Dime La VerDAD: Verify, Debunk, and Disseminate

Dime la Verdad (Tell me the truth) will evaluate the use of storytelling by community health workers as a communication strategy to disseminate reliable health information on social media and encourage informed decision-making in favor of recommended immunizations in communities with high morbidity and mortality due to respiratory virus infections.

Dime La Verdad is an innovative social media capacity-building program based on theoretical frameworks related to health communication that empowers community health workers to disseminate reliable information about respiratory virus protection strategies through the use of personal narratives on social media. The proposed work will use a rigorous stepped wedge design to 1) deliver a scalable program of science communicators using an adapted curriculum grounded in principles of health communication, 2) evaluate how diffusion of health messaging is perceived on social media, and 3) discern how use of personal narratives to enhance science communication can encourage informed decision-making to promote evidence-based immunization practices and improve health outcomes.

Study Overview

• Status: Recruiting
• Conditions: COVID-19; Influenza; Health Behavior; Communication Research; Respiratory Viral Infection
• Intervention / Treatment: Behavioral: Science Communication Curriculum Cohort 1; Behavioral: Science communication curriculum Cohort 2; Behavioral: Science communication curriculum Cohort 3; Behavioral: Science communication curriculum Cohort 4

Detailed Description

Public understanding of respiratory virus transmission and prevention is shaped by a wide range of information sources, including social media. As social media platforms play an increasingly central role in shaping health communication, it is critically important to define best practices to disseminate reliable information online. This is especially important when considering the lives of susceptible groups who may not have easy access to culturally relevant and language-concordant reputable sources. Although access to health care remains a significant barrier, access to reliable health messaging is a significant predictor of immunization against respiratory viruses. Yet, little is known about community-level differences in how narratives about respiratory virus protection emerge, how they are shared, and how they ultimately affect decision-making in favor of proven infection prevention strategies.

Social media posts that include personal narratives are effective at reliably communicating health recommendations, especially those that come from a trusted peer. Therefore, communication strategies that leverage neighborhood and interpersonal relationships can prove extremely effective at health communication. Community health workers are trusted community members who serve as links between health/social services and a defined region to improve access to health services and quality of service delivery. Community health workers can diffuse reliable information in the neighborhoods they serve and can be essential to address concerns about health recommendations, increase trust, and improve health outcomes; they have been at the forefront of addressing lower rates of testing for respiratory viruses and inform decision-making to promote evidence-based immunization practices in communities with unmet health and social needs. Community health workers are uniquely positioned as trusted messengers to disseminate reliable information through strategic use of social media and principles of health communication.

Employing a place-based approach (i.e., engaging with local neighborhood strengths and members) to enhance public communication was an effective strategy to diffuse reliable information during the most recent pandemic. Partnerships between multidisciplinary healthcare professionals and lay community health workers improved health communication on the ground and on social media. Reach has been particularly successful in communities with previously unmet needs for reliable, language-concordant information thanks to the co-creation of multi-lingual, easy-to-digest infographics.

Because community health workers are trusted community members who can improve the quality of health/social services delivery, they are uniquely positioned to provide place-based, reliable health communication on social media. To date, there has been no evaluation of whether training community health workers to improve science communication on social media can increase knowledge about respiratory virus prevention and improve decision-making in favor of recommended immunizations. Dime La Verdad (Tell me the truth) will create a scalable program of science communicators. We plan to do the following:

1. Identify and evaluate use of social media by community health workers to communicate health information in neighborhoods with low rates of immunization against respiratory viruses and high rates of influenza-like illness. We will interview community health workers that service areas with obstacles to reliable health communication in order to understand existing information sources, perceptions of safety of recommended immunizations, and personal plans to get immunized.
2. Engage community health workers as neighborhood champions in an adapted science communication curriculum where they can learn to diffuse reliable information. Participants will learn how to make their own infographics as well as incorporate personal narratives into their posts. Participants will share posts with their social media circles to test their effectiveness.
3. Test effectiveness of personal-narrative posts versus resharing of standardized content shared by community health workers with their social networks. Using a stepped-wedge approach, members of participants' social media circles will be surveyed to measure the reach and effectiveness of social media posts. We hypothesize that community health workers will be viewed as trusted messengers and that personal narrative posts designed using principles from the training program will be shared, viewed, and recalled more often as compared to standard informational posts, ultimately leading to improved decision-making in favor of recommended immunizations.

This work will test a model of community capacity-building while providing greater knowledge of how a place-based approach to dissemination of credible scientific information can effect health behavior change.

• Study Type: Interventional
• Enrollment (Estimated): 1400
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Yajaira Bolanos Flores, MPH; Phone Number: 773-571-0613; Email: Yajaira.BolanosFlores@bsd.uchicago.edu

Study Locations

• United States
  • Illinois
    • Chicago, Illinois, United States, 60637
      • Recruiting
      • University of Chicago
      • Contact: Marina Del Rios, MD; Email: marina.delrios@bsd.uchicago.edu
    • Chicago, Illinois, United States, 60612
      • Active, not recruiting
      • Rush University
  • Iowa
    • Iowa City, Iowa, United States, 52242
      • Active, not recruiting
      • University of Iowa
  • Michigan
    • Ann Arbor, Michigan, United States, 48109
      • Active, not recruiting
      • University of Michigan

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. 18 years or older
2. Fluent in English or Spanish
3. Provide services as a community health worker or similar designation in at least one of the seven communities with high morbidity and mortality due to respiratory virus infections
4. Have a social media presence (personal or work related)

Exclusion Criteria:

1. Plan to stop working as a community health worker or similar designation before spring of 2028 (end of data collection planned)
2. Do not wish to participate in a social media campaign

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Non-Randomized
• Interventional Model: Sequential Assignment
• Masking: Single

Number of Arms

5

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control: One year baseline period; Initial baseline period before rollout of the intervention in seven communities with high morbidity and mortality due to respiratory virus infections.
Experimental: Experimental: Cohort 1 participation in science communication curriculum; Community health workers servicing two geographically adjacent community areas out of the seven selected for participation in this study will receive a tailored curriculum where they can learn to diffuse reliable information and create infographics and media as well as incorporate their personal narratives into social media posts for their communities. The core of the implementation strategy consists of augmenting training and self-efficacy for natural community champions as trusted messengers to diffuse reliable information.	Behavioral: Science Communication Curriculum Cohort 1; Community health workers will receive a tailored curriculum where they can learn to diffuse reliable information and create infographics and media as well as incorporate their personal narratives into social media posts for their communities. Community health workers will share their final infographic and final post / social media strategy.
Experimental: Experimental: Cohort 2 participation in science communication curriculum; Community health workers servicing two geographically adjacent community areas out of the seven selected for participation in this study will receive a tailored curriculum where they can learn to diffuse reliable information and create infographics and media as well as incorporate their personal narratives into social media posts for their communities. The core of the implementation strategy consists of augmenting training and self-efficacy for natural community champions as trusted messengers to diffuse reliable information.	Behavioral: Science communication curriculum Cohort 2; Community health workers will receive a tailored curriculum where they can learn to diffuse reliable information and create infographics and media as well as incorporate their personal narratives into social media posts for their communities. Community health workers will share their final infographic and final post / social media strategy.
Experimental: Experimental: Cohort 3 participation in science communication curriculum; Community health workers servicing three geographically adjacent community areas out of the seven selected for participation in this study will receive a tailored curriculum where they can learn to diffuse reliable information and create infographics and media as well as incorporate their personal narratives into social media posts for their communities. The core of the implementation strategy consists of augmenting training and self-efficacy for natural community champions as trusted messengers to diffuse reliable information.	Behavioral: Science communication curriculum Cohort 3; Community health workers will receive a tailored curriculum where they can learn to diffuse reliable information and create infographics and media as well as incorporate their personal narratives into social media posts for their communities. Community health workers will share their final infographic and final post / social media strategy.
Experimental: Experimental: Cohort 4 participation in science communication curriculum; Community health workers servicing one community area out of the seven selected for participation in this study will receive a tailored curriculum where they can learn to diffuse reliable information and create infographics and media as well as incorporate their personal narratives into social media posts for their communities. The core of the implementation strategy consists of augmenting training and self-efficacy for natural community champions as trusted messengers to diffuse reliable information.	Behavioral: Science communication curriculum Cohort 4; Community health workers will receive a tailored curriculum where they can learn to diffuse reliable information and create infographics and media as well as incorporate their personal narratives into social media posts for their communities. Community health workers will share their final infographic and final post / social media strategy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Uptake of respiratory virus protection strategies among Community health workers' social media followers	Community health workers social media followers' intent to use respiratory virus protection strategies. Members of community health workers' social media circles will be surveyed to understand the reach and effectiveness of various types of social media posts. Investigators will measure effectiveness by surveying the social circles of the community health workers six months after the implementation of the curriculum (see recruitment and retention plan), and after the completion of the campaign. Specific items will include which posts the social circle members remembered most and why. Investigators will also ask whether this changed their thinking about respiratory virus protection strategies and or the specific call to action that was put in the infographic.	Year 2 - Year 4
Community health workers Social Media Self-Efficacy	Compare Community health workers confidence with disseminating reliable information on social media before and after completing the science communication curriculum. 15-minute survey to assess their work-related social media communication self-efficacy. The baseline survey will also gather demographics, social determinants of health and baseline usage of Facebook and other social media (e.g., social media apps they use, the number of friends on each social media platform, the frequency of reading from and posting/sharing on each platform), and confidence and preparedness to disseminate reliable information in their communities regarding about respiratory virus protection strategies	Year 1 - Year 3

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Learner satisfaction	Learner satisfaction will be measured through post-curriculum evaluations using Likert items based on satisfaction with the course and willingness to recommend to others.	Year 2 - Year 4
Verify circulating knowledge about respiratory virus protection strategies and related health beliefs in seven communities with high morbidity and mortality due to respiratory virus infections	Obtained through focus groups of Community health workers. An interview guide will include questions aimed at verifying their use of social media as an information source about respiratory virus protection strategies, related reliable information, characteristics of information sources they trust, perceptions of the safety, and personal plans to use protection strategies. Questions will be developed based on the Appreciative Inquiry (AI) model which is an asset-based approach to organizational and social engagement that utilizes questions and dialogue to help participants uncover existing strengths, advantages, or opportunities in their communities, organizations, or teams.	Year 1-2
Social media engagement	Investigators will first use social media data analytics to measure and understand reach in cyberspace. Investigators will ask for each community health workers' consent and train them how to export their Facebook posts into JSON files that will be shared with the research team. If investigators need to add another emerging social media platform that does not support direct data export, they will explore different options to retrieve data, such as joining community health workers' social circles or group chats, or instruct community health workers to self-report data of their social media posts. Investigators will quantify the volume of "impressions" (i.e., the number of users who will see the post) and "buzz" generated by community health workers (e.g., numbers of likes, comments or shares). Then text analytics methods will be adopted to analyze more fine-grained reactions to these posts.	Years 1- 5

Collaborators and Investigators

• Sponsor: University of Chicago
• Collaborators: National Institute on Minority Health and Health Disparities (NIMHD); University of Michigan; University of Iowa; Rush University Medical Center; Bedford Research Corporation, Inc.; Tanoma Consulting
• Investigators: Principal Investigator: Marina DelRios, MD, University of Chicago - Section of Emergency Medicine

Study record dates

Study Major Dates

• Study Start (Actual): July 2, 2024
• Primary Completion (Estimated): June 30, 2028
• Study Completion (Estimated): April 1, 2029

Study Registration Dates

• First Submitted: May 13, 2024
• First Submitted That Met QC Criteria: May 13, 2024
• First Posted (Actual): May 16, 2024

Study Record Updates

• Last Update Posted (Actual): March 2, 2026
• Last Update Submitted That Met QC Criteria: February 26, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Respiratory Tract Infections; Infections; Orthomyxoviridae Infections; RNA Virus Infections; Virus Diseases; Respiratory Tract Diseases; Lung Diseases; Pneumonia, Viral; Pneumonia; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; Behavior; COVID-19; Influenza, Human; Health Behavior
• Other Study ID Numbers: IRB24-1997; R01MD018730 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No