An interventional study of Gamified misinformation refutation quiz and Refutational text blog post (active control) in COVID-19, Vaccination Hesitancy and Health Misinformation, sponsored by University of South Carolina. Completed at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-11.
Sponsored by University of South Carolina · Not applicable, Interventional, and Other
COVID-19 vaccine misinformation contributed to vaccine hesitancy and preventable illness. This study tested whether a brief online game helps Canadian adults identify COVID-19 vaccine misinformation, and whether effects last one month. In the game, participants judged whether statements about COVID-19 vaccines were true or false and immediately received the correct answer with a brief evidence-based explanation, delivered in a game-like format with points, ranks, and feedback. Adults from a national non-probability online panel (n = 4,071) were randomized to the game, to the identical corrective content presented as a static blog post, or to a no-activity control. The game and blog groups were assessed immediately after the activity; all three groups were reassessed approximately one month later. The hypothesis was that gamified corrective information would produce more accurate knowledge than the same information presented as a static blog post and, at one month, than no activity. The primary outcome was accuracy in identifying true and false claims; vaccination intention, vaccine confidence, and self-reported vaccination were secondary outcomes. This is the fourth study in a research program whose first three trials are registered in a companion record.
This randomized controlled trial was the fourth study in a research program evaluating digital educational interventions to counter COVID-19 misinformation. The first three studies were conducted under a separate exempt determination from the University of South Carolina Institutional Review Board (Pro00099400) before participant enrollment and are registered in a companion record. This trial received a separate exempt determination (Pro00122534). This record retrospectively registers the completed trial.
The trial used the same intervention platform as the earlier studies: a true/false quiz covering a larger set of circulating COVID-19 vaccine misinformation items, with each response followed immediately by item-level refutational feedback (the correct answer plus a brief evidence-based explanation) embedded in a gamified interface with points, ranks, and affective feedback. A six-item subset was administered in the study surveys to measure knowledge accuracy.
Participants (N = 4,071) were recruited from a national non-probability online panel in Canada (Prodege, fielded by Nanos Research) and randomized to three arms: Game (n = 1,168), Text - the identical refutational content texts as a static blog post (n = 1,288), or no-activity Control (n = 1,615). The questionnaire was administered in English and French nationwide, including Quebec. All arms completed a Wave 1 baseline (fielded December 8-30, 2022); Game and Text then received their assigned activity and an immediate posttest; the Control arm received no activity and, by design, no immediate assessment. All three arms were reassessed at Wave 2, approximately one month later (January 23-February 13, 2023); 2,079 of 4,071 (51.1%) were retained.
Two contrasts were confirmatory: Game versus Text (incremental effect of gamified delivery; evaluated immediately and at one month) and Game versus Control (total intervention effect; one-month horizon, as the Control arm had no immediate assessment). Text versus Control was descriptive. Immediate analyses included all 2,456 participants randomized to the Game and Text arms. No post-randomization data-quality exclusions were applied. One-month analyses included all 2,079 participants who completed Wave 2; nonparticipation at Wave 2 was treated as loss to follow-up rather than an analytic exclusion.
7,990 studies on the registry are indexed under COVID-19; 466 are open to participants now.
This study's enrollment of 4,071 is above the median of 102 across 4,364 interventional studies indexed under COVID-19.
Browse COVID-19 studies →University of South Carolina is the lead sponsor of 197 studies on the registry; 42 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Gamified refutation quiz covering COVID-19 vaccine misinformation items, with immediate per-item corrective feedback, followed by immediate post-intervention assessments and one-month follow-up.
Behavioral: Gamified misinformation refutation quiz
Identical refutational content delivered as a static blog post text, followed by immediate post-intervention assessments and one-month follow-up.
Behavioral: Refutational text blog post (active control)
No activity. Completed the Wave 1 baseline and the one-month follow-up only; no immediate assessment by design.
Single-session online game in which participants judged a larger set of true/false statements about COVID-19 vaccines. Immediately after each response, participants received the correct answer and a brief evidence-based refutation within a gamified interface featuring points, ranks, and affective feedback. The game was administered in English or French. Six selected items from the game content were used in the survey-based knowledge outcome measure.
Identical refutational content delivered as a static blog post with no game elements. Administered in English or French.
Mean Knowledge Accuracy Score - Immediate
Mean score across 6 true/false COVID-19 vaccine misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy; "Unsure" responses received 0.5 points.
Time frame: Immediately post-intervention, Day 1 (Game and Text arms only; the Control arm has no immediate assessment by design)
Mean Knowledge Accuracy Score - One Month
Mean score across 6 true/false COVID-19 vaccine misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy; "Unsure" responses received 0.5 points.
Time frame: Approximately 1 month post-intervention (Wave 2), all arms.
Mean Vaccination Intention Score
Single self-report item, scale 1-4, reversed-coded so higher scores indicate greater intention to vaccinate; identical pre-randomization baseline measure at Wave 1. "Are you likely, somewhat likely, somewhat unlikely or unlikely to get a COVID-19 vaccine in the next 6 months (either a booster or a first vaccination)?" \[Likely / Somewhat likely / Somewhat unlikely / Unlikely\]
Time frame: Baseline (Wave 1); immediately post-intervention (Game and Text arms, Wave 1); approximately 1 month later (all arms, Wave 2)
Mean COVID-19 Vaccine Confidence
Single self-report item, scale 0-10, higher scores indicating greater confidence. "On a scale from 0 to 10 where 0 is no confidence at all and 10 is complete confidence, how much confidence do you have in COVID-19 vaccinations?" \[0-10\]
Time frame: Immediately post-intervention (Game and Text arms, Wave 1); approximately 1 month later (all arms, Wave 2)
Percentage of Participants Reporting Receipt of a COVID-19 Vaccination or Booster in the Past 30 Days
Percentage of participants who reported receiving a COVID-19 vaccination or booster during the preceding 30 days at Wave 2. "Have you received or not received any of the following in the past 30 days? - A COVID-19 vaccination or booster." \[Received / Not received / Prefer not to say\]. "Prefer not to say" was treated as missing.
Time frame: Approximately 1 month post-intervention (Wave 2 only), all arms.
Plan to share: Yes — Deidentified analysis-ready datasets and a data dictionary underlying published results will be available from the authors on reasonable request. Ethnicity is shared in grouped form and geographic region withheld to limit re-identification risk.
Supporting information: Analytic code
Time frame: Beginning upon publication of trial results; no end date.
Access criteria: Data shared with qualified researchers for verification or secondary analysis.
No publications or documents are linked to this record.
Ran from Dec 2022 to primary completion in Feb 2023, 2 months.
Of 1,338 non-industry interventional studies with no phase under COVID-19, half reached primary completion within 9 months of starting (the median), counting those still running; a quarter within 3 and three quarters within 20. This study's 2 months is below that.
Counting every sponsor, half of 1,476 studies reached it within 9 months; a quarter within 3 and three quarters within 19.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
University of South Carolina →