THE SOFT SELL FOR HARD (VAX) NOS — A free beer in New Jersey. Free tickets to Yankees and Mets games. A $100 savings bond for anyone between 16 and 35 in West Virginia. One hundred dollars for state employees in Maryland. These are just a handful of the incentives offered by cities, states and companies for people who get the Covid vaccine. The White House Covid response team has said it’s exploring the idea of incentives, working with businesses like grocery stores, retailers and sports leagues to offer special discounts and promotions for people who roll up their sleeves. With almost 50 percent of the U.S. population partially vaccinated, governments are starting to turn attention to a group Ken Resnicow, a professor of health behavior at the University of Michigan’s School of Public Health, calls the “hard nos.” And it’s possible that incentives like these could actually make this group less likely to get a shot, Resnicow told Nightly’s Myah Ward. “There’s a large concentration of a certain demographic, white, evangelical, male Republicans — we know for that subgroup, who’s the highest ‘hard no’ group in America, that for them, this is an issue of freedom, not feeling coerced, asserting their independence, avoiding feeling controlled,” he said. In a UCLA survey last week , 15 percent of respondents said they would be less likely to get a vaccine if offered $100. The incentives are still worth it: A larger number — 34 percent in the study — said they would be encouraged by a cash offer. But there’s a different way to target those that might be turned off by the incentive, Resnicow said. He envisions a tailored incentive structure that gives people choices: Do you want an incentive to get vaccinated? What might it be? How should the incentive be distributed? For example, if the incentive were a cash offer, you could give people the option to take the money or instead choose to give it to an organization on a list of charities. This approach would be difficult to implement on the federal level, Resnicow said, but counties and states could more easily survey their populations to determine what incentives and what approach would be most effective for their demographics. “That we can do relatively quickly,” he said. Instead of incentives, tactics like motivational interviewing could be used to persuade the hard-no resisters without making them feel “threatened,” Resnicow said. “In motivational interviewing, if you tell me you’re not going to quit smoking or you’re not going to stop drinking ... we try to reflect that back without judgment,” he said. The second principle behaviorists apply in motivational interviewing is affirmation. “We want to be able to create a connection,” Resnicow said. “You could say to someone who’s a high hard no: ‘You care about your health. You’ve researched a lot. You’ve thought about this, you really don’t think this is best for you and your family.’” Resnicow and his team at the University of Michigan trained providers at federally qualified health centers in the state to use these techniques. The university also just received two federal grants to train church members as vaccine navigators in their communities.
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