Behavior and Behavior Mechanisms, Communication
Conditions
Brief summary
The purpose of this study is to evaluate health messaging strategies that help individuals with a high degree of housing-related needs engage in COVID-19 vaccination and testing behaviors. Findings from this research can help other communities determine how best to integrate social needs and COVID-19 prevention services. Participants' contact information will be shared with us by 211 with the participants' previously given consent. The study team will send via text message a link to a survey that includes a screen where they will provide informed consent. Those who provide consent will be randomly assigned to receive one of two surveys. The order of the offers is what varies across the surveys. Participants will be asked, along with other survey items, if they have been vaccinated against COVID-19. If they have not, they will be asked if they are interested in receiving help to receive a vaccine. Participants will also be asked if they are interested in receiving an at-home COVID self-test. If they say yes to assistance with vaccination, a vaccine navigator will call and assist them. If they say yes to receiving a COVID test, the study team will ship them a test that has been procured from the City of St. Louis Mayor's office. One month later participants will be sent a follow-up survey that asks about their experiences either with testing or with vaccination if applicable.
Interventions
OTHERDoor-In-The-Face Technique
Sequential request strategies will be applied as an intervention. For the Door-In-The-Face Technique, participants first receive a large request they are unlikely to accept, followed by a smaller request that is the true behavior of interest.
Sequential request strategies will be applied as an intervention. For the Foot-In-The-Door Technique, participants are shown an easier first request that they are likely to accept, followed by a larger request that is not the behavior of interest.
Sponsors
Washington University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Applicants for rent and utility assistance in St. Louis City or County * English language proficiency * Be willing to be contacted via text message or email * Resident of St. Louis City or County
Exclusion criteria
* N/A
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion Vaccinated | Baseline | Via a mobile-optimized web-based survey, the investigators will ask individuals seeking rental/housing assistance if they are thinking about getting vaccinated and report the proportion "already vaccinated." |
| Sequential Request Strategy Effectiveness (Vaccination) | Baseline | To compare differences in testing acceptance and vaccination responses by sequential request strategy, the investigators will identify which strategy is associated with greater testing and vaccination intentions. This will be shown by those who accepted an offer for assistance getting vaccinated. |
| Sequential Request Strategy Effectiveness (Testing) | Baseline | To compare differences in testing acceptance and vaccination responses by sequential request strategy, the investigators will identify which strategy is associated with greater testing and vaccination intentions. This will be shown by those who accepted an offer for a test kit. |
Countries
United States
Participant flow
Recruitment details
The sampling frame was 9,181 adults who completed an application for emergency rent or utility payment assistance between August 2020 and December 2021. In the application, they consented to share their contact information with a network of social service providers. Following stratified sampling, survey links were texted to 2,900 potential participants between July 5, 2022, and July 20, 2022.
Pre-assignment details
Sampling frame was stratified by ZIP code, 8 were selected. Removing duplicate names yielded 2,959 individuals. We randomized the order of individuals in each ZIP code, selected an initial batch of five hundred names with equal representation from across the 8 ZIP codes, and texted each a survey link. Repeated the process until exceeding 500 survey responses. 531 participants completed the pre-randomization survey; 526 were enrolled in the experiment.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Customized Age | 41 Years STANDARD_DEVIATION 11 |
| Race/Ethnicity, Customized Race Black or African American | 196 Participants |
| Race/Ethnicity, Customized Race Missing | 2 Participants |
| Race/Ethnicity, Customized Race Other | 24 Participants |
| Race/Ethnicity, Customized Race White | 35 Participants |
| Sex/Gender, Customized Gender Man | 41 Participants |
| Sex/Gender, Customized Gender Missing | 3 Participants |
| Sex/Gender, Customized Gender Other | 11 Participants |
| Sex/Gender, Customized Gender Woman | 424 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
None listed