• Adriaan Barbaroux, Laurie Benoit, Romain A Raymondie, and Isabelle Milhabet.
• Département d'enseignement et de recherche en médecine générale, Université Cote d'Azur, RETINES, HEALTHY, Nice, France.
• Fam Pract. 2021 Jul 28; 38 (4): 410-415.

BackgroundA nudge corresponds to any procedure that influences choice architecture, without using persuasion or financial incentives. Nudges are effective in increasing vaccination with heterogeneous levels of acceptability.ObjectiveTo evaluate the effectiveness and acceptability of a nudge promoting influenza vaccination for general practice trainees, also called residents.MethodsThe hypothesis was that a reminder would be efficient and accepted and that prior exposure to a nudge increases its acceptability. Residents were randomly divided into three parallel experimental arms: a nudge group, a no-nudge group and a control group in order to evaluate the Hawthorne effect. The nudge consisted of providing a paper form for the free delivery of the vaccine and contacts for occupational health services.ResultsThe analysis included 161 residents. There was a strong consensus among the residents that it is very acceptable to nudge their peers and patients. Acceptability was better with residents exposed to the nudge and with residents included in step 1 (Hawthorne effect). The nudge did not increase vaccination coverage.ConclusionThe failure of this nudge highlights the importance of matching an intervention to the population's needs. The experimental approach is innovative in this context and deserves further attention.Clinicaltrials.Gov Pre RegistrationNCT03768596.© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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