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Related Concept Videos

Clinical Trials01:16

Clinical Trials

Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...

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Population-Based Digital Health Interventions to Deliver at-Home COVID-19 Testing: SCALE-UP II Randomized Clinical

Guilherme Del Fiol1, Tatyana V Kuzmenko1, Brian Orleans2

  • 1Department of Biomedical Informatics, University of Utah, 421 Wakara Way, Suite 140, Salt Lake City, UT, 84108, United States, 1 8015814080.

Journal of Medical Internet Research
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Summary

Simple SMS text messaging effectively delivered at-home COVID-19 testing kits, outperforming chatbots. Frequent messaging increased test requests but also opt-outs, highlighting a trade-off in digital health interventions for public health.

Keywords:
COVID-19at-home testingchatbotsdigital healthtext messaging

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Area of Science:

  • Digital Health
  • Public Health Interventions
  • Health Services Research

Background:

  • Digital health interventions offer a scalable solution for delivering at-home COVID-19 testing.
  • The COVID-19 pandemic underscored the need for accessible testing solutions beyond traditional clinical settings.

Purpose of the Study:

  • To evaluate the effectiveness of three digital health interventions—SMS text messaging, automated chatbot, and patient navigation—in facilitating mailed at-home COVID-19 test kit delivery.
  • To compare the efficacy of different intervention frequencies (10 vs. 30 days) and modalities (chatbot vs. SMS) in a pragmatic randomized controlled trial.

Main Methods:

  • A pragmatic randomized controlled trial involving over 33,000 participants across safety-net community health centers in Utah.
  • Participants were randomized into smartphone and non-smartphone study arms, receiving interventions like SMS, chatbots, patient navigation, and varying message frequencies.
  • The primary outcome measured was the proportion of participants who requested at-home COVID-19 test kits.

Main Results:

  • SMS text messaging was significantly more effective than the automated chatbot in prompting test kit requests among smartphone users (52.1% vs. 16.6%).
  • In the non-smartphone group, more frequent messaging (every 10 days) increased test kit requests (5.5% vs. 4.8%) but also led to higher opt-out rates (12.6% vs. 7.3%).
  • Patient navigation did not increase test kit requests in the non-smartphone group, showing a lower request rate compared to no navigation (4.3% vs. 5.9%).

Conclusions:

  • Automated bidirectional SMS text messaging presents a simple, scalable, and cost-effective strategy for improving access to at-home COVID-19 testing.
  • While frequent messaging can boost engagement, careful consideration of opt-out rates is necessary for sustainable digital health interventions.
  • These findings support the use of digital health tools, particularly SMS, for public health initiatives and expanding at-home testing access.