A Stepped-Wedge Social Media Training Intervention for Community Health Workers In Spanish-Speaking Communities: A Study Protocol for Dime La VerDAD.

Background: Social media has become a central channel for the dissemination of health information, enabling rapid sharing of evidence-based guidance while also facilitating the spread of inaccurate or misleading content. Exposure to such information has been associated with changes in vaccination-related attitudes and decision-making. These effects may not occur uniformly across populations, and there is limited understanding of how health information circulates within Spanish-language social media networks or which communication strategies are most effective in promoting engagement and informed decision-making. This study describes a protocol to evaluate a community-engaged intervention designed to address these gaps. Methods: This study will use a non-randomized stepped-wedge design to evaluate the implementation and effectiveness of the Dime La VerDAD intervention across community-based cohorts of promotores de salud in Chicago. Promotores will be grouped into geographically defined clusters and will transition from control to intervention at six-month intervals, such that all clusters receive the intervention by study end. The intervention will consist of a structured, bilingual training program focused on identifying inaccurate health claims, evaluating source credibility, and developing accessible, evidence-based social media content, including narrative-based messaging. Outcomes will be assessed using surveys, focus groups, social media analytics, and publicly available epidemiologic data. Primary and secondary outcomes will include changes in knowledge, communication practices, engagement with social media content, and vaccination-related decision-making. Analyses will use mixed-effects models to evaluate changes over time while accounting for clustering and repeated measures. Discussion: This study will generate evidence on how health information is shared and interpreted within Spanish-language social media networks and evaluate whether a structured, community-engaged communication intervention improves the quality and reach of health messaging. Findings will inform the development of scalable, community-based strategies to support dissemination of reliable health information and promote informed decision-making in diverse populations. Trial registration: ClinicalTrials.gov NCT06417762. Recruitment has begun and is ongoing at the time of manuscript submission.