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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

Digital contact tracing smartphone applications (apps) can mitigate the spread of COVID-19 through exposure notification.14 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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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

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

Data Sharing Statement: See Supplement 3.

References
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Ferretti  L , Wymant  C , Kendall  M ,  et al.  Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing.   Science. 2020;368(6491):eabb6936. doi:10.1126/science.abb6936 PubMedGoogle Scholar
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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 PubMedGoogle ScholarCrossref
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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 PubMedGoogle ScholarCrossref
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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 PubMedGoogle ScholarCrossref
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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 ScholarCrossref
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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 PubMedGoogle ScholarCrossref
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