The effects of framing and action instructions on whether older adults obtain flu shots

Health Psychol. 2002 Nov;21(6):624-8. doi: 10.1037//0278-6133.21.6.624.


The authors tested the effects of cues to action--messages intended to increase flu immunizations. North Dakota counties were randomly assigned to reminder letters, action letters, or no letters. Within the reminder-letter counties, Medicare recipients received either (a) a reminder from the state peer review organization (PRO) to obtain a flu shot or (b) a reminder from the PRO, framed either in terms of the loss associated with failing to get a shot or (c) the benefits associated with getting a shot. Within the action-letter counties, Medicare recipients leaned where and when to receive a flu shot. Reminder type failed to differentially affect the immunization rate (overall M = 24.5%). However, the action messages worked better (28.2%) than no message (19.6%).

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Female
  • Humans
  • Immunization / statistics & numerical data*
  • Influenza Vaccines / administration & dosage
  • Influenza Vaccines / supply & distribution
  • Influenza, Human / prevention & control*
  • Male
  • North Dakota
  • Patient Acceptance of Health Care*
  • Postal Service
  • Reminder Systems*
  • Social Marketing*


  • Influenza Vaccines