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Covid-19 Messaging to Underserved Communities - 2nd Experiment
Last registered on September 15, 2020

Pre-Trial

Trial Information
General Information
Title
Covid-19 Messaging to Underserved Communities - 2nd Experiment
RCT ID
AEARCTR-0006177
Initial registration date
August 05, 2020
Last updated
September 15, 2020 12:04 PM EDT
Location(s)

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Primary Investigator
Affiliation
MIT
Other Primary Investigator(s)
Additional Trial Information
Status
In development
Start date
2020-08-08
End date
2021-09-01
Secondary IDs
Abstract
Recent data have shown that covid19 is disproportionately infecting and killing African Americans and Latinx people in the United States. Moreover, since our last experiment, the killing of George Floyd by Minnesota police has raised awareness of structural racism in the United States.

The aim of the study is to build off results from our first experiment (AEARCTR-0005789, NCT04371419), and test whether messages that acknowledge racial injustice on behalf of institutions affect the retention of knowledge and movement of beliefs and behavior with respect to COVID-19. We will also test the effect of concordance of providers and whether highlighting the unequal burden of the disease has additional effects on knowledge, beliefs and behavior regarding covid-19. The sample will include African American and white adult Americans and oversample those with less than a college degree. We are also interested in whether there are differential impacts of racial concordance and acknowledgments of racial injustice by the race and political views of the message's recipient.
External Link(s)
Registration Citation
Citation
Duflo, Esther . 2020. "Covid-19 Messaging to Underserved Communities - 2nd Experiment." AEA RCT Registry. September 15. https://doi.org/10.1257/rct.6177-2.2.
Sponsors & Partners
Partner(s)
Type
private_company
Url
Experimental Details
Interventions
Intervention(s)
Our experiment will be conducted online with white and African American respondents with less than college eduction. Participants will first answer a set of baseline questions. They will then be given a series of video messages pertaining to health and health-preserving behaviors. The first message will be an AMA statement about either racial injustice (treatment) or drug pricing (control). The second set of messages will pertain either to COVID-19 or a placebo set of non-COVID-19 health topics. The racial concordance of the messengers in the videos with the participants will be randomized. Participants will then compete an endline questionnaire. 3-5 days later participants will be contacted to complete an online follow-up survey.
Intervention Start Date
2020-08-08
Intervention End Date
2020-09-11
Primary Outcomes
Primary Outcomes (end points)
1. The number of participants with knowledge of COVID related symptoms and transmission as assessed by a
questionnaire we've developed specifically relevant to the intervention videos we are using for the project.
We discuss asymptomatic transmission as well as the common symptoms of cough, fever, shortness of breath and
loss of taste/smell.
[Time Frame: immediately following the intervention]

2. The number of participants with knowledge of COVID related symptoms and transmission as assessed by a
questionnaire we've developed specifically relevant to the intervention videos we are using for the project.
We discuss asymptomatic transmission as well as the common symptoms of cough, fever, shortness of breath and
loss of taste/smell.
[Time Frame: At a follow-up within 2 weeks following the intervention]

3. Behavioral outcome 1: Number of participants who report behavior change related to messages provided in the
intervention videos; measured via a specific questionnaire instrument we've developed to correspond to the intervention.
Specific behaviors include physical distancing, mask wearing and hand hygiene.
[Time Frame: immediately following the intervention]

4. Behavioral outcome 1: Number of participants who report behavior change related to messages provided in the
intervention videos; measured via a specific questionnaire instrument we've developed to correspond to the intervention.
Specific behaviors include physical distancing, mask wearing and hand hygiene.
[Time Frame: At a follow-up within 2 weeks following the intervention]

5. Behavioral outcome 2: Willingness to pay (WTP) for masks
WTP: the participants will be asked to choose between two masks vs an unrestricted gift card. They will be asked what
amount of gift card would make them just as happy to receive two mask versus the gift card.
[Time Frame: immediately following the intervention]

6. Behavioral outcome 3: Number of people who click on links for additional information on the covid-19 behaviors
Links will include testing locations, state public health hotline and symptom tracker.
[Time Frame: immediately following the intervention]

7. Behavioral outcome 4: The amount of money donated to a COVID-19 relief fund.
The measurement tool are donations. The participant will be asked to decide how much of $1,000 (provided by the
investigators) would be donated to two charities, one focusing on COVID relief and one on Alzheimer research.
[Time Frame: immediately following the intervention]
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
We are also collecting participants' evaluations of each of the videos.

We also intend to ask if they plan to share the information with others.

At the endline, we will ask whether they actually discussed any of the information in the videos with others.
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
Individuals participating in the study will watch two sets of videos. We will randomize a) the content of the different videos and b) the racial concordance of the individual delivering the message.

Respondents will first be shown a statement that is consistent with the views of the American Medical Association on one of two issues:
1. Racial Injustice (treatment) [S-AMA]
2. Drug pricing (control) [S-DP]

The statement will be read by an actor. We will have several white and Black actors record each statement. The respondent will be randomized to see one version of the message. In this way, the racial concordance of the message will be randomized.

Respondents will next be shown a set of videos, delivered by a physician, discussing health issues. The treatment videos will pertain to COVID-19, while the control videos will pertain to other common health issues. Each individual will watch three videos, described below:

Treatment Videos

Version with no discussion of disparate incidence [Ta]
Video T1a: Introduction to COVID-19 and its symptoms
Video T2: Information about social distancing and hygiene
Video T3: Information about masks

Some individuals receiving the treatment videos about COVID-19 will receive a different variant of Video 1 with a discussion of disparate impacts. [Tb]
Video T1b: Introduction to COVID-19 and its symptoms, message about the disparate impact of COVID-19 on communities of color.

In Tb, individuals will also be shown Videos 2 and 3.

Placebo Videos [P]:
P1: Fitness Guidelines
P2: Sugar Intake
P3: Sleep

In all treatment arms, the racial concordance of the doctor with the participant will be randomized between condordant [RC] and non-concordant [RNC].

Within
Experimental Design Details
Not available
Randomization Method
We will randomize using the computer at the time of subject enrollment.
Randomization Unit
We are randomizing at the individual level.
Was the treatment clustered?
No
Experiment Characteristics
Sample size: planned number of clusters
We plan to enroll 20,000 individuals in the study. Randomization is at the individual level.
Sample size: planned number of observations
We plan to enroll 20,000 individuals in the study. Randomization is at the individual level.
Sample size (or number of clusters) by treatment arms
There are 24 treatment cells for the white respondents and 24 treatment cells for the African American respondents. We will recruit 10,000 participants total in each group. Across groups, the treatment cells will be the same size. We use the labels, defined above, to indicate treatment.

For example, (S-AMA, RC) + (Ta, RNC) indicates the AMA statement about race delivered by a racially concordant actor + the Ta version of the health videos delivered by a racially non-concordant physician.

Each participant group will be divided into treatments with the following sample sizes:
1. (S-AMA, RC) + (Ta, RC): 1,000
2. (S-AMA, RC) + (Tb, RC): 1,000
3. (S-AMA, RC) + (P, RC): 500
4. (S-AMA, RC) + (Ta, RNC): 1,000
5. (S-AMA, RC) + (Tb, RNC): 1,000
6. (S-AMA, RC) + (P, RNC): 500
7. (S-AMA, RNC) + (Ta, RC): 1,000
8. (S-AMA, RNC) + (Tb, RC): 1,000
9. (S-AMA, RNC) + (P, RC): 500
10. (S-AMA, RNC) + (Ta, RNC): 1,000
11. (S-AMA, RNC) + (Tb, RNC): 1,000
12. (S-AMA, RNC) + (P, RNC): 500
13. (S-DP, RC) + (Ta, RC): 1,000
14. (S-DP, RC) + (Tb, RC): 1,000
15. (S-DP, RC) + (P, RC): 500
16. (S-DP, RC) + (Ta, RNC): 1,000
17. (S-DP, RC) + (Tb, RNC): 1,000
18. (S-DP, RC) + (P, RNC): 500
19. (S-DP, RNC) + (Ta, RC): 1,000
20. (S-DP, RNC) + (Tb, RC): 1,000
21. (S-DP, RNC) + (P, RC): 500
22. (S-DP, RNC) + (Ta, RNC): 1,000
23. (S-DP, RNC) + (Tb, RNC): 1,000
24. (S-DP, RNC) + (P, RNC): 500
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Massachusetts Institute of Technology
IRB Approval Date
2020-07-24
IRB Approval Number
2003000118
Analysis Plan

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