A Mega-Study of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor’s Appointment

75 Pages Posted: 19 Feb 2021 Last revised: 5 May 2021

See all articles by Katherine L. Milkman

Katherine L. Milkman

University of Pennsylvania - The Wharton School

Mitesh S. Patel

University of Pennsylvania - Perelman School of Medicine, Department of Medicine

Linnea Gandhi

University of Pennsylvania

Heather Graci

University of Pennsylvania

Dena Gromet

University of Pennsylvania

Hung Ho

University of Pennsylvania - Operations & Information Management Department

Joseph Kay

University of Pennsylvania

Timothy Lee

University of Pennsylvania

Modupe Akinola

Columbia University - Columbia Business School

John Beshears

Harvard University - Business School (HBS); National Bureau of Economic Research (NBER)

Jon Bogard

University of California, Los Angeles (UCLA), Anderson School of Management, Students

Alison Buttenheim

University of Pennsylvania

Christopher Chabris

Geisinger Health System

Gretchen B. Chapman

Rutgers, The State University of New Jersey

James J. Choi

Yale School of Management; National Bureau of Economic Research (NBER)

Hengchen Dai

University of California, Los Angeles (UCLA) - Anderson School of Management

Craig R. Fox

University of California, Los Angeles (UCLA) - Anderson School of Management

Amir Goren

Geisinger Health System

Matthew Hilchey

University of Toronto

Jillian Hmurovic

University of Pennsylvania - The Wharton School

Leslie John

Harvard Business School

Dean Karlan

Northwestern University

Melanie Kim

University of Toronto

David Laibson

Harvard University - Department of Economics; National Bureau of Economic Research (NBER)

Cait Lamberton

The Wharton School

Brigitte C. Madrian

Brigham Young University Marriott School of Business; National Bureau of Economic Research (NBER)

Michelle N. Meyer

Clarkson University–Icahn School of Medicine at Mount Sinai Bioethics Program; Geisinger Health System, Center for Translational Bioethics and Health Care Policy

Maria Modanu

Columbia University

Jimin Nam

Harvard Business School

Todd Rogers

Harvard University - Harvard Kennedy School (HKS)

Renante Rondina

University of Toronto - Rotman School of Management

Silvia Saccardo

Carnegie Mellon University, Department of Social and Decision Sciences

Maheen Shermohammed

Geisinger Health System

Dilip Soman

University of Toronto - Behavioural Economics in Action at Rotman (BEAR)

Jehan Sparks

University of California, Los Angeles (UCLA)

Caleb Warren

University of Arizona

Megan Weber

University of California, Los Angeles (UCLA)

Ron Berman

University of Pennsylvania - The Wharton School

Chalanda Evans

University of Pennsylvania - Perelman School of Medicine

Christopher Snider

University of Pennsylvania - Perelman School of Medicine

Eli Tsukayama

University of Hawaii at West O'ahu

Christophe Van den Bulte

University of Pennsylvania - Marketing Department

Kevin Volpp

University of Pennsylvania - Perelman School of Medicine, Department of Medicine

Angela Duckworth

University of Pennsylvania - Department of Psychology

Date Written: January 27, 2021

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 (a) framed as reminders to get flu shots that were already reserved for the patient and (b) 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

JEL Classification: I12

Suggested Citation

Milkman, Katherine L. and Patel, Mitesh S. and Gandhi, Linnea and Graci, Heather and Gromet, Dena and Ho, Quoc Dang Hung and Kay, Joseph and Lee, Timothy and Akinola, Modupe and Beshears, John and Bogard, Jonathan and Buttenheim, Alison and Chabris, Christopher and Chapman, Gretchen B. and Choi, James J. and Dai, Hengchen and Fox, Craig R. and Goren, Amir and Hilchey, Matthew and Hmurovic, Jillian and John, Leslie and Karlan, Dean and Kim, Melanie and Laibson, David I. and Lamberton, Cait and Madrian, Brigitte C. and Meyer, Michelle N. and Meyer, Michelle N. and Modanu, Maria and Nam, Jimin and Rogers, Todd and Rondina, Renante and Saccardo, Silvia and Shermohammed, Maheen and Soman, Dilip and Sparks, Jehan and Warren, Caleb and Weber, Megan and Berman, Ron and Evans, Chalanda and Snider, Christopher and Tsukayama, Eli and Van den Bulte, Christophe and Volpp, Kevin and Duckworth, Angela, A Mega-Study of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor’s Appointment (January 27, 2021). Rotman School of Management Working Paper No. 3780267, Columbia Business School Research Paper Forthcoming, Available at SSRN: https://ssrn.com/abstract=3780267 or http://dx.doi.org/10.2139/ssrn.3780267

Katherine L. Milkman (Contact Author)

University of Pennsylvania - The Wharton School ( email )

Philadelphia, PA 19104
United States

Mitesh S. Patel

University of Pennsylvania - Perelman School of Medicine, Department of Medicine

Philadelphia, PA 19104
United States

Linnea Gandhi

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

Heather Graci

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

Dena Gromet

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

Quoc Dang Hung Ho

University of Pennsylvania - Operations & Information Management Department ( email )

Philadelphia, PA 19104
United States

Joseph Kay

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

Timothy Lee

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

Modupe Akinola

Columbia University - Columbia Business School ( email )

3022 Broadway
New York, NY 10027
United States

John Beshears

Harvard University - Business School (HBS) ( email )

Soldiers Field Road
Morgan 270C
Boston, MA 02163
United States

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Jonathan Bogard

University of California, Los Angeles (UCLA), Anderson School of Management, Students ( email )

Los Angeles, CA
United States

Alison Buttenheim

University of Pennsylvania

Philadelphia, PA 19104
United States

Christopher Chabris

Geisinger Health System ( email )

120 Hamm Drive, Suite 2A, MC 60-36
Lewisburg, PA 17837
United States

HOME PAGE: http://www.chabris.com

Gretchen B. Chapman

Rutgers, The State University of New Jersey ( email )

311 North 5th Street
New Brunswick, NJ 08854
United States

James J. Choi

Yale School of Management ( email )

135 Prospect Street
P.O. Box 208200
New Haven, CT 06520-8200
United States

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Hengchen Dai

University of California, Los Angeles (UCLA) - Anderson School of Management ( email )

110 Westwood Plaza
Los Angeles, CA 90095-1481
United States

Craig R. Fox

University of California, Los Angeles (UCLA) - Anderson School of Management ( email )

110 Westwood Plaza
Los Angeles, CA 90095-1481
United States

Amir Goren

Geisinger Health System ( email )

100 North Academy Ave.
Danville, PA 17822-4910
United States

Matthew Hilchey

University of Toronto ( email )

Toronto, Ontario M5S 3G8
Canada

Jillian Hmurovic

University of Pennsylvania - The Wharton School ( email )

3641 Locust Walk
Philadelphia, PA 19104-6365
United States

Leslie John

Harvard Business School

Boston, MA 02163
United States

Dean Karlan

Northwestern University ( email )

2001 Sheridan Road
Evanston, IL 60208
United States

Melanie Kim

University of Toronto ( email )

Toronto, Ontario M5S 3G8
Canada

David I. Laibson

Harvard University - Department of Economics ( email )

Littauer Center
Room M-14
Cambridge, MA 02138
United States
617-496-3402 (Phone)
617-495-8570 (Fax)

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Cait Lamberton

The Wharton School ( email )

700 Jon M. Huntsman Hall
3730 Walnut Street
Philadelphia, PA
United States
4127797280 (Phone)
19104 (Fax)

Brigitte C. Madrian

Brigham Young University Marriott School of Business ( email )

Provo, UT 84602
United States

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Michelle N. Meyer

Clarkson University–Icahn School of Medicine at Mount Sinai Bioethics Program ( email )

80 Nott Terrace
Schenectady, NY 12308
United States

HOME PAGE: http://www.michellenmeyer.com

Geisinger Health System, Center for Translational Bioethics and Health Care Policy ( email )

100 North Academy Ave.
Danville, PA 17822-4910
United States

HOME PAGE: http://www.michellenmeyer.com

Maria Modanu

Columbia University ( email )

3022 Broadway
New York, NY 10027
United States

Jimin Nam

Harvard Business School ( email )

Soldiers Field
Boston, MA 02163
United States

Todd Rogers

Harvard University - Harvard Kennedy School (HKS) ( email )

79 John F. Kennedy Street
Cambridge, MA 02138
United States

Renante Rondina

University of Toronto - Rotman School of Management ( email )

105 St. George Street
Toronto, Ontario M5S 3E6 M5S1S4
Canada

Silvia Saccardo

Carnegie Mellon University, Department of Social and Decision Sciences ( email )

Pittsburgh, PA 15213-3890
United States

Maheen Shermohammed

Geisinger Health System ( email )

100 North Academy Ave.
Danville, PA 17822-4910
United States

Dilip Soman

University of Toronto - Behavioural Economics in Action at Rotman (BEAR) ( email )

Jehan Sparks

University of California, Los Angeles (UCLA) ( email )

405 Hilgard Avenue
Box 951361
Los Angeles, CA 90095
United States

Caleb Warren

University of Arizona ( email )

McClelland Hall
P.O. Box 210108
Tucson, AZ 85721-0108
United States

Megan Weber

University of California, Los Angeles (UCLA) ( email )

405 Hilgard Avenue
Box 951361
Los Angeles, CA 90095
United States

Ron Berman

University of Pennsylvania - The Wharton School ( email )

3641 Locust Walk
Philadelphia, PA 19104-6365
United States

Chalanda Evans

University of Pennsylvania - Perelman School of Medicine ( email )

423 Guardian Drive
Philadelphia, PA 19104
United States

Christopher Snider

University of Pennsylvania - Perelman School of Medicine ( email )

423 Guardian Drive
Philadelphia, PA 19104
United States

Eli Tsukayama

University of Hawaii at West O'ahu ( email )

91-1001 Farrington Highway
Kapolei, HI 96707
United States

Christophe Van den Bulte

University of Pennsylvania - Marketing Department ( email )

700 Jon M. Huntsman Hall
3730 Walnut Street
Philadelphia, PA 19104-6340
United States

Kevin Volpp

University of Pennsylvania - Perelman School of Medicine, Department of Medicine ( email )

Philadelphia, PA 19104
United States

Angela Duckworth

University of Pennsylvania - Department of Psychology ( email )

3815 Walnut Street
Philadelphia, PA 19104-6196
United States

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