Sumar Kamal, Blue Lisa, Fatahi Gina, Bhatti Atiq, Sumar Mehek, Alvarez Stephanie, Cons Pedro, Valencia Nathalie, Williams Zachary, Parthasarathy Sairam, Doubeni Chyke A
Adelante Healthcare.
Providertech LLC.
Res Sq. 2023 Dec 11:rs.3.rs-3604972. doi: 10.21203/rs.3.rs-3604972/v1.
People from backgrounds that are economically/socially disadvantaged experienced disproportionately high COVID-19 death rates and had lower vaccination rates. Effective outreach strategies for increasing vaccine uptake during the pandemic are not fully known. Among patients receiving care at a Federally Qualified Health Center, we tested whether community engaged digitally-enabled outreach increased COVID vaccine uptake.
A 3-parallel-arm randomized controlled trial with a hybrid effectiveness-implementation design was conducted among patients ≥18 years old on study enrollment during 2021 with 1,650 assigned in 3:10:20 ratio; 2,328 were later selected for two subsequent implementation rounds.
From April 13 to June 10, 2021, patients were proactively sent a text-messaging invitation to make an appointment for vaccination as part of the routine practice (Arm 1, n=150) with added personalized clinician recommendation alone (Arm 2, n=500) or with an explicit nudge for answers to frequently asked questions (Arm 3, n=1,000). Further implementation used messaging addressing vaccine hesitancy (n=1,323) or adverse reactions to vaccines (n=1,005).
The primary outcome was the completion of the first SARS-Cov-2 vaccine dose determined at 14, 30 and 90 days after outreach.
Of 1,650 patients in effectiveness Arms, 61% was female. Vaccination rates for Arms 1, 2, and 3, were 6% (n=9), 5.4% (n=27) and 3.3% (n=33) at 14 days, and 11.5% (n=17), 11.6% (n=58), and 8.5% (n=85) at 90 days, respectively, which were similar in pairwise comparisons. At 90 days, vaccination rates were similar across the two implementation rounds (3.9% vs. 3.6%) and were similar to the rate (3.3%) among patients who were not selected for intervention arms or implementation rounds (n=8,671).
Digitally-enabled outreach that included SMS messaging outreach augmented with clinician recommendations did not improve COVID-19 vaccination rates.
This study is registered at ClinicalTrails.gov Identifier: NC-T04952376.
经济/社会背景处于弱势的人群新冠病毒疾病（COVID-19）死亡率高得不成比例，且疫苗接种率较低。大流行期间提高疫苗接种率的有效推广策略尚不完全清楚。在一家联邦合格健康中心接受治疗的患者中，我们测试了社区参与的数字化推广是否能提高新冠疫苗接种率。
研究设计、背景与参与者：一项采用混合有效性-实施设计的三平行组随机对照试验，于2021年研究入组时对年龄≥18岁的患者进行，按3:10:20的比例分配1650名患者；随后又从2328名患者中选出进行两轮后续实施。
2021年4月13日至6月10日，作为常规做法的一部分，主动向患者发送短信邀请预约接种疫苗（第1组，n = 150），单独增加个性化临床医生推荐（第2组，n = 500）或明确推动回答常见问题（第3组，n = 1000）。进一步实施时使用了针对疫苗犹豫情绪（n = 1323）或疫苗不良反应（n = 1005）的信息。
主要结局是在外展后14天、30天和90天确定的首次接种严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫苗剂量的完成情况。
在有效性分组的1650名患者中，61%为女性。第1组、第2组和第3组在14天时的疫苗接种率分别为6%（n = 9）、5.4%（n = 27）和3.3%（n = 33），在90天时分别为11.5%（n = 17）、11.6%（n = 58）和8.5%（n = 85），两两比较相似。在90天时，两轮实施的疫苗接种率相似（3.9%对3.6%），且与未被选入干预组或实施轮次的患者（n = 8671）的接种率（3.3%）相似。
包括短信推广并辅以临床医生推荐的数字化推广并未提高COVID-19疫苗接种率。
本研究已在ClinicalTrails.gov注册，标识符：NCT04952376。
