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Patients responded to primary care physicians’ messages for COVID-19 vaccinations

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Messages addressed vaccine safety, effectiveness, trust.

Electronic messages and postcards with primary care physicians’ (PCP) names got Black and Latino patients in the door for their COVID-19 vaccines.

Although the effects were “relatively modest,” if applied on a larger scale, an additional 238,000 Black and Latino older adults may have been vaccinated across the United States, according to a new study.

Kaiser Permanente Northern California’s Division of Research examined the effectiveness of standard and culturally tailored electronic messages and mailings from patients’ own PCPs encouraging COVID-19 vaccines from March 29 to May 20, 2021. The results were published in an original investigation, “Effect of Electronic and Mail Outreach from Primary Care Physicians for COVID-19 Vaccination of Black and Latino Older Adults: A Randomized Clinical Trial,” in the journal JAMA Network Open.

The study involved 8,287 patients aged 65 years and older, around the California Central Valley, Fresno, South Sacramento and San Jose, divided into three groups.

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Some patients who received standard PCP outreach, while others had culturally tailored PCP outreach, via mailings or electronic messages sent via electronic health record patient portals or letters. “Message content addressed trust in the vaccine, safety and effectiveness, side effects, and how to book a vaccine appointment,” the study said. Other patients received culturally tailored messages addressed additional issues: cost and immigration status, and racial and ethnic disparities of COVID-19 among Latino and Black populations.

Four weeks later, unvaccinated patients received follow-up postcards included vaccine information and scannable QR codes, website and telephone number to book an appointment, with added photos for the culturally tailored messages.

The third group received no standard or culturally tailored outreach, although health care staff in the study’s four services areas were not restricted from conducting other vaccination outreach.

Eight weeks later, there was no difference in vaccination rates between the groups receiving standard or culturally tailored messages, but both groups had higher vaccination rates than patients who had usual care with none of the outreach messages from PCPs. The results held true when the groups were subdivided by Black patients and Latino patients preferring English or Spanish language services.

The results align with surveys and expert opinions that physicians are key influencers with their patients, the study said, and suggest PCP outreach should not be overlooked as a potentially effective approach for Black and Latino adults.

“These findings lend credence to the suggestion that PCP outreach may particularly benefit Black and Latino adults, who tend to have higher rates of COVID-19 hesitancy than others,” the study said. “Still, this intervention’s effects were relatively modest. Increasing COVID-19 vaccination rates for these groups likely will require more intensive approaches, including real-time conversations and community-based outreach, as well as behavioral nudges.”


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