Eliciting Opinions on Health Messaging During the COVID-19 Pandemic: Qualitative Survey Study (Preprint)

Abstract

BACKGROUND Effective public health messaging has been necessary throughout the COVID-19 pandemic, but stakeholders have struggled to communicate critical information to the public, especially in different types of locations like urban and rural areas. OBJECTIVE To identify opportunities to improve COVID-19 messages for community distribution in rural and urban settings and summarize findings to inform future messaging. METHODS We purposively sampled by region (urban or rural) and participant type (general public or healthcare professional) to survey participants about their opinions on four COVID-19 health messages. We designed the survey and analyzed data following pragmatic health equity implementation approaches. Following qualitative analysis of surveys, we designed new COVID-19 messages incorporating participant feedback and redistributed the messages via short survey. RESULTS Sixty-seven participants enrolled: 31 from the rural Southeast Missouri “Bootheel,” 27 from urban St. Louis, and 9 St. Louis healthcare professionals. Overall, we found no qualitative differences between the responses of our urban and rural samples to the open-ended questions. Participants across groups wanted familiar COVID-19 protocols, personal choice in COVID-19 preventive behaviors, and clear source information. Healthcare professionals contextualized their suggestions within the specific needs of their patients. All groups suggested practices consistent with health literate communications. We reached 83.1% of participants for message redistribution, and most had overwhelmingly positive responses to the new messages. CONCLUSIONS We suggest new methods for community involvement in the creation of health messaging through the use of short online survey. We identify areas of improvement for future health messaging like re-affirming the preventive practices advertised early in a crisis, framing messages to allow for personal choice of preventive behavior, highlighting well-known source information, using plain language, and crafting messages for readers that are applicable to their circumstances.