Encouraging Mammograms Using Behavioral Economics: A Randomized Controlled Trial in Chile

Abstract

ObjectivesThis article illustrates the effect of a direct mail campaign that used insights from behavioral economics and psychology to increase the number of free mammograms in Chilean women aged 50 years or older. MethodsWe hypothesized 4 barriers in obtaining a mammogram based on previous literature and focus group analysis. A behavioral economic approach providing incentives was used to help overcome these barriers. We accessed a unique data set, which comprised 12 000 women 50 years old or older, with private health insurance who have not had a mammogram for 24 or more months. We conducted a randomized controlled trial with 8 treatments, each involving a specific combination of messages. ResultsThe intervention overall led to a 167% increase in the use of free mammograms, a 1.13% to 3.03% average increase from the control to treatment groups, respectively. Regarding barriers, we found that all messages were effective, with a slightly larger and persistent effect for the less complex ones in terms of information. This finding illustrates the benefits of keeping the message simple. ConclusionsFinally, these results suggest a successful public policy for increasing use of free mammography programs. Moreover, they are potentially transferable because the study considered decision-making heuristics that are not specific to one culture or social context.