Patient Text Messaging Plus Navigation Intervention Example

Background

Developing and evaluating interventions to address COVID-19 testing and vaccination among these populations are crucial to improving health inequities. The purpose of this paper is to describe the application of a rapid-cycle design and adaptation process from an ongoing trial to address COVID-19 among safety-net healthcare system patients.

Goal

These patient-level population health management interventions are a proactive and coordinated approach to healthcare, where patients at risk or likely to benefit from intervention are identified and receive repeated offers to engage in interventions.

Methods

Text messages include a brief message regarding risk, encouragement for COVID-19 testing/vaccination, and provision of information for scheduling testing/vaccination. Patients who accept testing/vaccination via text message receive additional text messages with instructions for how to schedule either a test or vaccination (e.g., locations, hours, contact information to schedule, online scheduler, or other COVID-19-related information specific to the patient’s clinic). Patients who decline testing/vaccination receive a text message with the clinic phone number and a note to call if anything changes. Patients in the text messaging plus patient navigation condition who accepted testing/ vaccination via text receive the same message as those in text message only condition, plus a note that a patient navigator will be contacting them to assist in connecting them to assistance for testing/vaccination, address any concerns for testing/vaccination, and address social determinants of health. Patient navigators were trained to provide information regarding testing/vaccination, and to address motivation and practical barriers to testing and vaccination. Navigation calls could also address social determinants of health that the patient may be experiencing or anticipates they will experience as a result of a positive test.