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Q&A: Cost-effective ‘nudges’ can increase flu vaccine uptake
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Although the CDC stresses the importance of vaccinating against influenza, only 38.6% of the United States population aged older than 6 months received the vaccine by early November 2017, according to the agency.
In a recent consumer behavior study, Ernest Baskin, PhD, assistant professor of food marketing at St. Joseph’s University, Philadelphia, examined different ways to encourage students, faculty and staff at a university to get vaccinated against influenza. In an email campaign, announcements were sent to 30,000 people at the university to remind them of the institution’s free vaccination clinics. For his study, Baskin used the university’s standard email campaign but included anywhere from zero to three motivators he said could potentially increase vaccination uptake. These three motivators, or “nudges,” included maps with locations of vaccination clinics, incentives, such as gift cards, for getting vaccinated and reminders of the negative effects of influenza.
Of the participants who received an email, 32.5% got a vaccination. Baskin found that people were more likely to get vaccinated if they received an email with maps showing the locations of vaccination clinics. He reported that presenting information with vaccination centers led to a 2% increase in vaccination uptake, or an additional 600 vaccinations. The other nudges did not result in increased vaccination rates, conflicting with previous research.
To learn more about increasing influenza vaccination coverage, Infectious Disease News spoke with Baskin about his study. - by Marley Ghizzone
What you made you focus your research on influenza vaccination consumer behavior?
The low uptake of influenza vaccination is a major public health issue. Additionally, consumer behavior has a lot of findings that can help us think about ways to increase influenza vaccination uptake. My thought was that there is a lot of literature in terms of changing people's choices and behaviors. In particular, there is a large field in nudging theory that discusses how to structure people's environments so that certain choices are easier to make. There has also been literature on implementation intentions where if you make people write down on a sheet of paper when they will go in for a vaccination (they don't have to actually go at that time), they are more likely to go and get vaccinated.
Why did you choose these three strategies?
I chose these three strategies as they have all seen varying degrees of success in the consumer behavior and psychology literatures. However, it is important to see which of these strategies is more effective in a real-world clinical setting.
What does this study tell you about human behavior , and how can clinicians apply these findings to their practice to increase vaccination rates?
This study allows us to understand how to easily nudge people to come in for an influenza vaccination. Clinicians can easily apply the results of this study by advertising their influenza clinic outreach efforts. In particular, they should make getting the influenza vaccine as convenient as possible. One easy way to do this is to offer location maps.
Why do you think the vaccination strategy that offered maps with locations of clinics was the most successful intervention? Was it surprising to you that this was the most successful tactic?
I think this was the most successful intervention because convenience is likely a major reason why people do not get a vaccination. By highlighting the convenience factor, people realize that it might be easier than they thought to fit the influenza vaccination into their busy lifestyle.
Why do you think the other strategies were not as successful?
Obviously, there are a number of reasons why the other interventions did not work. One reason could be that the incentive offered was not high enough. Another reason could be that people do not read many of their emails fully and, as such, interventions that are woven into the text of the email, such as the incentive and reminders of negative consequences, are less likely to work.
Disclosure: Baskin reports no relevant financial disclosures.
Reference:
Baskin E. PLoS One. 2018;doi:10.1371/journal.pone.0192594.