BackgroundClinical decision support (CDS) tools improve clinical diagnostic decision making and patient safety. The availability of CDS to health care professionals has grown in line with the increased prevalence of apps and smart mobile devices. Despite these benefits, patients may have safety concerns about the use of mobile devices around medical equipment.ObjectiveThis research explored the engagement of junior doctors (JDs) with CDS and the perceptions of patients about their use. There were three objectives for this research: (1) to measure the actual usage of CDS tools on mobile devices (mCDS) by JDs, (2) to explore the perceptions of JDs about the drivers and barriers to using mCDS, and (3) to explore the perceptions of patients about the use of mCDS.MethodsThis study used a mixed-methods approach to study the engagement of JDs with CDS accessed through mobile devices. Usage data were collected on the number of interactions by JDs with mCDS. The perceived drivers and barriers for JDs to using CDS were then explored by interviews. Finally, these findings were contrasted with the perception of patients about the use of mCDS by JDs.ResultsNine of the 16 JDs made a total of 142 recorded interactions with the mCDS over a 4-month period. Only 27 of the 114 interactions (24%) that could be categorized as on-shift or off-shift occurred on-shift. Eight individual, institutional, and cultural barriers to engagement emerged from interviews with the user group. In contrast to reported cautions and concerns about the impact of clinicians’ use of mobile phone on patient health and safety, patients had positive perceptions about the use of mCDS.ConclusionsPatients reported positive perceptions toward mCDS. The usage of mCDS to support clinical decision making was considered to be positive as part of everyday clinical practice. The degree of engagement was found to be limited due to a number of individual, institutional, and cultural barriers. The majority of mCDS engagement occurred outside of the workplace. Further research is required to verify these findings and assess their implications for future policy and practice.

People often overestimate others' support for their views (false consensus effect). Recent research has shown that this is particularly marked in the relation between perceived consensus and prejudice. The current research asked whether this partly arises in an in‐group stereotype of the community as prejudiced. We investigated relations between different sources of normative information (self, media, peers), estimates of community attitudes, and perceived consensus in a sample of 135 community members. Media prejudice predicted community attitudes, and this further predicted consensus. However, strongest was a direct relation between own prejudice and perceived consensus. The results indicate a desire to appear nonprejudiced, relative to others. Confronting prejudiced people with information about community norms is a promising intervention under these circumstances.

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Existing participatory research approaches have failed to identify innovative methods that overcome the persistent barriers to adolescent sexual and reproductive health service demand and access. Increasingly, programmers have turned to human-centered design (HCD), a problem-solving process that centers the needs, perspectives, and experiences of people, when developing solutions to complex SRH challenges. This article describes the application of a youth-engaged version of HCD as part of Adolescents 360, a transdisciplinary initiative to increase 15- to 19-year-old girls’ use of modern contraception in Nigeria, Ethiopia, and Tanzania. Youth-adult design teams (including 111 “youth designers” trained in HCD methods) undertook formative research to inform the design and implementation of interventions. We reflect on the practical implications of using instrumental strategies of HCD with a youth-led participatory approach. Our experience indicates that (1) engaging youth as project partners in transdisciplinary teams requires planned and dedicated financial and human resources; (2) involving youth as action researchers can help identify opportunities to improve program empathy and responsiveness; (3) it is difficult to recruit “extreme users” as project partners because of the high competencies needed in HCD; (4) centering empathy and employing design standards during prototyping can drive decision-making and resolve questions raised by conflicting evidence claims in existing bodies of literature; and (5) testing tangible services and products in real-world settings continues long after the intervention design phase. Youth-adult partnership should continue throughout this iterative and adaptive phase to ensure that the adolescent experience of the intervention remains at the core of intervention delivery.

The use of behavioral science interventions, and particularly social norms, in tax compliance is a growing industry for scholars and practitioners alike in recent years. However, the causal mechanism of these interventions is unknown, where effects could be explained by a pro-social desire to support one's community, conditional cooperation, desire to conform, or fear of reprisals. We conduct a field experiment in local government taxation in the United Kingdom which tests the effectiveness of a social (descriptive) norm against a control condition and against messages that highlight the enforcement process. The social norm outperforms enforcement salience, suggesting that this explanation, although more powerful than the control, does not fully explain compliance effects. This study further provides evidence that social norm type interventions can be effective at the subnational level, a context where previous work has shown they may produce null effects.