Pragmatic Trial of COVID Vaccine Text Outreach Interventions
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Pennsylvania
- Enrollment
- 19,554
- Locations
- 1
- Primary Endpoint
- Dose 1 Completion
Study Overview
Brief Summary
This project aims to evaluate different approaches to increase COVID-19 vaccine uptake among at-risk patients at Penn Medicine in an equitable and systematic manner through a centralized outreach program. The investigators will evaluate different text-based scheduling and messaging approaches informed by behavioral science to increase uptake among eligible patients, including the use of clinician endorsement, opt-out framing, and scarcity.
Detailed Description
This project will evaluate a centralized approach to increasing COVID through direct outreach to eligible patients via text messaging. This pragmatic randomized controlled trial has the following aims:
Aim 1: To conduct systematic large scale text message outreach for vaccine delivery among a defined group of Penn Medicine in a way that advances equity.
Aim 2: To offer different scheduling workflows through text messaging that might increase uptake and reduce disparities.
Aim 3: To compare the equity and efficiency of different messages informed by behavioral science, including PCP endorsement, opt-out framing, and scarcity.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Factorial
- Primary Purpose
- Health Services Research
- Masking
- Double (Participant, Investigator)
Eligibility Criteria
- Ages
- 16 Years to — (Child, Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •patients of Penn Medicine aged 18+ who reside in Philadelphia and who have had at least 1 visit in the past 5 years with a Penn Medicine primary care provider (PCP)
Exclusion Criteria
- •Patients who have completed any dose of the vaccine at Penn Medicine, are currently scheduled to receive the vaccine, have externally documented vaccination records, or have previously received text-message based vaccine outreach.
Arms & Interventions
1: Usual Care
Patients will receive a phone call to schedule their appointment from an Access Center representative. Access Center representatives will make up to 3 attempts to schedule an appointment with the patient. Patients randomized to this arm will not receive any text messaging.
Intervention: Phone Call (Behavioral)
2A: Call Back + Standard Msg
The message describes that the patient is eligible for the COVID vaccine. Will include a prompt to agree to scheduling. The access center will call these patients back to schedule, calling up to 3 times.
Intervention: Opt-In (Call-Back) (Behavioral)
2D: Call Back + Opt-Out Framing
The message will highlight that a vaccine is reserved for the patient, implying that they need to opt-outWill include a prompt to agree to scheduling. The access center will call these patients back to schedule, calling up to 3 times.
Intervention: Opt-In (Call-Back) (Behavioral)
2A: Call Back + Standard Msg
The message describes that the patient is eligible for the COVID vaccine. Will include a prompt to agree to scheduling. The access center will call these patients back to schedule, calling up to 3 times.
Intervention: Standard Message (Behavioral)
2B: Call Back + Clinician Endorsement
The message will describe an endorsement from the provider to get the vaccination. Will include a prompt to agree to scheduling. The access center will call these patients back to schedule, calling up to 3 times.
Intervention: Opt-In (Call-Back) (Behavioral)
2B: Call Back + Clinician Endorsement
The message will describe an endorsement from the provider to get the vaccination. Will include a prompt to agree to scheduling. The access center will call these patients back to schedule, calling up to 3 times.
Intervention: Clinician Endorsement (Behavioral)
2C: Call Back + Scarcity
The message will highlight the limited availability and the elevated priority for the patient to receive the vaccine at Penn Medicine. Will include a prompt to agree to scheduling. The access center will call these patients back to schedule, calling up to 3 times.
Intervention: Opt-In (Call-Back) (Behavioral)
2C: Call Back + Scarcity
The message will highlight the limited availability and the elevated priority for the patient to receive the vaccine at Penn Medicine. Will include a prompt to agree to scheduling. The access center will call these patients back to schedule, calling up to 3 times.
Intervention: Scarcity (Behavioral)
2D: Call Back + Opt-Out Framing
The message will highlight that a vaccine is reserved for the patient, implying that they need to opt-outWill include a prompt to agree to scheduling. The access center will call these patients back to schedule, calling up to 3 times.
Intervention: Opt-Out Framing (Behavioral)
3A: In-Bound Call + Standard Msg
The message describes that the patient is eligible for the COVID vaccine. Will include a prompt to agree to scheduling, which will be followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
Intervention: Opt-in (In-Bound) (Behavioral)
3A: In-Bound Call + Standard Msg
The message describes that the patient is eligible for the COVID vaccine. Will include a prompt to agree to scheduling, which will be followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
Intervention: Standard Message (Behavioral)
3B: In-Bound Call + Clinician Endorsement
The message will describe an endorsement from the provider to get the vaccination. Will include a prompt to agree to scheduling, which will be followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
Intervention: Opt-in (In-Bound) (Behavioral)
3B: In-Bound Call + Clinician Endorsement
The message will describe an endorsement from the provider to get the vaccination. Will include a prompt to agree to scheduling, which will be followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
Intervention: Clinician Endorsement (Behavioral)
3C: In-Bound Call + Scarcity
The message will highlight the limited availability and the elevated priority for the patient to receive the vaccine at Penn Medicine. Will include a prompt to agree to scheduling, which will be followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
Intervention: Opt-in (In-Bound) (Behavioral)
3C: In-Bound Call + Scarcity
The message will highlight the limited availability and the elevated priority for the patient to receive the vaccine at Penn Medicine. Will include a prompt to agree to scheduling, which will be followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
Intervention: Scarcity (Behavioral)
3D: In-Bound Call + Opt-Out Framing
The message will highlight that a vaccine is reserved for the patient, implying that they need to opt-out. Will include a prompt to agree to scheduling, which will be followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
Intervention: Opt-in (In-Bound) (Behavioral)
3D: In-Bound Call + Opt-Out Framing
The message will highlight that a vaccine is reserved for the patient, implying that they need to opt-out. Will include a prompt to agree to scheduling, which will be followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
Intervention: Opt-Out Framing (Behavioral)
Outcomes
Primary Outcomes
Dose 1 Completion
Time Frame: 1 month
Percentage of patients who complete the first dose of the COVID vaccine within 1 month of initial outreach
Secondary Outcomes
- Vaccine Completion(2 months)
- Dose 1 Completion(2 months)
Investigators
Shivan J Mehta
Principal Investigator
University of Pennsylvania