2021
Phase: Interventional
Are there results?: Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

Ages 18 years and older
All sexes
Healthy volunteers accepted
Adult, Older adult

Who may be able to join

Individuals viewing the ads must be Facebook users, 18 years and older. Facebook will decide specifically which users receive the messages within a target geographical area (zip or county).

Who cannot join

Trial locations and contacts

1 site in 1 country.

United States1 site

JPAL North America
Cambridge, Massachusetts, 02138

Other trials in United States

About this study

Facebook ads with physician-delivered videos were shown before the Thanksgiving and Christmas holidays and focused on staying safe during the COVID pandemic by limiting travel and mask-wearing.

Read the detailed description

The investigators used Facebook ads to show a 20 second video clip recorded by Massachusetts General Hospital, Harvard and Lynn Community health center doctors (6 people in all) to approximately 20,000,000 Facebook users. The ads will be shown before the Thanksgiving and Christmas holiday and will focus on staying safe - limiting travel and mask-wearing. The investigators will randomize exposure to the ad campaign at the ZIP code or county level to ask:

Do the videos change mobility and Thanksgiving and Christmas holiday travel? Do they reduce the spread of COVID-19?

Are there spillover impacts from the video messages? For example, if individuals decide to stay home, then do the geographical regions that tend to be visited by people from treated areas experience any effects, either through information spillovers or through a reduction in travel?

Conditions: Covid19
Being tested: Facebook Ads on the importance of staying safe during the Thanksgiving / Christmas holiday
Medical subject headings: COVID-19

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Facebook Ads on the importance of staying safe during the Thanksgiving / Christmas holidayBehavioural
Facebook ads to show a 15 second video clip recorded by MGH, Harvard and Lynn Community health center and other health care professionals. The ads will be shown before the Thanksgiving/Christmas holiday and will focus on staying safe - limiting travel and mask-wearing. The investigators will randomize exposure to the ad campaign at the ZIP code or county level.

Study groups in NCT04644328
Study group	Role	What they receive
High-Intensity Treatment Arm	Experimental	Treatment: Individuals received approximately 3 Facebook ads over a 2-week period. Each ad contained a short video recorded by a physician using a script that discusses staying safe during the holidays by considering not traveling and using a mask when appropriate. Randomization to treatment: The 13 states which centrally report COVID-19 cases at the ZCTA level contained 829 counties. At Thanksgiving, 9 counties were excluded due to data limitations. At Christmas, 62 counties were excluded due to data limitations and potential negative impacts in rural, conservative areas resulting from polarization in the wake of the 2020 presidential election. Approximately half of the counties were randomized to high-intensity treatment with the remaining randomized to low-intensity treatment. In high-intensity counties, 3/4 of ZCTAs were treated (i.e., Facebook users in those ZCTAs received ads) and 1/4 were not. In low-intensity counties, 1/4 of ZCTAs were treated and 3/4 were not. Receives: Behavioral: Facebook Ads on the importance of staying safe during the Thanksgiving / Christmas holiday
Low-Intensity Control Arm	No intervention	Control: Individuals did not receive ads containing short physician-recorded videos. Randomization to treatment: The 13 states which centrally report COVID-19 cases at the ZCTA level contained 829 counties. At Thanksgiving, 9 counties were excluded due to data limitations. At Christmas, 62 counties were excluded due to data limitations and potential negative impacts in rural, conservative areas resulting from polarization in the wake of the 2020 presidential election. Approximately half of the counties were randomized to high-intensity treatment with the remaining randomized to low-intensity treatment. In high-intensity counties, 3/4 of ZCTAs were treated (i.e., Facebook users in those ZCTAs received ads) and 1/4 were not. In low-intensity counties, 1/4 of ZCTAs were treated and 3/4 were not.

What is being measured

The primary outcome is the main question the study is designed to answer.

Facebook Movement Metric
The change in movement metric is the percent change in distance covered in a day compared to the same day of the week in the benchmark period of February 2-29, 2020, by people who started the day in a particular location. We define holiday travel as travel during the three days preceding each holiday, since the available data does not allow us to compute the impact of the intervention on the return travel (after the holiday). The reason is that the mobility data describes the behavior throughout the day, for people who were in each county that morning. Since the campaign was targeted based on home location, we can only capture its impact on travel away from home, not back home.
Measured: November 26, 2020 (Thanksgiving); December 24-25, 2020 (Christmas); February 2-29, 2020 (Baseline benchmark)
Percentage Leaving Home on Day of Holiday
The Facebook stay put metric is the percentage of people who stay within a small geographical area (a "tile" of 600m*600m in which they started the day). We use it to compute the share of people leaving home on the day of the holiday (i.e. this variable = 1 - stay put on the day of the holiday).
Measured: November 26, 2020 (Thanksgiving); December 24-25, 2020 (Christmas)
Inverse Hyperbolic Sine of COVID-19 Cases
Inverse hyperbolic sine of COVID-19 cases during a 14 day period starting 5 days after each holiday
Measured: December 1-14 (Thanksgiving arms) and January 1-14 (Christmas arms)

Secondary outcomes (3)

Knowledge of COVID-19 Prevention Message (Recall of ad, Intent to Travel, Mask Wearing and Beliefs About Travel)
Facebook will ask a set of users in treated zip codes to answer four survey questions (each user answers only one question each). A small within-zip control group will be held from being treated, enabling comparisons between those who see the videos and those who don't. These questions will be asked a few days after the ad is shown on the User's feed and will include 1) recall of the ad; 2) intention of traveling over holiday; 3) intention of wearing a mask; and 4) beliefs about whether people should travel over holiday.
Measured: up to one month
Average Number of Tiles People Occupy (Mobility Measure)
this measures each day "how much people move around by counting the number of level-16 Bing tiles they are seen in within a day. People seen in more tiles are probably moving around more, while people seen in fewer are probably moving around less. Each day take eligible people in a given region and compute the number of distinct tiles they were seen in." This is aggregated to the county level.
Measured: up to one month
Percentage of Eligible Participants Only Observed in a Single Level-16 Bing Tile (no Change in Movement)
Facebook "Stay-put" data: this measures each day "the percentage of eligible people who are only observed in a single level-16 Bing tile (600m x 600m) during the course of a day" aggregated to they county level.
Measured: up to one month

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

12 Nov 202011 Feb 2021

First posted25 Nov 2020
Study start12 Nov 2020
Primary completion11 Feb 2021
Study completion11 Feb 2021

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
Publications (1)Papers the sponsor has linked to this study.
Other trials for Covid19Studies of the same condition, open and under way.
What the trial phases meanHow a treatment moves from first tests in people to approval.

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design

Study type: Interventional
Phase: Phase N/A
Primary purpose: Prevention
Allocation: Randomised
Intervention model: Sequential
Model description: A total of 13 states, comprising 829 counties, centrally report COVID-19 cases at the ZCTA level. Two separate experiments were run within the study, one around Thanksgiving and one around Christmas. For each experiment, approximately half of the counties were randomized to high-intensity treatment with the remaining randomized to low-intensity treatment. In high-intensity counties, 3/4 of ZCTAs were treated and 1/4 were not. In low-intensity counties, 1/4 of ZCTAs were treated and 3/4 were not. In treated ZCTAs, Facebook users received ads with messages from physicians and other health personnel urging them to stay home and wear masks to stop the spread of COVID-19. Users in non-treated ZCTAs received no such ads. After exclusions, 820 counties were randomized to high- or low-intensity treatment during Thanksgiving and 767 counties were during Christmas.
Masking: None (open label)
Enrolment: 820 participants (actual)

IDs, dates and publications

ClinicalTrials.gov ID: NCT04644328
Sponsor's protocol ID: 2003000118A010
Status last verified: Dec 2021
First submitted: 13 Nov 2020
Last updated: 21 Dec 2021
Results posted: Yes, on ClinicalTrials.gov
Data monitoring committee: No
FDA-regulated drug: No
FDA-regulated device: No
Individual data sharing: Undecided: The pre-analysis plan will be posted publicly. The ability to share IPD will be based on discussions with our partner organization.

Publications

Breza E, Stanford FC, Alsan M, Alsan B, Banerjee A, Chandrasekhar AG, Eichmeyer S, Glushko T, Goldsmith-Pinkham P, Holland K, Hoppe E, Karnani M, Liegl S, Loisel T, Ogbu-Nwobodo L, Olken BA, Torres C, Vautrey PL, Warner ET, Wootton S, Duflo E. Effects of a large-scale social media advertising campaign on holiday travel and COVID-19 infections: a cluster randomized controlled trial. Nat Med. 2021 Sep;27(9):1622-1628. doi: 10.1038/s41591-021-01487-3. Epub 2021 Aug 19.
PubMed 34413518

Want to know more?

The sponsor has not listed a contact. The official record may have more details.

Talk to your doctor first and take this page with you. Only the study team can confirm whether you can join.

Questions to ask the study team

What is the study trying to find out?
What would I need to do, and how often would I visit?
Could I receive a placebo instead of the treatment?
What are the possible risks and benefits for me?
Will it cost me anything? Are travel or time paid for?
Can I keep seeing my own doctor during the study?
What happens when the study ends?

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Study at a glance

From the registry record, last updated by the sponsor on 21 Dec 2021. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: The Doctors for Coronavirus Prevention Project Thanksgiving / Christmas Messaging Campaign
ClinicalTrials.gov ID: NCT04644328
Acronym / sponsor ID: 2003000118A010
Conditions: Covid19
Study type: Interventional
Recruitment status: Completed
Enrolment: 820 participants (actual)
Lead sponsor: National Bureau of Economic Research, Inc.University, hospital or other
Collaborators: Massachusetts Institute of Technology, Harvard University, Massachusetts General Hospital, Yale University, Stanford University
Study start: 12 Nov 2020 (actual)
Primary completion: 11 Feb 2021 (actual)
Study completion: 11 Feb 2021 (actual)
First posted: 25 Nov 2020 (actual)
Results: Posted 21 Dec 2021

Clinical summary

The research question as the sponsor registered it. This describes what the study plans to test, not what it found.

Facebook ads with physician-delivered videos were shown before the Thanksgiving and Christmas holidays and focused on staying safe during the COVID pandemic by limiting travel and mask-wearing.

Detailed description

Do the videos change mobility and Thanksgiving and Christmas holiday travel? Do they reduce the spread of COVID-19?

Study design

Primary purpose: Prevention
Allocation: Randomised
Intervention model: Sequential
Masking: None (open label)
Number of arms: 2
Model description: A total of 13 states, comprising 829 counties, centrally report COVID-19 cases at the ZCTA level. Two separate experiments were run within the study, one around Thanksgiving and one around Christmas. For each experiment, approximately half of the counties were randomized to high-intensity treatment with the remaining randomized to low-intensity treatment. In high-intensity counties, 3/4 of ZCTAs were treated and 1/4 were not. In low-intensity counties, 1/4 of ZCTAs were treated and 3/4 were not. In treated ZCTAs, Facebook users received ads with messages from physicians and other health personnel urging them to stay home and wear masks to stop the spread of COVID-19. Users in non-treated ZCTAs received no such ads. After exclusions, 820 counties were randomized to high- or low-intensity treatment during Thanksgiving and 767 counties were during Christmas.

Arm	Type	Receives
High-Intensity Treatment Arm	Experimental	Behavioral: Facebook Ads on the importance of staying safe during the Thanksgiving / Christmas holidayTreatment: Individuals received approximately 3 Facebook ads over a 2-week period. Each ad contained a short video recorded by a physician using a script that discusses staying safe during the holidays by considering not traveling and using a mask when appropriate. Randomization to treatment: The 13 states which centrally report COVID-19 cases at the ZCTA level contained 829 counties. At Thanksgiving, 9 counties were excluded due to data limitations. At Christmas, 62 counties were excluded due to data limitations and potential negative impacts in rural, conservative areas resulting from polarization in the wake of the 2020 presidential election. Approximately half of the counties were randomized to high-intensity treatment with the remaining randomized to low-intensity treatment. In high-intensity counties, 3/4 of ZCTAs were treated (i.e., Facebook users in those ZCTAs received ads) and 1/4 were not. In low-intensity counties, 1/4 of ZCTAs were treated and 3/4 were not.
Low-Intensity Control Arm	No intervention	–Control: Individuals did not receive ads containing short physician-recorded videos. Randomization to treatment: The 13 states which centrally report COVID-19 cases at the ZCTA level contained 829 counties. At Thanksgiving, 9 counties were excluded due to data limitations. At Christmas, 62 counties were excluded due to data limitations and potential negative impacts in rural, conservative areas resulting from polarization in the wake of the 2020 presidential election. Approximately half of the counties were randomized to high-intensity treatment with the remaining randomized to low-intensity treatment. In high-intensity counties, 3/4 of ZCTAs were treated (i.e., Facebook users in those ZCTAs received ads) and 1/4 were not. In low-intensity counties, 1/4 of ZCTAs were treated and 3/4 were not.

Who may qualify

Ages: 18 years and older
Sex: All
Healthy volunteers: Accepted
Age groups: Adult, Older adult

Key inclusion criteria (1 listed)

Individuals viewing the ads must be Facebook users, 18 years and older. Facebook will decide specifically which users receive the messages within a target geographical area (zip or county).

Key exclusion criteria (1 listed)

Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.

Interventions

Intervention	Type	Arms
Facebook Ads on the importance of staying safe during the Thanksgiving / Christmas holidayFacebook ads to show a 15 second video clip recorded by MGH, Harvard and Lynn Community health center and other health care professionals. The ads will be shown before the Thanksgiving/Christmas holiday and will focus on staying safe - limiting travel and mask-wearing. The investigators will randomize exposure to the ad campaign at the ZIP code or county level.	Behavioural	High-Intensity Treatment Arm

Primary outcome

Facebook Movement Metric
Time frame: November 26, 2020 (Thanksgiving); December 24-25, 2020 (Christmas); February 2-29, 2020 (Baseline benchmark)
The change in movement metric is the percent change in distance covered in a day compared to the same day of the week in the benchmark period of February 2-29, 2020, by people who started the day in a particular location. We define holiday travel as travel during the three days preceding each holiday, since the available data does not allow us to compute the impact of the intervention on the return travel (after the holiday). The reason is that the mobility data describes the behavior throughout the day, for people who were in each county that morning. Since the campaign was targeted based on home location, we can only capture its impact on travel away from home, not back home.
Percentage Leaving Home on Day of Holiday
Time frame: November 26, 2020 (Thanksgiving); December 24-25, 2020 (Christmas)
The Facebook stay put metric is the percentage of people who stay within a small geographical area (a "tile" of 600m*600m in which they started the day). We use it to compute the share of people leaving home on the day of the holiday (i.e. this variable = 1 - stay put on the day of the holiday).
Inverse Hyperbolic Sine of COVID-19 Cases
Time frame: December 1-14 (Thanksgiving arms) and January 1-14 (Christmas arms)
Inverse hyperbolic sine of COVID-19 cases during a 14 day period starting 5 days after each holiday

3 secondary outcomes

Knowledge of COVID-19 Prevention Message (Recall of ad, Intent to Travel, Mask Wearing and Beliefs About Travel)
Time frame: up to one month
Average Number of Tiles People Occupy (Mobility Measure)
Time frame: up to one month
Percentage of Eligible Participants Only Observed in a Single Level-16 Bing Tile (no Change in Movement)
Time frame: up to one month

Results and safety

Results posted to the registry on 21 Dec 2021, as reported by the sponsor. Figures are copied from the record, not re-analysed. Full results on ClinicalTrials.gov.

Participant flow

Group	Started	Completed
High-Intensity Counties	–	–
Low-Intensity Counties	–	–

Primary outcome: Facebook Movement Metric

Time frame: November 26, 2020 (Thanksgiving); December 24-25, 2020 (Christmas); February 2-29, 2020 (Baseline benchmark). Mean (95% Confidence Interval). Unit: Percent change relative to Feb 2020

Measure	High-Intensity Counties n = NA	Low-Intensity Counties n = NA
Thanksgiving (Period 1)	-6.082 (-6.822 to -5.341)	-5.320 (-6.113 to -4.527)
Christmas (Period 2)	-2.603 (-3.279 to -1.927)	-1.823 (-2.588 to -1.057)

Population analysed: Rural, conservative counties were excluded during Christmas due to potential negative impacts of treatment resulting from polarization in the wake of the 2020 presidential election. The two periods have been entered as rows to avoid double-counting counties.

Primary outcome: Percentage Leaving Home on Day of Holiday

Time frame: November 26, 2020 (Thanksgiving); December 24-25, 2020 (Christmas). Mean (95% Confidence Interval). Unit: Percentage

Measure	High-Intensity Counties n = NA	Low-Intensity Counties n = NA
Thanksgiving (Period 1)	71.308 (70.885 to 71.731)	71.468 (71.071 to 71.866)
Christmas (Period 2)	72.859 (72.507 to 73.210)	72.852 (72.520 to 73.185)

Primary outcome: Inverse Hyperbolic Sine of COVID-19 Cases

Time frame: December 1-14 (Thanksgiving arms) and January 1-14 (Christmas arms). Mean (95% Confidence Interval). Unit: Inverse hyperbolic sine of individuals

Measure	Treatment ZCTAs n = NA	Control ZCTAs n = NA
Thanksgiving (Period 1)	4.333 (4.278 to 4.388)	4.298 (4.243 to 4.353)
Christmas (Period 2)	4.368 (4.310 to 4.425)	4.442 (4.385 to 4.499)

Population analysed: ZCTAs in rural, conservative counties were excluded during Christmas due to potential negative impacts of treatment resulting from polarization in the wake of the 2020 presidential election. The two periods have been entered as rows to avoid double-counting ZCTAs. Note that there are more ZCTAs in the Christmas control than Thanksgiving control because the two periods were randomized separately and the number of ZCTAs varies by county.

3 secondary outcomes are reported in the full results.

Adverse events

Time frame: All-Cause Mortality, Serious, and Other (Not Including Serious) Adverse Events were not monitored/assessed.. Other adverse events reported at 0% frequency or more

Group	Serious adverse events	Other adverse events	Deaths
High-Intensity Counties	0 of 0	0 of 0	0
Low-Intensity Counties	0 of 0	0 of 0	0

Loading the posted results from ClinicalTrials.gov…

Research links

Official record on ClinicalTrials.govLast updated by the sponsor 21 Dec 2021.
Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
Results publication: PubMed 34413518Breza E, Stanford FC, Alsan M, Alsan B, Banerjee A, Chandrasekhar AG, Eichmeyer S, Glushko T, Goldsmith-Pinkham P, Holland K, Hoppe E, Karnani M, Liegl S, Loisel T, Ogbu-Nwobodo L, Olken BA, Torres C, Vautrey PL, Warner ET, Wootton S, Duflo E. Effects of a large-scale social media advertising campaign on holiday travel and COVID-19 infections: a cluster randomized controlled trial. Nat Med. 2021 Sep;27(9):1622-1628. doi: 10.1038/s41591-021-01487-3. Epub 2021 Aug 19.
Individual participant dataSharing planned: Undecided. The pre-analysis plan will be posted publicly. The ability to share IPD will be based on discussions with our partner organization.

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Referral and contact

AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.

The record lists no contact. Use the official record to reach the sponsor.

1 site in 1 country: see every site and its status.

Questions about this trial

What is this clinical trial studying?

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Dec 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Dec 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Facebook Movement Metric (time frame: November 26, 2020 (Thanksgiving); December 24-25, 2020 (Christmas); February 2-29, 2020 (Baseline benchmark)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04644328, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Dec 2021.