{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:02:51Z","timestamp":1779951771596,"version":"3.53.1"},"reference-count":68,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Vaccine misinformation can undermine vaccine confidence, institutional trust, and uptake. Arabic speakers in Australia are disproportionately susceptible to vaccine misinformation and have experienced adverse health outcomes. This randomized controlled trial tested the effectiveness of\n                      <jats:italic>Cranky Uncle \u2013 Vaccine (Arabic)<\/jats:italic>\n                      , a gamified psychological inoculation intervention, in improving vaccine attitudes, misinformation discernment, and institutional trust among Arabic-speaking Australians.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Participants (\n                      <jats:italic>N\u202f=<\/jats:italic>\n                      \u202f198) were randomized 1:1 to either the intervention (game) or control (educational climate change video). Outcomes were assessed immediately and 3 weeks post-activity using a combination of validated and custom instruments: (1) the Vaccine Trust Indicator (VTI); (2) a misinformation discernment scale developed by the research team, and (3) items from the Institutional Trust subscale. Analyses were conducted using multiple imputation and adjusted linear regression models. The trial protocol was registered in the Australian and New Zealand Clinical Trials Registry (registration number: ACTRN12624000934549p).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No statistically significant differences were found between the intervention and control groups at either timepoint across primary or secondary outcomes, and no subgroup effects were observed by age or education.\n                      <jats:italic>Post-hoc<\/jats:italic>\n                      item analyses found that items assessing trust in scientists and trust in pharmaceutical companies demonstrated the greatest difference between groups at the immediate post-activity timepoint.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>\n                      This trial is the first RCT of the\n                      <jats:italic>Cranky Uncle \u2013 Vaccine<\/jats:italic>\n                      game. Findings highlight methodological and measurement challenges in misinformation research. Developing and validating standardized measures that are appropriately sensitive to detect meaningful changes should be an urgent priority for the field. Future evaluation of the\n                      <jats:italic>Cranky Uncle<\/jats:italic>\n                      intervention for different populations could consider testing delivery in structured educational group settings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1768612","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:18:39Z","timestamp":1779949119000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of an online vaccine misinformation game for Arabic-speaking Australians: a randomized controlled trial"],"prefix":"10.3389","volume":"14","author":[{"given":"Sophie","family":"Vasiliadis","sequence":"first","affiliation":[{"name":"Murdoch Children\u2019s Research Institute","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Cook","sequence":"additional","affiliation":[{"name":"Melbourne School of Psychological Sciences, The University of Melbourne","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kifarkis","family":"Nissan","sequence":"additional","affiliation":[{"name":"Foundation House","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanna","family":"Vidmar","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute","place":["Melbourne, VIC, Australia"]},{"name":"Department of Paediatrics, The University of Melbourne","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneke C.","family":"Grobler","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute","place":["Melbourne, VIC, Australia"]},{"name":"Department of Paediatrics, The University of Melbourne","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Cook","sequence":"additional","affiliation":[{"name":"Wendy Cook Design","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Sabin Vaccine Institute","place":["Washington, DC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsey","family":"Lepage","sequence":"additional","affiliation":[{"name":"Irimi Company","place":["Lyon, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angus","family":"Thomson","sequence":"additional","affiliation":[{"name":"Irimi Company","place":["Lyon, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margie","family":"Danchin","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute","place":["Melbourne, VIC, Australia"]},{"name":"Department of Paediatrics, The University of Melbourne","place":["Melbourne, VIC, Australia"]},{"name":"The Royal Children\u2019s Hospital Melbourne","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute","place":["Melbourne, VIC, Australia"]},{"name":"Department of Paediatrics, The University of Melbourne","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref1","volume-title":"Vaccines for Biodefense and Emerging and Neglected 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