Improving Health Equity for COVID-19 Vaccination for At-risk Populations Using Online Social Networks

March 18, 2026 updated by: Damon Centola, PhD, University of Pennsylvania

Improving Health Equity for COVID-19 Vaccination and Related Health Behaviors for At-risk Populations Using Online Social Networks

Social technologies for health have already become essential means for providing underserved populations greater social connectedness and increased access to novel health information. However, these technologies have also had negative unintended consequences. The resulting digital divide in social technology takes many forms - from explicit racism that excludes African American and Latinx populations from the resources enjoyed by White and Asian members of online communities, to self-segregation for the purposes of identity preservation and community-building that unintentionally results in limited informational diversity in underserved communities. The result is an often unnoticed, but highly consequential compounding of inequities.

This research seeks to use an online social network approach to address these challenges, in which the investigators demonstrate how reducing the online levels of network centralization and network homophily among African American community members directly increases their productive engagement with health-promoting information.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Active, not recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

To investigate the causal effects of network structure and composition on the acceptance of new or unfamiliar behavior-relevant health information, the investigators propose a randomized controlled experiment that compares several independent populations to identify and address participants' endorsement of biased information, and engagement with novel behavior relevant information (e.g., regarding COVID-19 vaccination). Each population will have its own network structure (i.e., level of centralization) and composition (i.e., level of homophily).

To run each experimental trial, the investigators will recruit 240 African American participants, aged 18 to 40, collectively to answer behavior-relevant questions over a period of no greater than 8 minutes. Participants can respond asynchronously - i.e., when the participants' time permits. As with previous studies, the technical infrastructure will manage participants' progress through the study to ensure that all participants have the relevant information about each other's responses.

To ensure causal identification, each network graph will constitute a single observation of how individual decisions change under conditions of interdependent social information. Thus, each trial of 240 people (6 networks x 40 participants per network) produces 6 observations of a community-level social learning process. Power calculations indicate that 8 independent trials are sufficient to produce results of p<0.05 with 85% power, resulting in a desired population of 1920 participants for each health topic (e.g., COVID-19 vaccination is a single "health topic"), producing 48 independent observations of collective decision making per health topic.

The studies will target health topics for which there is substantial racial disparity in outcomes and behavior, such as acceptance of COVID-19 vaccination, and spreading of various categories of COVID-19 misinformation (e.g. beliefs related to assessment of personal risk, effectiveness of protective behaviors, methods of transmission, disease prevention, treatment, origins of the virus) and related health practices (e.g. choice of appropriate contraceptive methods, value of heart disease screenings, etc.).

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
4476

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • United States
    • Pennsylvania
      • Philadelphia, Pennsylvania, United States, 19104
        • Annenberg School for Communication

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Having internet access
  • Aged 18 and above
  • Living in the United States

Exclusion Criteria:

  • Having no internet access
  • Aged below 18
  • Living outside of the United States

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Egalitarian Networks of Homogeneous Populations
Egalitarian networks are characterized by equal connectivity for all participants in an online network for information exchange. Each network is consisted of 40 individual participants. All network participants in this condition share similar baseline demographic characteristics, attitudes, or behavioral choices.
Behavioral: Online Social Network and Collective Intelligence Intervention
The online network intervention aims to use different configurations of online social networks to optimize the impacts of collective intelligence process to improve individuals' understanding, beliefs, and behavioral choices regarding a variety of health behaviors. Participants will be put into different online networks and respond to health questions while receiving feedback from their network members.
Experimental: Egalitarian Networks of Diverse Populations
Egalitarian networks are characterized by equal connectivity for all participants in an online network for information exchange. Each network is consisted of 40 individual participants. All network participants in this condition have very different baseline demographic characteristics, attitudes, or behavioral choices.
Behavioral: Online Social Network and Collective Intelligence Intervention
The online network intervention aims to use different configurations of online social networks to optimize the impacts of collective intelligence process to improve individuals' understanding, beliefs, and behavioral choices regarding a variety of health behaviors. Participants will be put into different online networks and respond to health questions while receiving feedback from their network members.
Experimental: Centralized Networks of Homogeneous Populations
Centralized networks have a small number of influential individuals, called "hubs," with connections to most other people. Centralized networks characterize situations in which most or all individuals are connected to, and seek advice from, a few well-connected "influencers." Each network is consisted of 40 individual participants. All network participants in this condition share similar baseline demographic characteristics, attitudes, or behavioral choices.
Behavioral: Online Social Network and Collective Intelligence Intervention
The online network intervention aims to use different configurations of online social networks to optimize the impacts of collective intelligence process to improve individuals' understanding, beliefs, and behavioral choices regarding a variety of health behaviors. Participants will be put into different online networks and respond to health questions while receiving feedback from their network members.
Experimental: Centralized Networks of Diverse Populations
Centralized networks have a small number of influential individuals, called "hubs," with connections to most other people. Centralized networks characterize situations in which most or all individuals are connected to, and seek advice from, a few well-connected "influencers." Each network is consisted of 40 individual participants. All network participants in this condition have very different baseline demographic characteristics, attitudes, or behavioral choices.
Behavioral: Online Social Network and Collective Intelligence Intervention
The online network intervention aims to use different configurations of online social networks to optimize the impacts of collective intelligence process to improve individuals' understanding, beliefs, and behavioral choices regarding a variety of health behaviors. Participants will be put into different online networks and respond to health questions while receiving feedback from their network members.
Experimental: Independent Control of Homogeneous Populations
Independent control condition does not have online networks. Participants in this condition are not put into online networks. Participants only respond to questions by themselves. All participants in this condition share similar baseline demographic characteristics, attitudes, or behavioral choices.
Behavioral: Independent Control
Independent control aims to test the baseline of population understanding of health behaviors and choices. Participants will respond to health questions independently without getting any feedback from others.
Experimental: Independent Control of Diverse Populations
Independent control condition does not have online networks. Participants in this condition are not put into online networks. Participants only respond to questions by themselves. All participants in this condition have very different baseline demographic characteristics, attitudes, or behavioral choices.
Behavioral: Independent Control
Independent control aims to test the baseline of population understanding of health behaviors and choices. Participants will respond to health questions independently without getting any feedback from others.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
COVID-19 vaccination attitude
Time Frame: Immediate after intervention
COVID-19 vaccination attitude scale, which is a self-reported scale measuring participants' attitudes toward COVID-19 vaccination. The scale is consisted of 5 questions (e.g., "How much confidence do you have that the COVID-19 vaccine in the U.S. is safe and effective?") with responses ranging from 1 (No confidence at all) to 5 (A great deal of confidence); a higher average score means a more positive attitude in favor of COVID-19 vaccination.
Immediate after intervention
COVID-19 vaccination intention
Time Frame: Immediate after intervention
COVID-19 vaccination intention scale, which is a self-reported scale measuring participants' intention toward COVID-19 vaccination. The scale is consisted of 5 questions (e.g., "Would you get a COVID-19 vaccine when it is available to you?") with responses ranging from 1 (Definitely Not) to 5 (Definitely); a higher average score means a stronger intention to receive the COVID-19 vaccine.
Immediate after intervention
COVID-19 vaccine safety perception
Time Frame: Immediate after intervention
One question asks participant's estimation of one potential side effect from the COVID-19 vaccine. The question asks "According to the most recent data, for every 10 million people in the US vaccinated for COVID-19, how many experienced a severe allergic reaction (anaphylaxis)? Answer must be between 0 and 10,000."
Immediate after intervention

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
COVID-19 vaccine belief
Time Frame: Immediate after intervention
COVID-19 vaccine belief scale, which is a self-reported scale measuring participants' knowledge and belief (including misbelief) about the COVID-19 vaccine safety and effectiveness. The scale is consisted of 12 items (e.g., "A COVID-19 vaccine will not alter my DNA") with responses ranging from 1 (completely disagree) to 5 (completely agree); a higher average score means more accurate knowledge and belief towards the COVID-19 vaccine.
Immediate after intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Pennsylvania

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
University of California, Berkeley
University of California, Davis
University of California, San Francisco

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Damon Centola, PhD, University of Pennsylvania

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
May 4, 2021

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
March 30, 2023

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 30, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 21, 2021

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 1, 2021

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 3, 2021

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 19, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 18, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 827141

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

We will share the data collected from our online experiments. All sets of data are anonymous.

IPD Sharing Time Frame

Data will be available when the primary intervention paper is published.

IPD Sharing Access Criteria

Data will be shared as a part of the published paper, in forms of supplementary materials. The public can access the data through the publisher's website.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ANALYTIC_CODE

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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