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Accepted (AM)Open Access (License Unspecified), Open
Journal article
A Randomized Trial of Behavioral Nudges Delivered Through Text Messages to Increase Influenza Vaccination Among Patients With an Upcoming Primary Care Visit
American journal of health promotion, pp 8901171221131021-8901171221131021
04 Oct 2022
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose
To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza vaccination rates.
Design
Randomized, controlled trial.
Setting
Two health systems in the Northeastern US between September 2020 and March 2021.
Subjects
74,811 adults.
Interventions
Patients in the 19 intervention arms received 1-2 text messages in the 3 days preceding their appointment that varied in their format, interactivity, and content.
Measures
Influenza vaccination.
Analysis
Intention-to-treat.
Results
Participants had a mean (SD) age of 50.7 (16.2) years; 55.8% (41,771) were female, 70.6% (52,826) were White, and 19.0% (14,222) were Black. Among the interventions, 5 of 19 (26.3%) had a significantly greater vaccination rate than control. On average, the 19 interventions increased vaccination relative to control by 1.8 percentage points or 6.1% (P = .005). The top performing text message described the vaccine to the patient as “reserved for you” and led to a 3.1 percentage point increase (95% CI, 1.3 to 4.9; P < .001) in vaccination relative to control. Three of the top five performing messages described the vaccine as “reserved for you.” None of the interventions performed worse than control.
Conclusions
Text messages encouraging vaccination and delivered prior to an upcoming appointment significantly increased influenza vaccination rates and could be a scalable approach to increase vaccination more broadly.
Metrics
Details
- Title
- A Randomized Trial of Behavioral Nudges Delivered Through Text Messages to Increase Influenza Vaccination Among Patients With an Upcoming Primary Care Visit
- Creators
- Mitesh S. Patel - Department of Clinical Transformation and Behavioral Insights, Ascension, St. Louis, MO, USAKatherine L. Milkman - University of PennsylvaniaLinnea Gandhi - University of PennsylvaniaHeather N. Graci - University of PennsylvaniaDena Gromet - University of PennsylvaniaHung Ho - University of ChicagoJoseph S. Kay - University of PennsylvaniaTimothy W. Lee - Northwestern UniversityJake Rothschild - University of PennsylvaniaModupe Akinola - Department of Management, Columbia Business School, Columbia University, New York, NY, USAJohn Beshears - Negotiation, Organizations & Markets Unit, Harvard Business School, Harvard University, Boston, MA, USAJonathan E. Bogard - University of California, Los AngelesAlison Buttenheim - University of PennsylvaniaChristopher Chabris - Geisinger Health SystemGretchen B. Chapman - Carnegie Mellon UniversityJames J. Choi - Yale UniversityHengchen Dai - University of California, Los AngelesCraig R. Fox - University of California, Los AngelesAmir Goren - Geisinger Health SystemMatthew D. Hilchey - University of TorontoJillian Hmurovic - Drexel UniversityLeslie K. John - Negotiation, Organizations & Markets Unit, Harvard Business School, Harvard University, Boston, MA, USADean Karlan - Northwestern UniversityMelanie Kim - University of TorontoDavid Laibson - Negotiation, Organizations & Markets Unit, Harvard Business School, Harvard University, Boston, MA, USACait Lamberton - University of PennsylvaniaBrigitte C. Madrian - Brigham Young UniversityMichelle N. Meyer - Geisinger Health SystemMaria Modanu - Department of Management, Columbia Business School, Columbia University, New York, NY, USAJimin Nam - Negotiation, Organizations & Markets Unit, Harvard Business School, Harvard University, Boston, MA, USATodd Rogers - Negotiation, Organizations & Markets Unit, Harvard Business School, Harvard University, Boston, MA, USARenante Rondina - University of TorontoSilvia Saccardo - Carnegie Mellon UniversityMaheen Shermohammed - Geisinger Health SystemDilip Soman - University of TorontoJehan Sparks - University of California, Los AngelesCaleb Warren - University of ArizonaMegan Weber - University of California, Los AngelesRon Berman - University of PennsylvaniaChalanda N. Evans - University of PennsylvaniaSeung Hyeong Lee - Negotiation, Organizations & Markets Unit, Harvard Business School, Harvard University, Boston, MA, USAChristopher K. Snider - University of PennsylvaniaEli Tsukayama - University of Hawaii–West OahuChristophe Van den Bulte - University of PennsylvaniaKevin G. Volpp - University of PennsylvaniaAngela L. Duckworth - University of PennsylvaniaMin Soo Kim - A.J. Drexel Nanomaterials Institute
- Publication Details
- American journal of health promotion, pp 8901171221131021-8901171221131021
- Publisher
- SAGE Publications
- Grant note
- AKO Foundation Robert Wood Johnson Foundation (https://doi.org/10.13039/100000867) The Flu Lab John Alexander P30AG034532 / National Institute on Aging (https://doi.org/10.13039/100000049) University of Pennsylvania Health System (https://doi.org/10.13039/100016783) Penn Center for Precision Medicine Accelerator Fund Mark J. Leder Warren G. Lichtenstein Bill and Melinda Gates Foundation (https://doi.org/10.13039/100000865)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics; Marketing; A.J. Drexel Nanomaterials Institute
- Web of Science ID
- WOS:000863950000001
- Scopus ID
- 2-s2.0-85139474066
- Other Identifier
- 991019173553804721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health