Background. We suggest and examine a behavioral approach to increasing seasonal influenza vaccine uptake. Our idea combines behavioral effects generated by a dominated option, together with more traditional tools, such as providing information and recommendations. Methods. Making use of the seasonal nature of the flu, our treatments present participants with 2 options to receive the shot: early in the season, which is recommended and hence “attractive,” or later. Three additional layers are examined: 1) mentioning that the vaccine is more likely to run out of stock late in the season, 2) the early shot is free while the late one costs a fee, and 3) the early shot carries a monetary benefit. We compare vaccination intentions in these treatments to those of a control group who were invited to receive the shot regardless of timing. Results. Using a sample of the Israeli adult population ( n = 3271), we found positive effects of all treatments on vaccination intentions, and these effects were significant for 3 of the 4 treatments. In addition, the vast majority of those who are willing to vaccinate intend to get the early shot. Conclusions. Introducing 2 options to get vaccinated against influenza (early or late) positively affects intentions to receive the flu shot. In addition, this approach nudges participants to take the shot in early winter, a timing that has been shown to be more cost-effective.

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BACKGROUND Textual messages are often used by healthcare authorities in order to increase compliance rates with medical recommendations. The effectiveness of different types of message framings have been examined over the past three decades. This study makes use of a large digital campaign held by Maccabi Healthcare Services (MHS), the second largest Health Maintenance Organization in Israel, to examine the effect of commonly-used message framings on uptake rates of medical checkups. It also examines the effectiveness of media channel on uptake rates and whether subject-line length is correlated with message opening rates. OBJECTIVE Examine the effectiveness of some of the most widely-used message framings on uptake rates of medical checkups. METHODS We conducted a large scale field study (n = 113,048) together with Maccabi Healthcare Services (MHS), the second largest Health Maintenance Organization in Israel. The study made use of a massive digital reach out campaign held in 20202021. Members aged 50-74 were invited to take their recommended medical actions from the following list: HPV, mammography, abdominal aortic aneurysm, fecal occult blood test and pneumococcal vaccination. Each member was randomly assigned to receive one of six types of messages: Control, positive outcomes, negative outcomes, physician recommendation, implementation intentions, and empowerment. RESULTS No significant effect of message framing on uptake rates was found. We identify two suggestive findings: (1) shorter subject lines are positively correlated with opening rates, and (2) emails outperform text messages. CONCLUSIONS No evidence was found for an effect of the above frames on uptake rates. In order to increase compliance rates, public health officials should consider alternative framings. In addition, media channels and subject line length should be given careful thought. CLINICALTRIAL The study was pre-registered on the AEA RCT Registry. Unique identifying number: AEARCTR-0006317.

The aim of the current study was to examine the emotional resilience, satisfaction with life, social support, and anxiety during the vaccination process of the Israeli population after the end of the third lockdown, according to religiosity degree. We hypothesized that a higher degree of religiosity (ultra-Orthodox and religious participants) would be associated with higher levels of resilience and with lower levels of anxiety than in secular individuals. In addition, it was hypothesized that satisfaction with life, social support, anxiety, and religiosity will predict resilience and anxiety. Nine hundred and ninety-three native Jewish Hebrew-speaking respondents representing ultra-Orthodox, religious, observant, and secular Jews participated in this study. Ultra-Orthodox participants showed higher resilience and satisfaction with life than other groups, and lower levels of anxiety. Satisfaction with life and social support predicted higher resilience. It is suggested that religious faith as well as satisfaction with life may provide a source of strength and resilience in stressful life events.

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