COVID-19NCT07758309
Online Games to Help Canadian and U.S. Adults Identify COVID-19 and Vaccine Misinformation: Three Sequential Randomized Studies
A study testing Gamified misinformation refutation quiz in people with COVID-19 and Vaccine Hesitancy, run by University of South Carolina at 1 site in United States.
Trial summary
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. 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, Vaccine 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
- 3,637 participants
- Where
- 1 siteUnited States
- Study dates
- 20 Nov 2020to 28 Dec 2020
- 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
- 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.
Who cannot join
- Trial 1: 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 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.
Read the detailed description
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).
- Conditions
- COVID-19, Vaccine Hesitancy, Health Misinformation, Communication
- Being tested
- Gamified misinformation refutation quiz, Refutational text (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: 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)Behavioural
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.
| Study group | Role | What they receive |
|---|---|---|
| Trial 1: Assessment-First Control | Other | Completed the knowledge assessment before receiving the gamified refutation quiz (single session). Receives: Behavioral: Gamified misinformation refutation quiz |
| Trial 1: Game | Experimental | Played the gamified refutation quiz using general COVID-19 items with immediate per-item feedback, followed by the post-intervention assessments. Receives: Behavioral: Gamified misinformation refutation quiz |
| Trial 2: Text Control | Active comparator | Judged all general COVID-19 items, then received all refutational content as a single static text block without game elements, confirmed reading the text, and then completed the post-intervention assessments. Receives: Behavioral: Refutational text (active control) |
| Trial 2: Game | Experimental | Played the gamified refutation quiz using general COVID-19 items with immediate per-item feedback, followed by the post-intervention assessments. Receives: Behavioral: Gamified misinformation refutation quiz |
| Trial 3: Text Control | Active comparator | Judged all vaccine-specific items, then received all refutational content as a single static text block without game elements, confirmed reading the text, and then completed the post-intervention assessments. Receives: Behavioral: Refutational text (active control) |
| Trial 3: Game | Experimental | Played the gamified refutation quiz using vaccine-specific items with immediate per-item feedback, followed by the post-intervention assessments. Receives: Behavioral: Gamified misinformation refutation quiz |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean Knowledge Accuracy Score
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.
Measured: 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.
Secondary outcomes (3)
Vaccination Intention Score - Trial 1
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]
Measured: Immediately post-intervention (single session, Day 1); control arm assessed at session start before game exposure.
Vaccination Intention Score - Trial 2
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]
Measured: Immediately post-intervention (single session, Day 1).
Vaccination Intention Score - Trial 3
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]
Measured: Baseline before randomization and immediately post-intervention during the single study session, Day 1.
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 start20 Nov 2020
- Primary completion28 Dec 2020
- Study completion28 Dec 2020
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 sequential, independently fielded two-arm parallel randomized trials under one protocol. Trial 1 (Canada): assessment before vs. assessment after gamified quiz (general COVID-19 misinformation). Trials 2-3 (U.S.): gamified quiz vs. identical content as static text (general COVID-19 and vaccine-specific misinformation, respectively). Participants were randomized only between the two arms of their respective trial and were never randomized among all six arms.
- Masking
- None (open label)
- Enrolment
- 3,637 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of South Carolina
- Sponsor type
- University, hospital or other
- Collaborators
- Digital Public Square, U.S. National Science Foundation, Canadian Heritage
- Responsible party
- Principal investigator, Gregory Trevors, University of South Carolina
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07758309
- Sponsor's protocol ID
- Pro00099400
- Other IDs
- 2030273, 1330729
- 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 per-trial 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
- NCT07758309
- Acronym / sponsor ID
- Pro00099400
- Conditions
- COVID-19, Vaccine Hesitancy, Health Misinformation, Communication
- Keywords
- misinformation, refutation, gamification, serious games, health education, vaccine hesitancy, infodemic, belief change
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 3,637 participants (actual)
- Lead sponsor
- University of South CarolinaUniversity, hospital or other
- Collaborators
- Digital Public Square, U.S. National Science Foundation, Canadian Heritage
- Study start
- 20 Nov 2020 (actual)
- Primary completion
- 28 Dec 2020 (actual)
- Study completion
- 28 Dec 2020 (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 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.
Detailed description
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).
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 6
- Model description
- Three sequential, independently fielded two-arm parallel randomized trials under one protocol. Trial 1 (Canada): assessment before vs. assessment after gamified quiz (general COVID-19 misinformation). Trials 2-3 (U.S.): gamified quiz vs. identical content as static text (general COVID-19 and vaccine-specific misinformation, respectively). Participants were randomized only between the two arms of their respective trial and were never randomized among all six arms.
| Arm | Type | Receives |
|---|---|---|
| Trial 1: Assessment-First Control | Other | Behavioral: Gamified misinformation refutation quizCompleted the knowledge assessment before receiving the gamified refutation quiz (single session). |
| Trial 1: Game | Experimental | Behavioral: Gamified misinformation refutation quizPlayed the gamified refutation quiz using general COVID-19 items with immediate per-item feedback, followed by the post-intervention assessments. |
| Trial 2: Text Control | Active comparator | Behavioral: Refutational text (active control)Judged all general COVID-19 items, then received all refutational content as a single static text block without game elements, confirmed reading the text, and then completed the post-intervention assessments. |
| Trial 2: Game | Experimental | Behavioral: Gamified misinformation refutation quizPlayed the gamified refutation quiz using general COVID-19 items with immediate per-item feedback, followed by the post-intervention assessments. |
| Trial 3: Text Control | Active comparator | Behavioral: Refutational text (active control)Judged all vaccine-specific items, then received all refutational content as a single static text block without game elements, confirmed reading the text, and then completed the post-intervention assessments. |
| Trial 3: Game | Experimental | Behavioral: Gamified misinformation refutation quizPlayed the gamified refutation quiz using vaccine-specific items with immediate per-item feedback, followed by the post-intervention assessments. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- 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.
Key exclusion criteria (1 listed)
- Trial 1: 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: 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. | Behavioural | Trial 1: Assessment-First Control, Trial 1: Game, Trial 2: Game, Trial 3: Game |
| Refutational text (active control)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. | Behavioural | Trial 2: Text Control, Trial 3: Text Control |
Primary outcome
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.
3 secondary outcomes
Vaccination Intention Score - Trial 1
Time frame: Immediately post-intervention (single session, Day 1); control arm assessed at session start before game exposure.
Vaccination Intention Score - Trial 2
Time frame: Immediately post-intervention (single session, Day 1).
Vaccination Intention Score - Trial 3
Time frame: Baseline before randomization and immediately post-intervention during the single study session, Day 1.
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 per-trial 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 Vaccine 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 (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.). 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; AzTrials last refreshed its copy on 7 Nov 2026.