COVID-19 Vaccine Text Outreach

Study Overview
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Brief Summary
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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
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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.

Official Title
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Pragmatic Trial of COVID Vaccine Text Outreach Interventions

Conditions
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Covid19

Intervention / Treatment
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* Behavioral: Opt-In (Call-Back)
* Behavioral: Opt-in (In-Bound)
* Behavioral: Standard Message
* Behavioral: Clinician Endorsement
* Behavioral: Scarcity
* Behavioral: Opt-Out Framing
* Behavioral: Phone Call


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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: Factorial Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: 1: Usual Care<br>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<br>* The access center will call these patients to schedule their vaccine appointment. These patients will not receive text messaging.<br>|
| Experimental: 2A: Call Back + Standard Msg<br>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)<br>* 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.<br>Behavioral: Standard Message<br>* The message describes that the patient is eligible for the COVID vaccine.<br>|
| Experimental: 2B: Call Back + Clinician Endorsement<br>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)<br>* 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.<br>Behavioral: Clinician Endorsement<br>* The message will describe an endorsement from the provider to get the vaccination.<br>|
| Experimental: 2C: Call Back + Scarcity<br>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)<br>* 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.<br>Behavioral: Scarcity<br>* The message will highlight the limited availability and the elevated priority for the patient to receive the vaccine at Penn Medicine.<br>|
| Experimental: 2D: Call Back + Opt-Out Framing<br>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)<br>* 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.<br>Behavioral: Opt-Out Framing<br>* This will highlight that a vaccine is reserved for the patient, implying that they need to opt-out.<br>|
| Experimental: 3A: In-Bound Call + Standard Msg<br>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)<br>* 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.<br>Behavioral: Standard Message<br>* The message describes that the patient is eligible for the COVID vaccine.<br>|
| Experimental: 3B: In-Bound Call + Clinician Endorsement<br>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)<br>* 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.<br>Behavioral: Clinician Endorsement<br>* The message will describe an endorsement from the provider to get the vaccination.<br>|
| Experimental: 3C: In-Bound Call + Scarcity<br>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)<br>* 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.<br>Behavioral: Scarcity<br>* The message will highlight the limited availability and the elevated priority for the patient to receive the vaccine at Penn Medicine.<br>|
| Experimental: 3D: In-Bound Call + Opt-Out Framing<br>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)<br>* 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.<br>Behavioral: Opt-Out Framing<br>* This will highlight that a vaccine is reserved for the patient, implying that they need to opt-out.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dose 1 Completion | Percentage of patients who complete the first dose of the COVID vaccine within 1 month of initial outreach | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dose 1 Completion | Percentage of patients who complete the first dose of the COVID vaccine within 2 months of initial outreach | 2 months | 
| Vaccine Completion | Percentage of patients who complete the vaccination process within 2 months of initial outreach | 2 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Vaccination Uptake, Text Messaging, Outreach