Beyond Conventional Messaging: Critical Communication Strategies to Boost Vaccine Intentions

Despite widespread efforts to increase COVID-19 vaccination uptake, racial and ethnic disparities persist due to structural barriers, healthcare access inequities, and cultural mistrust. This online randomized experimental study examined the comparative effectiveness of traditional public health messaging and critical communication strategies in promoting COVID-19 vaccination among young adults of color. Participants (n = 2,409) aged 18-35 years (24.9% African American, 23.7% English-speaking Latinx, 25.3% Spanish-speaking Latinx, 26.1% other racial/ethnic groups) were randomized to view either a fact-based expert-led campaign or a culturally grounded, empowerment-focused campaign delivered through social media. Both campaigns significantly improved vaccine-related attitudes, subjective norms, and behavioral intentions (p < .001). However, participants exposed to the critical communication campaign reported greater gains in self-efficacy (p = .031), perceived message credibility (p < .001), and emotional engagement (p < .05). Stratified analyses indicated stronger effects among Latinx participants for the critical communication approach, comparable responses across campaigns among African American participants, and slightly stronger behavioral outcomes favoring the traditional campaign among other racial/ethnic groups. These findings suggest that culturally engaged, community-centered communication strategies may expand motivational pathways beyond conventional information-based approaches, expacially for healthcare consumers of color. Future research should assess long-term behavioral impacts and scalability across diverse public health contexts.