Liz Foote Maui October 23, 2020

I’m sharing a recent article published in PLOSOne about a study carried out in Israel that investigated the effect of different messaging strategies on no-shows and appointment cancellations. The team tested 8 different appointment reminder SMS messages for patients using various types of framing and a 9th “generic” control message. Prior studies indicated that the “strategic narrative” of the SMS messages may increase compliance, and behavioral economics theory “suggests that different motivational narratives, such as fairness to others or adherence to social norms, can dramatically increase a message’s impact as compared with a generic informative format.” The results were consistent with principles from behavioral economics. They found five of the message frames (‘appointment cost’, ‘emotional relatives’, ‘emotional guilt’, ‘social norm’, and ‘social identity’) significantly differed from the control group, resulting in lower rates of no-shows and higher rates of canceling in advance. The authors note that strategically considering these reminder messages could potentially translate to hundreds of thousands of appointments saved. In fact, the health association involved in the study subsequently changed its policy to adopt the “emotional guilt” narratives. The authors did note some limitations to the study, but overall this study conveys the importance of A/B testing in order to select and adopt optimal message framing.