The main purpose of this trial was to evaluate the impact of user interface designs on intervening with cancer misinformation on social media. The investigators conducted a randomized clinical trial with a sample of 294 US adults (ages 18-65) who previously had a cancer diagnosis or were a cancer caregiver. This registration record only covers the 5 timepoint trial under the same IRB number.
This 5 timepoint trial aimed to determine whether user interface designs encouraged intervening and reduced sharing of cancer misinformation on social media. The investigators enrolled 294 adults, ages 18-65, who had received a cancer diagnosis or were a cancer caregiver. Participants completed 5 online surveys, space approximately 2 business days apart. In the first survey, participant were randomized to 1 of 3 trial arms, described below. During each online survey, participants interacted with a simulated social media platform, branded as Invibe. Participants had passive exposure to stimuli cancer misinformation posts and cancer support posts in social media feeds. Participants also had forced exposure to stimuli posts in the online survey after interacting with Invibe. The investigators recorded social media behavior on Invibe and assessed self-reported measures in the online survey. This study was preregister on AsPredicted.com on March 24, 2025, prior to data collection and data analysis (https://aspredicted.org/te3su2.pdf).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
294
Cancer misinformation posts are shown with a prompt above the post caption that read, "This post has been flagged as false and potentially harmful by \[47 or 48\] people on Invibe. If you want to report, click the flag below." The social media launch screen had an overlaid policy for removing flagged posts: "We are committed to working with you and others on Invibe to reduce false and potentially harmful information. When a post is flagged by 50 people, we remove it until we verify the information. Please help us make the Invibe experience a good one for all."
Cancer misinformation posts are shown with a prompt above the post caption that read, "This post has been flagged as false and potentially harmful. If you want to report, click the flag below."
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
Flagging
Measured with intervening behavior, defined as the flag icon selected. Response options were no (coded as 0) or yes (coded as 1). Assessed 15 times. Assessed for 2 cancer misinformation posts and 1 cancer support post at each timepoint approximately 2 business days apart, starting on the day of enrollment.
Time frame: Up to 2 weeks
Willingness to flag
Measured with 1 self-reported survey item: "How willing are you to flag this post?" Responses ranged from "not at all" (coded as 1) to "extremely" (5). Assessed 15 times. Assessed for 2 cancer misinformation posts and 1 cancer support post at each timepoint approximately 2 business days apart, starting on the day of enrollment.
Time frame: Up to 2 weeks
Disliking
Measured with intervening behavior, defined as the thumbs down icon selected. Response options were no (coded as 0) or yes (coded as 1). Assessed 15 times. Assessed for 2 cancer misinformation posts and 1 cancer support post at each timepoint approximately 2 business days apart, starting on the day of enrollment.
Time frame: Up to 2 weeks
Liking
Measured with intervening behavior, defined as the heart icon selected. Response options were no (coded as 0) or yes (coded as 1). Assessed 15 times. Assessed for 2 cancer misinformation posts and 1 cancer support post at each timepoint approximately 2 business days apart, starting on the day of enrollment.
Time frame: Up to 2 weeks
Willingness to dislike
Measured with 1 self-reported survey item: "How willing are you to dislike (thumbs down) this post?" Responses ranged from "not at all" (coded as 1) to "extremely" (5). Assessed 15 times. Assessed for 2 cancer misinformation posts and 1 cancer support post at each timepoint approximately 2 business days apart, starting on the day of enrollment.
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Time frame: Up to 2 weeks
Willingness to like
Measured with 1 self-reported survey item: "How willing are you to like (heart) this post?" Responses ranged from "not at all" (coded as 1) to "extremely" (5). Assessed 15 times. Assessed for 2 cancer misinformation posts and 1 cancer support post at each timepoint approximately 2 business days apart, starting on the day of enrollment.
Time frame: Up to 2 weeks
Willingness to comment
Measured with 1 self-reported survey item: "How willing are you to comment on this post?" Responses ranged from "not at all" (coded as 1) to "extremely" (5). Assessed 15 times. Assessed for 2 cancer misinformation posts and 1 cancer support post at each timepoint approximately 2 business days apart, starting on the day of enrollment.
Time frame: Up to 2 weeks
Willingness to share
Measured with 1 self-reported survey item: "How likely are you to share or tell someone about this post?" Responses ranged from "not at all" (coded as 1) to "extremely" (5). Assessed 15 times. Assessed for 2 cancer misinformation posts and 1 cancer support post at each timepoint approximately 2 business days apart, starting on the day of enrollment.
Time frame: Up to 2 weeks
Comment valence
Measured with 1 self-reported survey item: "What type of comment would you write on this post?" Response options were "comment to agree" (share), "comment to disagree" (intervene), "other," or "I would not comment." Assessed 15 times. Assessed for 2 cancer misinformation posts and 1 cancer support post at each timepoint approximately 2 business days apart, starting on the day of enrollment.
Time frame: Up to 2 weeks
Sharing recipient
Measured with 1 self-report survey item: "Who would you share about this post with?" Response options were "someone with cancer," "someone who is a cancer caregiver," "health-care provider," "other," or "no one." Assessed 6 times. Assessed for 2 cancer misinformation posts and 1 cancer support post at first timepoint and last timepoint approximately 2 weeks apart.
Time frame: Up to 2 weeks
Sharing channel
Measured with 1 self-report survey item: "How would you share about this post?" Response options were "private message on social media," "text message," "in person," "repost on your social media," "other," and "none of these ways." Assessed 6 times. Assessed for 2 cancer misinformation posts and 1 cancer support post at timepoint 1 and timepoint 5 approximately 2 weeks apart.
Time frame: Up to 2 weeks
Past week intervening behavior
Measured with 1 self-reported survey item: "In the last 7 days, did you take action against false and potentially harmful cancer posts from social media? Select all that apply." Response options included muted accounts, flagged posts, disliked posts, commented to correct posts, chatted with others to disagree with posts information, encouraged someone to flag or report a posts, other or did not do anything. Assessed 1 time. Assessed at timepoint 4 approximately a week after the day of enrollment
Time frame: Up to 2 weeks
Past week intervening platform
Measured with 1 self-reported survey item per reported interpersonal intervening behavior: "Who did you \[intervening behavior\]? Select all that apply." Response options were "someone with cancer," "someone who is a cancer caregiver," "health-care provider," "other," or "no one." Assessed up to 2 times. Assessed at timepoint 4 approximately a week after the day of enrollment.
Time frame: Up to 2 weeks
Past week intervening topic
Measured with 1 self-reported survey item per reported intervening behavior: "What was the \[source for intervening\] about? Select all that apply." Response options were "to adopt a new mindset," "diet and nutrition advice," "physical activity advice," "advice to stop clinical care," "to seek treatment outside the US," or "other." Assessed up to 6 times. Assessed at timepoint 4 approximately a week after the day of enrollment.
Time frame: Up to 2 weeks