COVID-19
Conditions
Brief summary
Eligible participants who were active beneficiaries of a large insurer living in Pennsylvania were sent an email encouraging them to download the contact tracing app in Pennsylvania, COVID Alert PA. Participants will be randomly assigned to one of four conditions in a 2 (Self-benefit vs. Other-Benefit) x 2 (Social Norms Present vs. Social Norms absent) design. All participants received an email that said : COVID Alert PA is the official Exposure Notification App from the Pennsylvania Department of Health. Join Penn Medicine in the fight against COVID-19 and download COVID Alert PA today! ---Investigators manipulated the content here--- The app uses Bluetooth to sense when one person is in close contact with another person with the app. If someone tests positive for COVID-19, and they decide to upload the information to the health department, people who have the app and who have been in contact with them will be alerted. If you are interested in downloading the app, please click COVID Alert PA. We appreciate you joining our efforts. Together we can beat COVID-19! In the Other-Benefit condition, it said: It can help you reduce your risk of unknowingly spreading the virus to your friends, family, and larger community. In the Self-Benefit condition, it said: It can help you determine where and when to get testing, and how to get care if you need it. In the Social Norms Present condition, it said: Over 650,000 Pennsylvanians have already downloaded the app! In the Social Norms Absent condition, it said the statement about social norms above. Participants who do not open the initial email received a follow-up email.
Interventions
BEHAVIORALSelf-Benefit/Social Norm
As part of their email, they will read, It can help you determine where and when to get testing, and how to get care if you need it. and Over 650,000 Pennsylvanians have already downloaded the app!
BEHAVIORALSelf-Benefit/No Social Norm
As part of their email, they will read, It can help you determine where and when to get testing, and how to get care if you need it. They will not read any information about the number of Pennsylvanians who downloaded the app.
BEHAVIORALOther Benefit/Social Norm
As part of their email, they will read, It can help you reduce your risk of unknowingly spreading the virus to your friends, family, and larger community. and Over 650,000 Pennsylvanians have already downloaded the app!
BEHAVIORALOther Benefit/No Social Norm
As part of their email, they will read, It can help you reduce your risk of unknowingly spreading the virus to your friends, family, and larger community. They will not read any information about the number of Pennsylvanians who downloaded the app.
Sponsors
Pennsylvania Department of Health
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Participants were unaware they were participating in a study, and were thus blinded to their treatment assignment.
Intervention model description
This is a 2 (Self-Benefit vs. Other-Benefit) x 2 (Social Norm vs. No Social Norm) design. There are thus four conditions total.
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Eligible participants were active beneficiaries of a large insurer living in Pennsylvania.
Exclusion criteria
* Participants who did not subscribe to offers and promotions emails were excluded, as were Medigap beneficiaries.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Click on Link to Download COVID Alert PA App | 48 days | The investigators measured choice to click on the link to download the COVID Alert PA app or not, conditional on opening the email. Because participants may not immediately open their e-mail, or may return to the e-mail to click the link, we allowed for a period of approximately 7 weeks or 48 days from date of initial e-mail for completion of outcome measure. |
Countries
United States
Participant flow
Recruitment details
39,938 Pennsylvania members of a larger insurer were randomly assigned to receive one email in a 2 (Focus on Self vs. Focus on Others) x 2 (Social Norm vs. No Social Norm) design. 16,903 members opened the e-mail - this is considered enrollment for the purposes of our study.
Pre-assignment details
For this study, participants are considered enrolled once they open the e-mail that is sent to them by the large private insurer.
Participants by arm
| Arm | Count |
|---|---|
| Self-Benefit/Social Norm As part of their email, they read, It can help you determine where and when to get testing, and how to get care if you need it. and Over 650,000 Pennsylvanians have already downloaded the app!
Self-Benefit/Social Norm: As part of their email, they will read, It can help you determine where and when to get testing, and how to get care if you need it. and Over 650,000 Pennsylvanians have already downloaded the app! | 4,232 |
| Self-Benefit/No Social Norm As part of their email, they read, It can help you determine where and when to get testing, and how to get care if you need it. They did not read any information about the number of Pennsylvanians who downloaded the app.
Self-Benefit/No Social Norm: As part of their email, they will read, It can help you determine where and when to get testing, and how to get care if you need it. They will not read any information about the number of Pennsylvanians who downloaded the app. | 4,246 |
| Other Benefit/Social Norm As part of their email, they read, It can help you reduce your risk of unknowingly spreading the virus to your friends, family, and larger community. and Over 650,000 Pennsylvanians have already downloaded the app!
Other Benefit/Social Norm: As part of their email, they will read, It can help you reduce your risk of unknowingly spreading the virus to your friends, family, and larger community. and Over 650,000 Pennsylvanians have already downloaded the app! | 4,211 |
| Other Benefit/No Social Norm As part of their email, they read, It can help you reduce your risk of unknowingly spreading the virus to your friends, family, and larger community. They did not read any information about the number of Pennsylvanians who downloaded the app.
Other Benefit/No Social Norm: As part of their email, they will read, It can help you reduce your risk of unknowingly spreading the virus to your friends, family, and larger community. They will not read any information about the number of Pennsylvanians who downloaded the app. | 4,214 |
| Total | 16,903 |
Baseline characteristics
| Characteristic | Other Benefit/Social Norm | Total | Other Benefit/No Social Norm | Self-Benefit/No Social Norm | Self-Benefit/Social Norm |
|---|---|---|---|---|---|
| Age, Continuous | 46.74 years STANDARD_DEVIATION 13.39 | 46.93 years STANDARD_DEVIATION 13.35 | 46.83 years STANDARD_DEVIATION 13.43 | 47.31 years STANDARD_DEVIATION 13.26 | 46.85 years STANDARD_DEVIATION 13.33 |
| Race and Ethnicity Not Collected | — | 0 Participants | — | — | — |
| Region of Enrollment United States | 4211 participants | 16903 participants | 4214 participants | 4246 participants | 4232 participants |
| Sex/Gender, Customized Female | 2449 Participants | 9937 Participants | 2416 Participants | 2560 Participants | 2512 Participants |
| Sex/Gender, Customized Male | 1762 Participants | 6966 Participants | 1798 Participants | 1686 Participants | 1720 Participants |
| Sex/Gender, Customized Unknown | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 4,232 | 0 / 4,246 | 0 / 4,211 | 0 / 4,214 |
| other Total, other adverse events | 0 / 4,232 | 0 / 4,246 | 0 / 4,211 | 0 / 4,214 |
| serious Total, serious adverse events | 0 / 4,232 | 0 / 4,246 | 0 / 4,211 | 0 / 4,214 |
Outcome results
Primary
Click on Link to Download COVID Alert PA App
The investigators measured choice to click on the link to download the COVID Alert PA app or not, conditional on opening the email. Because participants may not immediately open their e-mail, or may return to the e-mail to click the link, we allowed for a period of approximately 7 weeks or 48 days from date of initial e-mail for completion of outcome measure.
Time frame: 48 days
Population: Pennsylvania members of large private insurer.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Self-Benefit/Social Norm | Click on Link to Download COVID Alert PA App | Number opened e-mail | 4232 Participants |
| Self-Benefit/Social Norm | Click on Link to Download COVID Alert PA App | Number clicked link | 353 Participants |
| Self-Benefit/No Social Norm | Click on Link to Download COVID Alert PA App | Number clicked link | 380 Participants |
| Self-Benefit/No Social Norm | Click on Link to Download COVID Alert PA App | Number opened e-mail | 4246 Participants |
| Other Benefit/Social Norm | Click on Link to Download COVID Alert PA App | Number opened e-mail | 4211 Participants |
| Other Benefit/Social Norm | Click on Link to Download COVID Alert PA App | Number clicked link | 355 Participants |
| Other Benefit/No Social Norm | Click on Link to Download COVID Alert PA App | Number opened e-mail | 4214 Participants |
| Other Benefit/No Social Norm | Click on Link to Download COVID Alert PA App | Number clicked link | 744 Participants |