Introduction From the onset of the COVID-19 pandemic, public health officials have sought to develop evidence-based messages to reduce COVID-19 transmission by communicating key information to media outlets and the public. We describe the development of an interdisciplinary rapid message testing model to quickly create, test, and share messages with public health officials for use in health campaigns and policy briefings. Methods An interdisciplinary research team from the University of North Carolina at Chapel Hill assembled in March 2020 to assist the state health department in developing evidence-based messages to influence social distancing behaviors in the state. We developed and iteratively executed a rapid message testing model; the components of the 4-step model were message creation, survey development, survey administration, and analysis and presentation to health department officials. The model was executed 4 times, each during a 7-day period in April and May, and each subsequent survey included new phrasing and/or messaging informed by the previous week’s survey. A total of 917 adults from North Carolina participated in the 4 surveys. Results Survey participants rated messages focused on protecting oneself and others higher than messages focused on norms and fear-based approaches. Pairing behaviors with motivations increased participants’ desire to social distance across all themes and subgroups. For example, adding “Protect your grandmother, your neighbor with cancer, and your best friend with asthma,” to messaging received a 0.9-point higher score than the base message, “Stay 6 feet apart from others when out in public.” Practice Implications Our model to promote social distancing in North Carolina during the COVID-19 pandemic can be used for rapid, iterative message testing during public health emergencies.

COVID-19 was the third leading cause of death in the United States in 2020. Prior to the wide dissemination of SARS-CoV-2 vaccines, individual prevention behaviors, such as wearing face masks, have been the primary non-pharmaceutical interventions to reduce infections. We surveyed 404 North Carolina residents recruited through Amazon MTurk in July 2020 to assess adherence to key prevention behaviors (6-foot distancing, mask wearing, and gathering limits) and barriers to and facilitators of adherence. Participants reported past 7-day prevention behaviors and behavioral barriers and facilitators informed by the Integrated Behavior Model and the Health Belief Model (perceived risk, perceived severity, behavioral attitudes, injunctive and descriptive norms, and personal agency). Reported adherence to each behavior in the past 7 days was generally high, with lower adherence to 6-foot distancing and mask wearing in the work context. The most commonly endorsed barriers to 6-foot distancing included physical impediments, forgetting, and unfavorable descriptive norms. For mask wearing, ability to keep a distance, discomfort/inconvenience, and forgetting were most commonly endorsed. In logistic regression models, injunctive social norms followed by perceived personal agency were the strongest independent correlates of 6-foot distancing. Behavioral attitudes and injunctive social norms were independently associated with mask wearing. For gathering size limit adherence, perceived personal agency was the strongest independent predictor followed by perceived severity of COVID-19. Messaging campaigns targeting these barriers and facilitators should be tested. Interventions improving the convenience and salience of physical distancing and mask wearing in high-density public places and places of work may also promote prevention behaviors.

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Introduction: Engaging patient advocates in research is a practice that identifies and prioritizes patient perspectives and needs throughout the academic or clinical research process. “Patient advocates” may refer to those receiving care, survivors, caregivers, or other individuals with a stake in a patient’s respective health outcomes. Research shows that engaging advocates in research can have a multifaceted positive impact, including better quality research, expanded applicability of research, and greater understanding of findings within the patient community. However, most researchers report limited engagement of advocates in their research citing significant challenges in its implementation. Purpose:The purpose of this project was to identify the needs of researchers and advocates involved in research at the UNC Lineberger Comprehensive Cancer Center (Lineberger), in order to expand the capability and quality of their engagement. Lineberger recognized the importance of understanding the current engagement structure and identifying ways to increase meaningful opportunities for advocates to participate throughout the research process.Methods:To assess the needs of Lineberger researchers and advocates, we took a mixed-method approach to data collection and analysis. The needs of researchers were assessed quantitatively using a Qualtrics survey aimed at measuring researchers’ involvement and satisfaction with involving advocates in research, current communication methods, and training needs. Four interviews were also conducted with key informant researchers. To assess advocate needs, we conducted a focus group with five Lineberger advocates to explore their connection process with researchers, their training experience, and perceived utilization in cancer research. Quantitative data collected from the survey was analyzed using both Qualtrics’s internal report output and Excel. The interview and focus group recordings were reviewed and critical ideas were transcribed to identify themes.Results: Several common themes emerged when assessing the needs of researchers and advocates. Both groups felt the connection process between researchers and advocates could be improved. The lack of a formal process was a hindrance, with 25% of researchers reporting at least one experience where they were unable to find an advocate to include in their research. Participants also felt training would be helpful. Moreover, advocates and researchers felt that more frequent and streamlined communication would improve project work. Lastly, both groups expressed a desire to expand the advocate pool to include more diverse voices that adequately represent the community.Recommendations:We proposed several recommendations to address the identified needs. To increase connection between advocates and researchers, we recommend a centralized list of trained and vetted advocates available to all Lineberger researchers, and a process, run by a dedicated coordinator, to match available patients with study needs. To improve and increase communication between the two groups, Lineberger should develop a bidirectional, web-based communication platform. For increased efficacy of advocate contributions to research, Lineberger should provide formal, systematic training for researchers and advocates , each group receiving training on distinct, tailored topics. We recommend that the patient pool be intentionally diversified to include categories of gender, race, age, education level, economic status, and cancer-specific knowledge, which would better represent the Lineberger patient. profile. Lineberger should also provide adequate compensation for advocates involved in Lineberger research to ensure the engagement is equitable and ethical. Citation Format: Thomas Blount, Katherine Gora Combs, Caroline Mann Norwood, Emily Rose Skywark, Jennifer A. Potter, Angela Zhang, Patricia A. Spears. Assessing the engagement related needs of researchers and patient advocates at the UNC Lineberger Comprehensive Cancer Center [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-15-02.

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