Optimising COVID-19 testing intentions and behaviour with enhanced messaging

This study is testing the effects of two interventions (enhanced messaging and enhanced action planning), all conducted online through a survey platform. Participants will be recruited via Dynata, a market research company experienced in panel survey sampling with whom we have a strong track record of collaboration. Dynata has an extensive database of participants (over 600,000 Australian adults) who are willing to be involved in online research. Participants will be directed to the landing page where they can read the PIS and Consent Form before accessing the survey. The survey itself will be hosted on the survey platform Qualtrics, where it is possible to track adherence to the intervention, such that we can see at what point participants left the survey, if they did not complete it. Participants will answer demographic questions and then will be randomised to receive either the education intervention or a control. This will take about 5 minutes to complete. Immediately following this, they will be asked our outcome questions, and then will be randomised again, to either the action intervention or a control condition. This part will also take about 5 minutes to complete. Therefore the complete survey will take about 10 minutes in total. Participants are told in the PIS that the results of the study will be posted on our website (https://sydneyhealthliteracylab.org.au). EDUCATION INTERVENTION: Enhanced messaging: Relevant COVID-19 testing information from an Australian government website (NSW Health COVID-19 FAQ: https://www.health.nsw.gov.au/Infectious/covid-19/Pages/frequently-asked-questions.aspx#4 ) will be run through a specialised editor developed by the Sydney Health Literacy Lab (the SHLL Editor). This is a new tool that identifies issues like complex language and long sentences and suggests alternatives to improve understandability. This text will be accompanied by an image – demonstrating the community benefits of COVID-19 testing – to increase salience of the message. This uses the behaviour change techniques of: instruction on how to perform a behaviour, information about health consequences, and salience of consequences (from the Behaviour Change Technique Taxonomy). ACTION INTERVENTION Enhanced action planning: A series of action plans will be developed and tested with a consumer representative based on the top 10 barriers to testing found in our nationally representative survey in November 2020. These action plans will use if-then statements paired with icon images. For example, ‘IF I feel I don’t have time to get tested, THEN I will remind myself that getting tested helps to protect the community’. Our previous work has shown if-then plans improve behaviour change amongst people with varying levels of health literacy. Participants will be provided with a brief description of the action plans. They will select the barrier/s most relevant to them, and shown a corresponding action plan. If the plan is rated as too hard, users will be prompted to create a different plan. This uses the behaviour change techniques of action planning, behavioural substitution and problem solving (from the Behaviour Change Technique Taxonomy).