Periodic Reporting for period 1 - JITSUVAX (JIU-JITSU WITH MISINFORMATION IN THE AGE OF COVID: USING REFUTATION-BASED LEARNING TO ENHANCE VACCINE UPTAKE AND KNOWLEDGE AMONG HEALTHCARE PROFESSIONALS AND THE PUBLIC)
Période du rapport: 2021-04-01 au 2022-09-30
Despite the unquestionable success of immunisation in reducing and eliminating infectious diseases, scepticism about vaccine efficacy and safety remains a universal problem. The WHO has attributed this scepticism to misinformation, spread mainly on the internet. Misinformation comes from a variety of sources and may be disseminated for a variety of reasons: the common factor is that it is false and can be debunked. By training health care professionals (HCPs) how to debunk misinformation effectively, and enabling them to communicate more constructively with patients, the JITSUVAX project aspires to contribute to the increase of public confidence in immunisation.
JITSUVAX is coordinated by the University of Bristol, with five other teams around the EU and a group in Canada. Teams are based at the University of Cambridge, Turun yliopisto in Finland, L'Observatoire Régional de la Santé in France, the University of Erfurt in Germany, Universidade de Coimbra in Portugal, and Université de Sherbrooke in Canada.
In line with a “Jiu Jitsu model of persuasion”, described by Hornsey and Fielding in 2017, the JITSUVAX project uses Jiu Jitsu as its explanatory analogy. Jiu Jitsu is a martial art that teaches you not to go toe-to-toe with your opponent's strength, but to understand it and leverage it to your advantage. JITSUVAX therefore explores ways of working with people’s motivations and attitudes rather than fighting them.
JITSUVAX is coordinated by the University of Bristol, with five other teams around the EU and a group in Canada. Teams are based at the University of Cambridge, Turun yliopisto in Finland, L'Observatoire Régional de la Santé in France, the University of Erfurt in Germany, Universidade de Coimbra in Portugal, and Université de Sherbrooke in Canada.
In line with a “Jiu Jitsu model of persuasion”, described by Hornsey and Fielding in 2017, the JITSUVAX project uses Jiu Jitsu as its explanatory analogy. Jiu Jitsu is a martial art that teaches you not to go toe-to-toe with your opponent's strength, but to understand it and leverage it to your advantage. JITSUVAX therefore explores ways of working with people’s motivations and attitudes rather than fighting them.
During the first period (18 months), JITSUVAX pursued three subgoals that are crucial to achieving the project’s overarching objective: (1) Understanding vaccine hesitancy among HCPs, (2) Identifying attitudinal roots of believing in vaccination misinformation and (3) Designing and testing promising interventions.
1) Understanding vaccine hesitancy among HCPs.
HCPs can have doubts about vaccines and their safety, and this can affect how they discuss and recommend these vaccines to their patients. To measure these doubts and underlying contributing factors, partners from France and Canada created a tool, known as the Pro-VC-Be (Health Professionals Vaccine Confidence and Behaviors), to ask professionals about their confidence in vaccines, perceptions of vaccine risks, the usefulness of vaccines, and various other issues.
This tool was adapted and validated in several European countries to provide a common, international measurement for vaccine confidence in HCPs. A short-version of the original Pro-VC-Be has also been shown to accurately predict vaccination behaviours, providing a more time- and cost-effective tool for busy HCPs. After validation, this tool was used to measure vaccine hesitancy using cross-national surveys among HCPs (N=2,800) in five European countries (United Kingdom, Finland, France, Germany, Portugal).
2) Identifying attitudinal roots of believing in vaccination misinformation
The spread of vaccine misinformation is a threat to the success of many immunisation programmes. Effectively rebutting such misinformation requires an approach that goes beyond addressing flaws in the arguments, by also considering the attitudinal roots (the underlying psychological attributes driving a person’s belief) of opposition to vaccines. The JITSUVAX groups have developed a psychologically informed classification of arguments expressing opposition toward vaccines to guide the training materials and investigations to be developed during the following periods of the JITSUVAX project. This taxonomy encompasses 11 well-established psychological traits or “attitude roots”, such as fear and phobias, worldview and politics, and religious concerns, which motivate the endorsement of 62 thematic groups of anti-vaccination arguments.
The taxonomy has been validated through a systematic review of 152 scientific articles and the design of a computational linguistic model capable of predicting the attitude roots of a given anti-vaccination argument. Rebuttals that follow the Jiu Jitsu approach were designed for all 62 thematic groups of anti-vaccination arguments and are available at an online learning resource: www.jitsuvax.info
3) Designing and testing promising interventions
HCPs are in an excellent position to speak with patients about their vaccination decisions. Training HCPs to refute misleading anti-vaccination arguments that patients may raise can help increase their confidence in having such conversations. The JITSUVAX groups designed an “empathetic refutational interview technique” (see figure) that is reflected in the online learning resource https://jitsuvax.info/ . The technique involves first affirming the patient’s underlying attitude root and then refuting common misconceptions. This technique was successfully tested in a series of psychological experiments among vaccine-hesitant individuals. Field tests of the new technique will be conducted during the second project period.
Furthermore, members of JITSUVAX designed a 10-minute online game that seeks to improve people’s ability to recognise manipulation strategies commonly used in vaccine misinformation. JITSUVAX has completed three randomised controlled studies to test whether playing the game improves people’s recognition of manipulation strategies in vaccine-related social media content. The game was then adapted to include the anti-vaccination arguments that were shown to be difficult for HCPs to tackle, and that were based on the most prominent "attitude roots" from the taxonomy. This new adapted game specifically aims to help HCPs in identifying attitude roots and enabling them to communicate more constructively with patients. The game will be tested in experiments and made publicly available in the second period of JITSUVAX.
1) Understanding vaccine hesitancy among HCPs.
HCPs can have doubts about vaccines and their safety, and this can affect how they discuss and recommend these vaccines to their patients. To measure these doubts and underlying contributing factors, partners from France and Canada created a tool, known as the Pro-VC-Be (Health Professionals Vaccine Confidence and Behaviors), to ask professionals about their confidence in vaccines, perceptions of vaccine risks, the usefulness of vaccines, and various other issues.
This tool was adapted and validated in several European countries to provide a common, international measurement for vaccine confidence in HCPs. A short-version of the original Pro-VC-Be has also been shown to accurately predict vaccination behaviours, providing a more time- and cost-effective tool for busy HCPs. After validation, this tool was used to measure vaccine hesitancy using cross-national surveys among HCPs (N=2,800) in five European countries (United Kingdom, Finland, France, Germany, Portugal).
2) Identifying attitudinal roots of believing in vaccination misinformation
The spread of vaccine misinformation is a threat to the success of many immunisation programmes. Effectively rebutting such misinformation requires an approach that goes beyond addressing flaws in the arguments, by also considering the attitudinal roots (the underlying psychological attributes driving a person’s belief) of opposition to vaccines. The JITSUVAX groups have developed a psychologically informed classification of arguments expressing opposition toward vaccines to guide the training materials and investigations to be developed during the following periods of the JITSUVAX project. This taxonomy encompasses 11 well-established psychological traits or “attitude roots”, such as fear and phobias, worldview and politics, and religious concerns, which motivate the endorsement of 62 thematic groups of anti-vaccination arguments.
The taxonomy has been validated through a systematic review of 152 scientific articles and the design of a computational linguistic model capable of predicting the attitude roots of a given anti-vaccination argument. Rebuttals that follow the Jiu Jitsu approach were designed for all 62 thematic groups of anti-vaccination arguments and are available at an online learning resource: www.jitsuvax.info
3) Designing and testing promising interventions
HCPs are in an excellent position to speak with patients about their vaccination decisions. Training HCPs to refute misleading anti-vaccination arguments that patients may raise can help increase their confidence in having such conversations. The JITSUVAX groups designed an “empathetic refutational interview technique” (see figure) that is reflected in the online learning resource https://jitsuvax.info/ . The technique involves first affirming the patient’s underlying attitude root and then refuting common misconceptions. This technique was successfully tested in a series of psychological experiments among vaccine-hesitant individuals. Field tests of the new technique will be conducted during the second project period.
Furthermore, members of JITSUVAX designed a 10-minute online game that seeks to improve people’s ability to recognise manipulation strategies commonly used in vaccine misinformation. JITSUVAX has completed three randomised controlled studies to test whether playing the game improves people’s recognition of manipulation strategies in vaccine-related social media content. The game was then adapted to include the anti-vaccination arguments that were shown to be difficult for HCPs to tackle, and that were based on the most prominent "attitude roots" from the taxonomy. This new adapted game specifically aims to help HCPs in identifying attitude roots and enabling them to communicate more constructively with patients. The game will be tested in experiments and made publicly available in the second period of JITSUVAX.
The Horizon call expects projects (1) to contribute to increasing vaccine coverage in Europe, in particular in specific populations with low vaccine uptake and in specific contexts (e.g. uptake among HCPs); (2) to develop practical and readily implementable guidelines to aid public health authorities to increase vaccination rates.
To achieve these goals, JITSUVAX helps health professionals effectively counter misinformation and communicate constructively with patients. Thereby, JITSUVAX strives to make a difference through the development, evaluation, and dissemination of evidence-based tools to counter vaccination misinformation. JITSUVAX has begun to develop and field-test new tools to increase vaccine uptake across a broad range of cultural contexts, with emphasis on the important role of HCPs.
The JITSUVAX team is already disseminating the findings through numerous channels. During the first period, the JITSUVAX team has published over 10 articles in peer-reviewed journals such as Nature Reviews Psychology and Expert Review of Vaccines. Team members have given over 60 scientific talks at various psychological and medical conferences, expert panels, NGO meetings, and workshops. Moreover, members of JITSUVAX published or were mentioned in over 60 non-scientific articles and conducted over 15 TV/radio appearances. An entire work package (for 2024) is dedicated to impact and dissemination of the results to inform HCP practices in the future.
To achieve these goals, JITSUVAX helps health professionals effectively counter misinformation and communicate constructively with patients. Thereby, JITSUVAX strives to make a difference through the development, evaluation, and dissemination of evidence-based tools to counter vaccination misinformation. JITSUVAX has begun to develop and field-test new tools to increase vaccine uptake across a broad range of cultural contexts, with emphasis on the important role of HCPs.
The JITSUVAX team is already disseminating the findings through numerous channels. During the first period, the JITSUVAX team has published over 10 articles in peer-reviewed journals such as Nature Reviews Psychology and Expert Review of Vaccines. Team members have given over 60 scientific talks at various psychological and medical conferences, expert panels, NGO meetings, and workshops. Moreover, members of JITSUVAX published or were mentioned in over 60 non-scientific articles and conducted over 15 TV/radio appearances. An entire work package (for 2024) is dedicated to impact and dissemination of the results to inform HCP practices in the future.