Understanding health care consumer preferences is key to effective Covid-19 vaccination messaging

-Jarrett Lewis & Sanjula Jain, Ph.D.

(This commentary originally appeared in STAT on November 10).

Health care, like politics, is local. The performance of certain procedures or the prevalence of particular conditions vary from community to community. So do individuals’ preferences on how they choose to obtain care. One thing that doesn’t vary as much is the trust people have in their providers.

That’s why throughout the Covid-19 pandemic, apart from mandates, frontline clinicians broadly have had the greatest impact on influencing the adoption of Covid-19 vaccines. Understanding the impact physicians have is particularly important as the country continues to drive vaccine uptake among adults, approach expanding eligibility to those under age 12, and begin the booster phase of Covid-19 vaccines.

Yet the sway clinicians have with their patients is not enough on its own to convince potentially “movable” vaccine-hesitant individuals to migrate to the vaccinated column. The message is just as important as the messenger. While visibility into the reasons for delaying or avoiding Covid-19 vaccination — fear of side effects, not enough evidence, and the like — is important, insight into the psychographic profile, which represents the motivations and values that underlie the behavior of consumers of everything from entertainment and groceries to health care, is key to effectively influencing vaccination decisions.

The five psychographic profiles of health care consumers are:

• Self Achievers, the most proactive about their health, investing in regular medical checkups and screenings.
• Balance Seekers, who define their health themselves and not by health care professional guidelines. They are open to a diversity of ideas, sources of information, and treatment options.
• Priority Jugglers, who are busy with responsibilities, so they are reactive when it comes to their own health but proactive when it comes to their family’s health.
• Direction Takers, who look for credible resources and take direction and guidance from health care professionals.
• Willful Endurers, independent thinkers who deprioritize their health.

Notably, there is no one psychographic profile that predicts an individual’s vaccination status.

Using Trilliant Health’s national all-payer claims and consumer database, which categorizes people into these five psychographic profiles, we determined that there is wide variation in the distribution of profiles among unvaccinated individuals.

That’s why developing messages that account for the individual attitudes, values, and personalities that motivate health care decisions is essential to effective communication, informing the tone, content, channel, and frequency of messaging. The influx of information about Covid-19 across the media, care providers, government, social networks, and the like is received and perceived differently by individuals with different psychographic profiles, thus influencing different health care choices.

To evaluate the effectiveness of specific vaccine-persuasion arguments for different psychographic profiles, we tested 12 different video messages recorded by a group of clinicians on three online discussion boards among unvaccinated adults and evaluated the vaccine messaging that each profile responded to best.

Although vaccines have become a nationalized issue, individuals perceive their health care as unique to the needs of their regions, communities, and even families. Our findings suggest that unvaccinated Americans draw a distinction between a clinician in their communities and a clinician from the federal government or in the media. Clinicians with personal connections to the local community and understanding of it are the ideal vaccine spokespeople for the Self Achiever and the Direction Taker.

The Priority Juggler and the Balance Seeker responded well to a question as opposed to a command. Clinicians asking unvaccinated individuals with these profiles to talk with their personal provider was more effective than a directive to “take the shot.”

Clinicians are most effective when they exude patience, especially in public settings like social media and press conferences. While Covid-19 has been politicized at every level, most clinicians continue to operate above the political fray: They are viewed by their patients as apolitical, and their patience and provision of information reinforces their nonpartisanship. This is especially important to the Willful Endurer as well as to the Balance Seeker and Priority Juggler.

Across profiles, we found that patients are more likely to trust and follow medical recommendations that they perceive as specific to their local community, personal to them, and unbiased by politics.

Of course, patients don’t wear their psychographic profiles on their sleeves when they enter the clinic. But providers can infer preferences using hyper-local data about the predominant profile in their communities. For instance, according to Trilliant Health’s data, Willful Endurers represent the dominant psychographic profile in counties with the lowest vaccination rates in Florida (44.6%) and Massachusetts (36.6%), and Self Achievers account for the largest psychographic segment of the least vaccinated county in Tennessee (37.9%). An individual’s choice of provider site can also be an indicator: Willful Endurers, for example, are seven times more likely to seek treatment at urgent care facilities.

To increase the vaccination rate in the U.S., providers and public health officials cannot take a one-size-fits-all approach to persuading vaccine-hesitant individuals. Effectively communicating with those who have not yet been vaccinated requires messaging tailored to their health decision-making profiles.

Sanjula Jain is the senior vice president for market strategy and the chief research officer for Trilliant Health. Jarrett Lewis is a partner with Public Opinion Strategies.