Persuasion in Medicine: Experimental Evidence on Sender and Signal Effects
Condition: Flu, Human; Influenza, Human; Covid19
MeSH terms: Influenza, Human
Study type: Interventional

Summary: 
      The aim of the study is to identify what sender/signal combinations are most persuasive in
      encouraging low socioeconomic males living in the U.S. to take-up seasonal flu vaccination.
      The investigators plan to recruit male subjects and randomly assign them to four persuasion
      treatments: three of which vary dimensions of the sender of a medical recommendation (racial
      concordance and authority treatments) and one which varies the signal (standard vs.
      empathetic). Specifically, the investigators will show subjects videos of either Black or
      white actors/actresses providing scripted information on the flu vaccination. The
      investigators will randomize the race of the sender and if the subject is Black, also
      randomize the authority of the sender, with the actor portraying either a doctor or a
      layperson. In addition, the investigators will vary the script used in the experiment between
      one that acknowledges past injustices (indicated as an empathetic script hereafter) and one
      that does not (indicated as a standard script hereafter). The investigators will provide
      subjects a free flu shot coupon and elicit the price at which subjects would be willing to
      give up this coupon for a cash reward. Lastly, in light of the relevance of vaccination
      take-up in combating COVID-19 pandemic, the investigators will assess demand for information
      about a COVID-19 vaccine, with subjects invited to receive results of a safety and efficacy
      review from a trusted or standard source. The design requires the collection of baseline and
      endline surveys combined with administrative data from pharmacies about coupon redemption.
      The primary outcomes of interest are posterior beliefs about seasonal flu vaccination, demand
      and willingness-to-pay (WTP) for a free flu shot coupon, redemption of the coupon, and demand
      for information about a COVID-19 vaccine.
    

Detailed description: 
      The investigators will recruit approximately 3350 African-American or Caucasian adult males
      with a high-school diploma or less. A pilot study, which ran during the 2019-20 flu season,
      recruited approximately 850 subjects, and a planned scale-up will recruit an additional 2500
      subjects during the 2020-21 flu season. The investigators will oversample African American
      individuals, emphasizing low-income and minority men because these characteristics are
      correlated with lower relative take-up of flu vaccination. After informed consent is
      obtained, subjects will be asked about sociodemographic information (age, education, income
      and marital status), healthcare experience and past medical history, knowledge and beliefs
      about flu vaccination, and location of the nearest pharmacy. The investigators will then
      randomly assign the adult male subjects to videos which contain one of Black or white actors
      playing the role of either a doctor or a layperson as well as different scripts. The content
      of the infomercial will be the safety and effectiveness of adult seasonal flu vaccination.
      After the video, the investigators will obtain information on beliefs regarding vaccination,
      feedback on the video, attention to the video and willingness-to-pay for a flu shot coupon.
      The final baseline module will consist of a randomly assigned invitation to receive the
      results of an upcoming review of a COVID-19 vaccine, with subjects assigned to receive
      information from a trusted or standard source. The investigators will track flu coupon
      redemption, which is redeemable at most pharmacies nationwide.
    

Intervention name(s): Video about safety and effectiveness of adult seasonal flu vaccination
Intervention type(s): Behavioral
Intervention description(s): The investigators will show subjects videos of either Black or white male actors providing scripted information on the flu vaccination. The content of the video will be the safety and effectiveness of adult seasonal flu vaccination. The videos contain one of Black or white actors playing the role of either a doctor or a layperson as well as different scripts.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary purpose: Health Services Research
Keywords: Belief Updating; Preventive Care; Racial Disparity