The University of Pennsylvania’s Behavior Change for Good Initiative Partners with Walmart on Research Study to Identify Communications that Encourage Vaccinations


The Behavior Change for Good Initiative (BCFG) at the Wharton School and School of Arts and Sciences of the University of Pennsylvania has partnered with Walmart to conduct the largest-ever communication research study aimed at increasing flu vaccinations during the Fall 2020 flu season. The results of the study will be well-timed to assist with encouraging COVID-19 vaccinations.

As Penn Professors Katy Milkman, Mitesh Patel, and Angela Duckworth noted in their recent USA Today op-ed about the American COVID-19 response, “In the war to establish herd immunity, developing a vaccine is only half the battle. We also need behavior change techniques to encourage an unprecedented number of Americans to choose vaccination when the time comes.”

The BCFG-Walmart study focuses on closing what behavioral scientists call the intention-action gap.

“We focused on giving people an extra nudge to do something they already intended to do so it wouldn’t slip through the cracks. Sometimes that’s just a timely reminder, but it can also include a dose of encouragement when the task at hand feels arduous and easy to put off indefinitely. Past research suggests that we fail to act on anywhere from a third to two thirds of our intentions, particularly when it comes to our health,” said Katy Milkman, Wharton professor and BCFG Co-Director.

The goal is to learn how scientifically-informed messages can help increase vaccinations at scale. When a COVID-19 vaccine becomes available, these learnings can then be deployed to help motivate people to receive the vaccine and combat the spread of the virus.

BCFG’s interdisciplinary team of scientific experts designed 22 distinct text messaging strategies to encourage flu vaccination among hundreds of thousands of Walmart pharmacy customers who had agreed to receive messages from their pharmacy. These 22 communication strategies were then evaluated simultaneously in a massive A/B test in September 2020 to determine which were most effective at increasing flu shot uptake overall, as well as which were most effective among different sub-populations.

Some text messages prompted people to text “I will get a flu shot” to their pharmacy — a commitment to spur future action. Others took a more jovial approach to motivating vaccination by sharing a joke about flu season. Still other texts asked people to encourage others to get flu shots by passing along a motivational message that could easily be copied and pasted. This is just a small sample of the many messaging techniques evaluated, each designed to provide the last needed boost for getting vaccinated.

BCFG will rapidly analyze the results of this A/B test and share the most effective communication strategies in early 2021 to ensure healthcare providers around the world can benefit from these insights.

“I am incredibly excited about the potential of this project to advance knowledge and save lives,” said Angela Duckworth, Penn and Wharton Professor and BCFG Co-Director.

“Walmart is well-prepared for flu season, and we want to better learn how to encourage our customers to get vaccines to keep themselves, their families and their communities safe,” said Michelle Leclerc, Walmart Pharmacist. “Providing access to immunizations and effective communication of the importance of getting a flu shot is another way we can help people live better.”

Walmart took many steps in 2020 to make it easier than ever for customers to get a flu shot. Walmart also launched a digital scheduler so customers could pre-book an appointment for a flu shot at any one of their 4,700+ pharmacies and hosted twice-weekly “fast flu” events to encourage customers to get flu shots during their regular shopping trips. Walmart has also ensured its 1.5 million associates have access to flu shots with no out-of-pocket costs, regardless of their insurance status.

About The Behavior Change for Good Initiative

The Behavior Change for Good Initiative (BCFG) at the Wharton School and School of Arts and Sciences of the University of Pennsylvania unites a world-class, interdisciplinary team of over 100 behavioral science experts (including two Nobel Laureates, five MacArthur Genius Award winners, and numerous members of the National Academy of Sciences) with leading organizational partners to help advance the science and practice of behavior change. BCFG identifies what works at scale by conducting mega-studies (massive random-assignment A/B tests), which simultaneously test the BCFG Scientific Team’s best ideas for changing a target behavior. This approach gives BCFG the power to understand which strategies work best overall, what works best for whom, and how to most effectively use behavioral science to transform people’s lives for the better. To learn more, visit https://bcfg.wharton.upenn.edu.

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