Nudging Public Employees Through Descriptive Social Norms in Healthcare Organizations

Abstract

We draw on the focus theory of normative conduct and nudge theory to experimentally test the effect of descriptive social norms on desired behaviors that public employees may engage in at suboptimal levels, namely, vaccination and help-seeking. Through a series of framed randomized controlled trials with 19,984 public healthcare professionals, we demonstrate that descriptive norms-doing what the majority of others do-trigger conformity. Specifically, employees are more likely to get a flu shot and advocate vaccination when knowing that the majority of their colleagues get vaccinated against the seasonal influenza compared to when most colleagues do not. Similarly, the probability of making help requests on the job is noticeably higher when asking colleagues for advice is the norm rather than not. We discuss the theoretical and practical implications of these experiments for scholars and policy makers interested in predictably altering high-stakes behaviors among public employees through low-powered incentives. Evidence for Practice• Public organizations and their managers can leverage social norms to fuel desired behaviors that employees may otherwise engage in at suboptimal levels. • Public organizations with high vaccination coverage rates can promote vaccination by informing their employees that the majority of their colleagues get the flu shot. • Public organizations with low vaccination coverage rates must implement interventions to increase vaccination coverage before they can take advantage of the effect of descriptive social norms. • Explicitly communicating that asking colleagues for help is a desirable social norm can foster widespread adoption of this behavior, which in turn can trigger helping at work.

Influence of Adult Attachment on COVID-19 Vaccination Intention: The Mediating Roles of Help-Seeking Style and Professional Help-Seeking Behavior

“…Seeking help from professionals such as doctors could improve individuals' intention to get vaccinated under the stress of the COVID-19 outbreak [7][8][9]. One study demonstrated that asking professional colleagues for help was a desirable social norm that was able to increase the coverage rate of the COVID-19 vaccine [21]. Therefore, Hypothesis 3 is proposed in this study:…”

“…Previous studies have indicated that adult attachment could affect individual help-seeking behavior [19,20]. Additionally, the impact of help-seeking on vaccination behavior has also been demonstrated [21]. Thus, help-seeking seems to be a potential mediator of the relationship between adult attachment and COVID-19 vaccination intention.…”

“…In contrast, avoidance-oriented help-seekers with low dependence emphasized self-independence, and their decision-making behavior was associated with the perception of personal goal achievement and motivation [23]. Since studies have claimed that more help-seeking behavior is associated with higher vaccine acceptance [21], dependency-oriented and autonomy-oriented help-seeking styles may predict greater COVID-19 vaccination intention, while avoidance-oriented help-seeking style may predict lower intention. Therefore, Hypothesis 2 is proposed in this study: Hypothesis 2 (H2).…”

Negativity in online news coverage of vaccination rates in Serbia: A content analysis

“…Many intervention studies have shown that describing positive behaviors as typical has the potential to introduce social change in a variety of domains (e.g., Behavioural Insights Team, 2012;Gerber & Rogers, 2009;Goldstein et al, 2008). Some studies have shown the same effect in the domain of vaccination: participants reported greater vaccination intentions when presented with a higher vaccination rate among their peers (Belle & Cantarelli, 2021;Hershey et al, 1994;Palm et al, 2021;Romley et al, 2016). This finding, however, was not corroborated in several other experiments (Clayton et al, 2021;Sinclair & Agerström, 2021;Xiao & Borah, 2020).…”

Branding, Value‐Signaling, and Nudging: When Push Comes to Shove

“…I have organized these articles around two themes: bureaucratic discretion and associated innovations on one hand, and subsequently, administrative burden and barriers to implementation on the other. Beginning with the former, this issue is led by an article by Belle and Cantarelli (2021). Using an experimental design, they demonstrate that descriptive norms lead to conformity in healthcare organizations.…”