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Contagious Misinformation Trial (CMT)

Primary Purpose

Misinformation

Status
Completed
Phase
Not Applicable
Locations
Sierra Leone
Study Type
Interventional
Intervention
Debunking Misinformation through Audio Dramas
Control group audio jingles
Sponsored by
Karolinska Institutet
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Misinformation focused on measuring Misinformation, Communication, Infectious diseases

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Adults
  • Living in Freetown
  • In possession of a mobile phone that has WhatsApp
  • Fluent in Krio

Exclusion Criteria:

  • Deafness

Sites / Locations

  • Focus1000

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Intervention group 1

Intervention group 2

Control group

Arm Description

Audio messages in this group are focussed on providing a Plausible Alternative to the misinformation

Audio messages in this group focus on Avoiding the Misinformation and instead only provide the correct information

Audio messages in this control group are on a different topic

Outcomes

Primary Outcome Measures

Change in the belief in misinformation
The change in the belief in misinformation will be measured through Yes/No questions in the baseline and follow-up surveys. Using logistic regression models, the prevalence of the belief in misinformation about 2 aspects of an infectious disease compared to the control group will be analysed using an intention-to-treat and per-protocol analysis

Secondary Outcome Measures

Inadvertent promotion of misinformation: the backfire effect
To test whether the interventions might inadvertently have promoted the belief in misinformation, the same yes/no questions as the primary outcome will be used in ordinal logistic regression models to analyse if the there has been a backfire effect in the intervention groups, compared to the control group.
As treated analysis of primary outcomes
The Yes/No questions of the primary outcomes will be tested in an as-treated analysis. The investigators will only include participants who can correctly recall the basic storylines of the audio messages.
Knowledge about preventive methods
Using an open question, asking the respondent to name up to 3 preventive methods, a score will be created. For every correct answer, the participants gets a point, and one point is subtracted for every wrong answer; leading to a potential score of -3 to +3. Ordinal logistic regression models will be fitted to compare the scores of the intervention groups with the control group.
Health-related discussions among family/friend
The question asking whether the participant has discussed the content of the audio messages will be used for this analysis, together with the question about how often the participant discussed health issues with family/friends. Logistic regression models will be fitted to test whether the interventions have influenced health-related discussions with family or friends, as compared to the control group.
Method of administration
To understand if the intervention works outside of WhatsApp, 60 additional people will be recruited who do not have WhatsApp. Participants will instead be called and listen to the audio dramas on the phone; 30 will listen to the audio drama of intervention group 1 and 30 will listen to the audio drama of intervention group 2. The two primary outcomes will be analysed similar to the primary outcome analysis (ITT and per protocol) among the 2 groups and compared to the control group, as well as to their equivalent group of respondents with WhatsApp.
Differences in self-efficacy
Participants will answer 3 questions about their perceived self-efficacy on 3 specific preventive behaviours. Answers are on a 5-item scale: from not at all true to exactly true. Ordinal logistic regression models will be specified to test whether the interventions had an influence on people's self-efficacy about three specific preventive behaviours, compared to the control group.
Risk perception & preventive methods
Risk perception about the infectious disease will be measured with a question that asks how likely it is that the participants gets the disease in the next year. A question which asks what kind of actions the participants has undertaken, or is planning to undertake, to prevent infection with the disease - will be used to assess if and what kind of actions are taken. Several analyses will be carried out to test whether the intervention influenced risk perception and preventive methods. Furthermore, analyses will be carried out to determine if the a change in risk perception influenced preventive methods.
Objective versus subjective learning
In the follow-up survey, there is a question asking if the participant feels like he/she learned from the audio messages (yes/no question). A Chi-Square analysis will be done to determine whether those who feel like they learned also learned objectively, using the two primary outcomes.

Full Information

First Posted
September 27, 2019
Last Updated
January 20, 2020
Sponsor
Karolinska Institutet
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1. Study Identification

Unique Protocol Identification Number
NCT04112680
Brief Title
Contagious Misinformation Trial
Acronym
CMT
Official Title
The Contagious Misinformation Trial: Debunking Prevalent Misinformation About an Infectious Disease Through Audio Dramas in Freetown, Sierra Leone
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
October 7, 2019 (Actual)
Primary Completion Date
December 21, 2019 (Actual)
Study Completion Date
December 21, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Karolinska Institutet

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
In the Contagious Misinformation Trial the investigators aim to debunk prevalent misinformation about an infectious disease using two evidence-based methods of debunking. The two debunking methods are packaged in two audio dramas of 4 episodes each, which will be sent to the WhatsApp of participants who are randomised to intervention group 1 or 2. The control group will receive audio messages about a different topic. The primary outcome is the reduction in belief in two misinformation statements about the infectious diseases.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Misinformation
Keywords
Misinformation, Communication, Infectious diseases

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Interventional study, with 3 arms (2 intervention groups, 1 control group) to test communication elements of audio dramas aiming to counter prevalent belief in misinformation about an infectious disease in Freetown, Sierra Leone
Masking
ParticipantInvestigatorOutcomes Assessor
Masking Description
Participant will not know the group they are assigned to, as all groups (also the control group) will receive audio messages. The investigator and outcomes assessors will only be handed an anonymised data set.
Allocation
Randomized
Enrollment
750 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Intervention group 1
Arm Type
Experimental
Arm Description
Audio messages in this group are focussed on providing a Plausible Alternative to the misinformation
Arm Title
Intervention group 2
Arm Type
Experimental
Arm Description
Audio messages in this group focus on Avoiding the Misinformation and instead only provide the correct information
Arm Title
Control group
Arm Type
Placebo Comparator
Arm Description
Audio messages in this control group are on a different topic
Intervention Type
Behavioral
Intervention Name(s)
Debunking Misinformation through Audio Dramas
Intervention Description
The audio dramas (one drama of 4 episodes per intervention group), aim to debunk misinformation about an infectious disease. The content of the two dramas differ in the two groups; in intervention group 1, the drama will state the misinformation and provide a plausible alternative, delivered through a trusted source, in line with world views. In intervention group 2, the audio drama will avoid mentioning the misinformation and instead only state the correct information about the infectious disease
Intervention Type
Behavioral
Intervention Name(s)
Control group audio jingles
Intervention Description
The control group will receive audio jingles about exclusive breastfeeding
Primary Outcome Measure Information:
Title
Change in the belief in misinformation
Description
The change in the belief in misinformation will be measured through Yes/No questions in the baseline and follow-up surveys. Using logistic regression models, the prevalence of the belief in misinformation about 2 aspects of an infectious disease compared to the control group will be analysed using an intention-to-treat and per-protocol analysis
Time Frame
Up to 2 months
Secondary Outcome Measure Information:
Title
Inadvertent promotion of misinformation: the backfire effect
Description
To test whether the interventions might inadvertently have promoted the belief in misinformation, the same yes/no questions as the primary outcome will be used in ordinal logistic regression models to analyse if the there has been a backfire effect in the intervention groups, compared to the control group.
Time Frame
Up to 2 months
Title
As treated analysis of primary outcomes
Description
The Yes/No questions of the primary outcomes will be tested in an as-treated analysis. The investigators will only include participants who can correctly recall the basic storylines of the audio messages.
Time Frame
Up to 2 months
Title
Knowledge about preventive methods
Description
Using an open question, asking the respondent to name up to 3 preventive methods, a score will be created. For every correct answer, the participants gets a point, and one point is subtracted for every wrong answer; leading to a potential score of -3 to +3. Ordinal logistic regression models will be fitted to compare the scores of the intervention groups with the control group.
Time Frame
Up to 2 months
Title
Health-related discussions among family/friend
Description
The question asking whether the participant has discussed the content of the audio messages will be used for this analysis, together with the question about how often the participant discussed health issues with family/friends. Logistic regression models will be fitted to test whether the interventions have influenced health-related discussions with family or friends, as compared to the control group.
Time Frame
Up to 2 months
Title
Method of administration
Description
To understand if the intervention works outside of WhatsApp, 60 additional people will be recruited who do not have WhatsApp. Participants will instead be called and listen to the audio dramas on the phone; 30 will listen to the audio drama of intervention group 1 and 30 will listen to the audio drama of intervention group 2. The two primary outcomes will be analysed similar to the primary outcome analysis (ITT and per protocol) among the 2 groups and compared to the control group, as well as to their equivalent group of respondents with WhatsApp.
Time Frame
Up to 2 months
Title
Differences in self-efficacy
Description
Participants will answer 3 questions about their perceived self-efficacy on 3 specific preventive behaviours. Answers are on a 5-item scale: from not at all true to exactly true. Ordinal logistic regression models will be specified to test whether the interventions had an influence on people's self-efficacy about three specific preventive behaviours, compared to the control group.
Time Frame
Up to 2 months
Title
Risk perception & preventive methods
Description
Risk perception about the infectious disease will be measured with a question that asks how likely it is that the participants gets the disease in the next year. A question which asks what kind of actions the participants has undertaken, or is planning to undertake, to prevent infection with the disease - will be used to assess if and what kind of actions are taken. Several analyses will be carried out to test whether the intervention influenced risk perception and preventive methods. Furthermore, analyses will be carried out to determine if the a change in risk perception influenced preventive methods.
Time Frame
Up to 2 months
Title
Objective versus subjective learning
Description
In the follow-up survey, there is a question asking if the participant feels like he/she learned from the audio messages (yes/no question). A Chi-Square analysis will be done to determine whether those who feel like they learned also learned objectively, using the two primary outcomes.
Time Frame
Up to 2 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adults Living in Freetown In possession of a mobile phone that has WhatsApp Fluent in Krio Exclusion Criteria: Deafness
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Helena Nordenstedt, MD PHD
Organizational Affiliation
Karolinska Institutet
Official's Role
Principal Investigator
Facility Information:
Facility Name
Focus1000
City
Freetown
State/Province
Western Area
Country
Sierra Leone

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
After publication of the primary analysis and study results, the anonymised data will be published in a public repository
IPD Sharing Time Frame
January 2022
Citations:
PubMed Identifier
34758970
Citation
Winters M, Oppenheim B, Sengeh P, Jalloh MB, Webber N, Pratt SA, Leigh B, Molsted-Alvesson H, Zeebari Z, Sundberg CJ, Jalloh MF, Nordenstedt H. Debunking highly prevalent health misinformation using audio dramas delivered by WhatsApp: evidence from a randomised controlled trial in Sierra Leone. BMJ Glob Health. 2021 Nov;6(11):e006954. doi: 10.1136/bmjgh-2021-006954.
Results Reference
derived

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Contagious Misinformation Trial

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