Integrating Operant and Cognitive Behavioral Economics to Inform Infectious Disease Response: Prevention, Testing, and Vaccination in the COVID-19 Pandemic

Abstract

The role of human behavior to thwart transmission of infectious diseases like COVID-19 is evident. Yet, many areas of psychological and behavioral science are limited in the ability to mobilize to address exponential spread or provide easily translatable findings for policymakers. Here we describe how integrating methods from operant and cognitive approaches to behavioral economics can provide robust policy relevant data. Adapting well validated methods from behavioral economic discounting and demand frameworks, we evaluate in four crowdsourced samples (total N = 1,366) behavioral mechanisms underlying engagement in preventive health behaviors. We find that people are more likely to social distance when specified activities are framed as high risk, that describing delay until testing (rather than delay until results) increases testing likelihood, and that framing vaccine safety in a positive valence improves vaccine acceptance. These findings collectively emphasize the flexibility of methods from diverse areas of behavioral science for informing public health crisis management.

The Effectiveness of Interventions for Increasing COVID-19 Vaccine Uptake: A Systematic Review

“…In an online RCT, doing so decreased vaccine hesitancy in strongly hesitant individuals [ 20 ]. Furthermore, in an online experiment (pre-print), participants were more likely to accept less effective vaccines if the development process took 12 rather than 7 months [ 32 ]. However, a message detailing the development process (pre-print) did not increase vaccination intention compared to no message in an online RCT in the US [ 22 ].…”

“…There was mixed effectiveness of framing on vaccination intention, although the evidence is limited. An online experiment (pre-print) found that positive framing of vaccine safety (95% safe) increased acceptance of less effective vaccines compared to negative framing (5% unsafe) [ 32 ]. On the other hand, an online RCT did not find a difference in intention when a news article framed vaccination protection against the virus negatively as opposed to positively [ 31 ].…”

“…An online experiment found that pre-scheduling a vaccination appointment for an individual increased vaccine intention compared to asking participants if they wanted to receive the vaccine [ 47 ]. Another online study (pre-print) found that pre-selecting ‘yes’ or ‘no’ options as responses for wanting to receive the vaccine did not have an impact on vaccine acceptance [ 32 ].…”

“…Although this provides preliminary insight into the effectiveness of interventions, it does not always reflect real-life behaviours [ 16 ]. In addition, a minority of studies did not include a control group [ 32 , 43 ], so it is not possible to identify the extent of the intervention’s effectiveness.…”

Predictors of COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers in Southern California: Not Just “Anti” vs. “Pro” Vaccine

“…For instance, some hospitals use peer pressure to encourage vaccination (e.g., HCWs wearing "I am vaccinated" badges, public posting of vaccination rates) [48]. Pre-scheduling vaccination appointments or providing vaccination bonuses are promising evidence-based nudges to reach this group [49]. Additionally, messaging promoting prosocial motivations (e.g., protecting one's community from COVID-19) can enhance vaccination intentions in this group [50].…”