Development, Implementation, and Results from a COVID-19 Messaging Campaign to Promote Health Care Seeking Behaviors Among Community Clinic Patients

J Community Health. 2021 Aug;46(4):728-739. doi: 10.1007/s10900-020-00939-0. Epub 2020 Oct 30.

Abstract

Care-delays can further exacerbate racial and ethnic health disparities in novel coronavirus disease 2019 (COVID-19) related complications. The purpose of our study was to describe and evaluate a Patient Engagement Messaging campaign (PEM campaign) promoting health care seeking behaviors among community and rural clinic patients in North Carolina. Text and voice messages were delivered over 3-weeks. Messages encouraged patients to call a regional operation call center (ROC) line for information related to health care appointments and testing. A cross-sectional evaluation was conducted on the total population (n = 48,063) and a sample without recent health care contact (n = 29,214). Among the sample, logistic regression was used to model determinants of calls to the ROC-line and associations between calling the ROC-line and health care seeking behaviors (scheduling any health care appointment or receiving a COVID-19 test). 69.9% of text messages and 89% of voice messages were delivered. Overall, 95.4% of the total population received at least 1 message. Successful delivery was lower among Black patients and higher among patients with moderate health-risk comorbidities. Among the sample, 7.4% called the ROC-line, with higher odds of calling among minority patients (vs. White) and among Medicaid and uninsured (vs. private insurance). Calling the ROC-line was associated with higher odds of scheduling any health care appointment (OR: 4.14; 95% CI 2.93-5.80) and receiving a COVID-19 test (OR: 2.39; 95% CI 1.64-3.39). Messaging campaigns may help disconnected patients access health care resources and reduce disparities, but are likely still limited by existing barriers.

Keywords: COVID-19; Health care; Health disparities; Insurance; Telephone campaign.

MeSH terms

  • Aged
  • COVID-19 / prevention & control*
  • Cross-Sectional Studies
  • Female
  • Health Promotion / methods*
  • Healthcare Disparities*
  • Humans
  • Male
  • Medicare
  • Pandemics
  • Patient Acceptance of Health Care / psychology*
  • SARS-CoV-2
  • Telephone
  • Text Messaging*
  • United States