TY - JOUR
T1 - Large-scale influenza vaccination promotion on a mobile app platform
T2 - A randomized controlled trial
AU - Lee, Wei Nchih
AU - Stück, David
AU - Konty, Kevin
AU - Rivers, Caitlin
AU - Brown, Courtney R.
AU - Zbikowski, Susan M.
AU - Foschini, Luca
N1 - Funding Information:
LF thanks Prof. Katherine Milkman for fruitful input, and Glenn Morell for help in the campaign implementation. All authors attest they meet the ICMJE criteria for authorship. This research was funded by DARPA -BAA-15-35, Award Number W911NF-16-C-0055 .
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2020/4/16
Y1 - 2020/4/16
N2 - While health-care providers have used incentives in an attempt to motivate patients to obtain vaccinations, their effect on vaccination rates has not been systematically evaluated on a large scale. In this study, we examined whether mobile applications may improve population vaccination rates through enhanced communication and incentives education. Our study is the first randomized controlled trial assessing the effect of large-scale messaging combined with individualized incentives on influenza-vaccination rates. In this trial, we delivered messages regarding influenza vaccinations to 50,286 adults, aged 18 through 65, then compared the subsequent vaccination rate, the effectiveness of the message content and the timing. Multiple rounds of messaging occurred over a seven-week period during the 2016 flu season, after which vaccination rates were observed for one week. Participants were randomly assigned to one of three messaging approaches: conspicuous (highlighting the amount of rewards to be received for obtaining a flu shot); generic (promoting vaccinations with no mention of rewards); or no-message. Evidence of vaccination obtainment was indicated by medical and pharmacy claims, augmented by patients self-reporting through the mobile wellness app during the study period. Of the people assigned to receive messaging, 23.2% obtained influenza vaccination, compared to 22.0% of people who obtained vaccination in the no-messaging control arm. This difference was statistically significant (p < 0.01). The research revealed that messaging effectiveness decreased after each successive batch sent, suggesting that most participants responsive to messaging would become activated immediately after receiving one alert. Interestingly, in this large-scale study, there were no significant differences between conspicuous incentives and generic messaging, suggesting an important area for future research. Trial Registration: clinicaltrials.gov identifier: NCT02908893.
AB - While health-care providers have used incentives in an attempt to motivate patients to obtain vaccinations, their effect on vaccination rates has not been systematically evaluated on a large scale. In this study, we examined whether mobile applications may improve population vaccination rates through enhanced communication and incentives education. Our study is the first randomized controlled trial assessing the effect of large-scale messaging combined with individualized incentives on influenza-vaccination rates. In this trial, we delivered messages regarding influenza vaccinations to 50,286 adults, aged 18 through 65, then compared the subsequent vaccination rate, the effectiveness of the message content and the timing. Multiple rounds of messaging occurred over a seven-week period during the 2016 flu season, after which vaccination rates were observed for one week. Participants were randomly assigned to one of three messaging approaches: conspicuous (highlighting the amount of rewards to be received for obtaining a flu shot); generic (promoting vaccinations with no mention of rewards); or no-message. Evidence of vaccination obtainment was indicated by medical and pharmacy claims, augmented by patients self-reporting through the mobile wellness app during the study period. Of the people assigned to receive messaging, 23.2% obtained influenza vaccination, compared to 22.0% of people who obtained vaccination in the no-messaging control arm. This difference was statistically significant (p < 0.01). The research revealed that messaging effectiveness decreased after each successive batch sent, suggesting that most participants responsive to messaging would become activated immediately after receiving one alert. Interestingly, in this large-scale study, there were no significant differences between conspicuous incentives and generic messaging, suggesting an important area for future research. Trial Registration: clinicaltrials.gov identifier: NCT02908893.
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U2 - 10.1016/j.vaccine.2019.11.053
DO - 10.1016/j.vaccine.2019.11.053
M3 - Article
C2 - 31787410
AN - SCOPUS:85076225656
SN - 0264-410X
VL - 38
SP - 3508
EP - 3514
JO - Vaccine
JF - Vaccine
IS - 18
ER -