COVID-19NCT07758296
An Online Game to Help Canadian Adults Identify COVID-19 Vaccine Misinformation With One-Month Follow-Up
A study testing Gamified misinformation refutation quiz in people with COVID-19 and Vaccination Hesitancy, run by University of South Carolina at 1 site in United States.
Trial summary
COVID-19 vaccine misinformation contributed to vaccine hesitancy and preventable illness. This study tested whether a brief online game helps Canadian adults identify COVID-19 vaccine misinformation, and whether effects last one month. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- COVID-19, Vaccination Hesitancy, Health Misinformation
- What is being tested?
- Gamified misinformation refutation quiz
- Type of treatment
- Vaccines, Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 4,071 participants
- Where
- 1 siteUnited States
- Study dates
- 8 Dec 2022to 13 Feb 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
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
- Canadian residents aged 18 or older
- Internet access
- Able to complete the questionnaire in English or French (fielded nationwide, including Quebec)
Who cannot join
- Employment in market research, advertising, media, or by a political party
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Leveraging Digital Tools to Increase COVID-19 Vaccine Adoption
COVID-19 vaccine misinformation contributed to vaccine hesitancy and preventable illness. This study tested whether a brief online game helps Canadian adults identify COVID-19 vaccine misinformation, and whether effects last one month. In the game, participants judged whether statements about 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. Adults from a national non-probability online panel (n = 4,071) were randomized to the game, to the identical corrective content presented as a static blog post, or to a no-activity control. The game and blog groups were assessed immediately after the activity; all three groups were reassessed approximately one month later. The hypothesis was that gamified corrective information would produce more accurate knowledge than the same information presented as a static blog post and, at one month, than no activity. The primary outcome was accuracy in identifying true and false claims; vaccination intention, vaccine confidence, and self-reported vaccination were secondary outcomes. This is the fourth study in a research program whose first three trials are registered in a companion record.
Read the detailed description
This randomized controlled trial was the fourth study in a research program evaluating digital educational interventions to counter COVID-19 misinformation. The first three studies were conducted under a separate exempt determination from the University of South Carolina Institutional Review Board (Pro00099400) before participant enrollment and are registered in a companion record. This trial received a separate exempt determination (Pro00122534). This record retrospectively registers the completed trial.
The trial used the same intervention platform as the earlier studies: a true/false quiz covering a larger set of circulating COVID-19 vaccine misinformation items, with each response followed immediately by item-level refutational feedback (the correct answer plus a brief evidence-based explanation) embedded in a gamified interface with points, ranks, and affective feedback. A six-item subset was administered in the study surveys to measure knowledge accuracy.
Participants (N = 4,071) were recruited from a national non-probability online panel in Canada (Prodege, fielded by Nanos Research) and randomized to three arms: Game (n = 1,168), Text - the identical refutational content texts as a static blog post (n = 1,288), or no-activity Control (n = 1,615). The questionnaire was administered in English and French nationwide, including Quebec. All arms completed a Wave 1 baseline (fielded December 8-30, 2022); Game and Text then received their assigned activity and an immediate posttest; the Control arm received no activity and, by design, no immediate assessment. All three arms were reassessed at Wave 2, approximately one month later (January 23-February 13, 2023); 2,079 of 4,071 (51.1%) were retained.
Two contrasts were confirmatory: Game versus Text (incremental effect of gamified delivery; evaluated immediately and at one month) and Game versus Control (total intervention effect; one-month horizon, as the Control arm had no immediate assessment). Text versus Control was descriptive. Immediate analyses included all 2,456 participants randomized to the Game and Text arms. No post-randomization data-quality exclusions were applied. One-month analyses included all 2,079 participants who completed Wave 2; nonparticipation at Wave 2 was treated as loss to follow-up rather than an analytic exclusion.
- Conditions
- COVID-19, Vaccination Hesitancy, Health Misinformation, Communication
- Being tested
- Gamified misinformation refutation quiz, Refutational text blog post (active control)
- Keywords
- misinformation, refutation, gamification, serious games, health education, vaccine hesitancy, infodemic, belief change, debunking, online intervention
- Medical subject headings
- COVID-19, Vaccination Hesitancy, Communication, Health Education
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Gamified misinformation refutation quizBehavioural
Single-session online game in which participants judged a larger set of true/false statements about COVID-19 vaccines. Immediately after each response, participants received the correct answer and a brief evidence-based refutation within a gamified interface featuring points, ranks, and affective feedback. The game was administered in English or French. Six selected items from the game content were used in the survey-based knowledge outcome measure.
Refutational text blog post (active control)Behavioural
Identical refutational content delivered as a static blog post with no game elements. Administered in English or French.
| Study group | Role | What they receive |
|---|---|---|
| Game | Experimental | Gamified refutation quiz covering COVID-19 vaccine misinformation items, with immediate per-item corrective feedback, followed by immediate post-intervention assessments and one-month follow-up. Receives: Behavioral: Gamified misinformation refutation quiz |
| Text | Active comparator | Identical refutational content delivered as a static blog post text, followed by immediate post-intervention assessments and one-month follow-up. Receives: Behavioral: Refutational text blog post (active control) |
| Control | No intervention | No activity. Completed the Wave 1 baseline and the one-month follow-up only; no immediate assessment by design. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean Knowledge Accuracy Score - Immediate
Mean score across 6 true/false COVID-19 vaccine misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy; "Unsure" responses received 0.5 points.
Measured: Immediately post-intervention, Day 1 (Game and Text arms only; the Control arm has no immediate assessment by design)
Mean Knowledge Accuracy Score - One Month
Mean score across 6 true/false COVID-19 vaccine misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy; "Unsure" responses received 0.5 points.
Measured: Approximately 1 month post-intervention (Wave 2), all arms.
Secondary outcomes (3)
Mean Vaccination Intention Score
Single self-report item, scale 1-4, reversed-coded so higher scores indicate greater intention to vaccinate; identical pre-randomization baseline measure at Wave 1.
"Are you likely, somewhat likely, somewhat unlikely or unlikely to get a COVID-19 vaccine in the next 6 months (either a booster or a first vaccination)?" [Likely / Somewhat likely / Somewhat unlikely / Unlikely]
Measured: Baseline (Wave 1); immediately post-intervention (Game and Text arms, Wave 1); approximately 1 month later (all arms, Wave 2)
Mean COVID-19 Vaccine Confidence
Single self-report item, scale 0-10, higher scores indicating greater confidence.
"On a scale from 0 to 10 where 0 is no confidence at all and 10 is complete confidence, how much confidence do you have in COVID-19 vaccinations?" [0-10]
Measured: Immediately post-intervention (Game and Text arms, Wave 1); approximately 1 month later (all arms, Wave 2)
Percentage of Participants Reporting Receipt of a COVID-19 Vaccination or Booster in the Past 30 Days
Percentage of participants who reported receiving a COVID-19 vaccination or booster during the preceding 30 days at Wave 2. "Have you received or not received any of the following in the past 30 days? - A COVID-19 vaccination or booster." [Received / Not received / Prefer not to say]. "Prefer not to say" was treated as missing.
Measured: Approximately 1 month post-intervention (Wave 2 only), all arms.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Aug 2026
- Study start8 Dec 2022
- Primary completion13 Feb 2023
- Study completion13 Feb 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for COVID-19Studies of the same condition, open and under way.
- More trials run by University of South CarolinaThe sponsor's other registered studies.
- 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
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Three-arm parallel randomized trial with baseline, immediate posttest (Game and Blog arms only), and one-month follow-up (all arms).
- Masking
- None (open label)
- Enrolment
- 4,071 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of South Carolina
- Sponsor type
- University, hospital or other
- Collaborators
- Digital Public Square, Public Health Agency of Canada (PHAC)
- Responsible party
- Principal investigator, Gregory Trevors, University of South Carolina
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07758296
- Sponsor's protocol ID
- Pro00122534
- Other IDs
- 2122-HQ-000238
- Status last verified
- Jul 2026
- First submitted
- 31 Jul 2026
- Last updated
- 11 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Deidentified analysis-ready datasets and a data dictionary underlying published results will be available from the authors on reasonable request. Ethnicity is shared in grouped form and geographic region withheld to limit re-identification risk.
Study at a glance
From the registry record, last updated by the sponsor on 11 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Leveraging Digital Tools to Increase COVID-19 Vaccine Adoption
- ClinicalTrials.gov ID
- NCT07758296
- Acronym / sponsor ID
- Pro00122534
- Conditions
- COVID-19, Vaccination Hesitancy, Health Misinformation, Communication
- Keywords
- misinformation, refutation, gamification, serious games, health education, vaccine hesitancy, infodemic, belief change
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 4,071 participants (actual)
- Lead sponsor
- University of South CarolinaUniversity, hospital or other
- Collaborators
- Digital Public Square, Public Health Agency of Canada (PHAC)
- Study start
- 8 Dec 2022 (actual)
- Primary completion
- 13 Feb 2023 (actual)
- Study completion
- 13 Feb 2023 (actual)
- First posted
- 11 Aug 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
COVID-19 vaccine misinformation contributed to vaccine hesitancy and preventable illness. This study tested whether a brief online game helps Canadian adults identify COVID-19 vaccine misinformation, and whether effects last one month. In the game, participants judged whether statements about 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. Adults from a national non-probability online panel (n = 4,071) were randomized to the game, to the identical corrective content presented as a static blog post, or to a no-activity control. The game and blog groups were assessed immediately after the activity; all three groups were reassessed approximately one month later. The hypothesis was that gamified corrective information would produce more accurate knowledge than the same information presented as a static blog post and, at one month, than no activity. The primary outcome was accuracy in identifying true and false claims; vaccination intention, vaccine confidence, and self-reported vaccination were secondary outcomes. This is the fourth study in a research program whose first three trials are registered in a companion record.
Detailed description
This randomized controlled trial was the fourth study in a research program evaluating digital educational interventions to counter COVID-19 misinformation. The first three studies were conducted under a separate exempt determination from the University of South Carolina Institutional Review Board (Pro00099400) before participant enrollment and are registered in a companion record. This trial received a separate exempt determination (Pro00122534). This record retrospectively registers the completed trial.
The trial used the same intervention platform as the earlier studies: a true/false quiz covering a larger set of circulating COVID-19 vaccine misinformation items, with each response followed immediately by item-level refutational feedback (the correct answer plus a brief evidence-based explanation) embedded in a gamified interface with points, ranks, and affective feedback. A six-item subset was administered in the study surveys to measure knowledge accuracy.
Participants (N = 4,071) were recruited from a national non-probability online panel in Canada (Prodege, fielded by Nanos Research) and randomized to three arms: Game (n = 1,168), Text - the identical refutational content texts as a static blog post (n = 1,288), or no-activity Control (n = 1,615). The questionnaire was administered in English and French nationwide, including Quebec. All arms completed a Wave 1 baseline (fielded December 8-30, 2022); Game and Text then received their assigned activity and an immediate posttest; the Control arm received no activity and, by design, no immediate assessment. All three arms were reassessed at Wave 2, approximately one month later (January 23-February 13, 2023); 2,079 of 4,071 (51.1%) were retained.
Two contrasts were confirmatory: Game versus Text (incremental effect of gamified delivery; evaluated immediately and at one month) and Game versus Control (total intervention effect; one-month horizon, as the Control arm had no immediate assessment). Text versus Control was descriptive. Immediate analyses included all 2,456 participants randomized to the Game and Text arms. No post-randomization data-quality exclusions were applied. One-month analyses included all 2,079 participants who completed Wave 2; nonparticipation at Wave 2 was treated as loss to follow-up rather than an analytic exclusion.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- Three-arm parallel randomized trial with baseline, immediate posttest (Game and Blog arms only), and one-month follow-up (all arms).
| Arm | Type | Receives |
|---|---|---|
| Game | Experimental | Behavioral: Gamified misinformation refutation quizGamified refutation quiz covering COVID-19 vaccine misinformation items, with immediate per-item corrective feedback, followed by immediate post-intervention assessments and one-month follow-up. |
| Text | Active comparator | Behavioral: Refutational text blog post (active control)Identical refutational content delivered as a static blog post text, followed by immediate post-intervention assessments and one-month follow-up. |
| Control | No intervention | –No activity. Completed the Wave 1 baseline and the one-month follow-up only; no immediate assessment by design. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Canadian residents aged 18 or older
- Internet access
- Able to complete the questionnaire in English or French (fielded nationwide, including Quebec)
Key exclusion criteria (1 listed)
- Employment in market research, advertising, media, or by a political party
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 |
|---|---|---|
| Gamified misinformation refutation quizSingle-session online game in which participants judged a larger set of true/false statements about COVID-19 vaccines. Immediately after each response, participants received the correct answer and a brief evidence-based refutation within a gamified interface featuring points, ranks, and affective feedback. The game was administered in English or French. Six selected items from the game content were used in the survey-based knowledge outcome measure. | Behavioural | Game |
| Refutational text blog post (active control)Identical refutational content delivered as a static blog post with no game elements. Administered in English or French. | Behavioural | Text |
Primary outcome
Mean Knowledge Accuracy Score - Immediate
Time frame: Immediately post-intervention, Day 1 (Game and Text arms only; the Control arm has no immediate assessment by design)
Mean score across 6 true/false COVID-19 vaccine misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy; "Unsure" responses received 0.5 points.
Mean Knowledge Accuracy Score - One Month
Time frame: Approximately 1 month post-intervention (Wave 2), all arms.
Mean score across 6 true/false COVID-19 vaccine misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy; "Unsure" responses received 0.5 points.
3 secondary outcomes
Mean Vaccination Intention Score
Time frame: Baseline (Wave 1); immediately post-intervention (Game and Text arms, Wave 1); approximately 1 month later (all arms, Wave 2)
Mean COVID-19 Vaccine Confidence
Time frame: Immediately post-intervention (Game and Text arms, Wave 1); approximately 1 month later (all arms, Wave 2)
Percentage of Participants Reporting Receipt of a COVID-19 Vaccination or Booster in the Past 30 Days
Time frame: Approximately 1 month post-intervention (Wave 2 only), all arms.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Aug 2026.
- Individual participant dataSharing planned: Yes. Deidentified analysis-ready datasets and a data dictionary underlying published results will be available from the authors on reasonable request. Ethnicity is shared in grouped form and geographic region withheld to limit re-identification risk.
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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?
A study testing Gamified misinformation refutation quiz in people with COVID-19 and Vaccination Hesitancy, run by University of South Carolina at 1 site in United States.
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 3 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 11 Aug 2026. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Mean Knowledge Accuracy Score - Immediate (time frame: Immediately post-intervention, Day 1 (Game and Text arms only; the Control arm has no immediate assessment by design)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 11 Aug 2026.