Using MOST to Optimize an Intervention to Increase COVID-19 Testing for Frontline Essential Workers

NCT05139927 | Completed Results

• 1 other identifier: IRB-FY2022-6023
• Study Type: interventional
• Target: 438
• Locations: 1 country
• Sites: 1

Brief Summary

COVID-19 testing is essential to controlling the COVID-19 pandemic to break transmission chains and reduce community transmission. However, Black and Latino/Hispanic populations in lower status frontline essential occupations such as food preparation, retail, building maintenance, personal services, and in-home health care have serious barriers to COVID-19 testing and, therefore, insufficient testing rates. The proposed study will use the multiphase optimization strategy framework to address the problem of low COVID-19 testing rates for this population: We will test the effects of four distinct candidate intervention components and then create an efficient multicomponent made up of the most effective combination of the components that can be rapidly scaled up in community settings to boost COVID-19 testing rates.

Conditions

COVID-19; COVID-19 Testing

Keywords

multiphase optimization strategy (MOST); COVID-19 testing; Black and Latino; frontline essential workers

Outcome Measures

Primary Outcomes (1)

• COVID-19 Testing at Follow-up Assessment

  COVID-19 testing at the 6- and/or 12-week follow-up assessment (at least one instance)

  by the 12-week FU

Study Arms (16)

Condition 1

EXPERIMENTAL

Component A: motivational interviewing counseling - ON Component B: Text message intervention - ON Component C: Peer education - ON Component D: Navigation

Behavioral: Motivational interviewing (MI) counseling; Behavioral: Text messages (TMs) and quiz questions (QQs); Behavioral: Peer education; Behavioral: Access to COVID testing

Condition 2

EXPERIMENTAL

Component A: motivational interviewing counseling - ON Component B: Text message intervention - ON Component C: Peer education - ON Component D: Self-test kit

Behavioral: Motivational interviewing (MI) counseling; Behavioral: Text messages (TMs) and quiz questions (QQs); Behavioral: Peer education; Behavioral: Access to COVID testing

Condition 3

EXPERIMENTAL

Component A: motivational interviewing counseling - OFF Component B: Text message intervention - ON Component C: Peer education - ON Component D: Navigation

Behavioral: Text messages (TMs) and quiz questions (QQs); Behavioral: Peer education; Behavioral: Access to COVID testing

Condition 4

EXPERIMENTAL

Component A: motivational interviewing counseling - OFF Component B: Text message intervention - ON Component C: Peer education - ON Component D: Self-test kit

Behavioral: Text messages (TMs) and quiz questions (QQs); Behavioral: Peer education; Behavioral: Access to COVID testing

Condition 5

EXPERIMENTAL

Component A: motivational interviewing counseling - ON Component B: Text message intervention - OFF Component C: Peer education - ON Component D: Navigation

Behavioral: Motivational interviewing (MI) counseling; Behavioral: Peer education; Behavioral: Access to COVID testing

Condition 6

EXPERIMENTAL

Component A: motivational interviewing counseling - ON Component B: Text message intervention - OFF Component C: Peer education - ON Component D: Self-test kit

Behavioral: Motivational interviewing (MI) counseling; Behavioral: Peer education; Behavioral: Access to COVID testing

Condition 7

EXPERIMENTAL

Component A: motivational interviewing counseling - OFF Component B: Text message intervention - OFF Component C: Peer education - ON Component D: Navigation

Behavioral: Peer education; Behavioral: Access to COVID testing

Condition 8

EXPERIMENTAL

Component A: motivational interviewing counseling - OFF Component B: Text message intervention - OFF Component C: Peer education - ON Component D: Self-test kit

Behavioral: Peer education; Behavioral: Access to COVID testing

Condition 9

EXPERIMENTAL

Component A: motivational interviewing counseling - ON Component B: Text message intervention - ON Component C: Peer education - OFF Component D: Navigation

Behavioral: Motivational interviewing (MI) counseling; Behavioral: Text messages (TMs) and quiz questions (QQs); Behavioral: Access to COVID testing

Condition 10

EXPERIMENTAL

Component A: motivational interviewing counseling - ON Component B: Text message intervention - ON Component C: Peer education - OFF Component D: Self test kit

Behavioral: Motivational interviewing (MI) counseling; Behavioral: Text messages (TMs) and quiz questions (QQs); Behavioral: Access to COVID testing

Condition 11

EXPERIMENTAL

Component A: motivational interviewing counseling - OFF Component B: Text message intervention - ON Component C: Peer education - OFF Component D: Navigation

Behavioral: Text messages (TMs) and quiz questions (QQs); Behavioral: Access to COVID testing

Condition 12

EXPERIMENTAL

Component A: motivational interviewing counseling - OFF Component B: Text message intervention - ON Component C: Peer education - OFF Component D: Self test kit

Behavioral: Text messages (TMs) and quiz questions (QQs); Behavioral: Access to COVID testing

Condition 13

EXPERIMENTAL

Component A: motivational interviewing counseling - ON Component B: Text message intervention - OFF Component C: Peer education - OFF Component D: Navigation

Behavioral: Motivational interviewing (MI) counseling; Behavioral: Access to COVID testing

Condition 14

EXPERIMENTAL

Component A: motivational interviewing counseling - ON Component B: Text message intervention - OFF Component C: Peer education - OFF Component D: Self test kit

Behavioral: Motivational interviewing (MI) counseling; Behavioral: Access to COVID testing

Condition 15

EXPERIMENTAL

Component A: motivational interviewing counseling - OFF Component B: Text message intervention - OFF Component C: Peer education - OFF Component D: Navigation

Behavioral: Access to COVID testing

Condition 16

EXPERIMENTAL

Component A: motivational interviewing counseling - OFF Component B: Text message intervention - OFF Component C: Peer education - OFF Component D: Self test kit

Behavioral: Access to COVID testing

Interventions

Motivational interviewing (MI) counseling BEHAVIORAL

Those assigned to receive Component A will engage in a MI single session lasting approximately 30-45 minutes. The overall goal of the session is to increase participants' motivation and readiness to test for COVID-19 in various circumstances.

Condition 1; Condition 10; Condition 13; Condition 14; Condition 2; Condition 5; Condition 6; Condition 9

Text messages (TMs) and quiz questions (QQs) BEHAVIORAL

This intervention lasts 6 weeks. This component is grounded in principles of behavioral economics. Its main goal is to add interest and excitement to the goal of COVID-19 testing, serve as a reminder that COVID-19 testing is recommended in a number of scenarios, and "nudge" participants toward testing and creating a habit of serial screening and COVID-19 testing as needed. Participants first receive a brief orientation to the component (15 min.), and the participant will put the study phone number into his/her phone and a test TM and QQ will be sent. TMs and QQs are programmed into the Telerivet program and sent automatically. Twice a week participants will receive a TM with information about COVID and COVID-19 testing followed by a true/false question about that TM two days later, for which they earn 10 points for a correct answer, and 5 points for an incorrect answer. Participants earn modest prizes based on their points.

Condition 1; Condition 10; Condition 11; Condition 12; Condition 2; Condition 3; Condition 4; Condition 9

Peer education BEHAVIORAL

This component has two aspects: Participants are trained to educate their peers on core messages about the importance of COVID-19 testing that address social norms about COVID-19 testing and highlight COVID-19 testing as an altruistic act (15-20 min. training). Then, participants are given the opportunity to educate three peers who are Black and Latino/Hispanic frontline essential workers on the core messages. These peers contact the study directly and receive a brief assessment and referrals to testing, but are not enrolled in the study.

Condition 1; Condition 2; Condition 3; Condition 4; Condition 5; Condition 6; Condition 7; Condition 8

Access to COVID testing BEHAVIORAL

Component D is an adaptive intervention component that avoids unnecessary costs; it is only provided if needed. Level 1: Over a 2-3 week period, navigation includes a brief needs assessment and guidance to assist participants in prioritizing, accessing, and completing COVID-19 testing sequences in a timely fashion and resolving barriers such as transportation or the possible need to take off work if diagnosed with COVID-19. Level 2: 1 month after enrollment, participants will be contacted by phone. If they have not been tested, we will provide them with a BinaxNOW test kit which can be picked up or mailed to them.

Condition 1; Condition 10; Condition 11; Condition 12; Condition 13; Condition 14; Condition 15; Condition 16; Condition 2; Condition 3; Condition 4; Condition 5; Condition 6; Condition 7; Condition 8; Condition 9

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

Sponsors & Collaborators

• New York University: lead

Study Sites (1)

New York University Silver School of Social Work

New York, New York, 10003, United States

Location

Related Publications (1)

• Gwadz M, Cleland CM, Lizardo M, Hawkins RL, Bangser G, Parameswaran L, Stanhope V, Robinson JA, Karim S, Hollaway T, Ramirez PG, Filippone PL, Ritchie AS, Banfield A, Silverman E. Using the multiphase optimization strategy (MOST) framework to optimize an intervention to increase COVID-19 testing for Black and Latino/Hispanic frontline essential workers: A study protocol. BMC Public Health. 2022 Jun 21;22(1):1235. doi: 10.1186/s12889-022-13576-0.

  PMID: 35729622 DERIVED

MeSH Terms

Conditions

COVID-19

Interventions

Motivational Interviewing; Counseling

Condition Hierarchy (Ancestors)

Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases

Intervention Hierarchy (Ancestors)

Directive Counseling; Mental Health Services; Behavioral Disciplines and Activities; Health Services; Health Care Facilities Workforce and Services; Community Health Services

Results Point of Contact

• Title: Marya Gwadz, PhD
• Organization: NYU

mg2890@nyu.edu

917-863-2125

Study Officials

• Marya Gwadz, PhD

  New York University

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Full factorial experiment testing 4 behavioral intervention components. There are 16 conditions needed to test the effects of the 4 components. Each condition comprises a combination of components. In the sections that follow, we describe the 16 conditions.

Study Record Dates

• First Submitted: November 29, 2021
• First Posted: December 1, 2021
• Study Start: June 1, 2022
• Primary Completion: March 1, 2024
• Study Completion: March 1, 2024
• Last Updated: May 16, 2025
• Results First Posted: May 16, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)