Influencing Canadian young adults to receive additional COVID-19 vaccination shots: the efficacy of brief video interventions focusing on altruism and individualism

Abstract

Younger adults, aged 18-39 years, exhibit low COVID-19 additional vaccine (i.e., vaccination beyond the original 2-dose series) uptake recommended in Canada. No study has examined how altruistic and individualistic messaging can influence COVID-19 additional dose intentions. The present study aimed to estimate the efficacy of altruism and individualism-based videos on vaccine intentions and to explore the multivariable associations between vaccine related individual psychosocial factors and intention to receive the COVID-19 vaccine. Using a web-based survey in a three-arm, pre-post randomized control trial design, we recruited Canadians aged 18-39 years in both English and French. Participants were randomly allocated in a 1:1:1 ratio to receive the active control (COVID-19 general information), control + altruism or control + altruism + individualism. The video interventions were developed with a media company, based on results of a focus group study conducted previously. The measurement of COVID-19 additional dosage intentions before and after completing the interventions was informed by the multistage Precaution Adoption Process Model. The McNemar Chi-square was used to evaluate within-group changes, and the Pearson Chi-square test was used to evaluate between-group changes post-intervention. The measurement of various psychosocial factors was informed by use of validated scale and self-report questions. We employed a generalized Structural Equation Model to evaluate the associations between COVID-19 vaccine intentions and the psychosocial factors. Analyses were performed on 3,431 participants (control: n = 1,149, control + altruism: n = 1,142, control + altruism + individualism: n = 1,140). Within-group results showed that participants transitioned significantly in all three groups in the direction of higher intentions for receiving additional COVID-19 vaccine doses. The between-group differences in post intervention vaccine intentions were not significant. We found that psychosocial factors that include, collectivism, intellectual humility, intolerance to uncertainty, religiosity, identifying as gender diverse, and being indigenous were associated with higher vaccine intentions, whereas pandemic fatigue was associated with lower vaccine intentions. Our study highlighted that a short video that includes altruism and individualism messaging or general COVID-19 information can increase intentions to vaccine among young adults. Furthermore, we gained a comprehensive understanding of various psychosocial factors that influence ongoing COVID-19 vaccination. Our findings can be used to influence public health messaging around COVID-19 vaccination.

Keywords: COVID-19; altruism; individualism; mRNA vaccines; randomized controlled trials; vaccine intentions; video intervention; young adults.

Figure 1

Samples from each video intervention group. Reprinted with permission from “COVID-19 Booster Video Control EN” (Informational Video (Group 1)), “COVID-19 Booster Video Control + Alt EN” (Altruism Video (Group 2)), “COVID-19 Booster Video Control + Alt + Ind EN” (Individualism Video (Group 3)) by Akufen licensed under Individual License.

Figure 2

CONSORT diagram. CONSORT, Consolidated Standards of Reporting Trials; PAPM, Precaution Adoption Process Model.

Figure 3

Significant transitions pre-to-post intervention Group 1 (control).

Figure 4

Significant transitions pre-to-post intervention Group 2 (control + altruism).

Figure 5

Significant transitions pre-to-post intervention Group 2 (control + altruism + individualism).

Figure 6

General Structural Equation Model demonstrating factors associated with vaccine intentions.