NCT04289623

Brief Summary

The purpose of the study is to evaluate, prospectively, the potential impact on myHealth Rewards wellness program enrollment (prior to the 2020 deadline) of sending different messages via email to Geisinger Health Plan (GHP) members who have not yet enrolled. In particular, this study aims to replicate and extend (with greater sample size and statistical power) the findings from a previous study in which email communication using loss framing language achieved significantly higher click-through rates than a more standard communication, whereas actual enrollment rates were not significantly higher.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
13,546

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Feb 2020

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 25, 2020

Completed
2 days until next milestone

First Submitted

Initial submission to the registry

February 27, 2020

Completed
1 day until next milestone

First Posted

Study publicly available on registry

February 28, 2020

Completed
11 days until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 10, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 10, 2020

Completed
1.3 years until next milestone

Results Posted

Study results publicly available

July 9, 2021

Completed
Last Updated

July 9, 2021

Status Verified

June 1, 2021

Enrollment Period

14 days

First QC Date

February 27, 2020

Results QC Date

June 17, 2021

Last Update Submit

June 17, 2021

Conditions

Keywords

Prospect theorySocial normsSocial proofAuthority

Outcome Measures

Primary Outcomes (2)

  • Rate of Enrollment (14 Days)

    Enrollment in the myHealth Rewards program (yes/no) within 14 full days of the beginning of the intervention for each of the three waves.

    14 days

  • Rate of Logging in (14 Days)

    Logging into the myHealth Rewards program (yes/no) within 14 full days of the beginning of the intervention for each of the three waves.

    14 days

Study Arms (6)

Standard email

This email mentions the cost-saving benefits of enrollment by participants who met their 2018 goals. It also includes the message that registration can be completed quickly (in less than five minutes). Finally, it also includes reward incentive information, wherein registering by a March deadline provides qualified recipients with the potential to win prizes. This information is contained in all other emails.

Behavioral: Email

Loss frame email

In addition to the content of the generic email, the subject line and content of the loss frame email recommends that GHP members not "throw away" a precise dollar amount in savings (over $2,000) by not participating and that they can therefore avoid missing out on substantial gains (i.e., savings) by taking action. This email further frames the reward as something recipients will miss out on if they do not sign up. This intervention frames the status quo as a state from which recipients, via inaction, are slated to forfeit a sizable and precise monetary amount to which they should otherwise feel entitled (via loss aversion and the endowment effect). People tend to be risk-seeking in the domain of losses; therefore, this intervention is hypothesized to increase enrollment in the hope of achieving zero loss by meeting program goals, as opposed to a sure loss via inaction.

Behavioral: EmailBehavioral: Loss frame

Testimonial (medical expert) email

In addition to the content of the generic email, the testimonial (medical expert) email includes a testimonial from a doctor, which notes the personal benefits of myHealth Rewards in terms of managing blood pressure, blood sugar, cholesterol, weight, and stress. This intervention shows proof of other people successfully enrolling and benefitting from the program. Specifically, it is an endorsement from a presumed authority figure. Recipients may be more likely to enroll for this program if they see a physician - who would be seen as an authority on health and wellness - talking about the medical benefits of the program. It is unclear in the current context and population if a message from an expert or rank-and-file employee would be more effective.

Behavioral: EmailBehavioral: Testimonial (medical expert)

Testimonial (rank-and-file) email

In addition to the content of the generic email, the testimonial (rank-and-file) email includes a testimonial from a customer care specialist, which notes the personal benefits of myHealth Rewards in terms of managing blood pressure, blood sugar, cholesterol, weight, and stress. This intervention shows proof of other people successfully enrolling and benefitting from the program. Specifically, it is an endorsement from a peer (relative to most Geisinger employees). Recipients may be more likely to enroll for this program if they see a rank-and-file employee talking about the program as this person would be more relatable (relative to a doctor). It is unclear in the current context and population if a message from an expert or rank-and-file employee would be more effective.

Behavioral: EmailBehavioral: Testimonial (rank-and-file)

Social norms (percentage) email

In addition to the content of the generic email, the social norms (percentage) email will include communication about the percentage of benefit-eligible employees who had already registered for myHealth Rewards. This message sets up a descriptive norm, showing that a majority of people are doing a certain behavior. When people see a behavior as the norm, they are more likely to follow it. The use of percentages makes it clear that this behavior is indeed being done by most people in the group. It is unclear in the current context and population if a message using percentages or numbers would be more effective.

Behavioral: EmailBehavioral: Social norms (percentage)

Social norms (number) email

In addition to the content of the generic email, the social norms (number) email will include communication about the number of benefit-eligible employees who had already registered for myHealth Rewards. This message sets up a descriptive norm, showing that a large number of people are doing a certain behavior. When people see a behavior as the norm, they are more likely to follow it. While the use of numbers does not indicate that this behavior is being done by a majority, using a large number can be more convincing just in showing sheer quantity.

Behavioral: EmailBehavioral: Social norms (number)

Interventions

EmailBEHAVIORAL

Email

Loss frame emailSocial norms (number) emailSocial norms (percentage) emailStandard emailTestimonial (medical expert) emailTestimonial (rank-and-file) email
Loss frameBEHAVIORAL

Email

Also known as: Endowment effect
Loss frame email

Email

Also known as: Authority
Testimonial (medical expert) email

Email

Also known as: Social proof
Testimonial (rank-and-file) email

Email

Also known as: Social proof
Social norms (percentage) email

Email

Also known as: Social proof
Social norms (number) email

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodProbability Sample
Study Population

The population consists of Geisinger Health System employees who are also Geisinger Health Plan members and are not currently enrolled in myHealth Rewards.

You may qualify if:

  • Geisinger Health Plan members
  • Geisinger Health System employees who have not yet enrolled in myHealth Rewards

You may not qualify if:

  • Enrollment in myHealth Rewards before the email launch date for each wave
  • Do not have an email address on file

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Geisinger

Danville, Pennsylvania, 17822, United States

Location

Limitations and Caveats

For this study, we only received data about engagement with the email. Individual patients were not identified and demographic information such as age, sex, or gender were not collected.

Results Point of Contact

Title
Amir Goren, PhD
Organization
Geisinger Clinic

Study Officials

  • Amir Goren, PhD

    Geisinger Clinic

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 27, 2020

First Posted

February 28, 2020

Study Start

February 25, 2020

Primary Completion

March 10, 2020

Study Completion

March 10, 2020

Last Updated

July 9, 2021

Results First Posted

July 9, 2021

Record last verified: 2021-06

Data Sharing

IPD Sharing
Will share

Data with no personally identifiable information will be made available to other researchers on the Open Science Framework for transparency. This will include the essential data and code needed to replicate the analysis that yielded reported findings. The PI did not examine or analyze any data from this study prior to this registration.

Shared Documents
STUDY PROTOCOL
Time Frame
The data will become available after publication of study results in a scientific journal and will be available as long as the Open Science Framework hosts the data.
Access Criteria
The data on the Open Science Framework will be open to anyone requesting that information.
More information

Locations