A 680,000-person megastudy of nudges to encourage vaccination in pharmacies.

Encouraging vaccination is a pressing policy problem. To assess whether text-based reminders can encourage pharmacy vaccination and what kinds of messages work best, we conducted a megastudy. We randomly assigned 689,693 Walmart pharmacy patients to receive one of 22 different text reminders using a variety of different behavioral science principles to nudge flu vaccination or to a business-as-usual control condition that received no messages. We found that the reminder texts that we tested increased pharmacy vaccination rates by an average of 2.0 percentage points, or 6.8%, over a 3-mo follow-up period. The most-effective messages reminded patients that a flu shot was waiting for them and delivered reminders on multiple days. The top-performing intervention included two texts delivered 3 d apart and communicated to patients that a vaccine was "waiting for you." Neither experts nor lay people anticipated that this would be the best-performing treatment, underscoring the value of simultaneously testing many different nudges in a highly powered megastudy.

A megastudy of text-based nudges encouraging patients to get vaccinated at an upcoming doctor's appointment.

Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor's appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.

What Makes Things Funny? An Integrative Review of the Antecedents of Laughter and Amusement.

Despite the broad importance of humor, psychologists do not agree on the basic elements that cause people to experience laughter, amusement, and the perception that something is funny. There are more than 20 distinct psychological theories that propose appraisals that characterize humor appreciation. Most of these theories leverage a subset of five potential antecedents of humor appreciation: surprise, simultaneity, superiority, a violation appraisal, and conditions that facilitate a benign appraisal. We evaluate each antecedent against the existing empirical evidence and find that simultaneity, violation, and benign appraisals all help distinguish humorous from nonhumorous experiences, but surprise and superiority do not. Our review helps organize a disconnected literature, dispel popular but inaccurate ideas, offers a framework for future research, and helps answer three long-standing questions about humor: what conditions predict laughter and amusement, what are the adaptive benefits of humor, and why do different people think vastly different things are humorous?

Perturbational phenotyping of human blood cells reveals genetically determined latent traits associated with subsets of common diseases.

Although genome-wide association studies (GWAS) have successfully linked genetic risk loci to various disorders, identifying underlying cellular biological mechanisms remains challenging due to the complex nature of common diseases. We established a framework using human peripheral blood cells, physical, chemical and pharmacological perturbations, and flow cytometry-based functional readouts to reveal latent cellular processes and performed GWAS based on these evoked traits in up to 2,600 individuals. We identified 119 genomic loci implicating 96 genes associated with these cellular responses and discovered associations between evoked blood phenotypes and subsets of common diseases. We found a population of pro-inflammatory anti-apoptotic neutrophils prevalent in individuals with specific subsets of cardiometabolic disease. Multigenic models based on this trait predicted the risk of developing chronic kidney disease in type 2 diabetes patients. By expanding the phenotypic space for human genetic studies, we could identify variants associated with large effect response differences, stratify patients and efficiently characterize the underlying biology.

Is laughter the best marketing? Why this is the wrong question.

Humor is often described as a miracle pill for marketers, yet the effects of humor on advertising, content marketing, service, and other marketing functions are wildly inconsistent. Before scholars can know whether a pun, prank, meme, or laugh will attract sales, clicks, or five-star reviews, they need to understand why the effects of humor appear to vary. Humor has different effects because scholars have treated humor as different constructs while studying how it influences different marketing outcomes with different types of stimuli in different of situations on different types of people. Only by recognizing these differences can scholars begin to understand when, why, and how humor can benefit marketers. To navigate this complexity, researchers need to develop a theory of humor that can help explain how different attempts to be humorous influence different consumers in different situations.

A Randomized Trial of Behavioral Nudges Delivered Through Text Messages to Increase Influenza Vaccination Among Patients With an Upcoming Primary Care Visit.

PURPOSE: To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza vaccination rates. DESIGN: Randomized, controlled trial. SETTING: Two health systems in the Northeastern US between September 2020 and March 2021. SUBJECTS: 74,811 adults. INTERVENTIONS: Patients in the 19 intervention arms received 1-2 text messages in the 3 days preceding their appointment that varied in their format, interactivity, and content. MEASURES: Influenza vaccination. ANALYSIS: Intention-to-treat. RESULTS: Participants had a mean (SD) age of 50.7 (16.2) years; 55.8% (41,771) were female, 70.6% (52,826) were White, and 19.0% (14,222) were Black. Among the interventions, 5 of 19 (26.3%) had a significantly greater vaccination rate than control. On average, the 19 interventions increased vaccination relative to control by 1.8 percentage points or 6.1% (P = .005). The top performing text message described the vaccine to the patient as "reserved for you" and led to a 3.1 percentage point increase (95% CI, 1.3 to 4.9; P < .001) in vaccination relative to control. Three of the top five performing messages described the vaccine as "reserved for you." None of the interventions performed worse than control. CONCLUSIONS: Text messages encouraging vaccination and delivered prior to an upcoming appointment significantly increased influenza vaccination rates and could be a scalable approach to increase vaccination more broadly.

Too close for comfort, or too far to care? Finding humor in distant tragedies and close mishaps.

Humor is ubiquitous and often beneficial, but the conditions that elicit it have been debated for millennia. We examine two factors that jointly influence perceptions of humor: the degree to which a stimulus is a violation (tragedy vs. mishap) and one's perceived distance from the stimulus (far vs. close). Five studies show that tragedies (which feature severe violations) are more humorous when temporally, socially, hypothetically, or spatially distant, but that mishaps (which feature mild violations) are more humorous when psychologically close. Although prevailing theories of humor have difficulty explaining the interaction between severity and distance revealed in these studies, our results are consistent with the proposal that humor occurs when a violation simultaneously seems benign. This benign-violation account suggests that distance facilitates humor in the case of tragedies by reducing threat, but that closeness facilitates humor in the case of mishaps by maintaining some sense of threat.

Benign violations: making immoral behavior funny.

Humor is an important, ubiquitous phenomenon; however, seemingly disparate conditions seem to facilitate humor. We integrate these conditions by suggesting that laughter and amusement result from violations that are simultaneously seen as benign. We investigated three conditions that make a violation benign and thus humorous: (a) the presence of an alternative norm suggesting that the situation is acceptable, (b) weak commitment to the violated norm, and (c) psychological distance from the violation. We tested the benign-violation hypothesis in the domain of moral psychology, where there is a strong documented association between moral violations and negative emotions, particularly disgust. Five experimental studies show that benign moral violations tend to elicit laughter and amusement in addition to disgust. Furthermore, seeing a violation as both wrong and not wrong mediates behavioral displays of humor. Our account is consistent with evolutionary accounts of laughter, explains humor across many domains, and suggests that humor can accompany negative emotion.

Differentiating what is humorous from what is not.

After 2.5 millennia of philosophical deliberation and psychological experimentation, most scholars have concluded that humor arises from incongruity. We highlight 2 limitations of incongruity theories of humor. First, incongruity is not consistently defined. The literature describes incongruity in at least 4 ways: surprise, juxtaposition, atypicality, and a violation. Second, regardless of definition, incongruity alone does not adequately differentiate humorous from nonhumorous experiences. We suggest revising incongruity theory by proposing that humor arises from a benign violation: something that threatens a person's well-being, identity, or normative belief structure but that simultaneously seems okay. Six studies, which use entertainment, consumer products, and social interaction as stimuli, reveal that the benign violation hypothesis better differentiates humorous from nonhumorous experiences than common conceptualizations of incongruity. A benign violation conceptualization of humor improves accuracy by reducing the likelihood that joyous, amazing, and tragic situations are inaccurately predicted to be humorous. (PsycINFO Database Record

Values and preferences: defining preference construction.

Extensive research in the values and preferences literature suggests that preferences are sensitive to context and calculated at the time of choice. This has led to the view that preferences are constructed. Recent work calls for a better understanding of when preferences are constructed and when they are not. We contend that the answer to this question depends on the meaning of the term constructed. Constructed can mean that a preference changes across contexts. If construction is synonymous with context sensitivity, we contend that preferences are always constructed because context influences nearly every aspect of the judgment and choice process. As a motivating example, we show that preferences are influenced by goals and goals are highly context sensitive. Constructed, however, can mean instead that a preference is calculated or formulated during the judgment and choice process. If construction is synonymous with calculation, we contend that many preferences are calculated and the more important question is to what degree preferences are calculated. We review the literature that shows that the degree to which decision makers calculate preferences is influenced by goals, cognitive constraints, and experience. WIREs Cogni Sci 2011 2 193-205 DOI: 10.1002/wcs.98 For further resources related to this article, please visit the WIREs website.