Trust in public health institutions moderates the effectiveness of COVID-19 vaccine discussion groups on Facebook

ABSTRACT

Background

Distrust and partisan identity are theorized to undermine health communications. We examined the role of these factors on the efficacy of discussion groups intended to promote vaccine uptake.

Method

We analyzed survey data from unvaccinated Facebook users (N = 371) living in the US between January and April 2022. Participants were randomly assigned to Facebook discussion groups (intervention) or referred to Facebook’s COVID-19 Information Center (control). We used Analysis of Covariance to test if the intervention was more effective at changing vaccination intentions and beliefs compared to the control in subgroups based on participants’ partisan identity, political views, and information trust views.

Results

We found a significant interaction between the intervention and trust in public health institutions (PHIs) for improving intentions to vaccinate (P = .04), intentions to encourage others to vaccinate (P = .03), and vaccine confidence beliefs (P = .01). Among participants who trusted PHIs, those in the intervention had higher posttest intentions to vaccinate (P = .008) and intentions to encourage others to vaccinate (P = .002) compared to the control. Among non-conservatives, participants in the intervention had higher posttest intentions to vaccinate (P = .048). The intervention was more effective at improving intentions to encourage others to vaccinate within the subgroups of Republicans (P = .03), conservatives (P = .02), and participants who distrusted government (P = .02).

Conclusions

Facebook discussion groups were more effective for people who trusted PHIs and non-conservatives. Health communicators may need to segment health messaging and develop strategies around trust views.

KEYWORDS:

• COVID-19
• vaccination
• hesitancy
• social media
• Facebook

Ethics approvals

Institutional Review Board approvals were obtained from George Washington University (January 24, 2022, Ref. n. FWA00005945).

Conflicts of interest

LA receives royalties for the sale of Text2Quit. DAB has received consulting fees from Merck & Co. for participating in the 2021 Merck Global Vaccine Confidence Expert Input Forum, and has received a speaking honorarium from the United Nations Shot@Life Foundation.

Authors contribution

DAB and LA designed the study, obtained grant funding and oversaw project administration. DK, MN, SS contributed to study design and methodology. DK, DAB, and LA analyzed the data and wrote the draft manuscript. All authors reviewed the manuscript and confirm the approval of the submitted manuscript.

Data availability

Data are available upon reasonable request.

Notes

1 An earlier version of this manuscript was published in the GWU Proquest dissertation library prior to being-peer reviewed [49].

Additional information

Funding

This work was supported in part by the Vaccine Confidence Fund, by the John S. and James L. Knight Foundation to the GW Institute for Data, Democracy, and Politics, and by the NIST-NSF Institute for Trustworthy AI in Law and Societyunder NSF [grant number #222985].

Notes on contributors

Donald Koban

Donald Koban, PhD is an Assistant Professor in the Department of Systems Engineering at the United States Military Academy. At the time of this study, Dr. Koban was a PhD candidate in the Department of Engineering Management and Systems Engineering within the School of Engineering and Applied Science at The George Washington University.

Lorien C. Abroms

Lorien C. Abroms, PhD is a professor in the Department of Prevention and Community Health within the Milken Institute School of Public Health at the George Washington University. Dr. Abroms' research focuses on the application of digital communication technologies for health promotion, including for smoking cessation and vaccine uptake.

Melissa Napolitano

Melissa Napolitano, PhD is a Professor in the Departments of Prevention and Community Health & Exercise and Nutrition Sciences within the Milken Institute School of Public Health at The George Washington University. Dr. Napolitano applies behavioral science principles and communication techniques to develop, implement and evaluate physical activity and weight management programs for delivery via digital strategies.

Samuel Simmens

Sam Simmens, PhD is a retired Professor of Biostatistics and Bioinformatics and currently an internal consulting biostatistician at the Milken Institute School of Public Health at the George Washington University.

David A. Broniatowski

David A. Broniatowski, PhD is an Associate Professor in the Department of Engineering Management and Systems Engineering within the School of Engineering and Applied Science at The George Washington University. Dr. Broniatowski conducts research in decision making under risk, group decision making, the design and analysis of complex systems, and behavioral epidemiology.