Use of nudge techniques in General practice (GP) to promote HPV vaccination among parents of boys aged 11-14 years: effectiveness and acceptability

BackgroundA nudge is any procedure that modifies and/or influences the architecture of a choice, without using persuasion or financial incentives. It is commonly referred to as a "psychological nudge". Nudges are effective in promoting public health issues such as HPV vaccination. Several systematic reviews of the literature place nudges among the most promising interventions for increasing vaccination coverage. ObjectiveThe objective of this study is to evaluate the effectiveness and acceptability of a nudge towards HPV vaccination based on the proposal of a consultation appointment to the parents of boys aged 11 to 14 years in the patient base of two general practitioners. The secondary objective is to evaluate the role of the feeling of control in this acceptability. MethodsParticipants were divided into two parallel experimental arms: a nudge group and a non-nudge group. The procedure used was a simple randomization of the parents of boys aged 11-14 years into two groups in the general practitioners practice. The study was conducted in two phases and took the form of a proposed appointment at the private practice of the participants in the nudged group. A questionnaire was administered to the participants in both groups one month after these appointments, asking them about their vaccination status regarding HPV vaccination, their acceptability of the nudge and their feeling of control in this procedure. ResultsThe analysis was carried out on 32 participants in each of the two groups. The nudge was significantly effective in terms of vaccination coverage. Similar acceptability was found in both groups. The absence of a feeling of control was noted. ConclusionThis study shows that the prevalence of a vaccination can be significantly modified by a nudge. This study did not show a significant difference in the acceptability of the nudge in the two groups. However, the acceptability of the nudge is significant in both groups. The literature shows good external consistency across different populations in France. This could mean that the French population is predominantly pro-nudge. Thus, a nudge deemed acceptable by the participants is not necessarily ethical, and may insidiously implant an idea. The ethical approach to nudges before their implementation is therefore essential.