Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor’s appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.
Many educational interventions encourage parents to engage in their child’s education as if parental time and attention is limitless. Sadly, though, it is not. Successfully encouraging certain parental investments may crowd out other productive behaviors. A randomized field experiment (N = 2,212) assessed the impact of an intervention in which parents of middle and high school students received multiple text messages per week encouraging them to ask their children specific questions tied to their science curriculum. The intervention increased parent–child at-home conversations about science but did not detectably impact science test scores. However, the intervention decreased parent engagement in other, potentially productive, parent behaviors. These findings illustrate that parent engagement interventions are not costless: There are opportunity costs to shifting parental effort.
Increasing virtuous behaviors, such as initiating healthy habits, is an important goal for policymakers and social scientists. To promote compliance with requests to perform virtuous behaviors, we study “returnable reci procity.” Whereas traditional reciprocity involves giving people unreturnable unsolicited gifts to encourage compliance, returnable reciprocity involves offering opportunities to return the unsolicited gifts if they choose not to comply. Four studies (and two additional supplemental studies) show that returnable reciprocity (compared to traditional reciprocity) leads to higher enrollment in a hypothetical workplace wellness program (Study 1), as well as greater compliance in an incentive-compatible large-scale field experiment (Study 2) and conceptual lab replications (Studies 3 & S1). Returnable reciprocity may be more effective than traditional reciprocity because it induces increased feelings of guilt for non-compliance (Study 3). Though making an un solicited gift returnable can be inexpensive, it appears to impose psychological costs that negatively affect the tactic’s overall impact on social welfare (Studies 4 & S2).