“A Friendly Conversation.” Developing an eHealth Intervention to Increase COVID-19 Testing and Vaccination Literacy Among Women with Criminal and Legal System Involvement

Abstract

Many women leaving jails are ill-prepared to follow recommended COVID-19 mitigation practices, including testing and vaccination. Low COVID-19-related health literacy, exposure to disinformation, and mistrust in authorities put women at increased risk. Research on this population has shown significant use of mobile devices for communication and web access and public Wi-fi for the internet. Using inductive (formative empirical research with the community) and deductive (theory-based) practices, we designed, developed, and pilot-tested a multimedia, culturally tailored web-based electronic health (eHealth) application to increase COVID-19-specific health literacy and promote testing and vaccination among women with criminal and legal system involvement (CLSI). The intervention included a serialized animated multimedia component and a telenovela-style series, complementing each other and addressing knowledge needs identified in the formative research phase of the project. The eHealth intervention was pilot-tested with 13 CLSI women by using online activity logs and semi-structured telephone interviews. Findings confirmed that eHealth interventions employing multimodal information delivery had increased chances of engaging audiences, especially when developed with input from the target population and are culturally tailored. In addition, using a web-based delivery optimized for mobile made the intervention accessible on various devices and decreased the risk of technical problems.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data Deposition

Data sharing is unavailable due to confidentiality issues, as participants are women with CLSI.

Acknowledgments

The authors want to thank all the women with CLSI who provided feedback and supported the design and conceptualization of this intervention, as well as our research colleagues from Kansas City, Birmingham, and Oakland who helped with participant recruitment, data collection, and provided valuable feedback on both the content and eHealth application. A special thanks to the Center for Excellence in Health Communication to Underserved Populations from the University of Kansas School of Journalism and Mass Communications for filming and multimedia production.

Notes

¹ eHealth is defined as health services and information delivered or enhanced through the Internet and related technologies.

² We use the word “women” here acknowledging that most of the people we work with identified as female when we met them. Though for some, gender status has changed over time. We also acknowledge that many people, regardless of their stated gender, are unfairly incarcerated in sex-segregated facilities according to their sex assigned at birth.

Additional information

Funding

This work was supported by a RadX-UP grant from the NIH, The National Institute on Minority Health and Health Disparities under grant U01MD017415: Localized mHealth approach to boosting COVID-19 testing and vaccine literacy, access, and uptake among women with criminal legal system involvement (2022-2024).Human Subjects ProtectionThe Institutional Review Board of the University of Kansas approved the study.