CERVIXCHECK: A SPIRITUALLY-BASED SMS TEXT MESSAGING PILOT INTERVENTION TO INCREASE CERVICAL CANCER AWARENESS AND PAP TEST SCREENING INTENTION AMONG AFRICAN AMERICAN WOMEN

African American women account for a disproportionate burden of cervical cancer incidence and mortality rate when compared to non-Hispanic White women. Cervical cancer is one of the most preventable types of cancer, and women can be screened for it with a routine Pap test. Given that religion occupies an essential place in African American lives, framing health messages with important spiritual themes and delivering them through a popular communication delivery channel may allow for a more culturally-relevant and accessible technology-based approach to promoting cervical cancer educational content to African American women. Using community-engaged research as a framework, the purpose of this multiple methods study was to develop, pilot test, and evaluate the feasibility, acceptability, and initial efficacy of a spiritually-based SMS text messaging intervention to increase cervical cancer awareness and Pap test screening intention among African American women. The study recruited church-attending African American women ages 21-65 and was conducted in three phases. Phases 1 and 2 consisted of a series of focus group discussions (n=15), cognitive response interviews (n=8), and initial usability testing that were conducted to inform the intervention development and modifications. Phase 3 utilized a non-experimental one-group pretest-posttest design to pilot test the 16-day text messaging intervention (n=52). Of the individuals enrolled, forty-six completed the posttest (retention rate=88%). Findings provided evidence for the early feasibility, high acceptability, and some initial efficacy of the CervixCheck intervention. There were significant pre-post increases observed for knowledge about cervical cancer and the Pap test (p = .001) and subjective norms (p = .006). Additionally, results post-intervention revealed that 83% of participants reported being either “satisfied” or “very satisfied” with the program and 85% found the text messages either “useful” or “very useful”. 85% of the participants also indicated that they would “likely” or “very likely” share the information they learned from the intervention with the women around them, with 39% indicating that they had already shared some of the information they received with others they knew. A spiritually-based SMS text messaging intervention could be a culturally appropriate and cost-effective method of promoting cervical cancer early detection information to African American women.

ENGINEERING DIGITAL SHARING PLATFORM TO CREATE SOCIAL CONTAGION: EVIDENCE FROM LARGE SCALE RANDOMIZED FIELD EXPERIMENTS

Peer-to-peer information sharing has fundamentally changed customer decision-making process. Recent developments in information technologies have enabled digital sharing platforms to influence various granular aspects of the information sharing process. Despite the growing importance of digital information sharing, little research has examined the optimal design choices for a platform seeking to maximize returns from information sharing. My dissertation seeks to fill this gap. Specifically, I study novel interventions that can be implemented by the platform at different stages of the information sharing. In collaboration with a leading for-profit platform and a non-profit platform, I conduct three large-scale field experiments to causally identify the impact of these interventions on customers’ sharing behaviors as well as the sharing outcomes. The first essay examines whether and how a firm can enhance social contagion by simply varying the message shared by customers with their friends. Using a large randomized field experiment, I find that i) adding only information about the sender’s purchase status increases the likelihood of recipients’ purchase; ii) adding only information about referral reward increases recipients’ follow-up referrals; and iii) adding information about both the sender’s purchase as well as the referral rewards increases neither the likelihood of purchase nor follow-up referrals. I then discuss the underlying mechanisms. The second essay studies whether and how a firm can design unconditional incentive to engage customers who already reveal willingness to share. I conduct a field experiment to examine the impact of incentive design on sender’s purchase as well as further referral behavior. I find evidence that incentive structure has a significant, but interestingly opposing, impact on both outcomes. The results also provide insights about senders’ motives in sharing. The third essay examines whether and how a non-profit platform can use mobile messaging to leverage recipients’ social ties to encourage blood donation. I design a large field experiment to causally identify the impact of different types of information and incentives on donor’s self-donation and group donation behavior. My results show that non-profits can stimulate group effect and increase blood donation, but only with group reward. Such group reward works by motivating a different donor population. In summary, the findings from the three studies will offer valuable insights for platforms and social enterprises on how to engineer digital platforms to create social contagion. The rich data from randomized experiments and complementary sources (archive and survey) also allows me to test the underlying mechanism at work. In this way, my dissertation provides both managerial implication and theoretical contribution to the phenomenon of peer-to-peer information sharing.