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

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.

SUBMITTER: Milkman KL

PROVIDER: S-EPMC8157982 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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

Milkman Katherine L KL Patel Mitesh S MS Gandhi Linnea L Graci Heather N HN Gromet Dena M DM Ho Hung H Kay Joseph S JS Lee Timothy W TW Akinola Modupe M Beshears John J Bogard Jonathan E JE Buttenheim Alison A Chabris Christopher F CF Chapman Gretchen B GB Choi James J JJ Dai Hengchen H Fox Craig R CR Goren Amir A Hilchey Matthew D MD Hmurovic Jillian J John Leslie K LK Karlan Dean D Kim Melanie M Laibson David D Lamberton Cait C Madrian Brigitte C BC Meyer Michelle N MN Modanu Maria M Nam Jimin J Rogers Todd T Rondina Renante R Saccardo Silvia S Shermohammed Maheen M Soman Dilip D Sparks Jehan J Warren Caleb C Weber Megan M Berman Ron R Evans Chalanda N CN Snider Christopher K CK Tsukayama Eli E Van den Bulte Christophe C Volpp Kevin G KG Duckworth Angela L AL

Proceedings of the National Academy of Sciences of the United States of America 20210501 20

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 (<i>N</i> = 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 perform ...[more]

PMID: 33926993

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Project description:ImportanceOutpatient colonoscopy is important for colorectal cancer screening. However, nonadherence and poor bowel preparation are common.ObjectiveTo determine if an automated text messaging intervention with a focus on informational and reminder functions could improve attendance rates and bowel preparation quality for outpatient colonoscopy.Design, setting, and participantsThis randomized clinical trial was conducted in an endoscopy center at an urban academic medical center. Adult patients scheduled for outpatient colonoscopy between January and September 2019 were enrolled by telephone call (early phase) or by automated text message (late phase). Data were analyzed from October 2019 to January 2020.InterventionsAfter enrollment, patients were randomized in a 1:1 ratio to usual care (ie, written instructions and nurse telephone call) or to the intervention (ie, usual care plus an automated series of 9 educational or reminder text messages in the week prior to scheduled colonoscopy).Main outcomes and measuresThe primary outcome was appointment attendance rate with good or excellent bowel preparation. Secondary outcomes included appointment attendance rate, bowel preparation quality (poor or inadequate, fair or adequate, and good or excellent), and cancellation lead time (in days).ResultsAmong 753 patients included and randomized in the trial (median [interquartile range] age, 56 [49-64] years; 364 [48.3%] men; 429 [57.2%] Black), 367 patients were randomized to the intervention group and 386 patients were randomized to the control group. There was no significant difference in the primary outcome between groups (patients attending appointments with good or excellent bowel preparation: intervention, 195 patients [53.1%]; control, 210 patients [54.4%]; P = .73), including when stratified by early or late phase enrollment groups. Similarly, there were no significant differences in secondary outcomes.Conclusions and relevanceThis randomized clinical trial found no significant difference in appointment attendance or bowel preparation quality with an automated text messaging intervention compared with the usual care control. Future work could optimize the content and delivery of text message interventions or identify patient subgroups that may benefit from this approach.Trial registrationClinicalTrials.gov Identifier: NCT03710213.

Dataset Information

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

Publications

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

Similar Datasets

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