Encouraging people to take the COVID-19 vaccine is the challenge of our time. Hounslow Council shaped their approach by talking to residents and using behaviour change techniques. Sterling Rippy and Eddie Coates-Madden explain.
In Hounslow, comms started planning for a vaccine comms campaign with behaviour change specialists from the public health team towards the end of 2020.
Even at the earliest stages it was clear misinformation was going to be an issue.
The plan set out comms in four key areas:
- Logistics – ensuring residents know where to attend, how to get there and how to get away, to avoid bottlenecks
- Encouraging take-up.
- Myth-busting for key groups as part of the encouragement work, and
- Contingency crisis responses to any actual problems with the vaccine.
We were clear about complementing NHS comms work, not replicating it by doing personal communications to patients, or providing medical information.
We set out to use local government’s key strengths: comms that knows the area and knows local communities.
We laid out some principles: partner branding, socialisation, behaviour change ‘rewards’ and detailed segmentation identifying, for example, messengers, community languages, tailored assets, messages, channels and rewards.
In one of the most diverse council areas in the country, we were very aware we also needed a clear view of the vaccine concerns of particular communities, e.g. South Asian origin communities, the financially excluded, Afro-Carribean communities, women aged 30-40, and younger people.
The key realisation has been that the challenge of hesitancy is about getting good information – as opposed to bad information – into those communities.
In the absence of other sources, we created detailed, extensive FAQs on our website.
The challenge is getting that right information to the right people. The approach developed with behaviour change colleagues seeks to use the messenger principle to address misinformation. Working through surveys and engagement sessions, we realised misinformation was circulating, specifically among South East Asian and Black Afro-Caribbean communities.
We ran focus groups with members of these communities to identify barriers and enablers. Across all conversations residents wanted to speak to their GP about their questions in order to make an informed decision.
One of the prevalent rumours is that vaccine trials were rushed and skipped important safety trials. Residents also told us they didn’t want to be forced, or attacked for their hesitancy. Utilising feedback gained from the insight sessions and, recognising people are generally more receptive to information coming from figures they trust, we designed and tested four types of messages and messengers.
Hounslow Council’s four types of messages and messengers
- An NHS infographic stating the vaccine went through all of the same trials as other vaccines and medications.
- A council branded message redirecting viewers to a FAQ page with information on the vaccine.
- A quote from a local GP of either South East Asian or Black Afro-Caribbean background stating that the vaccine went through all the same trials as other vaccines framed as a ‘MYTH vs FACT.’
- A quote from a local GP of either South East Asian or Black Afro-Caribbean background, stating that the vaccine went through all the same trials as other vaccines but framed as ‘you asked, your GP answered’.
Testing all four on Facebook, we targeted people within 10 miles of Hounslow, and recorded click-through as the outcome metric – an indicator of engagement – as tracking actual vaccination rates was not available.
Message version four was, perhaps unsurprisingly, the clear winner. What was more surprising is that people preferred the ‘you asked, we answered’ questions over ‘myth vs fact’.
We’re using this testing to inform the basis of our campaigns to ensure informed decision making in hesitant communities.
Other quick wins have included, using local GPs to deliver FAQ sessions, and leveraging social norms by providing residents with stickers to display prominently showing they’ve had the vaccine.
There is much yet to do, and we recognise we have yet to reach the more hesitant priority groups. Hounslow has had good uptake to date, with over 90 per cent of our top four priority groups, and over 54,000 people in the Borough having had the vaccine in total. There has been excellent uptake in care homes amongst both staff and residents, with some of the highest rates in the capital.
We won’t be getting into arguments with anti-vaxxers, because our focus is on that segmented, targeted, tested approach. The prize is to convert hesitancy and it’s our belief that that is best done through local knowledge, local partnerships and driven by Behaviour Change expertise.
Sterling Rippy is strategic lead behavioural insights at Hounslow Council and Eddie Coates-Madden is interim head of communications and events.