https://orcid.org/0000-0002-0321-2397
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ABSTRACT
Background
COVID-19 vaccination is a global priority. Latin American countries have some of the highest COVID-19 death rates worldwide with vaccination hampered by a variety of reasons, including mis- and disinformation, vaccine hesitancy, and vaccine supply constraints. Addressing vaccine hesitancy through effective messages has been found to help increase vaccine uptake. Participatory processes could be used to co-design health messages for this purpose.
Objective
This article describes the methodology used to co-design evidence-based audio messages to be deployed in a cohort of individuals through an interactive voice response (IVR) mobile phone survey intervention, aimed towards increasing vaccination uptake in an adult population in Colombia.
Methods
Participants of the COVID-19 vaccination message co-design process included a sample of the general population of the country, representatives of the funder organisation, and research team members. The co-design process consisted of four phases: (1) formative quantitative and qualitative research, (2) message drafting based on the results of the formative research, (3) message content evaluation, and (4) evaluation of the voices to deliver the audio messages; and was informed by reflexive meetings.
Results
Three categories of evidence-based audio messages were co-designed, each corresponding to an arm of the mHealth intervention: (1) factual messages, (2) narrative messages, and (3) mixed messages. An additional fourth arm with no message was proposed for control. The iterative co-design process ended with a total of 14 audio messages recorded to be deployed via the intervention.
Conclusions
Co-developing health messages in response to health emergencies is possible. Adopting more context-relevant, participatory, people-centred, and reflexive multidisciplinary approaches could help develop solutions that are more responsive to the needs of populations and public health priorities. Investing resources in message co-design is deemed to have a greater potential for influencing behaviours and improving health outcomes.
Responsible Editor Maria Nilsson
Responsible Editor Maria Nilsson
Acknowledgments
We thank Efraín Rincón, María Clara Calle Aguirre, Marino Mejía, Tatiana Bejarano Román, Rubén Darío Franco Contreras, and an anonymous epidemiologist, for recording test audio messages for the co-design workshop and the fourth phase of the co-design process. We are also grateful for the insights provided by the health economists of the IADB who participated in the evaluation of the content of the messages.
Author contributions
Funding was acquired by AIVO. NAP, SAL, OFS, and AIVO participated in the study design. NAP, OFS, MCLS, DNGT, MRP, CARS, and AIVO collected the data. NAP, SAL, OFS, MCLS, DNGT, MRP, CARS, and AIVO contributed to data analysis. NAP, OFS, and SAL performed the analysis. MCLS read and extracted from the interview transcripts excerpts that informed the development of the narrative messages. The voice evaluation was conducted by MCLS, MRP, and CARS, with guidelines by OFS and NAP. NAP, SAL, OFS, JOM, DNGT, MCLS, MRP, CARS, DCB, AJT, and AIVO participated in the message content evaluation. NAP, JOM, and OFS translated quotes from the mobile phone interview participants from Spanish to English. NAP drafted the initial manuscript. All authors critically revised the manuscript before final approval.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethics and consent
This research was approved by the Institutional Review Board (IRB) of Johns Hopkins Bloomberg School of Public Health (IRB approval #17868) and by the Research and Ethics Committee of the Institute of Public Health at Pontificia Universidad Javeriana Bogota.
Paper context
The COVID-19 pandemic represents a global priority. Effective communication could help increase COVID-19 vaccine uptake. Using participatory methods could help in developing messages with greater potential for behaviour change impact. Limited evidence describing how vaccination promotion messages are developed exists. This article describes the methodology used to co-develop COVID-19 vaccination messages to be deployed to a cohort of adults in Colombia via interactive voice response (IVR) mobile phone surveys.