Nudging Public Employees Through Descriptive Social Norms in Healthcare Organizations

We draw on the focus theory of normative conduct and nudge theory to experimentally test the effect of descriptive social norms on desired behaviors that public employees may engage in at suboptimal levels, namely, vaccination and help-seeking. Through a series of framed randomized controlled trials with 19,984 public healthcare professionals, we demonstrate that descriptive norms-doing what the majority of others do-trigger conformity. Specifically, employees are more likely to get a flu shot and advocate vaccination when knowing that the majority of their colleagues get vaccinated against the seasonal influenza compared to when most colleagues do not. Similarly, the probability of making help requests on the job is noticeably higher when asking colleagues for advice is the norm rather than not. We discuss the theoretical and practical implications of these experiments for scholars and policy makers interested in predictably altering high-stakes behaviors among public employees through low-powered incentives.