Comparison of Knowledge and Information-Seeking Behavior After General COVID-19 Public Health Messages and Messages Tailored for Black and Latinx Communities : A Randomized Controlled Trial

Ann Intern Med. 2021 Apr;174(4):484-492. doi: 10.7326/M20-6141. Epub 2020 Dec 21.


Background: The paucity of public health messages that directly address communities of color might contribute to racial and ethnic disparities in knowledge and behavior related to coronavirus disease 2019 (COVID-19).

Objective: To determine whether physician-delivered prevention messages affect knowledge and information-seeking behavior of Black and Latinx individuals and whether this differs according to the race/ethnicity of the physician and tailored content.

Design: Randomized controlled trial. (Registration:, NCT04371419; American Economic Association RCT Registry, AEARCTR-0005789).

Setting: United States, 13 May 2020 to 26 May 2020.

Participants: 14 267 self-identified Black or Latinx adults recruited via Lucid survey platform.

Intervention: Participants viewed 3 video messages regarding COVID-19 that varied by physician race/ethnicity, acknowledgment of racism/inequality, and community perceptions of mask wearing.

Measurements: Knowledge gaps (number of errors on 7 facts on COVID-19 symptoms and prevention) and information-seeking behavior (number of web links demanded out of 10 proposed).

Results: 7174 Black (61.3%) and 4520 Latinx (38.7%) participants were included in the analysis. The intervention reduced the knowledge gap incidence from 0.085 to 0.065 (incidence rate ratio [IRR], 0.737 [95% CI, 0.600 to 0.874]) but did not significantly change information-seeking incidence. For Black participants, messages from race/ethnicity-concordant physicians increased information-seeking incidence from 0.329 (for discordant physicians) to 0.357 (IRR, 1.085 [CI, 1.026 to 1.145]).

Limitations: Participants' behavior was not directly observed, outcomes were measured immediately postintervention in May 2020, and online recruitment may not be representative.

Conclusion: Physician-delivered messages increased knowledge of COVID-19 symptoms and prevention methods for Black and Latinx respondents. The desire for additional information increased with race-concordant messages for Black but not Latinx respondents. Other tailoring of the content did not make a significant difference.

Primary funding source: National Science Foundation; Massachusetts General Hospital; and National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Video-Audio Media

MeSH terms

  • Adult
  • Black or African American*
  • COVID-19 / epidemiology
  • COVID-19 / ethnology*
  • COVID-19 / prevention & control*
  • Consumer Health Information*
  • Female
  • Hispanic or Latino*
  • Humans
  • Incidence
  • Information Seeking Behavior*
  • Male
  • Masks
  • Pandemics
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / prevention & control
  • Pneumonia, Viral / virology
  • Public Health / methods*
  • SARS-CoV-2
  • Surveys and Questionnaires
  • Video Recording

Associated data