Vaccination RefusalNCT04728594
Emails Promoting COVID-19 Vaccination Among Healthcare Workers
A study testing Social Proof, Reframing and Scarcity Message in people with Vaccination Refusal and Communication, run by Geisinger Clinic at 1 site in United States.
Trial summary
In this evaluation, two versions of emails will be sent to Geisinger employees who have not been vaccinated against COVID-19. A delayed-contact control group will be emailed after a delay of at least two days. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Vaccination Refusal, Communication
- What is being tested?
- Social Proof, Reframing and Scarcity Message
- Type of treatment
- Vaccines, Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 9,566 participants
- Where
- 1 siteUnited States
- Study dates
- 15 Jan 2021to 20 Jan 2021
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Employees at Geisinger Health System who have not gotten a COVID-19 vaccination
Who cannot join
- None
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Evaluation of an Email Intervention Promoting COVID-19 Vaccination Among Healthcare Workers
In this evaluation, two versions of emails will be sent to Geisinger employees who have not been vaccinated against COVID-19. A delayed-contact control group will be emailed after a delay of at least two days. The researchers hypothesize that either of the emails - which use content informed by behavioral nudge theory - will lead to more COVID-19 vaccinations than the delayed-contact control group.
Read the detailed description
The researchers aim to evaluate the effectiveness of email reminders in promoting COVID-19 vaccinations among Geisinger employees. The project will compare two emails, which will vary in the subject line and email content. Both emails will test different approaches that draw from principles in behavioral science: social proof, reframing, and scarcity. Employees receiving these emails will be compared with employees in a delayed-contact group, who will not receive emails. Employees in the control group will later receive one of the emails.The responses to the emails will help determine the communications later sent to the control group.
All emails will ask recipients if they want to receive a COVID-19 vaccination. If they click on a hyperlink indicating yes, they will be forwarded to an online registration and scheduling homepage. If they click on a hyperlink indicating no, they will be forwarded to an online questionnaire surveying people about their main reason for declining the vaccine at this time. The questionnaire will automatically present information intended to assuage the specific concern that people endorse, followed by a hyperlink to the scheduling site.
The data will be analyzed with logistic regression models with the control group as the reference group, to compare the two email conditions versus the control group. This set of analyses will only be conducted for scheduling a vaccination appointment as opposed to email engagement outcomes (e.g., number of emails opened), which will not be applicable for the control group. A second set of logistic regression models predicting scheduling a vaccination appointment and email engagement will also be run, comparing the two email conditions against each other. The data will be examined two days later (to help decide which email to send to the delayed-control group) and four days later (when the policy for employee vaccination will change, making the content of the email irrelevant).
Update: The researchers looked at 3 days of data - as the emails to the delayed contact group were only sent at that time - and 4 days of data when the policy for employee vaccinations changed.
- Conditions
- Vaccination Refusal, Communication
- Being tested
- Social Proof, Reframing, Scarcity Message
- Keywords
- Immunization, Persuasive Communication, Electronic Mail, Economics, Behavioral, Psychology
- Medical subject headings
- Vaccination Refusal, Communication, Behavior
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Social ProofBehavioural
Email
ReframingBehavioural
Email
Scarcity MessageBehavioural
Email
| Study group | Role | What they receive |
|---|---|---|
| Delayed Contact | No intervention | This group will not receive an email for at least two days. |
| Social Proof | Experimental | This group will receive an email that points out that vaccine availability for employees will soon be limited. It also emphasizes how many fellow health care workers have been vaccinated. Seeing the behaviors of other people might encourage recipients to copy that behavior. Receives: Behavioral: Social Proof; Behavioral: Scarcity Message |
| Reframing Side Effects and Adverse Reactions | Experimental | This group will receive an email that points out that vaccine availability for employees will soon be limited. It also addresses concerns about the side effects and adverse reactions of the vaccine. Due to potentially overblown concerns about the vaccine caused by the salience of side effects in the (social) media, the email attempts to reframe the risks by explicitly noting the small possibility of being affected by serious side effects and by contrasting that to the more severe effects of COVID-19. As a result of this reframing, recipients might recalibrate their perception of risks and benefits and opt for vaccination. Receives: Behavioral: Reframing; Behavioral: Scarcity Message |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Employees Who Scheduled Vaccination Appointments After 3 Days
Binary variable of a scheduled vaccination appointment 3 days after the emails were sent
Measured: 3 days
Secondary outcomes (2)
Number of Employees Who Opened Emails After 3 Days
Binary variable indicating whether the employee opened the email 3 days after the emails were sent
Measured: 3 days
Number of Employees Who Clicked Scheduling Links After 3 Days
Binary variable indicating whether the employee clicked the link to schedule a vaccination appointment 3 days after the emails were sent
Measured: 3 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Jan 2021
- Study start15 Jan 2021
- Primary completion17 Jan 2021
- Study completion20 Jan 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Vaccination RefusalStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- 1 x 3 design
- Masking
- Double blind
- Who is masked
- Participant, Care provider
- Enrolment
- 9,566 participants (actual)
Sponsor and investigators
- Lead sponsor
- Geisinger Clinic
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Michelle N. Meyer, Geisinger Clinic
- Investigators
- Michelle M Meyer, PhD, Principal investigator, Geisinger Clinic
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04728594
- Sponsor's protocol ID
- 2021-0128
- Status last verified
- Jul 2021
- First submitted
- 26 Jan 2021
- Last updated
- 26 Jul 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Data with no personally identifiable information will be made available to other researchers on the Open Science Framework for transparency. This will include the essential data and code needed to replicate the analysis that yielded reported findings.
Publications
Santos HC, Goren A, Chabris CF, Meyer MN. Effect of Targeted Behavioral Science Messages on COVID-19 Vaccination Registration Among Employees of a Large Health System: A Randomized Trial. JAMA Netw Open. 2021 Jul 1;4(7):e2118702. doi: 10.1001/jamanetworkopen.2021.18702.
PubMed 34319359
Study at a glance
From the registry record, last updated by the sponsor on 26 Jul 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of an Email Intervention Promoting COVID-19 Vaccination Among Healthcare Workers
- ClinicalTrials.gov ID
- NCT04728594
- Acronym / sponsor ID
- 2021-0128
- Conditions
- Vaccination Refusal, Communication
- Keywords
- Immunization, Persuasive Communication, Electronic Mail, Economics, Behavioral, Psychology
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 9,566 participants (actual)
- Lead sponsor
- Geisinger ClinicUniversity, hospital or other
- Study start
- 15 Jan 2021 (actual)
- Primary completion
- 17 Jan 2021 (actual)
- Study completion
- 20 Jan 2021 (actual)
- First posted
- 28 Jan 2021 (actual)
- Results
- Posted 26 Jul 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
In this evaluation, two versions of emails will be sent to Geisinger employees who have not been vaccinated against COVID-19. A delayed-contact control group will be emailed after a delay of at least two days. The researchers hypothesize that either of the emails - which use content informed by behavioral nudge theory - will lead to more COVID-19 vaccinations than the delayed-contact control group.
Detailed description
The researchers aim to evaluate the effectiveness of email reminders in promoting COVID-19 vaccinations among Geisinger employees. The project will compare two emails, which will vary in the subject line and email content. Both emails will test different approaches that draw from principles in behavioral science: social proof, reframing, and scarcity. Employees receiving these emails will be compared with employees in a delayed-contact group, who will not receive emails. Employees in the control group will later receive one of the emails.The responses to the emails will help determine the communications later sent to the control group.
All emails will ask recipients if they want to receive a COVID-19 vaccination. If they click on a hyperlink indicating yes, they will be forwarded to an online registration and scheduling homepage. If they click on a hyperlink indicating no, they will be forwarded to an online questionnaire surveying people about their main reason for declining the vaccine at this time. The questionnaire will automatically present information intended to assuage the specific concern that people endorse, followed by a hyperlink to the scheduling site.
The data will be analyzed with logistic regression models with the control group as the reference group, to compare the two email conditions versus the control group. This set of analyses will only be conducted for scheduling a vaccination appointment as opposed to email engagement outcomes (e.g., number of emails opened), which will not be applicable for the control group. A second set of logistic regression models predicting scheduling a vaccination appointment and email engagement will also be run, comparing the two email conditions against each other. The data will be examined two days later (to help decide which email to send to the delayed-control group) and four days later (when the policy for employee vaccination will change, making the content of the email irrelevant).
Update: The researchers looked at 3 days of data - as the emails to the delayed contact group were only sent at that time - and 4 days of data when the policy for employee vaccinations changed.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, care provider)
- Number of arms
- 3
- Model description
- 1 x 3 design
| Arm | Type | Receives |
|---|---|---|
| Delayed Contact | No intervention | –This group will not receive an email for at least two days. |
| Social Proof | Experimental | Behavioral: Social Proof, Behavioral: Scarcity MessageThis group will receive an email that points out that vaccine availability for employees will soon be limited. It also emphasizes how many fellow health care workers have been vaccinated. Seeing the behaviors of other people might encourage recipients to copy that behavior. |
| Reframing Side Effects and Adverse Reactions | Experimental | Behavioral: Reframing, Behavioral: Scarcity MessageThis group will receive an email that points out that vaccine availability for employees will soon be limited. It also addresses concerns about the side effects and adverse reactions of the vaccine. Due to potentially overblown concerns about the vaccine caused by the salience of side effects in the (social) media, the email attempts to reframe the risks by explicitly noting the small possibility of being affected by serious side effects and by contrasting that to the more severe effects of COVID-19. As a result of this reframing, recipients might recalibrate their perception of risks and benefits and opt for vaccination. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- Employees at Geisinger Health System who have not gotten a COVID-19 vaccination
Key exclusion criteria (1 listed)
- None
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Social ProofEmail | Behavioural | Social Proof |
| ReframingEmail | Behavioural | Reframing Side Effects and Adverse Reactions |
| Scarcity MessageEmail | Behavioural | Reframing Side Effects and Adverse Reactions, Social Proof |
Primary outcome
Number of Employees Who Scheduled Vaccination Appointments After 3 Days
Time frame: 3 days
Binary variable of a scheduled vaccination appointment 3 days after the emails were sent
2 secondary outcomes
Number of Employees Who Opened Emails After 3 Days
Time frame: 3 days
Number of Employees Who Clicked Scheduling Links After 3 Days
Time frame: 3 days
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 Jul 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 34319359Santos HC, Goren A, Chabris CF, Meyer MN. Effect of Targeted Behavioral Science Messages on COVID-19 Vaccination Registration Among Employees of a Large Health System: A Randomized Trial. JAMA Netw Open. 2021 Jul 1;4(7):e2118702. doi: 10.1001/jamanetworkopen.2021.18702.
- Individual participant dataSharing planned: Yes. Data with no personally identifiable information will be made available to other researchers on the Open Science Framework for transparency. This will include the essential data and code needed to replicate the analysis that yielded reported findings.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Michelle M Meyer, PhD principal investigator
Geisinger Clinic
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Social Proof, Reframing and Scarcity Message in people with Vaccination Refusal and Communication, run by Geisinger Clinic at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 26 Jul 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 26 Jul 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Employees Who Scheduled Vaccination Appointments After 3 Days (time frame: 3 days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04728594, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Jul 2021.