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Effect of Nudges on Downloads of COVID-19 Exposure Notification AppsA Randomized Clinical Trial

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Network Open

Published Online: December 23, 2021

Research Letter

Article Information and Disclosures

Marissa A. Sharif, PhD¹;

Erica Dixon, PhD²;

Elizabeth F. Bair, MS³;

Carolina Garzon, MSE⁴;

Laura Gibson, PhD³;

Kristin Linn, PhD^2,5;

Kevin Volpp, MD, PhD³

Author Affiliations

¹Marketing Department, Wharton School of the University of Pennsylvania, Philadelphia
²Center for Health Incentives and Behavioral Economics (CHIBE) at the University of Pennsylvania School of Medicine, Philadelphia
³Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia
⁴Center for Health Care Innovation, Penn Medicine, Philadelphia, Pennsylvania
⁵Department of Biostatistics, Epidemiology, and Informatics at the University of Pennsylvania School of Medicine, Philadelphia

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Digital contact tracing smartphone applications (apps) can mitigate the spread of COVID-19 through exposure notification.¹^- 4 However, their success requires widespread use. We examined the effectiveness of low-cost behavioral interventions (ie, nudges) in increasing downloads of Pennsylvania’s COVID Alert PA app. Specifically, we explored the effectiveness of 2 nudges⁵^,6 on 39 937 individuals, one nudge displaying a descriptive social norm (vs not) and another framing the benefit of downloading for others (vs self).

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Article Information

Accepted for Publication: October 30, 2021.

Published: December 23, 2021. doi:10.1001/jamanetworkopen.2021.40839

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Sharif MA et al. JAMA Network Open.

Corresponding Author: Marissa A. Sharif, PhD, Marketing Department, Wharton School of the University of Pennsylvania, 3730 Walnut Ave, Philadelphia, PA 19104 (masharif@wharton.upenn.edu).

Author Contributions: Ms Bair had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Sharif, Dixon, Garzon, Gibson, Volpp.

Acquisition, analysis, or interpretation of data: Sharif, Bair, Gibson, Linn.

Drafting of the manuscript: Sharif, Dixon.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Sharif, Bair.

Obtained funding: Dixon, Volpp.

Administrative, technical, or material support: Sharif, Dixon, Garzon, Volpp.

Supervision: Sharif, Dixon.

Conflict of Interest Disclosures: Dr Volpp reported being a part owner of VALHealth, a behavioral economics consulting firm; receiving research funding from Hawaii Medical Services Association, Humana, CVS, WW, and Vitality/Discovery; and receiving personal fees from Tandigm, Lehigh Valley Medical Center, Vizient, and the Center for Corporate Innovation. No other disclosures were reported.

Funding/Support: This study was supported by the Pennsylvania Department of Health for research involving COVID Alert PA, the exposure notification app for the Commonwealth of Pennsylvania.

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Trial Registration: ClinicalTrials.gov Identifier: NCT05080179

References

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Aleta A , Martín-Corral D , Pastore Y Piontti A , et al. Modelling the impact of testing, contact tracing and household quarantine on second waves of COVID-19. Nat Hum Behav. 2020;4(9):964-971. doi:10.1038/s41562-020-0931-9 PubMed Google Scholar Crossref

Rodríguez P , Graña S , Alvarez-León EE , et al; RadarCovidPilot Group. A population-based controlled experiment assessing the epidemiological impact of digital contact tracing. Nat Commun. 2021;12(1):587. doi:10.1038/s41467-020-20817-6 PubMed Google Scholar Crossref

Abueg M , Hinch R , Wu N , et al. Modeling the effect of exposure notification and non-pharmaceutical interventions on COVID-19 transmission in Washington state. NPJ Digit Med. 2021;4(1):49. doi:10.1038/s41746-021-00422-7 PubMed Google Scholar Crossref

Chung A , Rimal RN . Social norms: a review. Review of Communication Research. 2016;4:1-28. doi:10.12840/issn.2255-4165.2016.04.01.008 Google Scholar Crossref

Kelly BJ , Hornik RC . Effects of framing health messages in terms of benefits to loved ones or others: an experimental study. Health Commun. 2016;31(10):1284-1290. doi:10.1080/10410236.2015.1062976 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.