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

Katherine 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 Buttenheim, Christopher F. Chabris, Gretchen B. Chapman, James Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie K. John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte Madrian, Michelle N. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin G. Volpp and Angela L. Duckworth
Additional contact information
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
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
Melanie Kim: Behavioural Economics in Action at Rotman, Rotman School of Management, University of Toronto, Toronto, ON M5S 3E6, Canada
Cait Lamberton: Department of Marketing, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104
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
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

Proceedings of the National Academy of Sciences, 2021, vol. 118, issue 20, e2101165118

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.

Keywords: vaccination; COVID-19; nudge; influenza; field experiment (search for similar items in EconPapers)
Date: 2021
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Citations: View citations in EconPapers (15)

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