Effect of Text Messaging and Behavioral Interventions on COVID-19 Vaccination Uptake

Mehta, Shivan J.; Mallozzi, Colleen P.; Shaw, Pamela A.; Reitz, Catherine; McDonald, Caitlin; Vandertuyn, Matthew; Balachandran, Mohan; Kopinsky, Michael; Sevinc, Christianne; Johnson, Aaron M.; Ward, Robin; Park, Saehwan; Snider, Christopher K.; Rosin, Roy; Asch, David A.

doi:10.1001/jamanetworkopen.2022.16649

Cited by 17 publications

(41 citation statements)

References 26 publications

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“…Use familiar and trusted sources (e.g., health centers, large survey companies, etc.) to provide vaccination reminders/recalls; [25,35,36] 2. Write down arguments that could best convince another person to get vaccinated; [44] 3.…”

Section: Salient Remindermentioning

confidence: 99%

“…Highlighting the safety and rigor of COVID-19 vaccine clinical trials; [39] 6. SMS highlights the limited availability of vaccines; [35] 7. Description of vaccine retention for participants, highlighting vaccine ownership; [25,35,37] 8.…”

Section: Salient Remindermentioning

confidence: 99%

“…SMS highlights the limited availability of vaccines; [35] 7. Description of vaccine retention for participants, highlighting vaccine ownership; [25,35,37] 8. Video-based reminders and recalls to highlight vaccine safety, e cacy or vaccination retention information, convenience, etc; [25,41] 9.…”

Section: Salient Remindermentioning

confidence: 99%

“…Provide the true view held by physicians to correct misunderstandings about vaccine uptake);[46] 2. Clinicians provide vaccination advice; [35] 3. Expert (vs. lay) sources of vaccine support information.…”

Section: Salient Remindermentioning

confidence: 99%

“…Seven studies reported vaccine uptake results, with a total of 131,719 people included. [25,35,37,40,43,44,46] Five studies found statistically signi cant increases in vaccination uptake compared with control groups, [25,37,40,43,46] one study [44] reported mixed results, and one study [35] identi ed no effects from the nudging intervention. The pooled results showed that vaccine uptake was signi cantly higher in the nudging intervention group compared to the control (RR: 1.19, 95% CI [1.07, 1.33], p < 0.01, Fig.…”

Section: Impact Of Nudge Interventions On Vaccine Uptakementioning

confidence: 99%

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Nudging vaccination against COVID-19: A systematic review and meta-analysis

zhang¹,

Jin²

2023

Preprint

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Background: New approaches to mitigate vaccine hesitancy (VH) and improve vaccine uptake and willingness are urgently needed. Nudging is a new approach that has shown effective results in several areas of health. However, the effectiveness is unclear regarding nudging interventions to improve intentions and behaviors related to COVID-19 vaccination. Methods: We searched PubMed, Web of Science, and Scopus until August 5, 2022. Randomized controlled trials (RCTs) were considered to determine whether nudging improved COVID-19 vaccination behavior and intent. The risk ratio (RR) and 95% confidence interval (CI) were used as pooled measures to assess vaccination behavior. Intention to vaccinate was reported in the narrative synthesis. Results: A total of 15 RCTs involving 167,127 individuals were included. Nudge strategies significantly boosted the COVID-19 vaccine uptake rate (RR: 1.19, 95% CI [1.07, 1.33], p < 0.01). Subgroup analysis showed that there was a weak positive effect on vaccine uptake of social norms (RR: 2.04, 95% Cl [1.61, 2.57]), defaults (RR: 1.32, 95% CI [1.03, 1.69]), and salient reminders (RR: 1.19, 95% CI [1.04, 1.36]). Additionally, the effect of nudging interventions on COVID-19 vaccine uptake weakened over time(p < 0.0001). Most studies (9 of 10) involving vaccination intention outcomes showed positive or partially positive results. Conclusion: Nudging interventions can promote COVID-19 vaccination behavior and intentions, albeit with small magnitude, and need to be combined with other intervention strategies to promote vaccination.

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Section: Salient Remindermentioning

confidence: 99%

Section: Salient Remindermentioning

confidence: 99%

Section: Salient Remindermentioning

confidence: 99%

Section: Salient Remindermentioning

confidence: 99%

Section: Impact Of Nudge Interventions On Vaccine Uptakementioning

confidence: 99%

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Nudging vaccination against COVID-19: A systematic review and meta-analysis

zhang¹,

Jin²

2023

Preprint

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Behavioral Interventions to Improve Breast Cancer Screening Outreach

Mehta,

Rhodes,

Linn

et al. 2024

JAMA Intern Med

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ImportanceDespite public health efforts, breast cancer screening rates remain below national goals.ObjectiveTo evaluate whether bulk ordering, text messaging, and clinician endorsement increase breast cancer screening rates.Design, Setting, and ParticipantsTwo concurrent, pragmatic, randomized clinical trials, each with a 2-by-2 factorial design, were conducted between October 25, 2021, and April 25, 2022, in 2 primary care regions of an academic health system. The trials included women aged 40 to 74 years with at least 1 primary care visit in the past 2 years who were eligible for breast cancer screening.InterventionsPatients in trial A were randomized in a 1:1 ratio to receive a signed bulk order for mammogram or no order; in a factorial design, patients were concurrently randomized in a 1:1 ratio to receive or not receive text message reminders. Patients in trial B were randomized in a 1:1 ratio to receive a message signed by their primary care clinician (clinician endorsement) or from the organization (standard messaging); in a factorial design, patients were concurrently randomized in a 1:1 ratio to receive or not receive text message reminders.Main Outcomes and MeasuresThe primary outcome was the proportion of patients who completed a screening mammogram within 3 months.ResultsAmong 24 632 patients included, the mean (SD) age was 60.4 (7.5) years. In trial A, at 3 months, 15.4% (95% CI, 14.6%-16.1%) of patients in the bulk order arm and 12.7% (95% CI, 12.1%-13.4%) in the no order arm completed a mammogram, showing a significant increase (absolute difference, 2.7%; 95% CI, 1.6%-3.6%; P &lt; .001). In the text messaging comparison arms, 15.1% (95% CI, 14.3%-15.8%) of patients receiving a text message completed a mammogram compared with 13.0% (95% CI, 12.4%-13.7%) of those in the no text messaging arm, a significant increase (absolute difference of 2.1%; 95% CI, 1.0%-3.0%; P &lt; .001). In trial B, at 3 months, 12.5% (95% CI, 11.3%-13.7%) of patients in the clinician endorsement arm completed a mammogram compared with 11.4% (95% CI, 10.3%-12.5%) of those in the standard messaging arm, which was not significant (absolute difference, 1.1%; 95% CI, −0.5% to 2.7%; P = .18). In the text messaging comparison arms, 13.2% (95% CI, 12.0%-14.4%) of patients receiving a text message completed a mammogram compared with 10.7% (95% CI, 9.7%-11.8%) of those in the no text messaging arm, a significant increase (absolute difference, 2.5%; 95% CI, 0.8%-4.0%; P = .003).Conclusions and RelevanceThese findings show that text messaging women after initial breast cancer screening outreach via either electronic portal or mailings, as well as bulk ordering with or without text messaging, can increase mammogram completion rates.Trial RegistrationClinicalTrials.gov Identifier: NCT05089903

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