JMIR Publications

ABSTRACT

Background:

Social media has disseminated information and spread misinformation in the COVID-19 pandemic that affected prevention measures including social distancing and vaccine acceptance.

Objective:

In this study, we aimed to test the effect of social media messaging promoting COVID-19 NPIs and vaccine intentions and compare effects among three common types of information sources – government, near-peers, and news media.

Methods:

A sample of mothers of teen daughters (n=303) recruited from a prior trial were enrolled in a 3 (information source) x 4 (assessment period) randomized factorial trial from January to March 2021 to evaluate effects of information sources in a social media campaign addressing non-pharmaceutical interventions (i.e., social distancing), COVID-19 vaccinations, media literacy, and mother-daughter communication about COVID-19. Mothers received one post per day in a social media feed in three randomly-assigned Facebook private groups, Monday through Friday, covering all four topics each week, plus one additional post on a positive non-pandemic topic to promote engagement. Posts in the three groups had the same messages but differed by links to information from government agencies, near-peer parents, or news media in the post. Mothers reported on social distancing behavior and COVID-19 vaccine intentions for self and daughter, theoretic mediators, and covariates in baseline and 3-, 6-, and 9-weeks post-randomization assessments. Views, reactions, and comments related to each post were counted to measure engagement with the feed.

Results:

Nearly all mothers (98.3%) remained in the Facebook private groups throughout the 9-week trial period and follow-up rates were high (91.1%, completed 3-week posttest, 90.0%, 6-week posttest, and 90.7%, 9-week posttest; 80.5% completed all assessments). In intent-to-treat analyses, social distancing behavior by mothers (b=-0.10, 95% CI: -0.12, -0.08, p<.001) and daughters (b=-0.10, 95% CI: -0.18, -0.03, p<.001) decreased over time but vaccine intentions increased (mother b=0.34, 95% CI: 0.19, 0.49, p<.001; daughter b=0.17, 95% CI: 0.04, 0.29, p=.009). Decrease in social distancing by daughters was greater in the near-peer source group (b=-0.04, 95% CI: -0.07, 0.00, p=.030) and lesser in the government source group (b=0.05, 95% CI: 0.02, 0.09, p=.003). Higher perceived credibility of assigned information source increased social distancing (mother b=0.29, 95% CI: 0.09, 0.49, p<.01; daughter b=0.31, 95% CI: 0.11, 0.51, p<.01) and vaccine intentions (mother b=4.18, 95% CI: 1.83, 6.53, p<.001; daughter b=3.36, 95% CI: 1.67, 5.04, p<.001). Mothers’ intentions to vaccinate self may have increased when they considered near-peer source to be not credible (b=-0.50, 95% CI: -0.99, -0.01, p=.05).

Conclusions:

Decreasing case counts, relaxation of government restrictions, and vaccine distribution during the study may explain the decreased social distancing and increased vaccine intentions. Campaign planners may be more effective when selecting information sources that audiences consider credible when promoting COVID-19 prevention as no source was more credible in general. Clinical Trial: The ClinicalTrials.gov registration number is NCT02835807.