Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Dec 28, 2022
Date Accepted: Dec 10, 2023
The Framing Effect of Digital Textual Messages on Uptake Rates of Medical Checkups: A Field Study
ABSTRACT
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. Clinical Trial: The study was pre-registered on the AEA RCT Registry. Unique identifying number: AEARCTR-0006317.
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