Is it riskier to meet 100 people outdoors or 14 people indoors? Comparing public and expert perceptions of COVID-19 risk.

People have limited capacity to process and integrate multiple sources of information, so how do they integrate multiple contextual risk factors for Coronavirus disease (COVID-19) infection? In June 2020, we elicited risk perceptions from a nationally representative sample of the public (N = 800) using three psychologically-distinct tasks. Responses were compared to a sample of medical experts who completed the same tasks. Relative to experts, the public perceived lower risk associated with environmental factors (such as whether a gathering takes place indoors or outdoors) and were less inclined to treat risk factors as multiplicative. Our results are consistent with a heuristic simply to "avoid people" and with a coarse (e.g., "safe or unsafe") classification of social settings. A further task, completed only by the general public sample, generated novel evidence that when infection risk competes with risk in another domain (e.g., a different medical risk), people perceive a lower likelihood of contracting the virus. These results inform the policy response to the pandemic and have implications for understanding differences between expert and lay perception of risk. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Experimental pre-tests of public health communications on the COVID-19 vaccine: A null finding for medical endorsement, risk and altruism.

OBJECTIVE: Vaccination campaigns against COVID-19 will only be successful if enough people want to take the vaccine. We tested a government communications intervention to encourage uptake. DESIGN: A pre-registered randomised controlled trial. METHODS: A large, nationally representative sample were randomly assigned to see one of eight posters. The posters varied by image (general practitioner or two hospital doctors) and message (control with public health guidance not related to vaccination, endorsement of the vaccine from the pictured doctor, endorsement with information about COVID-19 risk, endorsement with information about risk and appeal to get vaccinated to protect friends and family). The posters were presented as part of a larger study. The main outcomes were intention to be vaccinated and how soon people would be willing to be vaccinated. RESULTS: The posters induced different reactions indicating that participants had engaged with them. The hospital image was generally preferred to the GP image. Perhaps critically, all intervention messages were trusted less than a control message which did not mention the vaccine (Control Poster Mean = 5.65, SE = 0.09 vs. Poster M Mean = 5.18, SE = 0.09, p <.001; vs. Poster M + R Mean = 5.11, SE = 0.09, p <.001; vs. Poster M + R + F Mean = 5.33, SE = 0.09, p =.01). There were no effects of poster type on intention to take the vaccine or how soon people were willing to take it. CONCLUSION: Although the intervention messages were based on the strongest correlates of vaccine hesitancy identified by contemporaneous surveys, none was effective. More recent research suggests that focusing on the risk of COVID-19 may be less effective than focusing on the benefits of vaccination. Null findings can be as important as positive findings for designing public health campaigns. This study informed government communications about the COVID-19 vaccine.

Using decision aids to support self-isolation during the COVID-19 pandemic.

OBJECTIVE: Self-isolation is a vital element of efforts to contain COVID-19. We set out to test whether decision aids can support self-isolation. DESIGN: We conducted a pre-registered online experiment with a nationally representative sample (n = 500). Three stages tested: (i) whether decision trees help people to decide whether they need to self-isolate; (ii) whether an online planning tool increases people's confidence in their ability to self-isolate; and (iii) whether infographics help people to absorb advice on managing a household in which someone must self-isolate. MAIN OUTCOME MEASURES: (i) Accuracy of matching symptom patterns to a response scale for the need to self-isolate; (ii) self-reported confidence in coping with self-isolation; (iii) objective tests of recall and comprehension. RESULTS: Decision trees improved decisions about when self-isolation was necessary, although participants systematically underestimated the need to self-isolate with less common COVID-19 symptoms (e.g. sore throat, fatigue). The online planning tool increased confidence about coping with self-isolation only among the adults aged under 40. Infographics improved recall and comprehension of how to manage self-isolation. CONCLUSION: Decision aids can be used to support self-isolation during COVID-19. The study also demonstrates how even an emergency public health response can benefit from rapid experimental pre-testing of interventions.

Motivating social distancing during the COVID-19 pandemic: An online experiment.

RATIONALE: Maintaining social distance during the COVID-19 pandemic can save lives. We therefore set out to test communication strategies to promote social distancing. OBJECTIVE: We aimed to test two novel public health messages against a control message. The first was designed to exploit the "identifiable victim" effect by highlighting the risk of transmission to identifiable vulnerable persons. The second sought to counteract intuitive underestimation of exponential transmission. METHOD: In total, 500 Irish adults undertook a pre-registered, online experiment. They were randomly assigned to a control group or one of two treatment groups. The control group viewed a current poster that encouraged a 2-m separation between people. The two treatment groups saw posters of similar design, but with narrative messages describing how an individual had infected a specific vulnerable person or multiple other people. Later questions measured intentions to undertake three specific types of social interaction over the coming days and the stated acceptability of three other types of social interaction. Pilot work had identified these six behaviors as "marginal" - people were unsure whether they were advisable. RESULTS: Participants in the treatment conditions were more cautious about undertaking the behaviors and less accepting of them. This positive effect occurred despite participants rating the treatment posters as likely to be less effective and memorable than the control poster. CONCLUSIONS: Messages that invoke thoughts of infecting vulnerable people or large numbers of people can motivate social distancing and, hence, help to limit the spread of COVID-19. Stated public evaluations (obtained via focus groups or surveys) may underestimate the actual effectiveness of such emotional messages.

It depends on how you ask: measuring bias in population surveys of compliance with COVID-19 public health guidance.

OBJECTIVE: Accurate measurement of compliance with COVID-19 guidance is important for public health policy and communications. Responses to surveys, however, are susceptible to psychological biases, including framing effects and social desirability. Our aim was to measure the effects of these biases on estimates of compliance with public health guidance (eg, hand-washing, social distancing). DESIGN: We conducted two online experiments (n=1800) and varied whether questions were framed positively or negatively (eg, 'I always wash my hands…' vs 'I don't always wash my hands…'). We also varied the degree to which anonymity was assured, via a 'list' experiment. RESULTS: Reported compliance, despite being generally high, was reduced by negatively framing questions and increasing anonymity using a list experiment technique. Effect sizes were large: compliance estimates diminished by up to 17% points and 10% points, respectively. CONCLUSION: Estimates of compliance with COVID-19 guidance vary substantially with how the question is asked. Standard tracking surveys tend to pose questions in ways that lead to higher estimates than alternative approaches. Experimental tests of these surveys offer public health officials greater insight into the range of likely compliance estimates to better inform policy and communications.