December 2018
Can social image concerns motivate adults to internalize health externalities? In collaboration with the Kenyan Government, we implement a new community program that offers free deworming treatment to 200,000 adults and emphasizes the public good aspect of deworming. Importantly, we randomize the introduction of two types of social signals in the form of colorful bracelets and ink applied to the thumb. The bracelets and ink allow adults to signal that they contributed to protecting their community from worms. To separate social signaling preferences from reminder and learning effects, we offer free text messages to a random subset of adults. Further, we exogenously vary the travel distance to treatment locations. We find that (1) bracelets as signals increase deworming take-up by 24 percent, outperforming a material incentive, (2) the effects are not due to pure reminder or learning effects, (3) there is no detectable effect for the ink signal, which we attribute to its lower visibility, (4) adults are highly sensitive to distance and both signaling treatments have a larger impact on take-up at far distances. The latter finding is consistent with the theoretical prediction that signaling returns increase as signals become more informative. Detailed survey data on first and second-order beliefs shed light on the underlying mechanism: signals reduce information asymmetries, and adults are more likely to think that others have information about their deworming decision.