Fostering Prosocial Preventive Behaviours Through Awe

Fostering Prosocial Behaviours Against Infectious Diseases Through Awe: A Randomized Controlled Trial

The goal of this randomized control trial is to investigate the impact pf awe on prosocial preventive behaviours against infectious diseases among adults from Hong Kong, Singapore, and ten major cities in Mainland China (Beijing, Shanghai, Guangzhou, Shenzhen, Hangzhou, Chongqing, Chengdu, Wuhan, Xi'an, Nanjing). The main questions it aims to answer are:

• Does experiencing awe increase adults' intentions to engage in prosocial preventive behaviours against infectious diseases, including vaccination, mask wearing, and social distancing?
• Does the impact vary across three research sites?

Study Overview

• Status: Recruiting
• Conditions: Infectious Diseases
• Intervention / Treatment: Behavioral: Awe intervention; Behavioral: Neutral imagination

Detailed Description

This study will be conducted as a nested sub-study within a main longitudinal study implemented online. The baseline assessment of the longitudinal study was conducted between October and November 2025. Participants who agreed to be recontacted will be invited to join the randomized controlled trial (RCT) approximately four months after the baseline assessment, in February-March 2026. At that time, participants will be randomized in a 1:1 ratio into either the intervention or control group.

• Study Type: Interventional
• Enrollment (Estimated): 456
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Qiuyan Liao; Phone Number: 39179289; Email: qyliao11@hku.hk

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong
    • Recruiting
    • University of Hong Kong School of Public Health
    • Contact: Qiuyan Liao, Dr; Phone Number: 39179289; Email: qyliao11@hku.hk
    • Contact: Xiaoting LUO, MA; Phone Number: 39176302; Email: magluo@connect.hku.hk

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Adults (age ≥18 years) who live in
• Hong Kong, Singapore, and ten major cities in Mainland China (Beijing, Shanghai, Guangzhou, Shenzhen, Hangzhou, Chongqing, Chengdu, Wuhan, Xi'an, Nanjing) over the past one year
• Able to read and understand written Chinese or English
• Have access to the internet through computers, mobile phones, or tablets

Exclusion Criteria:

• Individuals with cognitive or linguistic difficulties that would prevent them from completing an online survey will be excluded.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Awe intervention group; The intervention is a three-step mini game named Hidden Picture Puzzle designed to induce the feeling of awe. In the game, participants will first see a picture of nature covered by six opaque blocks. They will be asked to guess the content of the picture. After making their choice, participants will be instructed to click the six blocks to gradually uncover the picture. Once all six blocks are removed, the full image will be revealed. In the final step, participants will be instructed to imagine themselves in the scene and describe their feelings by selecting the word from a provided list. To ensure that participants will have sufficient time to complete the imagination tasks, they will be required to pause for at least 15s before proceeding to indicate their immediate feeling. Each participant will complete four rounds of this mini game, each with a different picture.	Behavioral: Awe intervention; The intervention is a three-step mini game named Hidden Picture Puzzle designed to induce the feeling of awe. In the game, participants will first see a picture of nature covered by six opaque blocks. They will be asked to guess the content of the picture. After making their choice, participants will be instructed to click the six blocks to gradually uncover the picture. Once all six blocks are removed, the full image will be revealed. In the final step, participants will be instructed to imagine themselves in the scene and describe their feelings by selecting the word from a provided list. To ensure that participants will have sufficient time to complete the imagination tasks, they will be required to pause for at least 15s before proceeding to indicate their immediate feeling. Each participant will complete four rounds of this mini game, each with a different picture.
Placebo Comparator: Neutral imagination control group; For the control group, the mini game Hidden Picture Puzzle will also follow a three-step format, identical in structure to the intervention condition. However, the images provided will depict everyday objects (e.g., a sofa or a bottle) rather than nature scenes. Similarly, when participants are asked to guess the content of the picture. After the participants finish uncovering the pictures, they will be asked to imagine their interaction with these daily objects and describe the features of the objects by selecting a word from a provided list. As in the intervention group, participants in the control group will complete four rounds of the mini game, each with a different image.	Behavioral: Neutral imagination; For the control group, the mini game Hidden Picture Puzzle will also follow a three-step format, identical in structure to the intervention condition. However, the images provided will depict everyday objects (e.g., a bottle) rather than nature scenes. Similarly, when participants are asked to guess the content of the picture. After the participants finish uncovering the pictures, they will be asked to imagine their interaction with these daily objects and describe the features of the objects by selecting a word from a provided list. As in the intervention group, participants in the control group will complete four rounds of the mini game, each with a different image.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intentions to participate in future preventive behaviours	Participants will be asked about their intentions to participate in future vaccination, mask wearing, and social distancing during next winter influenza season using a 7-point Likert scale (1=Never, 7=Certain).	Immediately after they complete the game with manipulation
Behavioural choices in the pandemic vignettes	Based on a hypothetical infectious disease pandemic, six vignettes will be shown to the participants, comprising three on vaccination and three on social distancing. Each vignette illustrates a trade-off between personal cost and social benefit in engaging in these prosocial behaviours. Participants will be asked to report how likely will they are to engage in the prosocial preventive behaviours using a 7-point Likert scale (1=Never, 7=Certain).	Immediately after they complete the game with manipulation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intentions to engage in social activities	Participants will also be asked their intentions to engage in social activities using a 5-point Likert scale (1=Very unwilling, 5=Very willing).	Immediately after they complete the game with manipulation

Collaborators and Investigators

• Sponsor: The University of Hong Kong

Study record dates

Study Major Dates

• Study Start (Actual): October 27, 2025
• Primary Completion (Estimated): March 31, 2026
• Study Completion (Estimated): October 31, 2026

Study Registration Dates

• First Submitted: February 5, 2026
• First Submitted That Met QC Criteria: February 5, 2026
• First Posted (Actual): February 12, 2026

Study Record Updates

• Last Update Posted (Actual): February 27, 2026
• Last Update Submitted That Met QC Criteria: February 24, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: infectious diseases; preventive behaviour; awe
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Infections; Pathological Conditions, Signs and Symptoms; Communicable Diseases
• Other Study ID Numbers: Socialconhealth2025

Drug and device information, study documents

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