Encouraging Mammograms Using Behavioral Economics: A Randomized Controlled Trial in Chile

Area of Science:

• Public Health
• Behavioral Economics
• Health Communication

Background:

• Mammography screening rates remain suboptimal, particularly among women aged 50 and older.
• Barriers to mammogram uptake include psychological and economic factors, often addressed by public health interventions.
• Behavioral economics offers novel strategies to overcome these barriers by understanding decision-making heuristics.

Purpose of the Study:

• To evaluate the effectiveness of a direct mail campaign utilizing behavioral economics principles to increase mammogram uptake.
• To identify which messaging strategies are most effective in overcoming barriers to screening among women aged 50+.
• To assess the potential for public policy implementation and cultural transferability of the intervention.

Main Methods:

• A randomized controlled trial was conducted with 12,000 women aged 50+ with private insurance and no mammogram in 24+ months.
• Eight treatment groups received direct mail with varying combinations of messages informed by behavioral economics and psychology.
• Data analysis compared mammogram utilization rates between control and treatment groups.

Main Results:

• The intervention resulted in a 167% increase in free mammogram utilization.
• Average increases in mammogram use ranged from 1.13% in control groups to 3.03% in treatment groups.
• Simpler, less complex messages demonstrated a slightly larger and more persistent effect on screening behavior.

Conclusions:

• Direct mail campaigns incorporating behavioral economics insights can significantly boost mammography screening rates.
• Simple messaging strategies are particularly effective and may be key to successful public health campaigns.
• The findings support the development of transferable public policies for increasing participation in free mammography programs across diverse populations.