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Editor’s note: This article originally appeared in the February 2021 issue of STChealth’s Immunization Intelligence News.
If you were to sit down with one of the world’s leading experts on influence and persuasion and talk through how to create a vax program that would maximize vaccination rates, here’s what you’d learn…
Our expert: Robert Cialdini, Ph.D., is often ranked as the country’s leading social psychologist (yes, there are rankings of such things) and his books have sold more than 3 million copies, including the bestseller Influence: The Psychology of Persuasion.
We talked with Cialdini, sometimes referred to as the “Godfather of Influence,” in early February to get his advice on creating a vaccination program.
What’s the Best Way to Talk About Vaccine Hesitancy?
When it comes to persuading those who aren’t sure they want the COVID vaccine, Cialdini said: The most important recommendation I’d make is to use the word trend. We’re seeing the number of people who don’t want the vaccine is falling. Let’s say that there were 40% who didn’t want the vaccine, and now that number is down to 30%. It would be a mistake to use just those two numbers. That’s because 40 is a statistic, 40 and 30 are a difference. But, if you say, it used to be 40, then 35, and now it’s 30 — that’s a trend.
“There’s magic in a trend because we know that people believe trends will continue and so the trend implies that they should get on board. It’s what we call social proof. Don’t cite a statistic or a difference — show a trend.”
As for the notion of “social proof,” Cialdini suggested we turn to his book Pre-suasion for research on the power of this principle. Here are our two favorites:
- When restaurants listed some items on the menu as “Most Popular,” the sales of those dishes increased 13% to 20%.
- In an experiment Cialdini conducted with colleagues, they sought to get households to reduce their usage of electricity. The researchers tried four campaigns that boiled down to these messages: 1. the environment will benefit from lower usage; 2. it’s socially responsible; 3. you’ll save money; and 4. that most of your neighbors are trying to conserve energy. The researchers then monitored actual energy use and found that the last of the four messages, the social proof one, led to reductions triple those of any other campaigns.
These and other studies make it clear why Cialdini was eager to turn data into social proof, giving new meaning to the old Wall Street maxim, “The trend is your friend.”
But What About Persuading an Anti-Vaxxer?
In dealing with someone who is more than just vaccine-hesitant, but actually anti-vaccine, Cialdini suggested, “convert communication.” In this case, the “converts” would be those who used to be anti-vaccine but then had something happen to change their minds — they didn’t just rethink the issue but had an experience that shifted their thinking.
He explained this phenomenon in a recent podcast: “You have to say, not just, ‘I used to believe it, then I saw the same thing that you are seeing and it changed my mind.’ No. You have to say, ‘I used to believe what you believe, and then I got a piece of personal information that changed my mind, information that you don’t have. Let me tell you what that is and why you should move in the direction to save yourself from the costs of what I experienced.’”
What Should Be the Key Message About Getting Vaccinated?
Cialdini’s research has led to him to be a believer in messaging around protecting others. (Notice how we were talking earlier about social proof as learning from others. This is a related idea, that those “others” are worth not just our attention but our consideration — social proof versus social sympathy.)
Here’s a study Cialdini referred to: A hospital wanted to get physicians to wash their hands when going between patients. They decided to put signs above soap dispensers and experimented with two slightly different messages. One was, “Hand hygiene protects you from catching diseases.” The other version changed just one word: “Hand hygiene protects patients from catching diseases.” The first sign saw no change in behavior, while the protect-the-patients message increased usage by 45%.
Given that many people do not personally fear getting COVID, the protect-others message would seem particularly relevant. And one more piece of research that we came across in reviewing Cialdini’s work (this from a book he co-authored, The Small Big: Small Changes That Spark Big Influence), research about charitable appeals which suggests one word in vaccination appeals that could have substantial leverage: “When researchers added the words DONATING = HELPING to standard charity collection boxes, they measured a 14% increase in donations. However, when the word helping was changed to loving, so the sign read DONATING = LOVING, donations increased by over 90% percent.”
Could something similar happen with a VACCINATIONS = LOVING campaign? Let’s hope someone will try that experiment.
The Art of ‘Pre-Suasion’
Another powerful force in the “pre-suasion” around vaccination is scarcity and loss aversion. When supply of something is limited, Cialdini reminds us, it fires up a desire that makes “people go a little crazy.”
We all watched that craziness with the great toilet paper rush of 2020, and we’re seeing it again with the COVID vaccine. So that helps fuel the early rush to get vaccinated, but Cialdini suggests that the same principles will apply later, when the vaccines are widely available. As Cialdini puts it, “Loss is the ultimate form of scarcity.” He added, “People hate to have something taken away, like losing their place in line.” People who may not have particularly wanted a place in line can still be distressed at the thought of losing that place.
Cialdini quotes a financial executive who’d discovered this principle as applied to making versus losing money: “If you wake multimillionaire clients at five the morning and say, ‘If you act now, you will gain $20,000,’ they’ll scream at you and slam down the phone But, if you say, ‘If you don’t act now, you will lose $20,000,’ they’ll thank you.”
One Last Suggestion
Finally, Cialdini spoke of another factor that could “pre-suade” people to get the vaccine. By the way, Cialdini created that term after reviewing stacks of research showing that the environment surrounding a decision plays a major role, and it does so in part because so few recognize that they are being influenced. (For instance, one study on wine selection showed that if you play French background music, the study participants are more likely to choose a French wine. Without realizing it, they were being directed to an outcome, or being persuaded in advance.) In this case, he recommends scientific imagery, such as vials, microscopes and lab coats.
“The goal is to reinforce the thought that scientists have come to conclusions about the vaccine. The mindset is fact-based, not belief-based.”
About the Author
Dale Dauten is a Tempe, Arizona-based business writer and coach.