Abstract
This paper reports on the results of a randomized controlled trial in which researchers collaborated with a department of health in a mid-size city to evaluate the effectiveness of targeted communications highlighting descriptive social norms to increase immunization compliance across 700 schools. Schools were randomly selected to receive a twice-annual immunization compliance report card reporting in detail their compliance rates compared to other schools of the same school type; the comparison rates reported included the school-type average, average compliance among the top 10% of performers, and the city target of 98% compliance. Shifts in immunization compliance are tracked in a city-wide administrative vaccine registry. The results suggest that there was no significant difference in compliance rates between treatment and control schools six months post-treatment. To our knowledge, it is the first randomized controlled trial evaluating the use of descriptive social norms in increasing immunization compliance rates in a school-based setting. In addition, it serves as an example of embedding a behaviorally-informed experiment in a government program utilizing high-quality administrative data.
Highlights
Background on Social NormsThe existing literature provides substantial evidence of the relevance of social norms for immunization decisions made by parents for their children and adolescents
This paper reports on a randomized controlled trial conducted in collaboration with the department of health of a mid-size city to evaluate the effectiveness of targeted communications highlighting descriptive social
Report cards on immunization rates were distributed to health practices in northern Manhattan as part of a broader intervention targeting zero to threeyear old immunization rates in the area, and quasiexperimental analysis suggests that the intervention was successful in increasing immunization rates (Findley, 2003)
Summary
Background on Social NormsThe existing literature provides substantial evidence of the relevance of social norms for immunization decisions made by parents for their children and adolescents. The collaborating department of health (DOH) has responsibility for overseeing immunization compliance rates within all educational institutions in the city, including day care centers and elementary, middle, and high schools (public, private, parochial, and charter).
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