Letters designed with behavioural science increase influenza vaccination in Medicare beneficiaries
Letters designed with behavioural science increase influenza vaccination in Medicare beneficiaries
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DOI：
10.1038/s41562-018-0432-2
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发表时间：
2018-10-01
影响因子：
29.9
通讯作者：
Choudhry, Niteesh K.
中科院分区：
文献类型：
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作者：
Yokum, David;Lauffenburger, Julie C.;Choudhry, Niteesh K.
流感（“流感”）疫苗接种成本低(1)且有效，通常可将感染可能性降低50-60%(2)。建议几乎所有6个月以上的人服用(3)；然而，每年只有40%的美国人接种疫苗。疫苗接种率在高危人群（如65岁以上人群）中较高，但仍然只有六成的人接种疫苗(4)。为了提高疫苗接种率，人们已经进行了许多尝试，使用了诸如以学校为基础的规划、财政激励和提醒等策略，但是这些通常都取得了有限的成功（5-7）。在成功的尝试中，大多数都是昂贵的-限制了可扩展性-并且尚未在老年人中进行评估(8)。相反，低成本的干预措施，如邮寄信息，有望成为一种可扩展的解决方案，但其有限的有效性可能源于它们的设计方式。我们随机分配228,000名年龄为>= 66岁的个体到旨在激励疫苗接种的五个版本中的一个，包括具有实施意图提示和增强的主动选择执行提示的版本。我们发现，与没有信件相比，一封邮寄信件显著提高了流感疫苗接种率。然而，用行为科学技术定制的四个不同字母之间的疫苗接种率没有差异。
The influenza ('flu') vaccination is low cost(1) and effective, typically reducing the likelihood of infection by 50-60%(2). It is recommended for nearly everyone older than 6 months of age(3); yet, only 40% of Americans are immunized each year. Vaccination rates are higher among at-risk groups, such as those >= 65 years of age, but still only 6 in 10 receive it(4). There have been numerous attempts to improve vaccination rates using strategies such as school-based programmes, financial incentives and reminders, but these have generally had limited success(5-7). Of the attempts that are successful, most are expensive-limiting scalability-and have not been evaluated in the elderly(8). Conversely, lower-cost interventions, such as mailed information, hold promise for a scalable solution, but their limited effectiveness may result from how they have been designed. We randomly assigned 228,000 individuals >= 66 years of age to one of five versions of letters intended to motivate vaccination, including versions with an implementation intention prompt and an enhanced active choice implementation prompt. We found that a single mailed letter significantly increased influenza vaccination rates compared with no letter. However, there was no difference in vaccination rates across the four different letters tailored with behavioural science techniques.