A Large Scale Examination of Textual Behavioral Nudges on Uptake Rates of Medical Checkups


Using a large scale field study (n= 113,048) held in Israel together with Maccabi Healthcare Services (MHS), we revisit the effect of some of the most widely used message framings on uptake rates of different medical checkups. Our frames include gains, losses, doctor recommendation, implementation intentions and empowerment. MHS invited members aged 50-74, via email or as a text message, to take preventive medical actions that are recommended for them by the ministry of health, depending on their medical history, gender and age. The campaign was intended to increase uptake rates of mammography, HPV, abdominal aortic aneurysm, fecal occult blood test and pneumococcal vaccination. Our main finding is a null result. No effect of message framing on uptake rates was observed. We report two secondary suggestive findings:(1) shorter subject lines are positively correlated with opening rates, and (2) emails seem to outperform text messages in terms of overall success rates. Our findings shed light on the on-going discussion and mixed evidence that appeared in the health related behavioral interventions literature over the past 30 years.