Changing collective behaviour and supporting non-pharmaceutical interventions is an important component in mitigating virus transmission during a pandemic. In a large international collaboration (Study 1, N = 49,968 across 67 countries), we investigated self-reported factors associated with public health behaviours (e.g., spatial distancing and stricter hygiene) and endorsed public policy interventions (e.g., closing bars and restaurants) during the early stage of the COVID-19 pandemic (April-May 2020). Respondents who reported identifying more strongly with their nation consistently reported greater engagement in public health behaviours and support for public health policies. Results were similar for representative and non-representative national samples. Study 2 (N = 42 countries) conceptually replicated the central finding using aggregate indices of national identity (obtained using the World Values Survey) and a measure of actual behaviour change during the pandemic (obtained from Google mobility reports). Higher levels of national identification prior to the pandemic predicted lower mobility during the early stage of the pandemic (r = −0.40). We discuss the potential implications of links between national identity, leadership, and public health for managing COVID-19 and future pandemics.

Understanding human cooperation is a major scientific challenge. While cooperation is typically explained with reference to individual preferences, a recent cognitive process view hypothesized that cooperation is regulated by socially acquired heuristics. Evidence for the social heuristics hypothesis rests on experiments showing that time-pressure promotes cooperation, a result that can be interpreted as demonstrating that intuition promotes cooperation. This interpretation, however, is highly contested because of two potential confounds. First, in pivotal studies compliance with time-limits is low and, crucially, evidence shows intuitive cooperation only when noncompliant participants are excluded. The inconsistency of test results has led to the currently unresolved controversy regarding whether or not noncompliant subjects should be included in the analysis. Second, many studies show high levels of social dilemma misunderstanding, leading to speculation that asymmetries in understanding might explain patterns that are otherwise interpreted as intuitive cooperation. We present evidence from an experiment that employs an improved time-pressure protocol with new features designed to induce high levels of compliance and clear tests of understanding. Our study resolves the noncompliance issue, shows that misunderstanding does not confound tests of intuitive cooperation, and provides the first independent experimental evidence for intuitive cooperation in a social dilemma using time-pressure.

Manipulations for activating reflective thinking, although regularly used in the literature, have not previously been systematically compared. There are growing concerns about the effectiveness of these methods as well as increasing demand for them. Here, we study five promising reflection manipulations using an objective performance measure — the Cognitive Reflection Test 2 (CRT-2). In our large-scale preregistered online experiment (N = 1,748), we compared a passive and an active control condition with time delay, memory recall, decision justification, debiasing training, and combination of debiasing training and decision justification. We found no evidence that online versions of the two regularly used reflection conditions — time delay and memory recall — improve cognitive performance. Instead, our study isolated two less familiar methods that can effectively and rapidly activate reflective thinking: (1) a brief debiasing training, designed to avoid common cognitive biases and increase reflection, and (2) simply asking participants to justify their decisions.

Background Influenza vaccine uptake remains low worldwide, inflicting substantial costs to public health. Messages promoting social welfare have been shown to increase vaccination intentions, and it has been recommended that health professionals communicate the socially beneficial aspects of vaccination. We provide the first test whether this prosocial vaccination hypothesis applies to actual vaccination behaviour of high-risk patients. Methods In a field experiment at a tertiary care public hospital in Istanbul, Turkey, we compare the effects of two motivational messages for promoting vaccination. Using a between-subjects single-blind experimental design patients were randomly assigned to frames emphasizing the vaccine’s benefits to self (n = 125) or social benefits (n = 119). Free influenza vaccination was offered to each patient. Results Among 222 patients who were not vaccinated for the season prior to the study (72% medically assessed to be at high risk), 42% in the self-benefit frame chose to receive a vaccination compared with 34% in the social-benefits frame, but the difference was not statistically significant (aOR = 1.63, 95% CI 0.90 to 2.95, p = 0.108). Reasons for vaccination focused primarily on self-benefit (67%) rather than social-benefit (5%). Exploratory analysis showed that the effect of messages depended on patient perception of risk group membership (aORHigh / aORLow = 5.59, 95% CI 1.30 to 24.05, p = 0.021). In particular, emphasis on self-benefit was more influential among patients who perceived themselves to be in the risk group (aOR = 6.22, 95% CI 1.69 to 22.88, p = 0.006). Conclusions In contrast to the literature observing intentions of low-risk populations, we found no evidence that social-benefit motivates actual vaccination behaviour among a high-risk patient population. Instead, those who self-categorize as being in the high risk group are more motivated by the self-benefit message. Our results suggest that a stratified approach can improve coverage: even if an emphasis on social-benefit could be effective among low-risk groups, an emphasis on self-benefit holds more promise for increasing vaccination in medical organizational settings where high-risk groups are prevalent. Trial registration ClinicalTrials.gov NCT04230343 Retrospectively registered on the 13th January 2020.