Behavioral Nudges for Flu Shot Uptake (BE IMMUNE Rep Trial)

Recruiting in Palo Alto (17 mi)

Overseen ByShivan Mehta, MD

Age: 18+

Sex: Any

Travel: May be covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: University of Pennsylvania

No Placebo Group

Trial Summary

What is the purpose of this trial?This study will be a 6-month, cluster randomized, pragmatic replication trial to evaluate the effectiveness of personalized nudges to clinicians and patients, relative to a control, to increase flu vaccination rates among older adults in accordance with CDC guidelines. This will include clinician and patient level nudge interventions, with additional, intensified nudge interventions for patients identified as high risk for not receiving a flu vaccine. Among the intervention clinics, patients will receive pre-visit text message reminders about the flu vaccine, and clinicians will receive a default pended order in the visit encounter in the EHR, along with monthly peer comparison feedback about their flu vaccine completion rate. Patients identified as high risk for noncompletion will be individually randomized to receive an additional bidirectional text message nudge or the standard text messaging

Eligibility Criteria

This trial is for older adults who are due to receive their flu vaccine, following CDC guidelines. It's designed to see if reminders and prompts (nudges) can help increase vaccination rates. People in the study will get text messages or have orders set up in their health records to remind them.

Participant Groups

The study tests whether different types of 'nudges' like pre-visit texts and monthly feedback to clinicians can boost flu shot numbers. Some high-risk patients will get extra nudges. Clinics are randomly chosen for standard reminders or these intensified efforts.

3Treatment groups

Experimental Treatment

Active Control

Group I: Intervention ArmExperimental Treatment3 Interventions

Clinics randomized to the intervention arm will receive the toolkit of clinician and patient facing nudges. Patient nudges will be pre-visit text message reminders (standard messaging content). Clinician nudges will be monthly peer comparison feedback and default pended orders.

Group II: High Risk Intensification ArmExperimental Treatment4 Interventions

Patients in the intervention clinics identified as high risk for noncompletion of the flu vaccine will be randomized 1:1 to receive the high risk intensification arm or remain in the standard intervention arm. Patients in the high risk intensification arm will receive an additional bidirectional texting component.

Group III: ControlActive Control1 Intervention

Clinics randomized to the control arm will receive standard of care.