Testing Multiple Behavioral Science Strategies to Increase Flu-Shot Rates at a Large Retail Pharmacy
- Conditions
- Influenza, Human
- Interventions
- Behavioral: Flu shot text messages
- Registration Number
- NCT04590066
- Lead Sponsor
- University of Pennsylvania
- Brief Summary
This research aims to identify which behavioral science strategies are most effective at increasing flu vaccination rates overall and based on patients' individual characteristics. Past behavioral science interventions have shown promise in increasing flu vaccinations. For example, successful interventions have encouraged people to make concrete plans for when they will get a flu vaccination, sent automated calls or text messages reminding patients to get a flu vaccination , or provided financial incentives for getting vaccinated. Although these results are promising, these studies have been conducted in isolation on different populations, which makes it difficult to compare their interventions' effectiveness or to have enough power to reliably detect differing responses to interventions based on individual characteristics.
This research will simultaneously test 22 different SMS interventions to increase flu vaccinations compared to a holdout control condition in a "mega-study" and apply machine learning to identify which interventions work best for whom. The interventions are designed by behavioral science experts from the Behavior Change for Good Initiative (BCFG), Penn Medicine Nudge Unit (PMNU), and Geisinger Behavioral Insights Team (BIT). Customers of a large retail pharmacy who received a flu shot from the pharmacy last year and receive SMS notifications will be included in this study. We expect this to include approximately 1.2 million participants.
The specific aims of this research are to identify (1) which behavioral science strategies effectively increase flu vaccination rates overall, and (2) which strategies are most effective for different subgroups (e.g., based on age, gender, race).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 734383
- Have agreed to receive SMS messages from the pharmacy
- Received a flu shot from the pharmacy in the 2019-2020 flu season, as documented in their pharmacy records.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Unpacking Risks Treatment Flu shot text messages Participants will be asked to think about the risks of catching the flu this flu season and to respond with the location they are most likely to catch the flu out of a list of given options (e.g. at work, at home). Active Commitment Control Flu shot text messages Participants receive a gain framed notification that they are eligible for a flu shot. Participants receive a general reminder 3 days later. Self-Generated Social Norms Control Flu shot text messages articipants will be informed of the opportunity to receive a flu vaccine at their appointment. They will receive a reminder 3 days later. Prosocial Condition Flu shot text messages Participants will receive a message describing the condition-specific benefit of getting a flu shot, and a reminder to ask for their flu shot. The message will also give prosocial reasons for vaccinating (i.e., protecting loved ones; preserving scarce resources). Self-Oriented + COVID-19 Flu shot text messages Participants will receive a message describing the condition-specific benefit of getting a flu shot, and a reminder to ask for their flu shot. The message will also emphasize the pandemic (e.g., risk of hospital-acquired COVID-19 infection; wasting scarce resources). No Humor Condition Flu shot text messages Participants will receive a text message encouraging them to get the flu shot. Foot-in-the-Door Treatment Flu shot text messages Participants will first receive a message enjoining them to encourage someone else to receive a flu vaccine this year. They will then be given a message that they might copy-paste to forward to friends, thereby lowering the effort costs of messaging others. They will receive a reminder 3 days later. Self-Oriented Condition Flu shot text messages Participants will receive a message describing the condition-specific benefit of getting a flu shot, and a reminder to ask for their flu shot. Dynamic + Static Norm Flu shot text messages Participants will receive a text message encouraging them to get a flu shot and informing them that more American adults are getting their flu shot than ever before and how many Americans got their flu shot last year. Dynamic Norm Flu shot text messages Participants will receive a text message encouraging them to get a flu shot and informing them that more American adults are getting their flu shot than ever before. Humor Placebo Flu shot text messages Participants will receive a text message encouraging them to get the flu shot. This message will include the same joke but participants will not be encouraged to share it. Self-Generated Social Norms Treatment Flu shot text messages Participants will first receive a message enjoining them to consider 2 peers who would want them to vaccinate. Then they will be asked to do those peers a favor by getting a vaccine at their next opportunity. They will receive a reminder 3 days later. Unpacking Risks Control Flu shot text messages Participants will be asked to think about the risks of catching the flu this flu season and to respond to confirm that they have received the message. Active Commitment Treatment Flu shot text messages Participants receive a gain framed notification that they are eligible for a flu shot. In addition, participants are told "Many people find it helpful to make a plan to get their shot" and are asked to commit by texting back "I will get a flu shot." Depending on their response, participants receive a general reminder or a commitment reminder 3 days later. Foot-in-the-Door Control Flu shot text messages Participants will be informed of the opportunity to receive a flu vaccine at their appointment. They will receive a reminder 3 days later. Prosocial + COVID-19 Flu shot text messages Participants will receive a message describing the condition-specific benefit of getting a flu shot, and a reminder to ask for their flu shot. The message will also give prosocial reasons for vaccinating (e.g., protecting loved ones; preserving scarce resources). The message will also emphasize the pandemic (e.g., risk of hospital-acquired COVID-19 infection; wasting scarce resources). Reverse Inference Condition Flu shot text messages Participants will receive a text message encouraging them to get a flu shot and informing them that Americans who get flu shots are healthier, wealthier, and more educated. Dynamic Norms Control Flu shot text messages Participants will only receive a text message encouraging them to get a flu shot. They will not receive any norm information. Sharing Humor Flu shot text messages Participants will receive a text message encouraging them to get the flu shot. The message will include a joke about the flu and will encourage participants to share the joke with nurses, doctors, or pharmacists. Connecting the Past Self to the Future Self Treatment Flu shot text messages Participants will receive a text message prompt to recall the negative experience of getting sick. When asked, "Do you wish you could have avoided getting sick by getting a simple shot?", participants will have the chance to respond Y for yes or N for no. Regardless of their response, they will be prompted with a second text message to connect their past experience with present-day opportunities for preventative care (getting a flu shot) to protect the future self from the flu. Connecting the Past Self to the Future Self Control Flu shot text messages In the first text message, participants will receive a simple text message encouragement to receive a flu shot. In the second text message, they will receive a reminder of the appointment time and provider name. Reverse Inference Control Condition Flu shot text messages Participants will receive a text message encouraging them to get a flu shot and informing them that Americans who get flu shots are less likely to get the flu.
- Primary Outcome Measures
Name Time Method Whether participants receive a flu shot vaccination at our pharmacy partner by December 31, 2020 98 days The primary outcome measure is whether participants receive a flu shot at our retail pharmacy partner by December 31, 2020 (as recorded in their pharmacy records) after receiving the SMS intervention on September 25, 2020.
Participants who receive a flu shot before September 25, 2020 when they received the SMS intervention will be excluded from the analyses.
- Secondary Outcome Measures
Name Time Method Whether participants receive a flu shot vaccination at our pharmacy partner by October 31, 2020 37 days The secondary outcome measure is whether participants receive a flu shot at our retail pharmacy partner by October 31, 2020 (as recorded in their pharmacy records) after receiving the SMS intervention on September 25, 2020.
Participants who receive a flu shot before they receive the SMS intervention on September 25, 2020 will be excluded from the analyses.
Trial Locations
- Locations (1)
University of Pennsylvania
🇺🇸Philadelphia, Pennsylvania, United States