Impact of a Mock-up Fact-checking Extension on HPV Vaccine Misinformation: A Survey Experiment

May 3, 2024 updated by: Zhiyuan Hou, Fudan University

Evaluating the Feasibility and Effectiveness of a Mock-up Fact-checking Extension to Improve Ability to Debunk HPV Vaccine Misinformation Among Parents of Middle School Girls: A Survey Experiment

The primary objective of this survey experiment study is to measure the impact of a mock-up Chinese fact-checking extension on the ability to dispel HPV and HPV vaccine-related misinformation among parents of middle school girls in China.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This survey experiment study aims to assess the feasibility and effectiveness of a mock-up Chinese fact-checking extension on improving the ability to identify HPV and HPV vaccine-related misinformation among parents of middle school girls in three economically diverse regions of China. This includes Shanghai megacity, an urban city in Anhui Province, and rural counties in Anhui Province. The participants will be parents of middle school girls who have not yet received the HPV vaccine. This experiment will randomly assign the participants into intervention or control group. Participants in the intervention group will use a mock-up Chinese fact-checking extension whereas those in control group will not.

The sample size for this study was determined based on the two primary outcomes: knowledge of the HPV vaccine and the ability to dispel misinformation. A review of the existing literature suggests that the intention or confidence among Chinese parents to vaccinate their children with the HPV vaccine, as well as their knowledge about the vaccine and capability to counteract misinformation, typically ranges from 50% to 70%. We assumed a baseline rate of 60% for both vaccine knowledge and misinformation discernment. It is anticipated that exposure to educational interventions will increase these rates by 10%, elevating them to 70%. Using a significance level of 0.05 and a statistical power of 90%, the required sample size was calculated to be a minimum of 473 participants per group. To accommodate potential variability and to strengthen the robustness of the study, 500 participants will be recruited for each group, maintaining a 1:1 ratio. This approach results in a total sample size of 1,000 participants. Such a sample size ensures that the study is sufficiently powered to detect a significant change in the outcomes of interest.

In this study, 11 mobile Weibo post screenshots were created, covering a range of topics including infertility, safety, vaccine ingredients, high-risk cervical cancer types, regular check-ups, transmission routes, and others.

The participants in both groups will complete a questionnaire consisting of six phases:

  1. Phase 1 (Baseline Assessment): Participants in both the intervention and control groups will complete a questionnaire covering (a) basic demographic information, (b) HPV vaccine knowledge, (c) HPV vaccine awareness and confidence, and (d) vaccination intentions.
  2. Phase 2 (Intervention Module 1): Participants in the intervention group will review six Weibo post screenshots, each featuring a mock-up Chinese fact-checking extension. The control group will view identical screenshots, but without the fact-checking extension. Half of these posts will include false information. After viewing each post, those in the intervention group will evaluate a statement related to the Weibo content and corresponding to one of the predefined (b) HPV vaccine knowledge. Their responses will be: 1) Correct, 2) Incorrect, or 3) I don't know, considering both the post content and the fact-checking extension's findings. Participants in the control group will assess the same statement based only on the post content, with the same response options.
  3. Phase 3 (Intervention Module 2): All participants will review four additional Weibo post screenshots, including two containing false information, to evaluate whether exposure to the mock-up fact-checking extension has improved the intervention group's ability to identify false information. The same question format from Intervention Module 1 will be used for responses.
  4. Phase 4 (Post-intervention Assessment): All participants are required to fill out sections on (c) HPV vaccine awareness and confidence, and (d) vaccine intentions.
  5. Phase 5 (Intervention Module 3): All participants in both groups will be asked whether they use a mock-up fact-checking extension when viewing Weibo post screenshots. If participants choose 'Yes', they will view a Weibo post screenshot with the extension displayed; if they choose 'No', the extension will not be displayed. The same question format from Intervention Module 1 will be used for responses. This phase aims to assess participants' behaviour regarding the use of the extension.
  6. Phase 6 (User Experience Assessment): All participants will complete the section (e) the user experience with a mock-up fact-checking extension.

Following the completion of the experiment, a debunking procedure will be conducted for participants in both the intervention and control groups. This is to avoid any potential risks associated with the spread of misinformation on Weibo.

Data analysis will employ Difference-in-Differences (DID) analysis, multiple logistic regression, and other suitable statistical methods to evaluate the effectiveness of the mock-up Chinese fact-checking extension.

Study Type

Interventional

Enrollment (Estimated)

1200

Phase

  • 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 Backup

Study Locations

  • China
    • Anhui
      • Chizhou, Anhui, China, 247100
        • Chizhou Health Center for Disease Control and Prevention
        • Contact:
    • Shanghai
      • Shanghai, Shanghai, China, 201800

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  1. Participants must be parents or legal guardians of female students currently enrolled in participating middle school.
  2. The parent's or guardian's female middle school student must not have received the HPV vaccine, must not have an HPV vaccination appointment scheduled, and must not have any contraindications to receiving the HPV vaccine.
  3. Participants must be free of mental health disorders or visual/reading disabilities that could prevent their full participation in and completion of the intervention activities.
  4. Participants must have provided informed consent and expressed a willingness to actively participate throughout the study.

Exclusion criteria are defined as individuals not meeting the aforementioned inclusion criteria.

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: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Mock-up fact-checking extension intervention group

Intervention group participants will engage with three modules:

In Module 1, participants will examine six Weibo post screenshots, each featuring a mock-up of a Chinese fact-checking extension. Participants in the intervention group will assess a statement linked to the content of each post, which aligns with predefined HPV vaccine knowledge from section (b). Their response options will be: 1) Correct, 2) Incorrect, or 3) I don't know, taking into account both the post and the extension's feedback.

In the module 2, participants will review four additional Weibo post screenshots, two of which include false information. Responses will follow the same format used in Module 1.

In Module 3, participants will choose whether to view Weibo post screenshots with the fact-checking extension enabled or disabled. If they choose "Yes", the screenshot will be displayed with the extension; if "No", it will be shown without the extension.
Other: Mobile Weibo post screenshot with mock-up Chinese fact-checking extension
The intervention in this survey experiment involves mobile Weibo post screenshots equipped with a mock-up Chinese fact-checking browser extension. All screenshots are based on actual Weibo posts. The fact-checking content is generated by a Large Language Model (LLM), tailored to relevant knowledge and prompts, and subsequently validated by experts. The Weibo posts cover a range of popular topics known to contain misinformation, including infertility, safety, vaccine ingredients, high-risk cervical cancer types, regular check-ups, transmission routes, and others.
No Intervention: Control group

Control group participants will participate in three modules:

In Modules 1 and 2, they will review six and four Weibo post screenshots, respectively, without the mock-up Chinese fact-checking extension. Participants will evaluate statements linked to the content of each post, aligning with predefined HPV vaccine knowledge from section (b). Their response options will be: 1) Correct, 2) Incorrect, or 3) I don't know, based solely on the content of the posts.

In Module 3, participants will choose whether to view Weibo post screenshots with the fact-checking extension enabled or disabled. If they choose "Yes", the screenshot will be displayed with the extension; if "No", it will be shown without the extension.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Ability to debunk misinformation
Time Frame: Day 1, in a single survey
This outcome measures participants' ability to debunk misinformation about the HPV or HPV vaccine. Total debunking scores range from 0 to 10, with higher scores reflecting better debunking skills.
Day 1, in a single survey

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
HPV vaccination intention
Time Frame: Day 1, in a single survey
Intention to vaccinate daughters against HPV, measured on a five-point Likert scale from 0 ("very unwilling") to 5 ("very willing").
Day 1, in a single survey
HPV vaccine confidence
Time Frame: Day 1, in a single survey
Vaccine Confidence Index (VCI), including confidence on vaccine effectiveness and safety, measured on a five-point Likert scale from 0 ("strongly disagree") to 5 ("strongly agree").
Day 1, in a single survey
Tool acceptance
Time Frame: Day 1, in a single survey
Determines whether participants would like to use a mock-up fact-checking extension when viewing screenshots of Weibo posts. Responses are either Yes (1) or No (0).
Day 1, in a single survey
User experience of mock-up fact-checking extension
Time Frame: Day 1, in a single survey
4 questions about the user experience of a mock-up fact-checking browser extension, measured using a five-point Likert scale from "strongly disagree" to "strongly agree"
Day 1, in a single survey

Collaborators and Investigators

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

Sponsor

Fudan University

Collaborators

The University of Hong Kong

Investigators

  • Principal Investigator: Zhiyuan Hou, PhD, Fudan University
  • Principal Investigator: Leesa Lin, PhD, The University of Hong Kong

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 (Estimated)

April 28, 2024

Primary Completion (Estimated)

May 31, 2024

Study Completion (Estimated)

June 30, 2024

Study Registration Dates

First Submitted

April 26, 2024

First Submitted That Met QC Criteria

May 3, 2024

First Posted (Actual)

May 8, 2024

Study Record Updates

Last Update Posted (Actual)

May 8, 2024

Last Update Submitted That Met QC Criteria

May 3, 2024

Last Verified

May 1, 2024

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • Fact-checking Extension

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Individual participant data that underlie the results reported in the article, after de-identification (text, tables, figures, and appendices), will be shared upon reasonable requests. A written data-sharing request for meta-analysis should be submitted by email with a methodologically sound proposal. Proposals should be directed to zyhou@fudan.edu.cn; to gain access, data requestors will need to sign a data access agreement.

IPD Sharing Time Frame

Beginning 12 months and ending 36 months following article publication

IPD Sharing Access Criteria

Researchers who provide a methodologically sound proposal for meta analysis. Proposals should be directed to zyhou@fudan.edu.cn; to gain access, data requestors will need to sign a data access agreement.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

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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