COVID-19 Vaccine Text Outreach

Purpose

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.

Condition

  • Covid19

Eligibility

Eligible Ages
Over 16 Years
Eligible 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.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Factorial Assignment
Primary Purpose
Health Services Research
Masking
Double (Participant, Investigator)

Arm Groups

ArmDescriptionAssigned Intervention
Active Comparator
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.
  • Behavioral: Phone Call
    The access center will call these patients to schedule their vaccine appointment. These patients will not receive text messaging.
Experimental
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.
  • Behavioral: Opt-In (Call-Back)
    Messaging will include a prompt to agree to scheduling. If patient agrees, the access center will call these patients back to schedule, calling up to 3 times.
  • Behavioral: Standard Message
    The message describes that the patient is eligible for the COVID vaccine.
Experimental
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.
  • Behavioral: Opt-In (Call-Back)
    Messaging will include a prompt to agree to scheduling. If patient agrees, the access center will call these patients back to schedule, calling up to 3 times.
  • Behavioral: Clinician Endorsement
    The message will describe an endorsement from the provider to get the vaccination.
Experimental
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.
  • Behavioral: Opt-In (Call-Back)
    Messaging will include a prompt to agree to scheduling. If patient agrees, the access center will call these patients back to schedule, calling up to 3 times.
  • Behavioral: Scarcity
    The message will highlight the limited availability and the elevated priority for the patient to receive the vaccine at Penn Medicine.
Experimental
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.
  • Behavioral: Opt-In (Call-Back)
    Messaging will include a prompt to agree to scheduling. If patient agrees, the access center will call these patients back to schedule, calling up to 3 times.
  • Behavioral: Opt-Out Framing
    This will highlight that a vaccine is reserved for the patient, implying that they need to opt-out.
Experimental
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.
  • Behavioral: Opt-in (In-Bound)
    Messaging will include a prompt to agree to scheduling followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
  • Behavioral: Standard Message
    The message describes that the patient is eligible for the COVID vaccine.
Experimental
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.
  • Behavioral: Opt-in (In-Bound)
    Messaging will include a prompt to agree to scheduling followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
  • Behavioral: Clinician Endorsement
    The message will describe an endorsement from the provider to get the vaccination.
Experimental
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.
  • Behavioral: Opt-in (In-Bound)
    Messaging will include a prompt to agree to scheduling followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
  • Behavioral: Scarcity
    The message will highlight the limited availability and the elevated priority for the patient to receive the vaccine at Penn Medicine.
Experimental
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.
  • Behavioral: Opt-in (In-Bound)
    Messaging will include a prompt to agree to scheduling followed by a prompt to call the Penn Medicine Vaccine Scheduling Hotline to schedule their vaccine appointment.
  • Behavioral: Opt-Out Framing
    This will highlight that a vaccine is reserved for the patient, implying that they need to opt-out.

Recruiting Locations

More Details

NCT ID
NCT04834726
Status
Completed
Sponsor
University of Pennsylvania

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.