Increasing Cancer Screening Rates and Vaccine Uptake using Digital Messages based on Insights from Behavioral Economics

Last registered on November 14, 2023
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Pre-Trial

Trial Information

General Information

Title
Increasing Cancer Screening Rates and Vaccine Uptake using Digital Messages based on Insights from Behavioral Economics
RCT ID
AEARCTR-0006317
Initial registration date
September 05, 2020

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
September 08, 2020, 9:35 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated
November 14, 2023, 6:44 AM EST

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Country
Israel
Region
Not Applicable

Primary Investigator

Name
Amnon Maltz
Affiliation
University of Haifa
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Other Primary Investigator(s)

PI Name
Rinat Mayo
PI Affiliation
Maccabi Healthcare Services
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PI Name
Adi Sarid
PI Affiliation
Sarid Research Institute
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PI Name
Stella Rashkovitz
PI Affiliation
Maccabi Healthcare Services
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PI Name
Neta Amorai-Belkin
PI Affiliation
Maccabi Healthcare Services
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PI Name
Tamar Alcalay
PI Affiliation
Maccabi Healthcare Services
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Additional Trial Information

Status
Completed
Start date
2020-07-29
End date
2021-12-06
Keywords
Behavior, Health
Additional Keywords
JEL code(s)
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
We examine whether different types of frames increase individuals' compliance with cancer screening and vaccination. Making use of a large digital message customer journey held in Israel by Maccabi Healthcare Services, we design 5 treatments that differ in their theme and underlying appeal. The five treatments include: Positive framing (benefits of early detection), negative framing (risks of late detection), empowerment ("your health is in your own hands"), recommendation by physicians, and implementation intention. A control group receives a message that only describes the importance of the screening/vaccination and the fact that they are recommended by the ministry of health. The population includes adults between the ages of 50-74 and the targeted screenings and vaccinations are: Occult blood test, mammography, screening for early detection of abdominal aortic aneurysm, HPV and Pneumococcal vaccine.
External Link(s)

Registration Citation

Citation
Alcalay, Tamar et al. 2023. "Increasing Cancer Screening Rates and Vaccine Uptake using Digital Messages based on Insights from Behavioral Economics." AEA RCT Registry. November 14. https://doi.org/10.1257/rct.6317-3.0
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
We have five treatments which may be considered as our interventions. Individuals insured by the HMO (Maccabi Healthcare Services) will be randomly assigned to one of 5 treatments and control. The treatments differ in the content included in the message. Each message emphasizes a different theme that is expected to increase compliance rates, based on previous behavioral and psychological research. The different treatments are: (1) Positive framing: stating the fact that early detection of a disease increases the treatment options and the chances of full recovery. (2) Negative framing: stating the fact that late detection of a disease reduces the treatment options and the chances of full recovery. (3) Empowerment: emphasizing the personal responsibility of the individual for his/her health. (4) Physician Recommendation: mentioning that doctors within the HMO recommend performing the suggested screenings. (5) Implementation Intention: presenting the screening and potential outcomes as an "if-then plan".
Intervention Start Date
2020-07-29
Intervention End Date
2021-12-06

Primary Outcomes

Primary Outcomes (end points)
A dummy variable recording whether the individual performed the screening/got the vaccination within 2-3 months since receiving the message.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
A dummy variable recording whether the individual scheduled an appointment to her/his recommended screening.
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The design is straightforward. 5 treatments plus a control. Treatments differ in the framing and content of the message and we will examine which of the above approaches has the highest success in increasing compliance rates.
Experimental Design Details
Randomization Method
Randomization by a computer.
Randomization Unit
Individual.
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
Roughly 150,000 individuals
Sample size: planned number of observations
Roughly 150,000
Sample size (or number of clusters) by treatment arms
25,000 individuals in each treatment/control
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Assuming n=25000 in each group, significance level 0.05, power of 95%, in a two sided test, the minimum detectable effect size is h=0.032.
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Maccabi Health Services
IRB Approval Date
2020-08-06
IRB Approval Number
Internal IRB prior to Helsinki Committee
Analysis Plan

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
Yes
Intervention Completion Date
December 06, 2021, 12:00 +00:00
Data Collection Complete
Yes
Data Collection Completion Date
December 06, 2021, 12:00 +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
129,070
Final Sample Size (or Number of Clusters) by Treatment Arms
After initial data cleaning: Control-20946, Gains-20385, Losses-15154, Recommendation-20573, Implementation Intentions-20687, Empowerment-15237
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Yes
Program Files URL
https://github.com/sarid-ins/medical_screening_amnon_maccabi
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials