Currently submitted to: JMIR Public Health and Surveillance
Date Submitted: Oct 24, 2025
Open Peer Review Period: Oct 24, 2025 - Dec 19, 2025
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Community Voices Matter: Experimental Evidence for the Effectiveness of Participatory COVID-19 Messaging
ABSTRACT
Background:
The COVID-19 pandemic highlighted the importance of public health communication while exposing its shortcomings, particularly among African American communities disproportionately affected by the virus. Traditional expert-driven communication campaigns often failed to resonate with this population due to pandemic fatigue, misinformation, and longstanding mistrust. Culturally grounded and co-created communication strategies are increasingly recognized as critical to improving the effectiveness of public health messaging. However, limited experimental evidence exists to evaluate whether community such messages outperform traditional expert-developed messages in promoting engagement and behavioral intent.
Objective:
This study aimed to evaluate the effectiveness of community co-created messages, developed through participatory design methods and supported by generative artificial intelligence tools, in promoting COVID-19 preventive behaviors among African American adults in North Carolina. Specifically, we sought to determine whether participatory messages outperformed standard public health messages in enhancing message credibility, emotional engagement, and behavioral intent.
Methods:
We employed a multi-phase crowdsourcing approach, including two open calls and a designathon, to develop a culturally grounded, community-driven video promoting COVID-19 prevention. A key innovation was the integration of generative AI tools enabling designers to translate ideas into digital outputs without requiring technical expertise. The community-driven video was compared with an expert-designed video widely circulated during the pandemic. African American adults (N = 546) recruited online were randomly assigned to view one of the two videos and then completed a survey assessing narrator relatability, youth versus adult appeal, motivation, attention, and perceived behavioral impact.
Results:
Regression analyses controlling for demographics indicated that participants rated the community-driven video as significantly more relatable, motivating, attention-grabbing, and behaviorally impactful than the expert-designed video. The community-driven video was also perceived as more appealing to youth, while the expert-designed video was seen as more appealing to adults. No significant differences emerged for message agreement or likelihood to recommend.
Conclusions:
Findings provide empirical evidence that community-driven communication can increase message appeal among African American audiences. Incorporating participatory design and creative co-production processes into public health campaigns may increase their resonance, strengthen trust, and improve equity in health communication. These results provide experimental support for embedding community perspectives at the center of message development in future public health initiatives.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.