A social norms approach intervention to address misperceptions of anti-vaccine conspiracy beliefs amongst UK parents

PLOS ONE RESEARCH ARTICLE A social norms approach intervention to address misperceptions of anti-vaccine conspiracy beliefs amongst UK parents Darel Cookson ID1, Daniel Jolley ID2, Robert C. Dempsey ID3*, Rachel Povey ID4 1 Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom, 2 Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom, 3 Department of Psychology, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom, 4 The Staffordshire Centre for Psychological Research, School of Life Sciences and Education, Staffordshire University, Stoke-on-Trent, United Kingdom a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Cookson D, Jolley D, Dempsey RC, Povey R (2021) A social norms approach intervention to address misperceptions of anti-vaccine conspiracy beliefs amongst UK parents. PLoS ONE 16(11): e0258985. https://doi.org/10.1371/journal. pone.0258985 Editor: Anat Gesser-Edelsburg, University of Haifa, ISRAEL Received: May 5, 2021 Accepted: October 10, 2021 Published: November 12, 2021 Copyright: © 2021 Cookson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All data is available from the Open Science Framework, https://osf.io/ rhb5p/. Funding: The funders of the PhD Studentship (Staffordshire University) had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The last author (RP) is currently employed as an Associate Professor at Staffordshire University. The PhD Studentship provided funding to the first author * Abstract Anti-vaccine conspiracy beliefs among parents can reduce vaccination intentions. Parents’ beliefs in anti-vaccine conspiracy theories are also related to their perceptions of other parents’ conspiracy beliefs. Further, research has shown that parents hold misperceptions of anti-vaccine conspiracy belief norms: UK parents over-estimate the anti-vaccine conspiracy beliefs of other parents. The present study tested the effectiveness of a Social Norms Approach intervention, which corrects misperceptions using normative feedback, to reduce UK parents’ anti-vaccine conspiracy beliefs and increase vaccination intentions. At baseline, 202 UK parents of young children reported their personal belief in anti-vaccine conspiracy theories, future intentions to vaccinate, and their perceptions of other UK parents’ beliefs and intentions. Participants were then randomly assigned to a normative feedback condition (n = 89) or an assessment-only control condition (n = 113). The normative feedback compared participants’ personal anti-vaccine conspiracy beliefs and perceptions of other UK parents’ beliefs with actual normative belief levels. Parents receiving the normative feedback showed significantly reduced personal belief in anti-vaccine conspiracy beliefs at immediate post-test. As hypothesised, changes in normative perceptions of anti-vaccine conspiracy beliefs mediated the effect of the intervention. The intervention, did not directly increase vaccination intentions, however mediation analysis showed that the normative feedback increased perceptions of other parents’ vaccination intentions, which in turn increased personal vaccination intentions. No significant effects remained after a six-week follow-up. The current research demonstrates the potential utility of Social Norms Approach interventions for correcting misperceptions and reducing anti-vaccine conspiracy beliefs among UK parents. Further research could explore utilising a top-up intervention to maintain the efficacy. PLOS ONE | https://doi.org/10.1371/journal.pone.0258985 November 12, 2021 1 / 16 PLOS ONE (DC) which was used to support participant reimbursements. Competing interests: The authors have declared that no competing interests exist. Conspiracy beliefs and a social norms intervention 1. Introduction Social norms are informal, unwritten expectations about appropriate social behaviour, outlining what is acceptable and not in particular contexts, and are important determinants of attitudes and behaviours [1–3]. Two types of social norms are commonly implicated in health behaviours: injunctive norms, which refer to one’s perception of what others approve or disapprove [1], and descriptive norms, which refer to one’s perception of how prevalent an attitude or behaviour is [4]. Perceived social norms are an important predictor of health behaviours [5]. Specifically, perceived norms of anti-vaccine conspiracy beliefs predict personal belief in anti-vaccine conspiracy theories among parents [6]. Anti-vaccine conspiracy beliefs among parents can reduce intentions to vaccinate, which is problematic as UK childhood vaccination rates are below target [7]. Social Norms Approach (SNA) interventions have been successfully used to improve health attitudes and behaviours by challenging commonly held misperceptions or misestimates of actual norms [8]. Thus, the current study aims to utilise the SNA intervention to reduce belief in anti-vaccine conspiracy theories and increase vaccination intentions among UK parents. The Social Norms Approach (SNA) begins with the premise that individuals are influenced by the beliefs and behaviours of others and often make misperceptions about how much others engage in certain behaviours [8, 9]. For example, people tend to over-estimate how much others engage in negative health behaviours, such as drinking alcohol (e.g., [10]), smoking tobacco (e.g., [11, 12]), and unhealthy snacking [13]. As social norms can provide an expectation about appropriate social behaviour [1, 2], individuals may be driven to match what they perceive to be the social norm [14]. An important consequence of such social norm misperceptions is the potential engagement in unhealthy behaviours due to a false belief that such behaviours are commonplace amongst peers [9, 15]. The SNA works by challenging these misperceptions of the belief and behaviours of others, reducing the perceived social pressure to engage in a problem behaviour, to promote healthier personal behaviours [8]. SNA interventions are often delivered online using computerised normative feedback to explicitly compare a) personal beliefs and behaviours to b) the perceived norms of peers and to c) the actual norms of a certain belief or behaviour (e.g., [16]). Therefore, this feedback explicitly demonstrates existing misperceptions in people’s perceptions of peer norms and highlights their norm deviant behaviours [8]. For example, normative feedback has often been used to reduce college student drinking [16], where correcting misperceptions has been shown to reduce perceived drinking norm (...truncated)