Information Safety Assurances Increase Intentions to Use COVID-19 Contact Tracing Applications, Regardless of Autonomy-Supportive or Controlling Message Framing

The Role of Communication Style and External Motivators in Predicting Vaccination Experiences and Intentions: An Experimental Vignette Study

This vignette-based study examined in a sample of unvaccinated Belgian citizens (N = 1918; Mage = 45.99) how health care workers could foster reflection about and intentions to get vaccinated against COVID-19 by experimentally varying their communication style (i.e., autonomy-supportive vs. controlling) and the reference to external motivators (i.e., use of a monetary voucher or corona pass vs. the lack thereof). Each participant was randomly assigned to one of six conditions and rated a vignette in terms of anticipated autonomy satisfaction, perceived effectiveness, reflection, and vaccination intention. An autonomy-supportive, relative to a controlling, communication style predicted greater autonomy need satisfaction, which in turn related positively to perceived effectiveness, reflection, and vaccination intention. External motivators failed to generate positive effects compared to the control condition. The findings highlight the critical role of autonomy support in promoting a self-endorsed decision to get vaccinated.

Antecedents predicting digital contact tracing acceptance: a systematic review and meta-analysis

An awareness of antecedents of acceptance of digital contact tracing (DCT) can enable healthcare authorities to design appropriate strategies for fighting COVID-19 or other infectious diseases that may emerge in the future. However, mixed results about these antecedents are frequently reported. Most prior DCT acceptance review studies lack statistical synthesis of their results. This study aims to undertake a systematic review and meta-analysis of antecedents of DCT acceptance and investigate potential moderators of these antecedents. By searching multiple databases and filtering studies by using both inclusion and exclusion criteria, 76 and 25 studies were included for systematic review and meta-analysis, respectively. Random-effects models were chosen to estimate meta-analysis results since Q, I 2, and H index signified some degree of heterogeneity. Fail-safe N was used to assess publication bias. Most DCT acceptance studies have focused on DCT related factors. Included antecedents are all significant predictors of DCT acceptance except for privacy concerns and fear of COVID-19. Subgroup analysis showed that individualism/collectivism moderate the relationships between norms/privacy concerns and intention to use DCT. Based on the results, the mean effect size of antecedents of DCT acceptance and the potential moderators may be more clearly identified. Appropriate strategies for boosting the DCT acceptance rate can be proposed accordingly.

A systematic literature review of voluntary behaviour change approaches in single use plastic reduction

Plastic waste is a leading contributor to climate change due to its build up in landfill and oceans, releasing harmful greenhouse gases and causing harm to ecosystems. The past decade has seen a rise in the number of policies and legislative regulations surrounding the use of single-use plastics (SUP). Such measures are needed and have shown effectiveness in the reduction of SUP's. However, it is becoming apparent that voluntary behaviour change efforts, which preserve autonomous decision making are also needed to further reduce demand for SUP. This mixed-methods systematic review had three aims, 1) synthesise existing voluntary behavioural change interventions and approaches aimed at reducing SUP consumption, 2) assess the level of autonomy preserved in interventions, and 3) assess the extent of theory use in voluntary SUP reduction interventions. A systematic search was executed across six electronic databases. Eligible studies were peer-reviewed literature published in English between 2000 and 2022 reporting on voluntary behaviour change programs aimed at reducing the consumption of SUPs. Quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Overall, 30 articles were included. Due to the heterogenic nature of outcome data in included studies, meta-analytic analysis was not possible. However, data were extracted and narratively synthesised. Communication and informational campaigns were the most common intervention approach with most interventions taking place in community or commercial settings. There was limited theory use among included studies (27% used theory). A framework was created using the criteria outlined by Geiger et al. (2021) to evaluate level of autonomy preserved in included interventions. Overall, level of autonomy preserved in included interventions was low. This review highlights the urgent need for more research into voluntary SUP reduction strategies, increased integration of theory in intervention development, and higher levels of autonomy preservation in SUP reduction interventions.

User Compliance With the Health Emergency and Disaster Management System: Systematic Literature Review

BACKGROUND

Health-related hazards have a detrimental impact on society. The health emergency and disaster management system (Health EDMS), such as a contact-tracing application, is used to respond to and cope with health-related hazards. User compliance with Health EDMS warnings is key to its success. However, it was reported that user compliance with such a system remains low.

OBJECTIVE

Through a systematic literature review, this study aims to identify the theories and corresponding factors that explain user compliance with the warning message provided by Health EDMS.

METHODS

The systematic literature review was conducted using Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines. The search was performed using the online databases Scopus, ScienceDirect, ProQuest, IEEE, and PubMed, for English journal papers published between January 2000 and February 2022.

RESULTS

A total of 14 papers were selected for the review based on our inclusion and exclusion criteria. Previous research adopted 6 theories when examining user compliance, and central to the research was Health EDMS. To better understand Health EDMS, based on the literature reviewed, we mapped the activities and features of Health EDMS with the key stakeholders involved. We identified features that require involvement from individual users, which are surveillance and monitoring features and medical care and logistic assistance features. We then proposed a framework showing the individual, technological, and social influencing factors of the use of these features, which in turn affects compliance with the warning message from Health EDMS.

CONCLUSIONS

Research on the Health EDMS topic increased rapidly in 2021 due to the COVID-19 pandemic. An in-depth understanding of Health EDMS and user compliance before designing the system is essential for governments and developers to increase the effectiveness of Health EDMS. Through a systematic literature review, this study proposed a research framework and identified research gaps for future research on this topic.

One year of digital contact tracing: Who was more likely to install the NHS COVID-19 app? Results from a tracker survey in England and Wales

Objective

To examine changes in the uptake of the National Health Service (NHS) COVID-19 proximity (contact) tracing application (‘app’) over one year, amongst smartphone users in England and Wales.

Methods

We conducted a longitudinal survey between October 2020 and September 2021, amongst an online panel representative of smartphone users aged 18–79 and a purposeful sample from six of the largest minority ethnic groups. We fitted pooled logistic regression models to examine factors associated with app installation and a longitudinal logistic regression model to estimate factors associated with installing/uninstalling the app over time.

Results

Around 50% of respondents had the app installed at each time point. The majority of installations took place soon after its launch. The key reason for installing at launch was ‘civic, public or social responsibility’. Amongst those who installed the app later, it was ‘needed to scan NHS QR code’. Uptake was higher amongst individuals who considered themselves vulnerable to COVID-19 or were concerned about the risk COVID-19 posed, were more highly educated, of White ethnicity, and who reported higher levels of trust in government information. Factors associated with installing the app over time included becoming more concerned about the risk COVID-19 poses to the country, or perceiving that the crisis in their local area had worsened.

Conclusions

Despite changes in pandemic response and case numbers, app installation in England and Wales remained relatively stable after launch. If governments wish to increase app installation and use rates in future pandemics, they need to highlight those app features that encourage engagement, and take related action to allay privacy concerns and improve trust in government information sharing.

Perceived legitimacy can moderate the effect of proscriptive versus prescriptive injunctions on intentions to comply with UK government COVID-19 guidelines and reactance

Proscriptive injunctions (i.e., telling people what they should not do) have been found in research to elicit greater perceptions of a threat to freedom, and greater reactance (anger, irritation and annoyance), than prescriptive injunctions (i.e., telling people what they should do), across several health and social behaviors. The current research investigated the effects of Injunction Type (proscriptive vs. prescriptive) and perceived legitimacy of the injunction, on intentions to comply with UK government behavioral guidelines during the COVID-19 pandemic, and on reactance. In two online experimental studies (Study 1: N = 142; Study 2: N = 307), UK participants were presented with information about UK government COVID-19 guidelines that included either a proscriptive injunction or prescriptive injunction and reported their perceptions of the legitimacy of the injunction, their intentions to comply with government guidelines, and their reactance. In both Study 1 and Study 2, the effect of Injunction Type on intentions to comply and reactance was moderated by perceived legitimacy. In both studies, when perceived legitimacy was low, participants exposed to the proscriptive injunction indicated lower intentions to comply with UK government COVID-19 guidelines than did participants exposed to the prescriptive injunction. The findings imply that using a prescriptive injunction frame can elicit greater intentions to comply than using a proscriptive injunction frame when people perceive the injunction to be unreasonable. The results are discussed in relation to the role of legitimacy in determining the effectiveness of different types of injunctions on compliance with rules and guidelines.

Motivations for personal financial management: A Self-Determination Theory perspective

Financial knowledge and sound financial decision making are now broadly recognized to be important determinants of both personal and societal prosperity, but research has yet to examine how distinct qualities of motivation may be associated with the way people manage their money. In two studies we applied the framework of Self-Determination Theory (SDT) to examine people's autonomous (volitional) and controlled (pressured) motivation for understanding and managing their finances, as well as their amotivation (lack of motivation) for doing so, and the differential associations these motives have with financial knowledge and financial well-being. American participants (Study 1, N = 516; Study 2, N = 534) completed detailed demographic surveys and questionnaires assessing the financial variables of interest. As hypothesized, SDT's motivational constructs were associated with financial outcomes over and above participants' age, gender, income, household wealth, and educational attainment. Autonomous motivation was positively associated with a host of positive financial behaviors and characteristics (e.g., saving/investing and financial self-efficacy, well-being, and self-awareness). Controlled motivation was negatively associated with financial well-being. Amotivation was positively associated with overspending and negatively associated with financial self-efficacy and well-being. These findings support the relevance of SDT's framework in this domain and suggest that interventions aimed at promoting financial knowledge and wellness may benefit by adopting evidence-supported strategies for optimizing more autonomous motivations and addressing amotivations.

Tracing app technology: an ethical review in the COVID-19 era and directions for post-COVID-19

We conducted a systematic literature review on the ethical considerations of the use of contact tracing app technology, which was extensively implemented during the COVID-19 pandemic. The rapid and extensive use of this technology during the COVID-19 pandemic, while benefiting the public well-being by providing information about people's mobility and movements to control the spread of the virus, raised several ethical concerns for the post-COVID-19 era. To investigate these concerns for the post-pandemic situation and provide direction for future events, we analyzed the current ethical frameworks, research, and case studies about the ethical usage of tracing app technology. The results suggest there are seven essential ethical considerations-privacy, security, acceptability, government surveillance, transparency, justice, and voluntariness-in the ethical use of contact tracing technology. In this paper, we explain and discuss these considerations and how they are needed for the ethical usage of this technology. The findings also highlight the importance of developing integrated guidelines and frameworks for implementation of such technology in the post- COVID-19 world.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10676-022-09659-6.

The psychological reassurance effect of mobile tracing apps in Covid-19 Era

As part of their public health policies, most countries have launched mobile tracing applications (apps) to reduce the spread of the COVID-19 virus and reassure their citizens. To the best of our knowledge, no study has explored the importance of 'well-being' and 'trust in the future' in the context of digital contact-tracing apps. This is an important gap, especially given the importance of citizens' acceptance of a mobile tracing app and its role in reassuring citizens. Therefore, we study the French government's tracing app-StopCovid-as experienced by a sample of 832 participants from France. The results establish strong links between perceived value and trust in government, well-being, and trust in the future, which are considered the key features of the reassurance effect in a pandemic context. In addition, a multigroup analysis (MGA) allows us to compare the effect of several moderators on the overall model, such as the users versus nonusers of tracking apps or infected versus noninfected with COVID-19. The study provides practical implications by highlighting how governments should deploy mobile tracing apps to contribute to public health and reassure their citizens during the pandemic.

A global experiment on motivating social distancing during the COVID-19 pandemic

Communicating in ways that motivate engagement in social distancing remains a critical global public health priority during the COVID-19 pandemic. This study tested motivational qualities of messages about social distancing (those that promoted choice and agency vs. those that were forceful and shaming) in 25,718 people in 89 countries. The autonomy-supportive message decreased feelings of defying social distancing recommendations relative to the controlling message, and the controlling message increased controlled motivation, a less effective form of motivation, relative to no message. Message type did not impact intentions to socially distance, but people’s existing motivations were related to intentions. Findings were generalizable across a geographically diverse sample and may inform public health communication strategies in this and future global health emergencies.

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges.

Contact tracing apps for the COVID-19 pandemic: a systematic literature review of challenges and future directions for neo-liberal societies

PURPOSE

The COVID-19 pandemic has spread with increased fatalities around the world and has become an international public health crisis. Public health authorities in many countries have introduced contact tracing apps to track and trace infected persons as part of measures to contain the spread of the Severe Acute Respiratory Syndrome-Coronavirus 2. However, there are major concerns about its efficacy and privacy which affects mass acceptance amongst a population. This systematic literature review encompasses the current challenges facing this technology and recommendations to address such challenges in the fight against the COVID-19 pandemic in neo-liberal societies.

METHODS

The systematic literature review was conducted by searching databases of Google Scholar, Web of Science, PubMed, IEEE Xplore Digital Library, PsycInfo and ScienceDirect using the search terms ("Contact Tracing" OR "Contact Tracing apps") AND ("COVID-19" OR "Coronavirus") to identify relevant literature. The searches were run against the title, keywords, or abstract, depending on the search platforms. The searches were conducted between January 1, 2020, through 31st January 2021. Further inputs were also taken from preprints, published government and technical reports. We explore and discuss from the selected literature, the key challenges and issues that influence unwillingness to use these contact tracing apps in neo-liberal societies which include the plausibility of abuse of user privacy rights and lack of trust in the government and public health authorities by their citizens. Other challenges identified and discussed include ethical issues, security vulnerabilities, user behaviour and participation, and technical constraints.

RESULTS AND CONCLUSION

Finally, in the analysis of this systematic literature review, recommendations to address these challenges, future directions, and considerations in the use of digital contact tracing apps and related technologies to contain the spread of future pandemic outbreaks are presented. For policy makers in neo-liberal societies, this study provides an in-depth review of issues that must be addressed. We highlight recommendations to improve the willingness to use such digital technologies and could facilitate mass acceptance amongst users.

What influences people's responses to public health messages for managing risks and preventing infectious diseases? A rapid systematic review of the evidence and recommendations

BACKGROUND

Individual behaviour changes, such as hand hygiene and physical distancing, are required on a population scale to reduce transmission of infectious diseases such as COVID-19. However, little is known about effective methods of communicating risk reducing information, and how populations might respond.

OBJECTIVE

To synthesise evidence relating to what (1) characterises effective public health messages for managing risk and preventing infectious disease and (2) influences people's responses to messages.

DESIGN

A rapid systematic review was conducted. Protocol is published on Prospero CRD42020188704.

DATA SOURCES

Electronic databases were searched: Ovid Medline, Ovid PsycINFO and Healthevidence.org, and grey literature (PsyarXiv, OSF Preprints) up to May 2020.

STUDY SELECTION

All study designs that (1) evaluated public health messaging interventions targeted at adults and (2) concerned a communicable disease spread via primary route of transmission of respiratory and/or touch were included. Outcomes included preventative behaviours, perceptions/awareness and intentions. Non-English language papers were excluded.

SYNTHESIS

Due to high heterogeneity studies were synthesised narratively focusing on determinants of intentions in the absence of measured adherence/preventative behaviours. Themes were developed independently by two researchers and discussed within team to reach consensus. Recommendations were translated from narrative synthesis to provide evidence-based methods in providing effective messaging.

RESULTS

Sixty-eight eligible papers were identified. Characteristics of effective messaging include delivery by credible sources, community engagement, increasing awareness/knowledge, mapping to stage of epidemic/pandemic. To influence intent effectively, public health messages need to be acceptable, increase understanding/perceptions of health threat and perceived susceptibility.

DISCUSSION

There are four key recommendations: (1) engage communities in development of messaging, (2) address uncertainty immediately and with transparency, (3) focus on unifying messages from sources and (4) frame messages aimed at increasing understanding, social responsibility and personal control. Embedding principles of behavioural science into public health messaging is an important step towards more effective health-risk communication during epidemics/pandemics.

I use a COVID-19 contact-tracing app. Do you? Regulatory focus and the intention to engage with contact-tracing technology

Based on regulatory focus theory, it is proposed that there is a relationship between the intention to use COVID-19 contact-tracing apps and goal-directed motivation. Two studies tested this proposal. Study 1 examined the relationship between participants’ chronic regulatory focus and the intention to use contact-tracing apps. Apps usage intention was positively associated with prevention focus. A mediation analysis showed that the relationship between prevention focus and apps usage intention was mediated by privacy and information security concerns. The stronger the prevention focus, the weaker the concerns, thus, the stronger the intention to use contact-tracing apps. Study 2 used priming to have participants adopt either a momentary promotion or prevention focus, after which they were asked about their intention to use contact-tracing apps. A situationally induced regulatory focus influenced the intention to use contact-tracing apps. A moderation analysis showed that age moderated the relationship between regulatory focus and apps usage intention.

The role of perceived level of threat, reactance proneness, political orientation, and coronavirus salience on health behavior intentions

OBJECTIVE

This pre-registered study was designed to test whether reminders of death and coronavirus would have similar or different effects on health behavior intentions concerning COVID-19 (e.g., mask wearing, social distancing) and whether the type of framing of these behaviors would moderate these effects.

DESIGN

The study utilized a 3 (threat: mortality salience vs. coronavirus reminder vs. control topic) x 3 (framing: autonomy-supportive vs. controlled vs. neutral) design. Measures of perceived threat of COVID-19, reactance proneness, and political orientation were included as individual differences.

RESULTS

Although the interaction between threat and framing conditions was not significant, the data revealed that (1) lower perceived threat of COVID-19 was associated with lower health behavior intentions to reduce the spread of the virus; (2) after an induction to express their thoughts and feelings about COVID-19, participants with low perceived threat of COVID-19 significantly increased their health intentions; (3) perceived threat of COVID-19 moderated the relationship between reactance proneness and health intentions, such that those high in reactance proneness reported lower intentions unless they had high perceptions of threat; and (4) politically conservative participants reported lower intentions to engage in healthy behaviors, and this relationship was mediated by their lower perceived threat of COVID-19.

Digital Contact Tracing Applications during COVID-19: A Scoping Review about Public Acceptance

Digital contact tracing applications (CTAs) have been one of the most widely discussed technical methods of controlling the COVID-19 outbreak. The effectiveness of this technology and its ethical justification depend highly on public acceptance and adoption. This study aims to describe the current knowledge about public acceptance of CTAs and identify individual perspectives, which are essential to consider concerning CTA acceptance and adoption. In this scoping review, 25 studies from four continents across the globe are compiled, and critical topics are identified and discussed. The results show that public acceptance varies across national cultures and sociodemographic strata. Lower acceptance among people who are mistrusting, socially disadvantaged, or those with low technical skills suggest a risk that CTAs may amplify existing inequities. Regarding determinants of acceptance, eight themes emerged, covering both attitudes and behavioral perspectives that can influence acceptance, including trust, privacy concerns, social responsibility, perceived health threat, experience of and access to technologies, performance expectancy and perceived benefits, and understanding. Furthermore, widespread misconceptions about the CTA function are a topic in need of immediate attention to ensure the safe use of CTAs. The intention-action gap is another topic in need of more research.

Implementing Public Health Strategies-The Need for Educational Initiatives: A Systematic Review

In the absence of a specific treatment or vaccines, public health strategies are the main measures to use in the initial stages of a pandemic to allow surveillance of infectious diseases. During the ongoing global pandemic of coronavirus disease 2019 (COVID-19), several countries initiated various public health strategies, such as contact tracing and quarantine. The present study aims to conduct a systematic literature review to identify the presence of educational initiatives that promote the implementation of public health strategies before public health emergencies, with a special focus on contact tracing applications. Using Science Direct, PubMed, Scopus, and Gothenburg University search engines, all published scientific articles were included, while conference, reports, and non-scientific papers were excluded. The outcomes of the reviewed studies indicate that the effective implementation of public health strategies depends on the peoples' willingness to participate and collaborate with local authorities. Several factors may influence such willingness, of which ethical, psychological, and practical factors seem to be the most important and frequently discussed. Moreover, individual willingness and readiness of a community may also vary based on the acquired level of knowledge about the incident and its cause and available management options. Educational initiatives, proper communication, and timely information at the community level were found to be the necessary steps to counteract misinformation and to promote a successful implementation of public health strategies and attenuate the effects of a pandemic. The systematic review conducted as a part of this study would benefit the relevant stakeholders and policy makers and assist with effective designing and implementation.