An Evaluation of a Dynamic Web-Based Visualization of Community Immunity

Study Overview
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Brief Summary
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This study is a PhD project conducted by Ms. Hina Hakim, supervised by Dr. Holly O. Witteman, PhD, and co-supervised Dr. Daniel Reinharz, professors and researchers at the Faculty of Medicine at Laval University. The purpose of this study is to evaluate the effects of visualization conveying the concept of community immunity or herd immunity on risk perception (towards individual, family, community and vulnerable people in communities) (primary outcome) and on emotions, attitudes, knowledge, and behavioural intentions (secondary outcomes).

Detailed Description
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Visualization is a powerful communication mechanism that uses pre-attentive processing to communicate large amounts of information rapidly in understandable and compelling ways (Healey and Enns 2012). A systematic review demonstrates that there are some interventions available for conveying the concept of community immunity, and very few evaluate interventions for their effects on vaccine intentions and uptake as well as their precursors, such as knowledge, attitudes, knowledge and none on emotions (Hakim et al. 2018). The purpose of this study is to evaluate the effects of visualization conveying the concept of community immunity on risk perception (to individual, family, community and vulnerable people in communities) (primary outcome) and on emotions, attitudes, knowledge, and behavioural intentions (secondary outcomes).

Official Title
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An Evaluation of a Dynamic Web-Based Visualization of Community Immunity

Conditions
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Understanding of Community Immunity as a Concept

Intervention / Treatment
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* Behavioral: herdimm
* Behavioral: guardianmeasles
* Behavioral: theotheredmundmeasles
* Behavioral: sbsnewsgeneric
* Behavioral: publichealthagencycanadaflu
* Behavioral: robertkochgeneric


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Members of the general population in Canada At least 18 years old Able to provide free and informed consent Able to read and understand French or English Able to use a computer Exclusion Criteria: - No internet access

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Factorial Assignment
Interventional Model Description: This study will be a multi-armed factorial randomized controlled trial. Each participant will be randomly allocated to focus on one of four possible vaccine-preventable diseases: measles, pertussis, flu (influenza), or a generic vaccine-preventable disease (hereby referred to as generic). All aspects of the study (visualization, questionnaire) will be focused on that one disease for that participant. The primary and secondary outcomes of the study which are risk perception, emotion, knowledge, trust in information provided, attitudes and a validated scale about vaccination (Betsch et al. 2018) will be assessed in an online questionnaire. Because three online visualizations are available only in English whereas our study will be conducted in both English and French, we will use slightly different randomization patterns for English- and French-speaking participants.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: controlgeneric<br>No intervention provided. Participant answers outcome questions about an unnamed vaccine-preventable disease. English and French. | |
| No Intervention: controlmeasles<br>No intervention provided. Participant answers outcome questions about measles. English and French. | |
| No Intervention: controlpertussis<br>No intervention provided. Participant answers outcome questions about pertussis. English and French. | |
| No Intervention: controlflu<br>No intervention provided. Participant answers outcome questions about flu. English and French. | |
| Experimental: herdimmgeneric<br>Web-based application (main intervention) provided. Participant answers outcome questions about an unnamed vaccine-preventable disease. English and French. | Behavioral: herdimm<br>* In this visualization participants can build their own avatar representing themselves and 8 other avatars representing people around them, like their family or coworkers. Our visualization then uses these avatars in a brief narrated video explaining how herd immunity works.<br>|
| Experimental: herdimmmeasles<br>Web-based application (main intervention) provided. Participant answers outcome questions about measles. English and French. | Behavioral: herdimm<br>* In this visualization participants can build their own avatar representing themselves and 8 other avatars representing people around them, like their family or coworkers. Our visualization then uses these avatars in a brief narrated video explaining how herd immunity works.<br>|
| Experimental: herdimmpertussis<br>Web-based application (main intervention) provided. Participant answers outcome questions about pertussis. English and French. | Behavioral: herdimm<br>* In this visualization participants can build their own avatar representing themselves and 8 other avatars representing people around them, like their family or coworkers. Our visualization then uses these avatars in a brief narrated video explaining how herd immunity works.<br>|
| Experimental: herdimmflu<br>Web-based application (main intervention) provided. Participant answers outcome questions about flu. English and French. | Behavioral: herdimm<br>* In this visualization participants can build their own avatar representing themselves and 8 other avatars representing people around them, like their family or coworkers. Our visualization then uses these avatars in a brief narrated video explaining how herd immunity works.<br>|
| Active Comparator: robertkochgeneric<br>Web-based application (comparator) provided. Participant answers outcome questions about an unnamed vaccine-preventable disease. English only. | Behavioral: robertkochgeneric<br>* A web-based application showing how herd immunity works in general: http://rocs.hu-berlin.de/D3/herd/<br>|
| Active Comparator: sbsnewsgeneric<br>Video (comparator) provided. Participant answers outcome questions about an unnamed vaccine-preventable disease. English only. | Behavioral: sbsnewsgeneric<br>* A video showing how herd immunity works in general: https://www.sbs.com.au/news/two-sydney-babies-too-young-to-be-vaccinated-infected-with-measles<br>|
| Active Comparator: guardianmeasles<br>Video (comparator) provided. Participant answers outcome questions about measles. English only. | Behavioral: guardianmeasles<br>* A screen capture of an interactive visualization: https://www.theguardian.com/society/ng-interactive/2015/feb/05/-sp-watch-how-measles-outbreak-spreads-when-kids-get-vaccinated<br>|
| Active Comparator: theotheredmundmeasles<br>Video (comparator) provided. Participant answers outcome questions about measles. English only. | Behavioral: theotheredmundmeasles<br>* A gif showing measles spreading through populations with differing levels of vaccine coverage: https://imgur.com/gallery/8M7q8#J7LANQ4<br>|
| Active Comparator: publichealthagencycanadaflu<br>Video (comparator) provided. Participant answers outcome questions about flu. English and French. | Behavioral: publichealthagencycanadaflu<br>* A video showing how herd immunity works in the context of influenza: https://www.canada.ca/fr/sante-publique/services/video/la-grippe-n-en-passez-pas-les-maux.html<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Risk perception | 6 ad hoc questions assessing risk perception | immediately after intervention or control | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| emotions, attitudes, knowledge, and behavioural intentions | ad hoc questions and 5C scale (Betsch et al.) | immediately after intervention or control | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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herd immunity, community immunity, web-based application, visualization