@Article{info:doi/10.2196/37328,
author="Zhu, Patricia
and Tatar, Ovidiu
and Griffin-Mathieu, Gabrielle
and Perez, Samara
and Haward, Ben
and Zimet, Gregory
and Tunis, Matthew
and Dub{\'e}, {\`E}ve
and Rosberger, Zeev",
title="The Efficacy of a Brief, Altruism-Eliciting Video Intervention in Enhancing COVID-19 Vaccination Intentions Among a Population-Based Sample of Younger Adults: Randomized Controlled Trial",
journal="JMIR Public Health Surveill",
year="2022",
month="May",
day="30",
volume="8",
number="5",
pages="e37328",
keywords="COVID-19; vaccination; altruism; prosocial motives; video intervention; randomized controlled trial; younger adults; vaccine hesitancy; public health; youth; digital intervention; health intervention; health promotion; web survey; digital health; online health; health information",
abstract="Background: High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have demonstrated lower levels of vaccine uptake compared to older adults, while being more likely to transmit the virus due to a higher number of social contacts. Consequently, this age group has been identified by public health authorities as a key target for vaccine uptake. Previous research has demonstrated that altruistic messaging and motivation is associated with vaccine acceptance. Objective: This study had 2 objectives: (1) to evaluate the within-group efficacy of an altruism-eliciting short, animated video intervention in increasing COVID-19 vaccination intentions amongst unvaccinated Canadian younger adults and (2) to examine the video's efficacy compared to a text-based intervention focused exclusively on non-vaccine-related COVID-19 preventive health measures. Methods: Using a web-based survey in a pre-post randomized control trial (RCT) design, we recruited Canadians aged 20-39 years who were not yet vaccinated against COVID-19 and randomized them in a 1:1 ratio to receive either the video intervention or an active text control. The video intervention was developed by our team in collaboration with a digital media company. The measurement of COVID-19 vaccination intentions before and after completing their assigned intervention was informed by the multistage Precaution Adoption Process Model (PAPM). The McNemar chi-square test was performed to evaluate within-group changes of vaccine intentions. Exact tests of symmetry using pairwise McNemar tests were applied to evaluate changes in multistaged intentions. Between-group vaccine intentions were assessed using the Pearson chi-square test postintervention. Results: Analyses were performed on 1373 participants (n=686, 50{\%}, in the video arm, n=687, 50{\%}, in the text arm). Within-group results for the video intervention arm showed that there was a significant change in the intention to receive the vaccine ($\chi$21=20.55, P<.001). The between-group difference in postintervention intentions ($\chi$23=1.70, P=.64) was not significant. When administered the video intervention, we found that participants who had not thought about or were undecided about receiving a COVID-19 vaccine were more amenable to change than participants who had already decided not to vaccinate. Conclusions: Although the video intervention was limited in its effect on those who had firmly decided not to vaccinate, our study demonstrates that prosocial and altruistic messages could increase COVID-19 vaccine uptake, especially when targeted to younger adults who are undecided or unengaged regarding vaccination. This might indicate that altruistic messaging provides a ``push'' for those who are tentative toward, or removed from, the decision to receive the vaccine. The results of our study could also be applied to more current COVID-19 vaccination recommendations (eg, booster shots) and for other vaccine-preventable diseases. Trial Registration: ClinicalTrials.gov NCT04960228; https://clinicaltrials.gov/ct2/show/NCT04960228 ",
issn="2369-2960",
doi="10.2196/37328",
url="https://publichealth.jmir.org/2022/5/e37328",
url="https://doi.org/10.2196/37328",
url="http://www.ncbi.nlm.nih.gov/pubmed/35544437"
}