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Strong, presumptive physician recommendation of vaccination is one of the most effective methods for increasing vaccine uptake; however, not all physicians recommend vaccines and not all recommendations look the same. Given the extreme importance of increasing vaccination rates in the U.S. for various infectious diseases, the goal of this research project is to better understand the context around recommendations and illuminate specific contexts where vaccination recommendation is underutilized, as well as determine contexts and potential methods for increasing and improving presumptive recommendations.

Misinformation and political polarization have continued to become more prevalent in an age of excess information. Exposing people to both the tactics used to convey misinformation and to weakened forms of misinformation can build up psychological resistance to similar forms of misinformation through a method called prebunking. Prebunking is founded in Inoculation Theory, where susceptibility to misinformation stems from not being familiar with particular tactics used by those who misinform or not having the tools for recognizing misinformation in a particular domain. The gamification of news has proven effective in teaching individuals how to distinguish fact from fiction. Behavioral scientists can incorporate fake and real news into simulations of social media feeds and analyze the actions of subjects through testing. Past studies have shown that playing games just once can boost an individual’s ability to identify misinformation. These have especially been shown to be effective at combating COVID-based misinformation. Examples of such games include Goviral, Bad News game, and Factitious. With this insight, our aim is to adapt these concepts to explore election-related content. Through CAH's partnership with TILT, we have built a gamified tool (Politricks: A Misinformation Game) designed to inoculate against and reduce the impact of election-related misinformation. This game will teach players about manipulation strategies used to spread misinformation and how they can identify and combat these methods.

Hospital employees were among the first groups eligible to receive the COVID-19 vaccine in early 2021. At that time, nationwide discussions of vaccines revolved around the speed of development and testing, sparking fears about safety and efficacy. Yet many hospital employees had spent the prior year witnessing—and often experiencing first-hand—the devastating effects of COVID-19. The combination of strong motivation for vaccination and widespread safety concerns led to questions about how hospital employees, and particularly essential health care workers (HCWs), felt about getting the vaccine in the first phase of its rollout. As first adopters, hospital employees would have a major downstream impact on their patient populations’ decisions to vaccinate or not. We therefore created a survey to ask hospital employees across the U.S. about their major concerns in receiving the COVID-19 vaccine, what messaging themes would be most effective in increasing their likelihood of vaccinating and, for HCWs, how they felt about discussing the vaccine with their patients.

We developed a series of 3 mini-games through which adolescents can practice making financial decisions and overcoming common behavioral biases related to money management. Participants of our survey will include visitors to the NOVA website who play the financial literacy games. The games are aimed at adolescents, but anyone can play them.

While the COVID-19 vaccines represent a triumph of medical science, they may also pose considerable challenges for the uptake of other vaccines. The unprecedented speed of development and testing of COVID-19 vaccines have generated considerable vaccine hesitancy - specifically around questions of safety and efficacy. Additionally, people are being bombarded with misinformation and disinformation around COVID-19 vaccination, which could have negative downstream consequences for other vaccines. The Center for Advanced Hindsight (CAH) is partnering with a large health insurer company to understand how perceptions of the COVID-19 vaccine will affect future vaccination uptake. We will do this by creating a series of studies to collect responses across the summer and fall of 2021 to monitor changes in vaccine hesitancy and reasons for hesitancy over time. We will also assess individual and contextual factors that we expect to influence uptake through different pathways. The study will consist of 2 surveys. The results of the first survey will be used to refine the survey and contribute to the development of a second survey within the same study, which will be sent out a few months after the first survey is sent out. This pre-reg is for survey 1. The following is the goals for survey 1: - Understand how current attitudes toward/perceptions of the COVID-19 vaccine affect perceptions of other vaccinations, with an emphasis on the flu shot. - Assess unique roots of vaccine hesitancy within target demographic groups, such as Black Americans and Latinx Americans. - Create interventions to leverage the continued success of the COVID-19 vaccine to improve uptake of the flu vaccine, while working to mitigate the negative impacts of a potential prolonged pandemic on flu shot uptake.

While the COVID-19 vaccines represent a triumph of medical science, they may also pose considerable challenges for the uptake of other vaccines. The unprecedented speed of development and testing of COVID-19 vaccines have generated considerable vaccine hesitancy - specifically around questions of safety and efficacy. Additionally, people are being bombarded with misinformation and disinformation around COVID-19 vaccination, which could have negative downstream consequences for other vaccines. The Center for Advanced Hindsight (CAH) is partnering with a large health insurer company to understand how perceptions of the COVID-19 vaccine will affect future vaccination uptake. We will do this by creating a series of surveys to collect responses across the summer and fall of 2021 to monitor changes in vaccine hesitancy and reasons for hesitancy over time. We will also assess individual and contextual factors that we expect to influence uptake through different pathways. The study will consist of 2 surveys. The results of the first survey were used to refine the survey and contribute to the development of a second survey within the same study, which will be sent out a few months after the first survey is sent out. This pre-reg is for survey 2. Goals of the current study: (1) Understand how current attitudes toward/perceptions of the COVID-19 vaccine affect perceptions of other vaccinations, with an emphasis on the flu shot. (2) Assess unique roots of vaccine hesitancy within target demographic groups, such as Black Americans and Latinx Americans. (3) Understand how the different three public health campaign messages (vs no message assignment) are related to people’s vaccine attitudes (COVID-19 and flu shot) and vaccine intentions (COVID-19 and flu).

Value-based contracts (VBCs), or contracts where medical providers are paid not on the volume of care they provide but on patient outcomes, are increasingly being adopted across all sectors of the healthcare system. However, very little research has been conducted on provider experiences with value-based contracts – why they opt in or out, what features encourage or discourage VBC use, how providers feel under VBCs. This study will survey providers on a wide variety of topics related to VBCs to provide practical guidance for future efforts to improve provider VBC experiences.

This study was an online survey completed by hospital workers in February of 2021. The current registration was created after the study was run and data were collected. This study had three main research questions: 1. What are health care workers' major concerns around receiving a vaccine against COVID-19? 2. What messaging themes are most effective to increase vaccination against COVID-19? 3. How do health care workers feel about discussing COVID vaccination with their patients? Study Design: After answering some questions about their pre-existing beliefs and attitudes toward COVID vaccination, participants saw one of three messages aimed at increasing their willingness to get vaccinated, or they were assigned to a no-message control group. The messages took the following general approaches: 1. A process-based message about the safety of COVID-19 vaccines despite their rapid development and a reminder that even essential workers, who were first in line to get the new vaccine, were not guinea pigs for it, but were coming after tens of thousands during testing before being offered to the general public. 2. A risk-assessment-based message using a signal detection theory theme. Here we described the idea that all decisions involve some degree of uncertainty and then described the difference in risk between getting the vaccine versus not. 3. An appeal to normalcy message where we asked participants to indicate things they missed about pre-pandemic life, to indicate how long they thought it would be before we could return to 'normal' life, and then asked how much would the participant pay to have that life back. We then described how the vaccine was the way back to that life, and that it did not cost a penny. Data were collected between February and early March of 2021.

We studied behavioral flexibility, or the ability to modify one's behavior in accordance with the changing environment, in pigeons using a reversal-learning paradigm. In two experiments, each session consisted of a series of five-trial sequences involving a simple simultaneous color discrimination in which a reversal could occur during each sequence. The ideal strategy would be to start each sequence with a choice of S1 (the first correct stimulus) until it was no longer correct, and then to switch to S2 (the second correct stimulus), thus utilizing cues provided by local reinforcement (feedback from the preceding trial). In both experiments, subjects showed little evidence of using local reinforcement cues, but instead used the mean probabilities of reinforcement for S1 and S2 on each trial within each sequence. That is, subjects showed remarkably similar behavior, regardless of where (or, in Exp. 2, whether) a reversal occurred during a given sequence. Therefore, subjects appeared to be relatively insensitive to the consequences of responses (local feedback) and were not able to maximize reinforcement. The fact that pigeons did not use the more optimal feedback afforded by recent reinforcement contingencies to maximize their reinforcement has implications for their use of flexible response strategies under reversal-learning conditions.