JMIR Publications

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.