Comparison of knowledge and information-seeking behavior after general COVID-19 public health messages and messages tailored for black and atinx communities: a randomized controlled trial

Alsan, Marcella; Stanford, Fatima Cody; Banerjee, Abhijit; Breza, Emily; Chandrasekhar, Arun G.; Eichmeyer, Sarah; Goldsmith-Pinkham, Paul; Ogbu-Nwobodo, Lucy; Olken, Benjamin A.; Torres, Carlos; Sankar, Anirudh; Vautrey, Pierre-Luc; Duflo, Esther

Background: The paucity of public health messages that directly address communities of color might contribute to racial and ethnic disparities in knowledge and behavior related to coronavirus disease 2019 (COVID-19).
Objective: To determine whether physician-delivered prevention messages affect knowledge and information-seeking behavior of Black and Latinx individuals and whether this differs according to the race/ethnicity of the physician and tailored content.
Design: Randomized controlled trial. (Registration:, NCT04371419; American Economic Association RCT Registry, AEARCTR-0005789).
Setting: United States, 13 May 2020 to 26 May 2020.
Participants: 14 267 self-identified Black or Latinx adults recruited via Lucid survey platform.
Intervention: Participants viewed 3 video messages regarding COVID-19 that varied by physician race/ethnicity, acknowledgment of racism/inequality, and community perceptions of mask wearing.
Measurements: Knowledge gaps (number of errors on 7 facts on COVID-19 symptoms and prevention) and information-seeking behavior (number of web links demanded out of 10 proposed).
Results: 7174 Black (61.3%) and 4520 Latinx (38.7%) participants were included in the analysis. The intervention reduced the knowledge gap incidence from 0.085 to 0.065 (incidence rate ratio [IRR], 0.737 [95% CI, 0.600 to 0.874]) but did not significantly change information-seeking incidence. For Black participants, messages from race/ethnicity-concordant physicians increased information-seeking incidence from 0.329 (for discordant physicians) to 0.357 (IRR, 1.085 [CI, 1.026 to 1.145]).
Limitations: Participants' behavior was not directly observed, outcomes were measured immediately postintervention in May 2020, and online recruitment may not be representative.
Conclusion: Physician-delivered messages increased knowledge of COVID-19 symptoms and prevention methods for Black and Latinx respondents. The desire for additional information increased with race-concordant messages for Black but not Latinx respondents. Other tailoring of the content did not make a significant difference.