COVID-19 Health Messaging to Underserved Communities

Massachusetts General Hospital, Stanford University, Yale University, Massachusetts Institute of Technology, Harvard University

Recent data have shown that covid19 is disproportionately infecting and killing African Americans and Latinx people in the United States. The aim of the study is to determine which messages are most effective at increasing knowledge and changing behaviors that can protect individuals and their communities from the virus. To accomplish this aim, we plan to recruit approximately 20,000 Hispanic and African-American individuals and randomly assign them to videos that vary either the sender or the framing of the message, while providing the relevant public health information.

The following procedures will be followed. The research subjects will participate online. Doctors from MGH who express interest in participating will record messages according to our scripts (US Doctors Script African American, US Doctors Script Latinx). They will be instructed to film several different versions each. We will recruit a sample of Latinx and African American study participants from across the country through Lucid, an online survey firm that has access to a large subject pool. Participants will first read a consent script and give us their informed consent (US Doctors Messaging Consent) Participants will then navigate through the following steps Brief demographics survey questions (US Doctors Messaging Survey) Videos 1 and 2: Introduction, Acknowledgement, Social Distancing (US Doctors Script African American, US Doctors Script Latinx). Individuals in the control group will not see videos. Beliefs survey questions (US Doctors Messaging Survey) Video 3: Masks (US Doctors Script African American, US Doctors Script Latinx). Again, individuals in the control group will not see a video here. Main outcomes survey (US Doctors Messaging Survey) Control group is shown a version of all 3 videos at end (US Doctors Script African American, US Doctors Script Latinx). The video messages each participant in one of the treatment groups sees will be randomized on the following dimensions. The different versions are clearly demarcated in the US Doctors Scripts document. Racial or ethnic identity of the doctor delivering the messages: concordant vs. discordant identity to the subject. Whether the message includes an acknowledgment of "elephant in the room" issues for each target group: trust in the medical system or fear of deportation. Whether the social distancing component of the message is delivered by Dr. Birx of the CDC or recorded by the MGH physicians. Whether individuals are given information about how representative individuals perceive mask wearers of color. This information comes from results of our nationally representative pilot survey. Some individuals in a control group will only see messages after all surveying has been completed.

Control Intro, CDC Social Distancing, Mask Control version delivered by minority doctor of same background as the recipient - other definitions are similar

Control Intro, CDC Social Distancing, Mask Control version delivered by majority doctor of different background as the recipient - other definitions are similar

Introduction Acknowledges past discrimination, MGH doctor talks about Social Distancing, Mask Control all by concordant MD

Introduction Acknowledges past discrimination, MGH doctor talks about Social Distancing, Mask Control all by discordant MD

o The video messages each participant in one of the treatment groups sees will be randomized on the following dimensions. The different versions are clearly demarcated in the US Doctors Scripts document. Racial or ethnic identity of the doctor delivering the messages: concordant vs. discordant identity to the subject. Whether the message includes an acknowledgment of "elephant in the room" issues for each target group: trust in the medical system or fear of deportation. Whether the social distancing component of the message is delivered by Dr. Birx of the CDC or recorded by the MGH physicians. Whether individuals are given information about how representative individuals perceive mask wearers of color. This information comes from results of our nationally representative pilot survey. Some individuals in a control group will see messages later.

Incidence rate for knowledge gaps is the count of knowledge gaps divided by the maximum possible count: 7

Incidence rate for Information-seeking behavior is the count of links demanded divided by the maximum possible count: 10

Incidence rate for knowledge gaps is the count of knowledge gaps divided by the maximum possible count: 7

Incidence rate for Information-seeking behavior is the count of links demanded divided by the maximum possible count: 10

Inclusion Criteria: Hispanic and African-American adult individuals, men and women - oversample of those with less completed education Exclusion Criteria: children, those who do not identify as above

Alsan M, Stanford FC, Banerjee A, Breza E, Chandrasekhar AG, Eichmeyer S, Goldsmith-Pinkham P, Ogbu-Nwobodo L, Olken BA, Torres C, Sankar A, Vautrey PL, Duflo E. Comparison of Knowledge and Information-Seeking Behavior After General COVID-19 Public Health Messages and Messages Tailored for Black and Latinx Communities : A Randomized Controlled Trial. Ann Intern Med. 2021 Apr;174(4):484-492. doi: 10.7326/M20-6141. Epub 2020 Dec 21.