Testing Multiple Behavioral Science Strategies to Increase Flu-Shot Rates at a Large Retail Pharmacy
NCT ID: NCT04590066
Last Updated: 2021-02-01
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
734383 participants
INTERVENTIONAL
2020-09-25
2020-12-31
Brief Summary
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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).
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
DOUBLE
Study Groups
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Holdout control
Participants will only receive the standard pharmacy messaging.
No interventions assigned to this group
Unpacking Risks Treatment
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).
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Unpacking Risks Control
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Active Commitment Treatment
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Active Commitment Control
Participants receive a gain framed notification that they are eligible for a flu shot. Participants receive a general reminder 3 days later.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Self-Generated Social Norms Treatment
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Self-Generated Social Norms Control
articipants will be informed of the opportunity to receive a flu vaccine at their appointment. They will receive a reminder 3 days later.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Foot-in-the-Door Treatment
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Foot-in-the-Door Control
Participants will be informed of the opportunity to receive a flu vaccine at their appointment. They will receive a reminder 3 days later.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Prosocial Condition
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).
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Self-Oriented Condition
Participants will receive a message describing the condition-specific benefit of getting a flu shot, and a reminder to ask for their flu shot.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Prosocial + COVID-19
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).
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Self-Oriented + COVID-19
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).
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Dynamic + Static Norm
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Dynamic Norm
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Dynamic Norms Control
Participants will only receive a text message encouraging them to get a flu shot. They will not receive any norm information.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Sharing Humor
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Humor Placebo
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
No Humor Condition
Participants will receive a text message encouraging them to get the flu shot.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Connecting the Past Self to the Future Self Treatment
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Connecting the Past Self to the Future Self Control
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Reverse Inference Condition
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Reverse Inference Control Condition
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.
Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Interventions
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Flu shot text messages
Participants will receive text messages per descriptions listed in the arms.
Eligibility Criteria
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Inclusion Criteria
2. Received a flu shot from the pharmacy in the 2019-2020 flu season, as documented in their pharmacy records.
Exclusion Criteria
18 Years
ALL
Yes
Sponsors
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University of Pennsylvania
OTHER
Responsible Party
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Locations
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University of Pennsylvania
Philadelphia, Pennsylvania, United States
Countries
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References
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Cutrona SL, Golden JG, Goff SL, Ogarek J, Barton B, Fisher L, Preusse P, Sundaresan D, Garber L, Mazor KM. Improving Rates of Outpatient Influenza Vaccination Through EHR Portal Messages and Interactive Automated Calls: A Randomized Controlled Trial. J Gen Intern Med. 2018 May;33(5):659-667. doi: 10.1007/s11606-017-4266-9. Epub 2018 Jan 30.
Milkman KL, Beshears J, Choi JJ, Laibson D, Madrian BC. Using implementation intentions prompts to enhance influenza vaccination rates. Proc Natl Acad Sci U S A. 2011 Jun 28;108(26):10415-20. doi: 10.1073/pnas.1103170108. Epub 2011 Jun 13.
Regan AK, Bloomfield L, Peters I, Effler PV. Randomized Controlled Trial of Text Message Reminders for Increasing Influenza Vaccination. Ann Fam Med. 2017 Nov;15(6):507-514. doi: 10.1370/afm.2120.
Nowalk MP, Lin CJ, Toback SL, Rousculp MD, Eby C, Raymund M, Zimmerman RK. Improving influenza vaccination rates in the workplace: a randomized trial. Am J Prev Med. 2010 Mar;38(3):237-46. doi: 10.1016/j.amepre.2009.11.011. Epub 2009 Dec 24.
Other Identifiers
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843523-Trial B
Identifier Type: -
Identifier Source: org_study_id
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