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A megastudy of text-based nudges encouraging patients to get vaccinated at an upcoming doctor’s appointment

Author

Listed:
  • Katherine L. Milkman

    (Department of Operations, Information and Decisions, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104)

  • Mitesh S. Patel

    (Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104)

  • Linnea Gandhi

    (Department of Operations, Information and Decisions, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104)

  • Heather N. Graci

    (Behavior Change for Good Initiative, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104)

  • Dena M. Gromet

    (Behavior Change for Good Initiative, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104)

  • Hung Ho

    (Department of Operations, Information and Decisions, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104)

  • Joseph S. Kay

    (Behavior Change for Good Initiative, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104)

  • Timothy W. Lee

    (Behavior Change for Good Initiative, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104)

  • Modupe Akinola

    (Management Division, Columbia Business School, Columbia University, New York, NY 10027)

  • John Beshears

    (Negotiation, Organizations & Markets Unit, Harvard Business School, Harvard University, Boston, MA 02163)

  • Jonathan E. Bogard

    (Department of Behavioral Decision Making, Anderson School of Management, University of California Los Angeles, Los Angeles, CA 90095)

  • Alison Buttenheim

    (Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104)

  • Christopher F. Chabris

    (Behavioral Insights Team, Steele Institute for Health Innovation, Geisinger Health System, Danville, PA 17822; Autism and Developmental Medicine Institute, Geisinger Health System, Lewisburg, PA 17837)

  • Gretchen B. Chapman

    (Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, PA 15213)

  • James J. Choi

    (Yale School of Management, Yale University, New Haven, CT 06511)

  • Hengchen Dai

    (Department of Management and Organizations, Anderson School of Management, University of California Los Angeles, Los Angeles, CA 90095)

  • Craig R. Fox

    (Department of Management and Organizations, Anderson School of Management, University of California Los Angeles, Los Angeles, CA 90095)

  • Amir Goren

    (Behavioral Insights Team, Steele Institute for Health Innovation, Geisinger Health System, Danville, PA 17822)

  • Matthew D. Hilchey

    (Behavioural Economics in Action at Rotman, Rotman School of Management, University of Toronto, Toronto, ON M5S 3E6, Canada)

  • Jillian Hmurovic

    (Wharton Risk Management and Decision Processes Center, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104)

  • Leslie K. John

    (Negotiation, Organizations & Markets Unit, Harvard Business School, Harvard University, Boston, MA 02163)

  • Dean Karlan

    (Department of Finance, Kellogg School of Management, Northwestern University, Evanston, IL 60208)

  • Melanie Kim

    (Behavioural Economics in Action at Rotman, Rotman School of Management, University of Toronto, Toronto, ON M5S 3E6, Canada)

  • David Laibson

    (Department of Economics, Harvard University, Cambridge, MA 02138)

  • Cait Lamberton

    (Department of Marketing, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104)

  • Brigitte C. Madrian

    (Department of Finance, Marriott School of Business, Brigham Young University, Provo, UT 84602)

  • Michelle N. Meyer

    (Behavioral Insights Team, Steele Institute for Health Innovation, Geisinger Health System, Danville, PA 17822; Center for Translational Bioethics and Health Care Policy, Geisinger Health System, Danville, PA 17822)

  • Maria Modanu

    (Management Division, Columbia Business School, Columbia University, New York, NY 10027)

  • Jimin Nam

    (Marketing Unit, Harvard Business School, Harvard University, Boston, MA 02163)

  • Todd Rogers

    (Harvard Kennedy School of Government, Harvard University, Cambridge, MA 02138)

  • Renante Rondina

    (Behavioural Economics in Action at Rotman, Rotman School of Management, University of Toronto, Toronto, ON M5S 3E6, Canada)

  • Silvia Saccardo

    (Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, PA 15213)

  • Maheen Shermohammed

    (Behavioral Insights Team, Steele Institute for Health Innovation, Geisinger Health System, Danville, PA 17822)

  • Dilip Soman

    (Behavioural Economics in Action at Rotman, Rotman School of Management, University of Toronto, Toronto, ON M5S 3E6, Canada)

  • Jehan Sparks

    (Department of Behavioral Decision Making, Anderson School of Management, University of California Los Angeles, Los Angeles, CA 90095)

  • Caleb Warren

    (Department of Marketing, Eller College of Management, University of Arizona, Tucson, AZ 85721)

  • Megan Weber

    (Department of Behavioral Decision Making, Anderson School of Management, University of California Los Angeles, Los Angeles, CA 90095)

  • Ron Berman

    (Department of Marketing, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104)

  • Chalanda N. Evans

    (Penn Medicine Nudge Unit, Penn Medicine, Philadelphia, PA 19104)

  • Christopher K. Snider

    (Center for Health Care Innovation, Penn Medicine, Philadelphia, PA 19104)

  • Eli Tsukayama

    (Business Administration Division, University of Hawai`i-West O`ahu, Kapolei, HI 96707)

  • Christophe Van den Bulte

    (Department of Marketing, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104)

  • Kevin G. Volpp

    (Penn Center for Health Incentives and Behavioral Economics, Departments of Medical Ethics and Health Policy and Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104)

  • Angela L. Duckworth

    (Department of Operations, Information and Decisions, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104; Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104)

Abstract

Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment ( N = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor’s appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.

Suggested Citation

  • Katherine L. Milkman & Mitesh S. Patel & Linnea Gandhi & Heather N. Graci & Dena M. Gromet & Hung Ho & Joseph S. Kay & Timothy W. Lee & Modupe Akinola & John Beshears & Jonathan E. Bogard & Alison But, 2021. "A megastudy of text-based nudges encouraging patients to get vaccinated at an upcoming doctor’s appointment," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 118(20), pages 2101165118-, May.
    • Handle: RePEc:nas:journl:v:118:y:2021:p:e2101165118
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    Citations

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    Cited by:

    1. Cornelia Betsch & Philipp Schmid & Pierre Verger & Stephan Lewandowsky & Anna Soveri & Ralph Hertwig & Angelo Fasce & Dawn Holford & Paul Raeve & Arnaud Gagneur & Pia Vuolanto & Tiago Correia & Lara T, 2022. "A call for immediate action to increase COVID-19 vaccination uptake to prepare for the third pandemic winter," Nature Communications, Nature, vol. 13(1), pages 1-6, December.
    2. Rowan Terrell & Abdallah Alami & Daniel Krewski, 2023. "Interventions for COVID-19 Vaccine Hesitancy: A Systematic Review and Narrative Synthesis," IJERPH, MDPI, vol. 20(12), pages 1-17, June.
    3. Felix Holzmeister & Magnus Johannesson & Robert Böhm & Anna Dreber & Jürgen Huber & Michael Kirchler, 2023. "Heterogeneity in effect size estimates: Empirical evidence and practical implications," Working Papers 2023-17, Faculty of Economics and Statistics, Universität Innsbruck.
    4. Angerer, Silvia & Glätzle-Rützler, Daniela & Lergetporer, Philipp & Rittmannsberger, Thomas, 2023. "How does the vaccine approval procedure affect COVID-19 vaccination intentions?," European Economic Review, Elsevier, vol. 158(C).
    5. Huang, Qian & Gilkey, Melissa B. & Thompson, Peyton & Grabert, Brigid K. & Dailey, Susan Alton & Brewer, Noel T., 2022. "Explaining higher Covid-19 vaccination among some US primary care professionals," Social Science & Medicine, Elsevier, vol. 301(C).
    6. Hirani, Jonas Cuzulan & Wüst, Miriam, 2024. "Reminder design and childhood vaccination coverage," Journal of Health Economics, Elsevier, vol. 93(C).
    7. Bonander, Carl & Ekman, Mats & Jakobsson, Niklas, 2022. "Vaccination nudges: A study of pre-booked COVID-19 vaccinations in Sweden," Social Science & Medicine, Elsevier, vol. 309(C).
    8. Victor, Vijay & Nair, Aparna M. & Meyer, Daniel Francois, 2023. "Nudges and choice architecture in public policy: A bibliometric analysis," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 104(C).
    9. Calder, Bobby J. & He, Sharlene & Sternthal, Brian, 2023. "Using theoretical frameworks in behavioral research," Journal of Business Research, Elsevier, vol. 161(C).
    10. Sasaki, Shusaku & Saito, Tomoya & Ohtake, Fumio, 2022. "Nudges for COVID-19 voluntary vaccination: How to explain peer information?," Social Science & Medicine, Elsevier, vol. 292(C).
    11. Zhu, Oscar Yuheng & Grün, Bettina & Dolnicar, Sara, 2022. "Tourism and vaccine hesitancy," Annals of Tourism Research, Elsevier, vol. 92(C).
    12. de Ridder, Denise & Adriaanse, Marieke & van Gestel, Laurens & Wachner, Jonas, 2023. "How does nudging the COVID-19 vaccine play out in people who are in doubt about vaccination?," Health Policy, Elsevier, vol. 134(C).
    13. Polman, Evan & Ruttan, Rachel L. & Peck, Joann, 2022. "Using curiosity to incentivize the choice of “should” options," Organizational Behavior and Human Decision Processes, Elsevier, vol. 173(C).

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