Parental Health Decision-making for Children During the COVID-19 Pandemic

The University of Hong Kong (HKU)

Status: Completed

Conditions: Coping Skills; Stress

Treatments: Behavioral: Neutral recall message; Behavioral: Positive imagination stimulation

Study type: Interventional

Funder types: Other

Identifiers

NCT05298865

20220113pavdm

Details and patient eligibility

About

Background: As major decision-maker for children's wellbeing, parents play a vital role in decisiding on a wide range of health-related issues including vaccination. Such decision-making process will be complicated by a great amount of psychosocial stressors emerging from the current pandemic. Stress can lead to various decision-making biases for children vaccination and subsequently lead to low vaccination intention amongst parents, which may hinder the progress for reaching herd immunity and end the COVID-19 pandemic. Effective risk communication intervention thus is in urgent need to address stress-induced decision-making biases for an upcoming COVID-19 vaccine for young children.

Aims: This study will investigate the interrelationships among parental perceived stress, and interpretive bias toward negative vaccine-related stimuli and and vaccination intention. In addition, this study will also conduct a survey experiment to develop positive affect-based messages and test its effect on correcting stress-induced biases in vaccination decision making among parents with high mental stress level.

Design and subjects: We aim to recruit parents aged 18 years or above with at least one child in our study. Participants will be recruited from our previous study through WhatsApp. Participants will be invited to read a list of vaccine-related news headlines with a mixture of positive and negative sentiments first. Then they will be asked to complete a series of assessment on their vaccination decision-making and intention. In the next phase, a survey-based experiment will be embedded in the online questionnaire to test the effect of risk communication interventions. Intervention messages will be designed based on previous qualitative study and literatures on positive psychology to simulate parents' positive mental images of COVID-19 vaccination consequences by using positive-affect visual stimuli.

Main outcome measures and analysis: Participants will be invited to complete a series of assessments through online questionnaire to assess their mental stress level, negative interpretive bias on processing ambiguous vaccine information and behavioural intention for vaccinating children.

Paired t-test will be used to determine negative interpretive bias between high-stress vs. low-stress parents. Structural equation modelling (SEM) will be performed to test the relationships among parental mental stress level, affect-driven decision-making constructs and vaccination intention for children. For the survey-based experiment, the effect of positive-affect messages intervention on tendency of correcting decision-making biases and COVID-19 vaccine uptake for children will be evaluated using logistic regression model with perceived stress level and intervention as the main between-group factors.

Enrollment: 843 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Has at least one child aged below 12 years old;
• Hong Kong resident；
• Able to communicate in Cantonese, Mandarin or English;
• Capable of completing online questionnaire via WhatsApp.

Exclusion criteria

• Subjects with cognitive and linguistic difficulties prohibiting completing the interview will be excluded.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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843 participants in 2 patient groups, including a placebo group

Neutral recall message

Placebo Comparator group

Description:

Control group will receive a set of messages guiding them to recall neutral life senarios/objects. The messages will contain eight brief paragraphs of neutral text and icon-based pictures to guide participants to recall their life senarios. The text message will include yesterday's meals, yesterday's wearing, home environment and nearby locations. This control condition equated attention and time on task but expect not to induce any emotions in participants.

Treatment:

Behavioral: Neutral recall message

Positive imagination stimulation

Experimental group

Description:

Positive-affect-priming group (PA) will receive a set of messages guiding participants to imagine positive future life senarios. Prior receiving the PA messages, a brief instruction will also be provided to guide participants to imagine concrete and personal images while browsing the following messages. The PA messages will contain eight pictures representing the life senarios and accompanying with short text to guide participants' imagination. Each senario will contain two pictures, one is used to familiarized participants with the context that they are going to imagine (i.e. imagine one of your best friends); the second one provides richer information to stimulate participants' concrete imagination (i.e. imagine you share a good news with your friend). These intervention messsages aim to intentionally manipulate participants' feelings arousal and mental representation for positive future life.

Treatment:

Behavioral: Positive imagination stimulation