COVID-19 Resource Offers Among Rent and Utility Assistance Applicants in St. Louis

Study Overview
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Brief Summary
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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.

Official Title
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Rapid Acceleration of Diagnostics Underserved Populations Supplement Rent Relief and COVID-19 in St. Louis: COVID-19 Resource Offers Among Rent and Utility Assistance Applicants in St. Louis

Conditions
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Behavior and Behavior Mechanisms, Communication

Intervention / Treatment
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* Other: Door-In-The-Face Technique
* Other: Foot-In-The-Door Technique


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Door-In-The-Face Technique<br>Using sequential request strategies, participants randomized to the Door-In-The-Face Technique group will be asked if they would like vaccination support (if not already vaccinated) and if they say no, they will be asked if they'd like to try a COVID-19 self-test at home. | Other: Door-In-The-Face Technique<br>* 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.<br>|
| Active Comparator: Foot-In-The-Door Technique<br>Using sequential request strategies, participants randomized to the Foot-In-The-Door Technique group will be first asked if they are interested in trying an at-home COVID-19 test and then asked if they are interested in vaccination support (if not already vaccinated). | Other: Foot-In-The-Door Technique<br>* 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.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion Vaccinated | 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. | Baseline | 
| Sequential Request Strategy Effectiveness | 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. | Baseline | 
| Testing and Vaccination Offer Acceptance | At baseline, participants will be offered vaccination support and free a COVID-19 self-test. The investigators will report the proportion of applicants who accept each of the offers. | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Testing and Vaccination Behaviors | After one month follow-up, the investigators will report the proportion of participants who complete the self-test and report the results, and report having been vaccinated since the baseline survey. | 1 month follow-up | 
| Rent Relief | The investigators will ask about the outcome of rent or utility assistance. | Baseline |