? All interventions
| Busso, Cristia, Humpage | ? Link |
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.
Preventive health behaviors like flu vaccination have important benefits, but compliance is poor, and the reasons are not fully understood. We conducted a large study across six colleges (N = 9358), with a methodology that offers an unusual opportunity to look at three potential factors: inattention to information, informed intentions to not comply, and problems following through on intentions. We also tested three interventions in an RCT. We find that inattention to information is not the primary driver of low take-up, while informed decisions to not get the vaccine, but also lack of follow-through, are important factors. A financial intervention increased take-up and had persistent, positive effects on intentions for vaccination in future years. Two low-cost “nudges” did not increase vaccination rates, although the peer endorsement nudge increased exposure to information, especially if aligned with social networks.
SUMMARY
To increase uptake of flu vaccines and maintain a healthy workforce during the 2016-17 flu season, New York City’s Behavioral Design Team (NYC BDT) partnered with WorkWell NYC to design behaviorally informed emails to encourage New York City employees to visit a worksite flu clinic. One version of the redesigned email used the strategy of “enhanced active choice,” whereby employees were prompted to make a choice that had a clear right answer. IMPACT
Behavioral emails more than doubled click-through rates and statistically increased appointment sign-ups. Most importantly, the enhanced active choice version of the email increased vaccine uptake by 5 percent at worksite locations.
| AV Banerjee, Duflo, Glennerster, Kothari | ? Link |
Objective To assess the efficacy of modest non-financial incentives on immunisation rates in children aged 1-3 and to compare it with the effect of only improving the reliability of the supply of services. Design Clustered randomised controlled study. Setting Rural Rajasthan, India. Participants 1640 children aged 1-3 at end point. Interventions 134 villages were randomised to one of three groups: a once monthly reliable immunisation camp (intervention A; 379 children from 30 villages); a once monthly reliable immunisation camp with small incentives (raw lentils and metal plates for completed immunisation; intervention B; 382 children from 30 villages), or control (no intervention, 860 children in 74 villages). Surveys were undertaken in randomly selected households at baseline and about 18 months after the interventions started (end point). Main outcome measures Proportion of children aged 1-3 at the end point who were partially or fully immunised. Results Among children aged 1-3 in the end point survey, rates of full immunisation were 39% (148/382, 95% confidence interval 30% to 47%) for intervention B villages (reliable immunisation with incentives), 18% (68/379, 11% to 23%) for intervention A villages (reliable immunisation without incentives), and 6% (50/860, 3% to 9%) for control villages. The relative risk of complete immunisation for intervention B versus control was 6.7 (4.5 to 8.8) and for intervention B versus intervention A was 2.2 (1.5 to 2.8). Children in areas neighbouring intervention B villages were also more likely to be fully immunised than those from areas neighbouring intervention A villages (1.9, 1.1 to 2.8). The average cost per immunisation was $28 (1102 rupees, about £16 or €19) in intervention A and $56 (2202 rupees) in intervention B. Conclusions Improving reliability of services improves immunisation rates, but the effect remains modest. Small incentives have large positive impacts on the uptake of immunisation services in resource poor areas and are more cost effective than purely improving supply.
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%).
