Attitudes and defaults save lives and protect the environment jointly and compensatorily: understanding the behavioral efficacy of nudges and other structural interventions

Breaking the chain with individual gain? Investigating the moral intensity of COVID-19 digital contact tracing

During the COVID-19 pandemic, contact tracing apps such as the German Corona-Warning-App (CWA) were introduced to facilitate contact tracing of infected individuals with the aim of breaking chains of infection. Therefore, using a contact tracing app is beneficial to society as a whole. Even though this is a good cause, the rather reluctant use of the CWA in the beginning indicated that the pains (e.g., privacy concerns) obviously outweighed the gains (helping others) at the level of the individual user. Thus, in order to identify what lies behind the gain of this app and how it can be promoted, we were interested in the individual's moral perspective (helping others) on the app. We expected a positive relation between CWA download and moral intensity derived from (i) the magnitude or seriousness of consequences, (ii) social norms about app use, (iii) the individual proximity to COVID-19 cases, and (iv) the probability of the app's positive effect. Using a heterogeneous German sample of N = 1,454, we found a strong influence of moral intensity on app download. Furthermore, a manipulation of moral intensity among non-users led to a higher number of downloads in a follow-up study (N = 662) as compared to the population. Our results show possibilities to enhance the adoption of contact tracing apps and potentially other apps for the common good in the population.

The (Un)availability of Human Activities for Social Intervention: Reflecting on Social Mechanisms in Technology Assessment and Sustainable Development Research

This article considers human activities as a central but deeply problematic aspect of sustainability. We argue that radical reduction in human activities could be an important lever to counter problems such as climate change. However, instead of pursuing a normative hypothesis that human activities ought to be subjected to specific kinds of sustainability measures, we pursue the hypothesis that human activities are largely unavailable for sustainability measures, because as an aggregated global phenomenon they are subject to social mechanisms, which accelerate rather than slow down activities. While social mechanisms are human inventions that render (inter)actions unlikely likely in the first place, they have evolved towards structural and historical embeddedness, which makes them unavailable for any instrumentalized design. The question is, how can we, experts in technology assessment, recognize social mechanisms in strategies to reduce human activities and to achieve a transformative impact on systemic reproduction. Our discussion centers on technical, psychological, and communicative social mechanisms of reproduction, and experiments with ideas of how to utilize social mechanisms and the (un)availability of human activities in technology assessment and sustainable development research.

Clinical Decision Support to Address Racial Disparities in Hypertension Control in an Integrated Delivery System: Evaluation of a Natural Experiment

INTRODUCTION

Effective, equity-promoting interventions implemented by health care systems are needed to address health care disparities and population-level health disparities. We evaluated the impact of a clinical decision support tool to improve evidence-based thiazide diuretic prescribing among Black patients to address racial disparities in hypertension control.

METHODS

We employed an interrupted time series design and qualitative interviews to evaluate the implementation of the tool. Our primary outcome measure was the monthly rate of thiazide use among eligible patients before and after implementation of the tool (January 2013-December 2016). We modeled month-to-month changes in thiazide use for Black and White patients, overall, and by sex and medical center racial composition. We conducted key informant interviews to identify modifiable facilitators and barriers to implementation of the tool across medical centers.

RESULTS

Of the 318,720 patients, 15.5% were Black. We observed no change in thiazide use or blood pressure control following the implementation of the tool in either racial subgroup. There was a slight but statistically significant reduction (2.32 percentage points, p < 0.01) in thiazide use among Black patients following the removal the tool that was not observed among White patients. Factors affecting the tool's implementation included physician and pharmacist resistance to thiazide use and a lack of ongoing promotion of the tool.

DISCUSSION

The clinical decision support tool was insufficient to change prescribing practices and improve blood pressure control among Black patients.

CONCLUSIONS

Future interventions should consider physician attitudes about thiazide prescribing and the importance of multilevel approaches to address hypertension disparities.

Psychological Processes and Institutional Actors in the Sustainable Energy Transition: A Case-Study Analysis of a Local Community in Italy

This paper presents the results of a qualitative study exploring the role of formal social units in the sustainable energy transition process. A small community in North-east Italy was assumed as case study, in the context of a wider EU-funded research project aimed at understanding the individual and collective dimensions of energy-related choices. Starting from a general framework and integrated approach to explain sustainable energy transitions proposed by Steg et al. (2015), the main aim of our study was to identify the psychological and social factors that motivated the key actors to undertake an energy self-sufficiency path in the case-study area. Our analyses aimed at understanding the social, cultural, and socioeconomic dynamics in the energy transition process of the community. The study outlined how these factors contributed to foster collaborative actions between public decision makers, relevant stakeholders, civil society, and citizens. Results of a computer-supported qualitative content analysis using the software MAXQDA helped to shed light on the specific mechanisms and dynamics driving energy choices and energy-related behavior among the community. The implication for best practices and successful implementations of energy transition process in small communities emerging from this case study are discussed.

The Campbell Paradigm as a Behavior-Predictive Reinterpretation of the Classical Tripartite Model of Attitudes

In this article, we introduce the "Campbell Paradigm" as a novel variant of Rosenberg and Hovland's (1960) tripartite model of attitudes. The Campbell Paradigm is based on a highly restricted measurement model that speaks of a compensatory relation between a person's latent attitude and the costs that come with any specific behavior. It overcomes the overarching weakness of the original tripartite model (i.e., its relative irrelevance for actual behavior) and offers a parsimonious explanation for behavior. Even though this seems attractive, we also discuss why the paradigm has not gained momentum in the 50 years since it was originally proposed by Donald T. Campbell. To demonstrate the paradigm's suitability even when implemented with an unrefined instrument in a domain where it has not been used previously, we apply the paradigm to a classic data example from attitude research from the 1984 US presidential election to account for the electorate's voting intentions and actual voting behaviors.