RAPID: How uncertainty about risk and conflicting messages affect preventive behaviors against Covid-19

冠状病毒爆发对我们的卫生系统构成了重大挑战。当人们生病需要医疗护理时，他们需要医院病床和呼吸机等资源。然而，如果许多人在短时间内生病，这些资源将不足以照顾所有人。如果我们要用尽可能好的医疗护理来治疗每一个病人，我们就需要预防和推迟新的感染。我们从历史和医学中知道，公众行为是预防这种疾病的最重要工具。但是，为了让公众提供帮助，人们需要知道做什么和如何做，以及理解为什么这些行为如此重要。人们从周围的人那里获得线索，以理解新的、不确定的情况。因此，确保每个人都能获得有关新冠肺炎风险以及如何预防的良好信息非常重要。官方信息需要反映科学知识，社区中出现的神话需要得到解决，以便人们能够理解并揭穿它们。研究团队一直在研究人们如何看待新冠肺炎的风险，以及他们正在做些什么来保护自己和社区。这项研究的一个关键发现是，当人们对风险不确定时，他们更有可能依靠其他人的做法来确定正确的做法。研究小组还发现，人们对社交距离的主要担忧是，他们担心没有薪水也能勉强度日，以及如何获得食物和满足其他紧急需求。该项目涉及调查和实验，以更好地了解这些问题，并提供新的知识，以帮助指导政策行动。首先，我们需要知道帮助人们了解如何预防感染是否真的会导致他们保护自己。这些实验测试并确定了如何最好地帮助人们理解，特别是那些没有完全参与社交距离的人。然后，在接下来的几个月里，随着情况的变化，研究团队开发信息，帮助人们了解正在发生的事情，以及他们的行为如何有助于保护自己和周围的人。2020年3月初，研究人员进行了一项探索性调查，以确定一些保护行为是否被报告为低水平，并确定依从性差的预测因素。研究表明，遵守更极端的社交距离行为似乎取决于社会规范，当其他人似乎没有参与这种距离时，比率较低。此外，人们似乎依赖于这些规范，特别是当他们对风险有更多的不确定性时。调查结果还显示，对失去工资和个人计划中断的担忧最能预测预期的不遵守留在家中的命令，其次是需要购买食物和其他紧急需求。这些研究结果表明，旨在让人们度过经济和后勤困难的政策方法至关重要，并有可能产生很大影响。新的研究更深入地探讨了这些问题以及它们与保护行动的关系。第一阶段确定哪些预测因素对保护行为有因果影响。第二阶段是评估保护行为的执行情况，并确定在第一阶段确定的具有全国代表性的样本（高风险地理位置的过采样）的因果预测因素。在第三阶段，针对每一个因果因素进行迭代，团队在试验台环境中开发和试点信息，在全国样本中使用实验设计测试最终信息（随着环境和流行病的演变定期重复），并对关键信息的子集进行为期3天的重新测试，以评估行为变化。最后，对于每个有效的消息，团队再次迭代地沿着推荐的消息，以及它们为什么有用以及如何理解它们的工作原理。这个奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

The coronavirus outbreak poses a major challenge for our health system. As people become sick and need medical care, they need resources like hospital beds and ventilators. However, if many people become sick in a short period of time, there will not be enough of these resources to care for them all. If we are to treat every sick person with the best possible medical care, we need to both prevent and delay new infections. We know from history and medical science that public behavior is the most important tool for this prevention. But for the public to help, people need to know what to do and how to do it, as well as to understand why these behaviors are so important. People take their cues from those around them in making sense of new, uncertain situations. This makes it important to make sure that everybody is getting good information about the risks of Covid-19 and how to prevent it. Official messages need to reflect scientific knowledge, and myths that pop up in communities need to be addressed so that people can understand and debunk them. The research team has been studying how people are thinking about the risks of Covid-19, and what they are doing to protect themselves and their community. One key finding from that work is that when people are uncertain about the risk, they are more likely to rely on what other people are doing to determine what the right thing to do is. The team also finds that people's main concerns about social distancing are that they are worried about getting by without a paycheck and how they will get food and meet other urgent needs. This project involves surveys and experiments to better understand these concerns and provide new knowledge to help guide policy action. First, we need to know whether helping people understand how to prevent infection will actually lead them to protect themselves. The experiments test and identify how best to help people understand, especially for those who are not fully engaging in social distancing. Then, over the next few months as the situation changes, the research team develops messages to help people understand what is happening and how their behavior can help protect themselves and the people around them.In early March 2020, the researchers conducted an exploratory survey to determine whether some protective behaviors were reported at low levels and identify predictors of poor compliance. The research showed that compliance with the more extreme social distancing behaviors appear to be dependent on social norms, with rates being lower when other people do not seem to be engaging in such distancing. Furthermore, people appear to rely on those norms particularly when they experience more uncertainty about the risk. The findings also were that concerns about losing pay and disruption of personal plans are most predictive of anticipated failures to comply with orders to stay home, followed by the need to shop for food and other urgent needs. These findings suggest that a policy approach aimed at getting people through financial and logistical hardship is critically important and has the potential to be highly impactful. The new research explores more deeply these concerns and how they relate to protective actions. The first phase establishes which predictive factors have causal influence on protective behaviors. The second phase is an assessment of how well protective behaviors are being performed and identifies causally predictive factors identified in the first phase for a nationally representative sample (oversampling high-risk geographical locations). In the third phase, iteratively for each causal factor, the team develops and pilots messages in a test-bed environment, testing final messages with an experimental design in a national sample (repeating regularly as the environment and pandemic evolve), and following up on a subset of critical messages with a 3-day retest to assess behavior change. Finally, again iteratively for each effective message, the team disseminates recommended messages along with the rationale for why they are useful and how they are understood to work. The team shares its findings with its established network of public health officials.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.