? All interventions
Researchers sought to examine the impact of factors including price, persuasion, promotion and the chlorination products themselves with a two-phase study. Prior to the study baseline surveys were administered to a random selection of households.In the first phase, households were given seven WaterGuard bottles, an individual water treatment product, each sufficient for one month’s supply of clean water. They were also provided with improved drinking water storage pots with a tap to prevent contamination and detailed instructions on use. One third of this group received twelve coupons for a 50 percent discount on WaterGuard bottles, each valid for one month during the next year, and calendars with reminders. Another third received additional verbal persuasion messages beyond the basic WaterGuard instructions, and another third received no additional coupons or messages. To estimate social networking effects, the free WaterGuard bottles were distributed in different percentages in each community, allowing researchers to see if higher community levels of use increased individual adoption. A follow-up survey was administered between 2 and 7 months after the free WaterGuard was distributed.In the second phase researchers compared six different treatments designed to increase WaterGuard adoption. For the first three treatments, scripted promotional messages were delivered at either the(1) household level, (2) community level, or (3) both. The second two treatments included repeated promotion of chlorination through a home visit by a community elected promoter. Despite volunteering to work for free, the promoter was paid either a (4) flat rate, or was (5) paid based on how many households had chlorinated water at follow-up visits. The last treatment (6) combined the incentivized promoter model with an unlimited supply of free WaterGuard delivered through a point-of-collection chlorine dispenser at the local water source. Follow-up surveys were conducted 3 weeks and 3-6 months after the start of the study.
This paper documents a widely overlooked dimension of relationship lending: the personal interaction between the borrower and the lender reduces the willingness of the borrower to engage in moral hazard and default on the loan officer. We conduct a randomized experiment with small business borrowers of the largest commercial bank in India to test the impact of three different levels of interactions between the borrower and the bank. Borrowers who are regularly called either by a single assigned relationship manager or by one manager randomly selected from a small team of managers show much better repayment behavior and greater satisfaction with the bank services than borrowers who either receive no follow up or only receive follow up calls from the bank when they are delinquent. The results are economically and statistically significant: borrowers who receive the more intensive treatment see a large reduction in the number of late payment spells and delinquencies.
| T Rogers, J Ternovski, E Yoeli|
People contribute more to public goods when their contributions are made more observable to others. We report an intervention that subtly increases the observability of public goods contributions when people are solicited privately and impersonally (e.g., mail, email, social media). This intervention is tested in a large-scale field experiment (n=770,946) in which people are encouraged to vote through get-out-the-vote letters. We vary whether the let-ters include the message, “We may call you after the election to ask about your voting experience.” Increasing the perceived ob-servability of whether people vote by including that message increased the impact of the get-out-the-vote letters by more than the entire effect of a typical get-out-the-vote letter. This tech-nique for increasing perceived observability can be replicated whenever public goods solicitations are made in private.
Low rates of adherence to artemisinin-based combination therapy (ACT) regimens increase the risk of treatment failure and may lead to drug resistance, threatening the sustainability of current anti-malarial efforts. We assessed the impact of text message reminders on adherence to ACT regimens. Methods
Health workers at hospitals, clinics, pharmacies, and other stationary ACT distributors in Tamale, Ghana provided flyers advertising free mobile health information to individuals receiving malaria treatment. The messaging system automatically randomized self-enrolled individuals to the control group or the treatment group with equal probability; those in the treatment group were further randomly assigned to receive a simple text message reminder or the simple reminder plus an additional statement about adherence in 12-hour intervals. The main outcome was self-reported adherence based on follow-up interviews occurring three days after treatment initiation. We estimated the impact of the messages on treatment completion using logistic regression. Results
1140 individuals enrolled in both the study and the text reminder system. Among individuals in the control group, 61.5% took the full course of treatment. The simple text message reminders increased the odds of adherence (adjusted OR 1.45, 95% CI [1.03 to 2.04], p-value 0.028). Receiving an additional message did not result in a significant change in adherence (adjusted OR 0.77, 95% CI [0.50 to 1.20], p-value 0.252). Conclusion
The results of this study suggest that a simple text message reminder can increase adherence to antimalarial treatment and that additional information included in messages does not have a significant impact on completion of ACT treatment. Further research is needed to develop the most effective text message content and frequency.
There is limited evidence on whether growing mobile phone availability in sub-Saharan Africa can be used to promote high adherence to antiretroviral therapy (ART). This study tested the efficacy of short message service (SMS) reminders on adherence to ART among patients attending a rural clinic in Kenya. Design
A randomized controlled trial of four SMS reminder interventions with 48 weeks of follow-up. Methods
Four hundred and thirty-one adult patients who had initiated ART within 3 months were enrolled and randomly assigned to a control group or one of the four intervention groups. Participants in the intervention groups received SMS reminders that were either short or long and sent at a daily or weekly frequency. Adherence was measured using the medication event monitoring system. The primary outcome was whether adherence exceeded 90% during each 12-week period of analysis and the 48-week study period. The secondary outcome was whether there were treatment interruptions lasting at least 48 h. Results
In intention-to-treat analysis, 53% of participants receiving weekly SMS reminders achieved adherence of at least 90% during the 48 weeks of the study, compared with 40% of participants in the control group (P=0.03). Participants in groups receiving weekly reminders were also significantly less likely to experience treatment interruptions exceeding 48 h during the 48-week follow-up period than participants in the control group (81 vs. 90%, P = 0.03). Conclusion
These results suggest that SMS reminders may be an important tool to achieve optimal treatment response in resource-limited settings.
| D Ortega, C Scartascini|
There is an ample literature on the determinants of tax compliance. Several field experiments have evaluated the effect and comparative relevance of sending deterrence and moral suasion messages to taxpayers. The effect of different delivery mechanisms, however, has not been evaluated so far. This study conducts a field experiment in Colombia that varies the way the National Tax Agency contacts taxpayers on payments due for income, value added, and wealth taxes. More than 20,000 taxpayers were randomly assigned to a control or one of three delivery mechanisms (letter, email, and personal visit by a tax inspector). Results indicate large and highly significant effects, as well as sizable differences across delivery methods. A personal visit by a tax inspector is more effective than a physical letter or an email, conditional on delivery, but email tends to reach its target more often. Improving the quality of taxpayer contact information can significantly improve the collection of delinquencies.
| N Malhotra, MR Michelson, T Rogers, A Valenzuela|
Dale and Strauss’s (DS) noticeable reminder theory (NRT) of voter mobilization posits that mobilization efforts that are highly noticeable and salient to potential voters, even if impersonal, can be successful. In an innovative experimental design, DS show that text messages substantially boost turnout, challenging previous claims that social connectedness is the key to increasing participation. We replicate DS’s research design and extend it in two key ways. First, whereas the treatment in DS’s experiment was a “warm” text message combined with contact, we test NRT more cleanly by examining the effect of “cold” text messages that are completely devoid of auxiliary interaction. Second, we test an implication of NRT that habitual voters should exhibit the largest treatment effects in lower salience elections whereas casual voters should exhibit the largest treatment effects in higher salience elections. Via these two extensions, we find support for NRT.
We tested whether providing adults with obstructive sleep apnea (OSA) with daily Web-based access to their positive airway pressure (PAP) usage over 3 mo with or without a financial incentive in the first week improves adherence and functional outcomes.Academic- and community-based sleep centers.One hundred thirty-eight adults with newly diagnosed OSA starting PAP treatment.Participants were randomized to: usual care, usual care with access to PAP usage, or usual care with access to PAP usage and a financial incentive. PAP data were transmitted daily by wireless modem from the participants' PAP unit to a website where hours of usage were displayed. Participants in the financial incentive group could earn up to $30/day in the first week for objective PAP use ≥ 4 h/day.Mean hours of daily PAP use in the two groups with access to PAP usage data did not differ from each other but was significantly greater than that in the usual care group in the first week and over 3 mo (P < 0.0001). Average daily use (mean ± standard deviation) during the first week of PAP intervention was 4.7 ± 3.3 h in the usual care group, and 5.9 ± 2.5 h and 6.3 ± 2.5 h in the Web access groups with and without financial incentive respectively. Adherence over the 3-mo intervention decreased at a relatively constant rate in all three groups. Functional Outcomes of Sleep Questionnaire change scores at 3 mo improved within each group (P < 0.0001) but change scores of the two groups with Web access to PAP data were not different than those in the control group (P > 0.124).Positive airway pressure adherence is significantly improved by giving patients Web access to information about their use of the treatment. Inclusion of a financial incentive in the first week had no additive effect in improving adherence.
The collection of delinquent fines is a vast and ongoing public administration challenge. In the United Kingdom, unpaid fines amount to more than 500 million pounds. Managing noncompliant accounts and dispatching bailiffs to collect fines in person is costly. This paper reports the results of a large randomized controlled trial, led by the UK Cabinet Office's Behavioural Insights Team, which was designed to test the effectiveness of mobile phone text messaging as an alternative method of inducing people to pay their outstanding fines. An adaptive trial design was used, first to test the effectiveness of text messaging against no treatment and then to test the relative effectiveness of alternative messages. Text messages, which are relatively inexpensive, are found to significantly increase average payment of delinquent fines. We found text messages to be especially effective when they address the recipient by name.
We report the results of a randomized field experiment aimed at improving the safety of long-distance mini-busses or matatus in Kenya. Our intervention combines evocative messages aimed at motivating passengers to speak up against bad driving with a lottery that rewards matatu drivers for keeping the stickers in place. Independent insurance claims data were collected for more than 2000 long-distance matatus before and after the intervention. Our results indicate that insurance claims fell by a half to two-thirds, from a baseline annual rate of about 10%, and that claims involving injury or death fell by 60%. While we are unable to identify the mechanism(s) underlying this effect, the intervention is more cost effective in reducing mortality than other documented public health interventions.
For this controlled trial, we randomly divided our sample population of 2,324 diabetics into four groups and sent each a different type of letter from the Oklahoma Health Care Authority. To track and compare the responses of the different groups, we analyzed Medicaid claims data for each patient over the next year, noting payments for physician visits, blood tests and filled prescriptions. By the end of our one-year analysis period, the control group had caught up with the nudge recipients (not surprising in a population of diabetics, who are likely to have medical checkups over an extended period). There was no longer a significant difference in the number of prescriptions filled, whether as the result of physician visits or renewals of existing prescriptions. So it seems that the value of the nudge is actually in prompting recipients to act more quickly – which should have a positive effect on long-term health outcomes, particularly when extended across a population of millions.
| Busso, Cristia, Humpage|
Many families fail to vaccinate their children despite the supply of these services at no cost. This study tests whether personal reminders can increase demand for vaccination. A field experiment was conducted in rural Guatemala in which timely reminders were provided to families whose children were due for a vaccine. The six-month intervention increased the probability of vaccination completion by 2.2 percentage points among all children in treatment communities. Moreover, for children in treatment communities who were due to receive a vaccine, and whose parents were expected to be reminded about that due date, the probability of vaccination completion increased by 4.6 percentage points. The cost of an additional child with complete vaccination due to the intervention is estimated at about $7.50.
Low response rates to government surveys hinder research and limit the robustness of the policy evaluations and recommendation. To compensate for low rates of response, research teams often need to increase sample sizes, making research more costly.
Recent severe weather events have increased concerns about growing flood risk and the resiliency of households in the floodplain, prompting efforts to improve preparedness and insurance coverage.
In 2014, only 48.6% of Nigeria's adult population had access to, and used, formal financial products.To make these products more accessible to people of all incomes, a major bank and a telecommunications company in Nigeria jointly launched a mobile bank account.
A randomized evaluation found that writing both a date and time increased the number of employees getting their flu shots.. Employees who received the more detailed "time plan" mailer were 4 percentage points more likely than those who received the standard mailer to get their shot (37.1% compared to 33.1%).
To help first-year students understand that the challenges they faced were neither unique to them nor evidence of personal failure, all incoming first-year students at SF State were asked to watch a three-minute video in which older students described the struggles they had faced and their routes to success.
there was a mismatch between the actual rent due date (the first of the month) and when renters perceived rent to be due (the 10 th of the month, when penalties kicked in).
| Fiorello, Potok, Wright|
ideas42 redesigned four aspects of the CARD Bank system to increase savings: a new account opening form, a printed savings plan, reminders to make savings deposits, and a new savings calendar.
A randomized evaluation found that among families where both students and parents received the redesigned emails, 50% filed their financial aid application by the priority deadline.
Past research indicates there is a positive relationship between parental involvement and students' success in school, but communication between educators and parents is often infrequent or unsystematic.
A randomized evaluation found that workers who received their earmarked savings in two envelopes saved an average of 414 rupees, or 72% more than the 241 rupees saved by workers who received their savings in one envelope.
Project Summary. The Queensland Government tested the impact of three different behaviorally informed letter designs on response rates. Impact. 21.8-24.8% of people responded to one of the intervention letters, compared to 5.3% who responded to the traditional control letter.
Students were instructed to download a smartphone app that, over a period of weeks, delivered timely reminders and simple instructions about important deadlines and upcoming tasks related to applying for financial aid.
| Dean Karlan, M McConnell, S Mullainathan, J Zinman|
Management Science, Volume 62 No. 12 pp. 3393-3411
Randomized evaluations in each country found that clients who were sent reminders had saved more and were more likely to have reached their savings goals by the commitment end dates (around a year after opening accounts) than clients who did not receive the messages.
| P Adams, S Hunt, Vale, Zaliauskas|
The FCA used a randomized evaluation to test the effect of the reminders in motivating consumers to switch their savings account. The study found that reminders increased the percentage of customers taking some action following the rate decrease, whether switching their account internally, or closing the account and moving to another institution, by between 5.4 and 7.9 percentage points.
A randomized evaluation found that on average, borrowers who were sent redesigned monthly statements and strategically timed reminders received 23% fewer penalties for having insufficient funds in their loan repayment
This randomized evaluation found that the average aid award for students receiving both redesigned emails rose by 2%, or $150.28 per student for the Spring semester, compared to students who received neither email ($6,368 vs. $6,217).
| Karlan, Morten, Zinman|
Behavioral Science & Policy, Volume 2, Issue 2, 2016
A randomized evaluation found that most of the messages failed to achieve any significant result on loan repayment. The only message that increased repayment rates was a positive framing and the inclusion of the account officer's name.