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Behavioural nudges increase COVID-19 vaccinations.
Nature. 2021 09; 597(7876):404-409.Nat

Abstract

Enhancing vaccine uptake is a critical public health challenge1. Overcoming vaccine hesitancy2,3 and failure to follow through on vaccination intentions3 requires effective communication strategies3,4. Here we present two sequential randomized controlled trials to test the effect of behavioural interventions on the uptake of COVID-19 vaccines. We designed text-based reminders that make vaccination salient and easy, and delivered them to participants drawn from a healthcare system one day (first randomized controlled trial) (n = 93,354 participants; clinicaltrials number NCT04800965) and eight days (second randomized controlled trial) (n = 67,092 individuals; clinicaltrials number NCT04801524) after they received a notification of vaccine eligibility. The first reminder boosted appointment and vaccination rates within the healthcare system by 6.07 (84%) and 3.57 (26%) percentage points, respectively; the second reminder increased those outcomes by 1.65 and 1.06 percentage points, respectively. The first reminder had a greater effect when it was designed to make participants feel ownership of the vaccine dose. However, we found no evidence that combining the first reminder with a video-based information intervention designed to address vaccine hesitancy heightened its effect. We performed online studies (n = 3,181 participants) to examine vaccination intentions, which revealed patterns that diverged from those of the first randomized controlled trial; this underscores the importance of pilot-testing interventions in the field. Our findings inform the design of behavioural nudges for promoting health decisions5, and highlight the value of making vaccination easy and inducing feelings of ownership over vaccines.

Authors+Show Affiliations

Anderson School of Management, University of California, Los Angeles, Los Angeles, CA, USA.Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, PA, USA.Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.Office of Population Health and Accountable Care, University of California, Los Angeles, Los Angeles, CA, USA.Office of Population Health and Accountable Care, University of California, Los Angeles, Los Angeles, CA, USA.Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.Office of Health Informatics and Analytics, University of California, Los Angeles, Los Angeles, CA, USA.Office of Health Informatics and Analytics, University of California, Los Angeles, Los Angeles, CA, USA.Department of Information Services and Solutions, UCLA Health System, Los Angeles, CA, USA.Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. dcroymans@mednet.ucla.edu.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

34340242

Citation

Dai, Hengchen, et al. "Behavioural Nudges Increase COVID-19 Vaccinations." Nature, vol. 597, no. 7876, 2021, pp. 404-409.
Dai H, Saccardo S, Han MA, et al. Behavioural nudges increase COVID-19 vaccinations. Nature. 2021;597(7876):404-409.
Dai, H., Saccardo, S., Han, M. A., Roh, L., Raja, N., Vangala, S., Modi, H., Pandya, S., Sloyan, M., & Croymans, D. M. (2021). Behavioural nudges increase COVID-19 vaccinations. Nature, 597(7876), 404-409. https://doi.org/10.1038/s41586-021-03843-2
Dai H, et al. Behavioural Nudges Increase COVID-19 Vaccinations. Nature. 2021;597(7876):404-409. PubMed PMID: 34340242.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Behavioural nudges increase COVID-19 vaccinations. AU - Dai,Hengchen, AU - Saccardo,Silvia, AU - Han,Maria A, AU - Roh,Lily, AU - Raja,Naveen, AU - Vangala,Sitaram, AU - Modi,Hardikkumar, AU - Pandya,Shital, AU - Sloyan,Michael, AU - Croymans,Daniel M, Y1 - 2021/08/02/ PY - 2021/04/01/received PY - 2021/07/21/accepted PY - 2021/8/3/pubmed PY - 2021/9/24/medline PY - 2021/8/2/entrez SP - 404 EP - 409 JF - Nature JO - Nature VL - 597 IS - 7876 N2 - Enhancing vaccine uptake is a critical public health challenge1. Overcoming vaccine hesitancy2,3 and failure to follow through on vaccination intentions3 requires effective communication strategies3,4. Here we present two sequential randomized controlled trials to test the effect of behavioural interventions on the uptake of COVID-19 vaccines. We designed text-based reminders that make vaccination salient and easy, and delivered them to participants drawn from a healthcare system one day (first randomized controlled trial) (n = 93,354 participants; clinicaltrials number NCT04800965) and eight days (second randomized controlled trial) (n = 67,092 individuals; clinicaltrials number NCT04801524) after they received a notification of vaccine eligibility. The first reminder boosted appointment and vaccination rates within the healthcare system by 6.07 (84%) and 3.57 (26%) percentage points, respectively; the second reminder increased those outcomes by 1.65 and 1.06 percentage points, respectively. The first reminder had a greater effect when it was designed to make participants feel ownership of the vaccine dose. However, we found no evidence that combining the first reminder with a video-based information intervention designed to address vaccine hesitancy heightened its effect. We performed online studies (n = 3,181 participants) to examine vaccination intentions, which revealed patterns that diverged from those of the first randomized controlled trial; this underscores the importance of pilot-testing interventions in the field. Our findings inform the design of behavioural nudges for promoting health decisions5, and highlight the value of making vaccination easy and inducing feelings of ownership over vaccines. SN - 1476-4687 UR - https://www.unboundmedicine.com/medline/citation/34340242/Behavioral_Nudges_Increase_COVID-19_Vaccinations. L2 - https://doi.org/10.1038/s41586-021-03843-2 DB - PRIME DP - Unbound Medicine ER -