An interventional study of Gamified misinformation refutation quiz and Refutational text (active control) in COVID-19, Vaccine 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 misinformation contributed to vaccine hesitancy and preventable illness. This record covers three sequential randomized studies (conducted in Canada and the United States, November-December 2020) testing whether a brief online game helps adults identify COVID-19 and vaccine misinformation. In the game, participants judged whether statements about COVID-19 or 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. Study 1 (Canada, n = 2,018) randomized participants to complete the knowledge assessment either before playing the game or immediately after playing it. Studies 2 (U.S., n = 822) and 3 (U.S., n = 797) compared the game against the identical corrective content presented as plain text, for general COVID-19 misinformation and vaccine-specific misinformation, respectively. The hypothesis was that gamified corrective information produces more accurate knowledge than non-gamified information. The primary outcome was accuracy in identifying true and false claims; vaccination intention was a secondary outcome.
This protocol comprised three sequential randomized controlled studies evaluating digital educational interventions to counter COVID-19 misinformation, conducted under a single IRB approval (University of South Carolina, Pro00099400) with study specific amendments. The University of South Carolina Institutional Review Board determined the study to be exempt before participant enrollment. A fourth study in the research program, conducted under a separate IRB approval (Pro00122534), is registered separately. Study 1 enrolled a national non-probability online panel sample in Canada (Nanos Research); Study 2 enrolled a U.S. MTurk sample on general COVID-19 misinformation; Study 3 enrolled a U.S. MTurk sample on vaccine misinformation. This record registers the three completed trials retrospectively. All three trials used the same intervention platform: a true/false quiz over circulating misinformation items, each response followed immediately by item-level refutational feedback (correct answer plus brief evidence-based explanation) embedded in a gamified interface (points, ranks, response-contingent feedback).
Trial 1 (Canada, N = 2,018; non-probability online panel fielded by Nanos Research, December 4-14, 2020; general COVID-19 content, 6 items): both arms received identical quiz-and-game content; arms differed in timing of the knowledge assessment within the single session (in Control assessed before playing, in Game immediately after).
Trial 2 (United States, N = 822; Amazon Mechanical Turk, November-December 2020; general COVID-19 content, 19 items): Game versus active-text control receiving the identical refutational content as a static text.
Trial 3 (United States, N = 797; Amazon Mechanical Turk, November-December 2020; vaccine-specific content, 17 items): same two-arm design as Trial 2.
All trials were single session. Knowledge accuracy was the primary outcome; vaccination intention was secondary. Data quality exclusions were applied at analysis: item-level missingness on the knowledge scale (Trial 1) and duplicate/non-U.S. IP screening plus, in the Game arm, completion code validation (Trials 2 and 3).
7,990 studies on the registry are indexed under COVID-19; 466 are open to participants now.
This study's enrollment of 3,637 is above the median of 102 across 4,364 interventional studies indexed under COVID-19.
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Exclusion Criteria:
Completed the knowledge assessment before receiving the gamified refutation quiz (single session).
Behavioral: Gamified misinformation refutation quiz
Played the gamified refutation quiz using general COVID-19 items with immediate per-item feedback, followed by the post-intervention assessments.
Behavioral: Gamified misinformation refutation quiz
Judged all general COVID-19 items, then received all refutational content as a single static text block without game elements, confirmed reading the text, and then completed the post-intervention assessments.
Behavioral: Refutational text (active control)
Played the gamified refutation quiz using general COVID-19 items with immediate per-item feedback, followed by the post-intervention assessments.
Behavioral: Gamified misinformation refutation quiz
Judged all vaccine-specific items, then received all refutational content as a single static text block without game elements, confirmed reading the text, and then completed the post-intervention assessments.
Behavioral: Refutational text (active control)
Played the gamified refutation quiz using vaccine-specific items with immediate per-item feedback, followed by the post-intervention assessments.
Behavioral: Gamified misinformation refutation quiz
Single-session online game: participants judge true/false statements about COVID-19 (Trials 1-2) or COVID-19 vaccines (Trial 3) and immediately after each response receive the correct answer with a brief evidence-based refutation, within a gamified interface (points, ranks, feedback). 6-19 knowledge items depending on trial.
Identical evidence-based refutational content presented as a single static text block without game elements or item-level feedback. Participants confirmed reading the text before completing the post-intervention assessments.
Mean Knowledge Accuracy Score
Mean score across true/false misinformation items, ranging from 0 to 1, with higher scores indicating greater accuracy. Trial 1 included 6 items, Trial 2 included 19 items, and Trial 3 included 17 items. In Trials 1 and 2, "Unsure" responses received 0.5 points; Trial 3 used forced-choice true/false responses.
Time frame: Single session (Day 1). Assessed immediately post-intervention in all intervention and text-control arms; in Trial 1's assessment-first control arm, assessed at the start of the session before game exposure.
Vaccination Intention Score - Trial 1
Single self-report item scored from 1 to 4, with higher scores indicating greater intention to receive a COVID-19 vaccine. "Are you interested, somewhat interested, somewhat not interested or not interested in receiving a vaccine for COVID-19 when it is available in Canada?" \[Interested / Somewhat interested / Somewhat not interested / Not interested\]
Time frame: Immediately post-intervention (single session, Day 1); control arm assessed at session start before game exposure.
Vaccination Intention Score - Trial 2
Single self-report item scored from 1 to 4, with higher scores indicating greater intention to receive a COVID-19 vaccine. "How likely or unlikely are you to do the following actions in the future in response to the new coronavirus? - Receive a vaccine for COVID-19 when it is available in the US" \[Not at all / Unlikely / Likely / Certain\]
Time frame: Immediately post-intervention (single session, Day 1).
Vaccination Intention Score - Trial 3
Single self-report item scored from 1 to 6, with higher scores indicating greater intention to receive a COVID-19 vaccine. "How likely or unlikely are you to receive a COVID-19 vaccine when one becomes available to you?" \[Not at all likely / Very unlikely / Somewhat unlikely / Somewhat likely / Very likely / Extremely likely\]
Time frame: Baseline before randomization and immediately post-intervention during the single study session, Day 1.
Plan to share: Yes — Deidentified per-trial 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.
This study is completed, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.
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