Successful Referrals Research Articles

Successful referral behavior in referral reward programs

PurposeReferral reward programs (RRPs) incentivize existing customers (inductors) to refer new customers (inductees). The effectiveness of RRPs is not well understood as previous studies either focused on referral intent and/or ignored inductee responses. However, an RRP is only effective if inductors recommend and inductees respond with buying the service. The purpose of this paper is to examine the drivers of existing customers’ successful referral behavior.Design/methodology/approachThis study combines a bank’s customer relationship management (CRM) data which were used to identify successful inductors and non-inductors. Then, observed behavioral and customer background data from the CRM database (including successful referrals, deposits in euros, number of products held, relationship duration, income, age, and gender) were combined with survey data capturing attitudinal variables (i.e. perceived relationship quality, reward attractiveness, referral metaperception, opportunism, and involvement). This approach allowed for the simultaneous testing of all hypothesized drivers of successful referral behavior.FindingsMetaperception (i.e. the process by which individuals determine the impressions other might form of them and their behavior) was the strongest and most significant driver of successful RRP participation, followed by attractiveness of the reward. That is, inductors recommended successfully when they believed that their incentivized referral did not look bad (or even looked good) and incentives were perceived as attractive. This finding is important as metaperception so far has only been examined in theoretical and experimental studies with intent as dependent variables. Second, latent class analysis (LCA) revealed that there were two segments of inductors of which one was opportunistic. Opportunism as a driver of referral behavior has not been shown in past research using more traditional analyses, whereas LCA uncovered it as a driver for one-third of all respondents.Practical implicationsThe findings offer managers a better understanding of the key determinants of successful referral behavior with important RRP design implications that counter frequent practice (e.g. designing RRPs with high face value but then reducing its usefulness through terms and conditions). Furthermore, managers may consider segment-specific reward structures to improve the effectiveness of their RRPs.Originality/valueThis study is the first to examine inductor determinants of successful referral behavior and identify inductor segments.

Understanding the quality–quantity conundrum of customer referral programs: effects of contribution margin, extraversion, and opinion leadership

Firms can substantially profit from customer referrals, but they must understand the different stages of the referral process to determine what drives the number of referrals (first stage), conversion (second stage), and average contribution margin per referral (third stage). Applying a framework that integrates perceptual and behavioral drivers, this study uses a financial services company’s customer survey and transaction data to investigate how the effect of contribution margins of referring customers at all three stages depends on their perceived extraversion and opinion leadership. Extreme extraversion and opinion leadership diminish the positive effect of the contribution margins of referring customers on the number of referrals; their effect on the number of successful referrals is insignificant. In terms of the contribution margin of successful referrals, extraversion has a negative and opinion leadership a positive moderating effect.

Potential predictive factors for successful referral from specialist mental-health services to less intensive treatment: A concept mapping study

Referring patients from specialist mental-health services (provided by multiple healthcare service providers and aimed at relieving symptoms of mental illness) to less intensive care (provided by a nurse or psychologist in cooperation with a general practitioner and aimed at improving quality of life) is feasible from the perspective of patients, service providers, and mental-health services. However, it is unclear which patients are most suitable for referral to less intensive care. In this study, we used concept mapping to identify factors that might determine whether a referral from specialist mental services to less intensive care might be successful. Participants (N = 34) were recruited from different parts of the Netherlands and included general practitioners, peer workers, community mental-health nurses, and social workers from several services who were based in different neighborhoods. The participants generated 54 statements (31 after clean-up), which were sorted into five clusters and rated on their expected ability to predict successful referral. Ordered from highest to lowest on expected predictive value, the clusters of factors were: Patient characteristics, patients’ informal support system, patients’ social situation, organization of services, and service provider related factors. The ordering was the same for all of the service providers, except that general practitioners expected the organization of services to be the most predictive. The ordering of the clusters is mostly consistent with existing knowledge about recovery during mental healthcare. In order to further improve the number of successful referrals from specialist mental-health services to less intensive care, a prospective prediction study is needed.

Diabetic retinopathy screening programme utilising non-mydriatic fundus imaging in slum populations of New Delhi, India.

To develop and implement a community-based programme for screening of diabetic retinopathy (DR) in urban populations of Delhi. Known diabetics (KDs) aged 40 years and older were identified through house-to-house surveys, volunteers and publicity. All KDs were referred to DR screening camps organised locally where procedures included brief medical history, ocular examination and non-mydriatic fundus photography using portable handheld camera. Fundal images were graded on the spot by trained optometrists for DR. Patients with DR were referred to tertiary centre for management. A total of 11 566 KDs were identified, of whom 9435 (81.6%) visited DR screening camps and 8432 (89.4%) had DR gradable images. DR was identified in 13.5% of subjects; 351 cases were mild NPDR, 567 moderate, 92 severe. Seventy-seven had PDR, and 49 had DME, and 2.7% of participants were blind (presenting visual acuity <3/60 in better eye). Non-use of lifestyle management, presence of systemic complications, BMI <18.5 kg/m2 , disease duration of >5 years and uncontrolled diabetes were associated with increased odds of DR. All cases with DR were referred, and 420 (37%) successful referrals to base hospital were observed. The programme of creating awareness about DR, identifying KDs and optometrist-led DR screening using non-mydriatic fundus camera based in slums was successful.

Utilization of Patient Navigators in an Urban Academic Pediatric Primary Care Practice.

Navigating health care systems can be a challenge for families. A retrospective descriptive cohort analysis was conducted assessing referrals to patient navigators (PNs) in one urban academic pediatric primary care practice. PNs tracked referral processes and a subset of PN referrals was assessed for markers of successful referrals. The most common reasons for referral were assistance overcoming barriers to care (46%), developmental concerns (38%), and adherence/care coordination concerns (14%). Significant predictors of referral were younger age, medical complexity, public insurance, male sex, and higher rates of no-show to visits in primary or subspecialist care. The majority of referrals were resolved. The referrals for process-oriented needs were significantly more successful than those for other concerns. PNs were more effective for discrete process tasks than for those that required behavior change by patients or families. Future directions include analysis of cost effectiveness of the PN program and analysis of parent and primary care provider experience.

Homeless youth: Barriers and facilitators for service referrals

Young people who are homeless and experiencing mental health issues are reluctant to use relevant services for numerous reasons. Youth are also at risk of disengaging from services at times of referral to additional or alternative services. This study aimed to identify barriers and facilitators for inter-service referrals for homeless youth with mental health issues who have already engaged with a service. Qualitative, semi-structured interviews were conducted with homeless youth (n = 10), homelessness support workers (n = 10), and mental health clinicians (n = 10). Barriers included: resource shortages; programs or services having inflexible entry criteria; complexity of service systems; homeless youth feeling devalued; and a lack of communication between services, for example, abrupt referrals with no follow up. Referral facilitators included: services providers offering friendly and client-centred support; supported referrals; awareness of other services; and collaboration between services. Relationships with service providers and inter-service collaboration appeared essential for successful referrals for homeless youth. These facilitating factors may be undermined by sector separation and siloing, as well as resource shortages in both the homelessness and mental health sectors. Service transitions may be conceptualised as a genuine service outcome for homeless youth, and as a basis for successful future service provision.

Monetizing Sharing Traffic Via Incentive Design: Evidence from a Randomized Field Experiment

Despite the increasing connectivity between consumers and the large volume of social shares supported by digital technologies, there is an absence of research systematically investigating how firms can design promotional incentives that jointly consider their consumers as both purchasers and sharers. In this study, we examine whether and how firms can leverage consumers’ social connections and engage consumers to share promotional incentives. In collaboration with a leading online deal platform, we report a large-scale randomized field experiment to test the effectiveness of different incentive designs (varying in the shareability and scarcity of promotion codes) in driving social sharing senders’ purchases and successful referrals. We find that the different incentive designs have distinct impacts on the purchase and referral outcomes. Specifically, providing senders with one non-shareable promo code significantly increases their own purchase likelihood, compared to the other experimental groups. In contrast, the senders who receive one shareable promo code are less likely to purchase themselves yet are more likely to make successful referrals. Surprisingly, the incentive design with two promo codes containing one non-shareable code and one shareable code increases neither the senders’ purchase nor their successful referrals. Managerially, we estimate that although the one non-shareable promo code group derives the highest net revenue for the experimental period, the one shareable promo code group derives the highest customer lifetime value for the firm from the new customers acquired through the successful referrals. We further conducted two online experiments on Amazon Mechanical Turk that replicate the field experiment’s findings and explore the underlying mechanisms of the observed relationships. We find that exclusivity perception and social motives triggered by the incentive designs with one promo code mediate their effects on senders’ self-purchases and successful referrals, respectively, and explain the ineffectiveness of two promo codes. Our study contributes to the bodies of literature on IT-enabled social sharing and social promotions, providing implications for firms on how to design promotional incentives that accommodate the dual role of consumers as purchasers and sharers.

Words Matter! Towards Pro-Social Call-to-Action for Online Referral: Evidence from Two Field Experiments

The underlying premise of referral marketing is to target existing, ostensibly delighted customers to spread awareness and influence adoption of a focal product amongst their friends who are also likely to benefit from adopting the product. In other words, referral programs are designed to accelerate organic word-of-mouth (WOM) exposure using financial incentives. This poses a challenge, in that it mixes an intrinsically motivated process (stemming from the desire to share a customer’s delight with a product or a service) with an extrinsic trigger in the form of a financial incentive. Prior research has shown that mixing intrinsic and extrinsic motivations can lead to sub-optimal outcomes, which in turn presents a conceptual dilemma in the design of referral programs. In this paper, we demonstrate how firms can benefit from framing calls-to-action for referral programs in such a way as to move closer to the original intent of organic, intrinsically motivated WOM marketing, and yet at the same time reap the benefits of using a financial incentive to increase referral rates. In particular, given a fixed incentive scheme and ceteris paribus, we show the efficacy of a pro-social call-to-action over some of the more commonly used calls-to-action observed in practice. We posit, and causally demonstrate via a large-scale randomized field experiment involving 100,000 customers, that an intrinsically pro-social element in framing the call-to-action to initiate the referral process is a necessary condition for success. When contrasted with egoistic and equitable framing of calls-to-action, the pro-social framing yields a significantly higher propensity to initiate a referral, as well as a significantly higher number of successful referrals. Additional mechanism-level analysis that interacts the treatments with customer characteristics such as repeat purchase, net promoter score, and time since last purchase, additional field experiment with more attractive referral reward, as well as an Amazon Mechanical Turk experiment, confirm the importance of an altruistic element in generating a higher quality of advocacy and reducing referral frictions. Subjects in the pro-social group report lower levels of guilt associated with sending a referral and are more able to identify family and friends’ benefit as a motive for sharing referrals and therefore, more selective in sharing referral message.

Paramedic Pathfinder pilot scheme produces a 34% increase in successful referrals

Paramedic Pathfinder pilot scheme produces a 34% increase in successful referrals

Customer Referral Incentives and Social Media

We study how to optimally attract new customers using a referral program. Whenever a consumer makes a purchase, the firm gives her a link to share with friends, and every purchase coming through that link generates a referral payment. The firm chooses the referral payment function and consumers play an equilibrium in response. The optimal payment function is nonlinear and not necessarily monotonic in the number of successful referrals. If we approximate the optimal policy using a linear payment function, the approximation loss scales with the square root of the average consumer degree. Using a threshold payment, the approximation loss scales proportionally to the average consumer degree. Combining the two, using a linear payment function with a threshold bonus, we can achieve a constant bound on the approximation loss. This paper was accepted by Noah Gans, stochastic models and simulation.

Facilitating anaplastic thyroid cancer specialized treatment: A model for improving access to multidisciplinary care for patients with anaplastic thyroid cancer.

Anaplastic thyroid cancer (ATC) is a highly aggressive thyroid cancer. Several treatment trials are available, but the number of eligible patients to participate is very low because of the rarity and aggressiveness of the disease. Facilitating Anaplastic Thyroid Cancer Specialized Treatment (FAST) is a quality improvement project aimed at decreasing time from referral to disposition (scheduling of first appointment) to our institution. After identifying reasons for delays, we created a new process flow specifically for patients with ATC allowing patients to be scheduled immediately. Historical data revealed a mean referral to disposition time for patients with ATC of 8.7 days before our intervention. After the intervention, the mean referral to disposition time was reduced to 0.5 days. Participation in treatment trials for all patients with ATC was 34%. Since the implementation of FAST, the access time has decreased and the number of successful referrals for ATC has increased significantly.

A Collaborative Process Model for Promoting Successful Referrals in College Counseling

The need to refer students to off‐campus mental health providers is common in college counseling. Such referrals can be challenging for college counselors who strive to meet students' counseling needs while adhering to ethical and center policy guidelines. In this article, the authors explore the nature and challenges of referral in college counseling settings and introduce a collaborative process model to enhance the likelihood of successful referrals. A case study is provided to illustrate the model.

Implications of Comprehensive Mental Health Services Embedded in an Adolescent Obstetric Medical Home.

Purpose Mental health issues in perinatal adolescents are well documented and studies have shown high rates of depressive disorders among this population. Treatment is challenging because pregnant adolescents are poorly adherent with mental health services. We describe a novel integrated mental health care program for pregnant and parenting adolescent mothers and their children. Methods The Colorado Adolescent Maternity Program (CAMP) is a comprehensive, multidisciplinary teen pregnancy and parenting medical home program serving an ethnically diverse and low socioeconomic status population in the Denver metro area. We describe the Healthy Expectations Adolescent Response Team (HEART), an embedded mental health care program focused on improving identification of mental health symptoms and increasing rates mental health treatment in adolescent mothers. Results From January 1, 2011-January 16 2014, 894 pregnant adolescents were enrolled in CAMP and 885 patients were screened for mental health issues. Prior to HEART's inception, 20% of patients were identified as having mood symptoms in the postpartum period. Successful referrals to community mental health facilities occurred in only 5% of identified patients. Following the creation of HEART, 41% of patients were identified as needing mental health services. Nearly half of the identified patients (47%) engaged in mental health treatment with the psychologist. Demographic factors including age, parity, ethnicity, and parent and partner involvement did not have a significant impact on treatment engagement. Trauma history was associated with lower treatment engagement. Conclusion Our findings suggest that an embedded mental health program in an adolescent obstetric and pediatric medical home is successful in improving identification and engagement in mental health treatment. Key components of the program include universal screening, intensive social work and case management involvement, and ready access to onsite mental health care providers. Limitations of the program are discussed as well directions for future research.

Teaching referral skills to medical students.

BackgroundReferrals are an important and frequent part of a junior doctor’s work. Difficulty with making successful referrals is also very common. Despite this, training in referral skills is not routinely carried out in medical schools.ResultsWe designed and delivered a 1-h interactive lecture to final year medical students to teach referral skills. The lecture was delivered on six occasions to up to 70 students at each session. 191 students attended and provided evaluation. 68 % of students had no previous training in referral skills and 99 % felt that referral skills should be included in the undergraduate curriculum. 90 % reported that the lecture had improved their understanding of referral techniques and 83 and 80 % felt that the lecture had improved their ability and confidence, respectively.ConclusionsReferral skills can be successfully taught in a large group lecture setting. We recommend that the teaching of referral skills is incorporated into all medical schools’ curricula.

G36 Using referrals for psychosocial support as a quality indicator for an educational intervention

Aims To assess the feasibility of referrals for social support as a locally designed Quality Indicator in the West Bank. Methods Three quality indicators (referrals for social support, safe prescriptions and exclusive breast feeding at 6 months) were piloted to evaluate the success of a RCPCH supported Masters in Child Health (MACH) at Al Quds University. This MACH student collected data on the referral rate of children to a local psychosocial centre from her clinic population in Nablus and the data informed interventions. Results In her reflection on the project DN wrote ‘after May I felt that there is something wrong because I advise people to go and I told the doctor working in my clinic to complete the referral form but the results didn9t improve. I thought I might need further help, so a friend working in the municipality as a social worker to go and to do home visits to these families and give me feed back’. What emerged from the social worker was ‘people thought a referral to the Al Makhfia centre is just like a referral to the mental hospital, so even giving them a referral form they will not go there. The centre will not accept a patient without a formal referral, and didn9t do home visits. So my friend who was working with disabled children as a social worker, and already doing home visits as a follow up and treatment session, was the key to successful referrals’. Conclusion Referrals for psychosocial support was sensitive Quality Indicator in this health system. Simply collecting data resulted in changes of behaviour at the clinic led by the MACH student and her conclusion at the end of the pilot was ‘I think that if we can arrange a day during the week or the month for the social worker to be with the team in the clinic, it will be very helpful to the patients and their families’.

Characteristics of Successful and Unsuccessful Mental Health Referrals of Refugees.

In this community based participatory research study, we explored key characteristics of mental health referrals of refugees using stories of providers collected through an on-line survey. Ten coders sorted 60 stories of successful referrals and 34 stories of unsuccessful referrals into domains using the critical incident technique. Principal components analysis yielded categories of successful referrals that included: active care coordination, establishing trust, proactive resolution of barriers, and culturally responsive care. Unsuccessful referrals were characterized by cultural barriers, lack of care coordination, refusal to see refugees, and system and language barriers. Recommendations for training and policy are discussed.

Successful Referrals Pay $100

Successful Referrals Pay $100

Race, stigma, and mental health referrals among clients of aging services who screened positive for depression.

This study examined rates of anticipated stigma and its impact on successful mental health referrals among elderly clients of home-delivered nutrition services who met criteria for depression. Elderly clients (N=732) admitted to a home meal program between December 2004 and June 2006 were assessed for depression, cognitive impairment, and anticipated stigma. Gender and race comparisons were conducted, and predictors of receiving a mental health referral were identified. African Americans were more likely than Caucasians to report high anticipated stigma, and African-American men reported the highest mean scores for anticipated stigma. There were no significant differences between African Americans and Caucasians in rates of depression or mental health referrals. For clients with depression, low anticipated stigma, younger age, and an interaction of race and gender predicted receipt of a mental health referral. Anticipated stigma can hinder the process of referring older adults for mental health treatment.

Customer Referral Incentives and Social Media

We study how to optimally attract new customers using a referral program. Whenever a consumer makes a purchase, the firm gives her a link to share with friends, and every purchase coming through that link generates a referral payment. The firm chooses the referral payment function and consumers play an equilibrium in response. The optimal payment function is nonlinear and not necessarily monotonic in the number of successful referrals. If we approximate the optimal policy using a linear payment function, the approximation loss scales with the square root of the average consumer degree. Using a threshold payment, the approximation loss scales proportionally to the average consumer degree. Combining the two, using a linear payment function with a threshold bonus, we can achieve a constant bound on the approximation loss.

Referring heroin users from compulsory detoxification centers to community methadone maintenance treatment: a comparison of three models

BackgroundBoth compulsory detoxification treatment and community-based methadone maintenance treatment (MMT) exist for heroin addicts in China. We aim to examine the effectiveness of three intervention models for referring heroin addicts released from compulsory detoxification centers to community methadone maintenance treatment (MMT) clinics in Dehong prefecture, Yunnan province, China.MethodsUsing a quasi-experimental study design, three different referral models were assigned to four detoxification centers. Heroin addicts were enrolled based on their fulfillment to eligibility criteria and provision of informed consent. Two months prior to their release, information on demographic characteristics, history of heroin use, and prior participation in intervention programs was collected via a survey, and blood samples were obtained for HIV testing. All subjects were followed for six months after release from detoxification centers. Multi-level logistic regression analysis was used to examine factors predicting successful referrals to MMT clinics.ResultsOf the 226 participants who were released and followed, 9.7% were successfully referred to MMT(16.2% of HIV-positive participants and 7.0% of HIV-negative participants). A higher proportion of successful referrals was observed among participants who received both referral cards and MMT treatment while still in detoxification centers (25.8%) as compared to those who received both referral cards and police-assisted MMT enrollment (5.4%) and those who received referral cards only (0%). Furthermore, those who received referral cards and MMT treatment while still in detoxification had increased odds of successful referral to an MMT clinic (adjusted OR = 1.2, CI = 1.1-1.3). Having participated in an MMT program prior to detention (OR = 1.5, CI = 1.3-1.6) was the only baseline covariate associated with increased odds of successful referral.ConclusionFindings suggest that providing MMT within detoxification centers promotes successful referral of heroin addicts to community-based MMT upon their release.