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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.

The popularity of New Year's resolutions suggests that people are more likely to tackle their goals immediately following salient temporal landmarks. If true, this little-researched phenomenon has the potential to help people overcome important willpower problems that often limit goal attainment. Across three archival field studies, we provide evidence of a “fresh start effect.” We show that Google searches for the term “diet” (Study 1), gym visits (Study 2), and commitments to pursue goals (Study 3) all increase following temporal landmarks (e.g., the outset of a new week, month, year, or semester; a birthday; a holiday). We propose that these landmarks demarcate the passage of time, creating many new mental accounting periods each year, which relegate past imperfections to a previous period, induce people to take a big-picture view of their lives, and thus motivate aspirational behaviors. Data, as supplemental material, are available at http://dx.doi.org/10.1287/mnsc.2014.1901 . This paper was accepted by Yuval Rottenstreich, judgment and decision making.

To deliver high-quality, reliable, and consistent services safely, organizations develop professional standards. Despite the communication and reinforcement of these standards, they are often not followed consistently. Although previous research suggests that high job demands are associated with declines in compliance over lengthy intervals, we hypothesized-drawing on theoretical arguments focused on fatigue and depletion-that the impact of job demands on routine compliance with professional standards might accumulate much more quickly. To test this hypothesis, we studied a problem that represents one of the most significant compliance challenges in health care today: hand hygiene. Using longitudinal field observations of over 4,157 caregivers working in 35 different hospitals and experiencing more than 13.7 million hand hygiene opportunities, we found that hand hygiene compliance rates dropped by a regression-estimated 8.7 percentage points on average from the beginning to the end of a typical 12-hr work shift. This decline in compliance was magnified by increased work intensity. Further, longer breaks between work shifts increased subsequent compliance rates, and such benefits were greater for individuals when they had ended their preceding shift with a lower compliance rate. In addition, (a) the decline in compliance over the course of a work shift and (b) the improvement in compliance following a longer break increased as individuals accumulated more total work hours the preceding week. The implications of these findings for patient safety and job design are discussed. Keywords AbstractIn order to deliver high quality, reliable, and consistent services safely, organizations

Milkman et al.

No abstract

The design and use of standard processes are foundational recommendations in many operations practices. Yet, given the demonstrated performance benefits of standardized processes, it is surprising that they are often not followed consistently. One way to ensure greater compliance is by electronically monitoring the activities of individuals, although such aggressive monitoring poses the risk of inducing backlash. In the setting of hand hygiene in healthcare, a context where compliance with standard processes is frequently less than 50% and where this lack of compliance can result in negative consequences, we investigated the effectiveness of electronic monitoring. We did so using a unique, radio frequency identification (RFID)-based system deployed in 71 hospital units. We found that electronically monitoring individual compliance resulted in a large, positive increase in compliance. We also found that there was substantial variability in the effect across units and that units with higher levels of preactivation compliance experienced increased benefits from monitoring relative to units with lower levels of prepreactivation compliance. By observing compliance rates over three and a half years, we investigated the persistent effects of individual monitoring and found that compliance rates initially increased before they gradually declined. Additionally, in multiple units, individual monitoring was discontinued, allowing for an investigation of the impact of removing the intervention on compliance. Surprisingly, we found that, after removal, compliance rates declined to below prepreactivation levels. Our findings suggest that, although individual electronic monitoring can dramatically improve process compliance, it requires sustained managerial commitment. AcknowledgmentsWe are grateful to many individuals at Proventix, including David Sellers, Harvey Nix, and Elizabeth Pembleton, whose assistance made this project possible. We thank Christian Terwiesch for his helpful comments as we developed the manuscript. We acknowledge the developmental assistance of the DE, AE, and reviewers in improving this paper throughout the review process. Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number P30AG034532. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Any errors are the responsibility of the authors. COMPLIANCE AND MONITORING 1 AbstractThe design and use of standard processes are foundational recommendations in many operations practices. Yet, given the demonstrated performance benefits of standardized processes, it is surprising that they are often not followed consistently. One way to ensure greater compliance is by electronically monitoring the activities of individuals, although such aggressive monitoring poses the risk of inducing backlash. In the setting of hand hygiene in healthcare -a context where compliance with st...

In reward-based crowdfunding, creators of entrepreneurial projects solicit capital from potential consumers to reach a funding goal and offer future products/services in return. The authors examine consumers’ contribution patterns using a novel data set of 28,591 projects collected at 30-minute resolution from Kickstarter. Extending prior research that assumes that economic considerations (e.g., project quality, campaign success likelihood) drive backers’ decisions, the authors provide the cleanest field evidence so far that consumers also have prosocial motives to help creators reach their funding goals. They find that projects collect funding faster right before (vs. right after) meeting their funding goals because consumers not only are more likely to fund projects but also contribute greater amounts of money prior to goal attainment. This effect is amplified when the nature of a project tends to evoke consumers’ prosocial motivation and when a project’s creator is a single person. These results suggest that consumers’ prosocial motives not only play a role in reward-based crowdfunding but also can outweigh the opposing effects of economic factors including rational herding and certainty about campaign success.