Minnesota COVID-19 Testing Project

Covid19 Clinical Trial

Official title:

Minnesota COVID-19 Testing Project

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04568889
• Other study ID #: IRB20-1444
• Status: Completed
• Phase: N/A
• Start date: September 28, 2020
• Est. completion date: August 31, 2022

Study information

• Verified date: October 2022
• Source: Harvard University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The goal of this project is to help the state of Minnesota understand why individuals are not getting tested and potentially identify trusted individuals or organizations that could be used in follow-up work to send messages. Investigators focus on the first two issues of unit and item nonresponse, which is not random across the population and thus could lead to nonresponse bias. To do so, investigators are deploying flyers through 10 Twin City area food shelves and potentially through public housing units with information on how to answer an online questionnaire.

Description:

In the United States, recent statistics show that African American and Latinx communities bear a disproportionate burden from COVID-19. Reaching vulnerable and underserved populations is therefore crucial to combating the disease. However, most public messaging campaigns are not targeted toward underserved communities and don't address fears of social stigma, mistrust in the healthcare system, or concerns about immigration status.

The goal of this project is to help the state of Minnesota understand why individuals are not getting tested and potentially identify trusted individuals or organizations that could be used in follow-up work to send messages. To do so, investigators are deploying flyers through 10 Twin City area food shelves and potentially through public housing units with information on how to answer an online questionnaire.

This provides us with an opportunity to study who answers surveys and why - and what questions are particularly sensitive. This is of general interest to academicians and policymakers alike.

The quality of household surveys is in decline, for three main reasons. First, households have become increasingly less likely to answer surveys at all (unit nonresponse). Second, those that respond are less likely to answer certain questions (item nonresponse). Third, when households do provide answers, they are less likely to be accurate (measurement error). This is important since household surveys help to estimate the employment rate, healthcare needs and of course the census determines resources/representation.

Investigators focus on the first two issues of unit and item nonresponse, which is not random across the population and thus could lead to nonresponse bias. Census tracts with predominantly Hispanic or Black residents had significantly lower response rates to the American Community Survey as compared to the response rates in predominantly white tracts. Similarly, response rates to the Health Information National Trends Survey (HINTS) were lower in areas with higher levels of Hispanic and minority residents.

Investigators hypothesize that financial incentives may encourage unit response; conversely, a close association with the government may discourage response. To test these hypotheses, investigators plan to cross-randomize the incentive amount offered and the emphasis placed on government involvement in the study on flyers advertising the baseline survey. Individuals will see either a) a 10 dollar incentive, or b) a 20 dollar incentive; and either a) messaging that emphasizes government involvement in the study, or b) messaging that emphasizes the involvement of academic researchers. Flyers will be randomized at the foodshelf-day level.

To test what affects item non-response on potentially sensitive questions, such as questions which ask for health information, investigators hypothesize that ethical framing may encourage individuals to answer questions. This takes two forms --- the deontological (or duty based) frame, and the consequential (or cost-benefit) frame. Moreover, knowing others feel the same way (regarding the obligation or benefits of providing health information) may amplify motivation. Finally, there is the possibility that emphasizing the importance of ethnic and racial disadvantage associated with COVID-19 outcomes may be important for improving item non-response on sensitive questions.

Upon completion of the demographic module of the survey but prior to starting several potentially sensitive survey modules, individuals will see a message that either a) emphasizes the public health benefits of answering the survey questions (cost-benefit frame); b) emphasizes an individual's responsibility to their community (duty frame); c) emphasizes the disproportionate impact of COVID-19 on certain ethnic and racial groups; or d) provides no messaging. Messaging content will be randomized at the individual level.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 561
• Est. completion date: August 31, 2022
• Est. primary completion date: August 31, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• All participants who are aged 18 or above and speak English or Spanish

Exclusion Criteria:

• Children, those who do not identify as above or adults who identify as above but do not agree to participate in survey during the consent stage.

Related Conditions & MeSH terms

• Communicable Diseases
• COVID-19
• Covid19
• Infections
• Infectious Disease

Intervention

Behavioral:
• A $10 Survey Incentive
Individuals see a 10 dollar incentive on the flyers advertising the baseline survey.
• A $20 Survey Incentive
Individuals see a 10 dollar incentive on the flyers advertising the baseline survey.
• Emphasis of Government Involvement
Individuals see a message emphasizing the involvement of the government in the study,
• Emphasis of Academic Researchers Involvement
Individuals see a message emphasizing the involvement of academic researchers in the study,
• Cost-Benefit Frame
Individuals will see messaging that emphasizes the public health benefits of answering the survey questions in the baseline survey (cost-benefit frame).
• Duty Frame
Individuals will see messaging that emphasizes an individual's responsibility to their community in the baseline survey (duty frame),
• Racial/Ethnic Frame
Individuals will see messaging that emphasizes the disproportionate impact of COVID-19 on certain ethnic and racial groups in the baseline survey.
• No Messaging
Individuals will see no messaging in the baseline survey.

Locations

Country	Name	City	State
United States	Volunteers Enlisted to Assist People	Bloomington	Minnesota
United States	Southern Anoka Community Assistance	Columbia Heights	Minnesota
United States	People Reaching Out to People Food Shelf	Eden Prairie	Minnesota
United States	Fridley Covenant Church	Fridley	Minnesota
United States	Calvary Lutheran Church Food Shelf	Minneapolis	Minnesota
United States	Community Emergency Assistance Programs	Minneapolis	Minnesota
United States	NorthPoint Health and Wellness	Minneapolis	Minnesota
United States	Intercongregation Communities Association	Minnetonka	Minnesota
United States	Valley Outreach	Stillwater	Minnesota
United States	White Bear Area Foodshelf	White Bear Lake	Minnesota

Sponsors (3)

Lead Sponsor	Collaborator
Harvard University	Abdul Latif Jameel Poverty Action Lab, Government of Minnesota Office of Management and Budget

Country where clinical trial is conducted

United States, 

References & Publications (3)

Griffin, DH. Measuring survey nonresponse by race and ethnicity. In Proceedings of the Annual Meetings of the American Statistical Association. 2002; 11-15.

Maitland A, Lin A, Cantor D, Jones M, Moser RP, Hesse BW, Davis T, Blake KD. A Nonresponse Bias Analysis of the Health Information National Trends Survey (HINTS). J Health Commun. 2017 Jul;22(7):545-553. doi: 10.1080/10810730.2017.1324539. Epub 2017 May 30. — View Citation

Meyer, Bruce D., Wallace KC Mok, and James X. Sullivan. Household surveys in crisis. Journal of Economic Perspectives. 2015; 29(4): 199-226.

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Effect of monetary incentives in increasing unit response 1	Number of participants who received a flyer that mentions a $20 incentive and completed the survey	This outcome will be assessed when the individual agrees to participate in the Baseline survey, which takes approximately 20 minutes.
Primary	Effect of monetary incentives in increasing unit response 2	Number of participants who received a flyer that mentions a $10 incentive and completed the survey.	This outcome will be assessed when the individual agrees to participate in the Baseline survey, which takes approximately 20 minutes.
Primary	Effect of a government frame in reducing unit response 1	Number of participants who received a flyer that mentions a government frame and completed the survey	This outcome will be assessed when the individual agrees to participate in the Baseline survey, which takes approximately 20 minutes.
Primary	Effect of a government frame in reducing unit response 2	Number of participants who received a flyer that mentions a research frame and completed the survey.	This outcome will be assessed when the individual agrees to participate in the Baseline survey, which takes approximately 20 minutes.
Primary	Interactions between monetary incentives and a government frame 1	Number of participants who received a flyer that mentions a government frame and $20 incentive and completed the survey	This outcome will be assessed when the individual agrees to participate in the Baseline survey, which takes approximately 20 minutes.
Primary	Interactions between monetary incentives and a government frame 2	Number of participants who received a flyer that mentions a government frame and $10 incentive and completed the survey	This outcome will be assessed when the individual agrees to participate in the Baseline survey, which takes approximately 20 minutes.
Primary	Interactions between monetary incentives and a government frame 3	Number of participants who received a flyer that mentions a researcher frame and $20 incentive and completed the survey	This outcome will be assessed during the 20-minute Baseline Survey.
Primary	Interactions between monetary incentives and a government frame 4	Number of participants who received a flyer that mentions a researcher frame and $10 incentive and completed the survey	This outcome will be assessed during the 20-minute Baseline Survey.
Primary	Demographic characteristics of participants assigned into each treatment arm	Demographic characteristics (e.g. sex, education level, income level, race/ethnicity) of participants who are assigned to each treatment arm and completed the survey.	This outcome will be assessed during the 20-minute Baseline Survey.
Primary	Effect of various messaging frames in increasing item non-response	Number of survey participants who are randomly assigned to receive each messaging frame that: a) emphasizes the public health benefits of answering the survey questions (cost-benefit frame); b) emphasizes an individual's responsibility to their community (duty frame); c) emphasizes the disproportionate impact of COVID-19 on certain ethnic and racial groups; or d) provides no messaging.	This outcome will be assessed during the 20-minute Baseline Survey.