Effect of Physician-Delivered COVID-19 Public Health Messages and Messages Acknowledging Racial Inequity on Black and White Adults' Knowledge, Beliefs, and Practices Related to COVID-19: A Randomized Clinical Trial.
JAMA Netw Open
; 4(7): e2117115, 2021 07 01.
Article
in English
| MEDLINE | ID: covidwho-1308937
ABSTRACT
Importance Social distancing is critical to the control of COVID-19, which has disproportionately affected the Black community. Physician-delivered messages may increase adherence to these behaviors. Objectives:
To determine whether messages delivered by physicians improve COVID-19 knowledge and preventive behaviors and to assess the differential effectiveness of messages tailored to the Black community. Design, Setting, andParticipants:
This randomized clinical trial of self-identified White and Black adults with less than a college education was conducted from August 7 to September 6, 2020. Of 44â¯743 volunteers screened, 30â¯174 were eligible, 5534 did not consent or failed attention checks, and 4163 left the survey before randomization. The final sample had 20â¯460 individuals (participation rate, 68%). Participants were randomly assigned to receive video messages on COVID-19 or other health topics.Interventions:
Participants saw video messages delivered either by a Black or a White study physician. In the control groups, participants saw 3 placebo videos with generic health topics. In the treatment group, they saw 3 videos on COVID-19, recorded by several physicians of varied age, gender, and race. Video 1 discussed common symptoms. Video 2 highlighted case numbers; in one group, the unequal burden of the disease by race was discussed. Video 3 described US Centers for Disease Control and Prevention social distancing guidelines. Participants in both the control and intervention groups were also randomly assigned to see 1 of 2 American Medical Association statements, one on structural racism and the other on drug price transparency. Main Outcomes andMeasures:
Knowledge, beliefs, and practices related to COVID-19, demand for information, willingness to pay for masks, and self-reported behavior.Results:
Overall, 18â¯223 participants (9168 Black; 9055 White) completed the survey (9980 [55.9%] women, mean [SD] age, 40.2 [17.8] years). Overall, 6303 Black participants (34.6%) and 7842 White participants (43.0%) were assigned to the intervention group, and 1576 Black participants (8.6%) and 1968 White participants (10.8%) were assigned to the control group. Compared with the control group, the intervention group had smaller gaps in COVID-19 knowledge (incidence rate ratio [IRR], 0.89 [95% CI, 0.87-0.91]) and greater demand for COVID-19 information (IRR, 1.05 [95% CI, 1.01-1.11]), willingness to pay for a mask (difference, $0.50 [95% CI, $0.15-$0.85]). Self-reported safety behavior improved, although the difference was not statistically significant (IRR, 0.96 [95% CI, 0.92-1.01]; P = .08). Effects did not differ by race (F = 0.0112; P > .99) or in different intervention groups (F = 0.324; P > .99). Conclusions and Relevance In this study, a physician messaging campaign was effective in increasing COVID-19 knowledge, information-seeking, and self-reported protective behaviors among diverse groups. Studies implemented at scale are needed to confirm clinical importance. Trial Registration ClinicalTrials.gov Identifier NCT04502056.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Physicians
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Black or African American
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Health Knowledge, Attitudes, Practice
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White People
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Racism
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COVID-19
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Health Promotion
Type of study:
Experimental Studies
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Observational study
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Prognostic study
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Randomized controlled trials
Limits:
Adult
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Female
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Humans
/
Male
/
Middle aged
/
Young adult
Language:
English
Journal:
JAMA Netw Open
Year:
2021
Document Type:
Article
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