The Lab @ DC, Washington DC, USA.
Center for Healthcare Delivery Sciences (C4HDS) and Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Nat Hum Behav. 2018 Oct;2(10):743-749. doi: 10.1038/s41562-018-0432-2. Epub 2018 Oct 1.
The influenza ('flu') vaccination is low cost and effective, typically reducing the likelihood of infection by 50-60%. It is recommended for nearly everyone older than 6 months of age; 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. 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. Of the attempts that are successful, most are expensive-limiting scalability-and have not been evaluated in the elderly. 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.
流感（“flu”）疫苗接种成本低且效果好，通常可将感染的可能性降低 50-60%。建议 6 个月以上的几乎所有人都接种疫苗；然而，每年只有 40%的美国人接种疫苗。在高危人群中，如≥65 岁的人群中，接种率较高，但仍只有 6 人中就有 1 人接种。为了提高接种率，人们已经尝试了多种策略，如基于学校的计划、经济激励和提醒等，但这些策略总体上收效甚微。在成功的尝试中，大多数策略成本较高（限制了可扩展性），并且尚未在老年人中进行评估。相反，成本较低的干预措施，如邮寄信息，为可扩展的解决方案提供了希望，但由于设计方式的限制，它们的效果有限。我们随机将 228000 名≥66 岁的人分配到五封旨在激励接种疫苗的信件中的任意一封，其中包括带有实施意图提示和增强的主动选择实施提示的信件。我们发现，与没有信件相比，单封邮寄的信件显著提高了流感疫苗的接种率。然而，在使用行为科学技术定制的四封不同信件中，接种率没有差异。
