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Alhajji M, Alzeer AH, Al-Jafar R, Alshehri R, Alyahya S, Alsuhaibani S, Alkhudair S, Aldhahiri R, Alhomaid A, Alali D, Alothman A, Alkhulaifi E, Alnashar M, Alalmaee A, Aljenaidel I, Alsaawi F. A national nudge study of differently framed messages to increase COVID-19 vaccine uptake in Saudi Arabia: A randomized controlled trial. Saudi Pharm J 2023; 31:101748. [PMID: 37662677 PMCID: PMC10472300 DOI: 10.1016/j.jsps.2023.101748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 08/09/2023] [Indexed: 09/05/2023] Open
Abstract
Background During the COVID-19 pandemic, Saudi Arabia witnessed hesitancy from a proportion of the population toward taking the vaccine; thus, it was necessary to nudge them to uptake it. This study was conducted to assess the impact of using different types of messages to nudge the public to increase the proportion of vaccinated individuals. Methods This study is a multi-arm randomized controlled trial aiming to assess the efficacy of using differently framed messages that appear as pop-notifications in Sehatty application. Of those who preregistered to receive a COVID-19 vaccine but didn't take it according to the Saudi national vaccine registry (n = 1,291,686), 12,000 individuals were randomly recruited and randomly assigned to one of five intervention groups (commitment, loss aversion, salience, social norms, and ego) or a control group. To ensure the exposure occurred in the intervention groups, we included only those who received the notification, which was confirmed by checking the information technology system. We used the Chi-square test to compare each intervention group against the control group separately. Also, we used the same test to investigate whether sex and age influenced the percentage of booked appointments in the intervention groups. Results Social norms, ego, salience and loss aversion groups had higher percentages of booked appointments when compared to the control group (21.0%, p = 0.001; 19.1%, p = 0.011; 19.0%, p = 0.013; 18.4%, p = 0.034, respectively). Moreover, when combining the intervention groups, the percentage was higher than the control group (p < 0.001). The percentages of booked appointments made by Young adults (18-35 years old) were higher than that of adults over 35 years old in the social norms (22.6%, p = 0.016) and ego groups (21.0%, p = 0.010). At the same time, sex didn't affect the percentages of booked appointments in any group. Conclusion Using different framings of messages to nudge the public to take vaccines can help increase the percentage of immunized individuals in a community. Nudges can boost the public health of a population during an unusual spread of vaccine-preventable diseases. Findings might also inspire governmental responses to other public health situations.
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Affiliation(s)
| | - Abdullah H. Alzeer
- Data Services Sector, Lean Business Services, Riyadh, Saudi Arabia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Rami Al-Jafar
- Data Services Sector, Lean Business Services, Riyadh, Saudi Arabia
- School of Public Health, Imperial College London, London, UK
| | - Reem Alshehri
- Nudge Unit, Ministry of Health, Riyadh, Saudi Arabia
| | - Saad Alyahya
- Nudge Unit, Ministry of Health, Riyadh, Saudi Arabia
| | - Sara Alsuhaibani
- Nudge Unit, Ministry of Health, Riyadh, Saudi Arabia
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sarah Alkhudair
- Data Services Sector, Lean Business Services, Riyadh, Saudi Arabia
| | - Raghad Aldhahiri
- Data Services Sector, Lean Business Services, Riyadh, Saudi Arabia
| | - Ahmed Alhomaid
- Data Services Sector, Lean Business Services, Riyadh, Saudi Arabia
| | - Dalal Alali
- Data Services Sector, Lean Business Services, Riyadh, Saudi Arabia
| | | | | | | | | | | | - Fahad Alsaawi
- Data Services Sector, Lean Business Services, Riyadh, Saudi Arabia
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