Consumers' perceptions of energy use and energy savings: A literature review

Background. Policy makers and program managers need to better understand consumers' perceptions of their energy use and savings to design effective strategies for promoting energy savings. Methods. We reviewed 14 studies from the emerging interdisciplinary literature examining consumers' perceptions electricity use by specific appliances, and potential savings. Results. We find that: (1) electricity use is often overestimated for low-energy consuming appliances, and underestimated for high-energy consuming appliances; (2) curtailment strategies are typically preferred over energy efficiency strategies; (3) consumers lack information about how much electricity can be saved through specific strategies; (4) consumers use heuristics for assessing the electricity use of specific appliances, with some indication that more accurate judgments are made among consumers with higher numeracy and stronger pro-environmental attitudes. However, design differences between studies, such as variations in reference points, reporting units and assessed time periods, may affect consumers' reported perceptions. Moreover, studies differ with regard to whether accuracy of perceptions was evaluated through comparisons with general estimates of actual use, self-reported use, household-level meter readings, or real-time smart meter readings. Conclusion. Although emerging findings are promising, systematic variations in the measurement of perceived and actual electricity use are potential cause for concern. We propose avenues for future research, so as to better understand, and possibly inform, consumers' perceptions of their electricity use. Ultimately, this literature will have implications for the design of effective electricity feedback for consumers, and related policies

Implementing a New Common Rule Requirement for Informed Consent: A Randomized Trial on Adult Asthma Patients

Objectives. To determine how the format of a clinical trial informed consent document can affect participants’ retention of enrollment-relevant information. Background. Recent changes to the US Federal Common Rule require informed consent documents for clinical trials to be concise and start with the information most relevant for enrollment decisions. However, there is limited guidance on how to identify this information or evaluate its impact. Design. Participants with a self-reported asthma diagnosis were randomized to one of five versions of the informed consent document for a clinical trial of an injectable asthma product: the original, full-length document; a concise version, removing information identified by asthma patients in an earlier study as not relevant to their enrollment decisions; an interactive version, where participants self-navigated to the information they chose; a reordered version, moving up information deemed more relevant for enrollment in an earlier study; and a highlights version, following the suggested revised Common Rule structure, starting with a summary of enrollment-relevant information based on patient ratings. Knowledge acquisition was evaluated with a knowledge test, with submeasures for information that had high and low relevance for enrollment decisions. Results. Participants who saw the highlights (“Common Rule”) version were more likely to answer questions about high enrollment-relevant information correctly than were participants who saw the full-length version (65% v 59%, P = 0.0105). Participants who saw the other revised versions did not perform significantly differently from the full-length version. Conclusions. An informed consent document designed to implement revised US Federal Common Rule requirements performed better than other designs, in terms of readers retaining information relevant for clinical trial enrollment, as characterized by potential trial participants in a separate study

Showing without telling: Indirect identification of psychosocial risks during andafter pregnancy

During the perinatal period, psychosocial health risks, including depression and intimate partner violence, are associatedwith serious adverse health outcomes for both parent and child. To appropriately intervene, healthcare professionals mustfirst identify those at risk, yet stigma often prevents people from disclosing the information needed to prompt an assess-ment. We use techniques from natural language processing to indirectly identify psychosocial risks in the perinatal period.We apply latent Dirichlet allocation (LDA) and latent semantic indexing (LSI) to categorize themes from brief diary entriesby pregnant and postpartum women and apply sentiment analysis to characterize affect, then perform regularized regres-sion to predict diagnostic measures of depression and emotional intimate partner violence. Journal text entries quantifiedthrough sentiment analysis and topic models show promise for improved identification of depression and intimate partnerviolence, both stigmatized risks. Such methods may serve as an initial or complementary screening approach

Assessing How Consumers Interpret and Act on Results from At-Home COVID-19 Self-test Kits : A Randomized Clinical Trial

Importance: The US Food and Drug Administration (FDA) authorized SARS-CoV-2 rapid at-home self-test kits for individuals with and without symptoms. How appropriately users interpret and act on the results of at-home COVID-19 self-tests is unknown. Objective: To assess how users of at-home COVID-19 self-test kits interpret and act on results when given instructions authorized by the FDA, instructions based on decision science principles, or no instructions. Design, Setting, and Participants: A randomized clinical trial was conducted of 360 adults in the US who were recruited in April 2021 to complete an online survey on their interpretation of at-home COVID-19 self-test results. Participants were given 1 of 3 instruction types and were presented with 1 of 4 risk scenarios. Participants were paid $5 and had a median survey completion time of 8.7 minutes. Data analyses were performed from June to July 2021. Intervention: Participants were randomized to receiving either the FDA-authorized instructions (authorized), the intervention instructions (intervention), or no instructions (control), and to 1 of 4 scenarios: 3 with a high pretest probability of infection (COVID-19 symptoms and/or a close contact with COVID-19) and 1 with low pretest probability (no symptoms and no contact). The intervention instructions were designed using decision science principles. Main Outcomes and Measures: Proportion of participants in the high pretest probability scenarios choosing to quarantine per federal recommendations and perceived probabilities of infection given a negative or positive COVID-19 test result. A Bonferroni correction accounted for multiple comparisons (3 instruction types × 4 scenarios; α = 0.004). Results: After excluding 22 individuals who completed the survey too quickly, the responses of 338 participants (median [IQR] age, 38 [31 to 48] years; 154 (46%) women; 215 (64%) with a college degree or higher) were included in the study analysis. Given a positive test result, 95% (322 of 338; 95% CI, 0.92 to 0.97) of the total participants appropriately chose to quarantine regardless of which instructions they had received. Given a negative test result, participants in the high pretest probability scenarios were more likely to fail to quarantine appropriately with the authorized instructions (33%) than with the intervention (14%; 95% CI for the 19% difference, 6% to 31%; P =.004) or control (24%; 95% CI for the 9% difference,-4% to 23%; P =.02). In the low pretest probability scenario, the proportion choosing unnecessary quarantine was higher with the authorized instructions (31%) than with the intervention (22%; 95% CI for the 9% difference,-14% to 31%) or control (10%; 95% CI for the 21% difference, 0.5% to 41%)-neither comparison was statistically significant (P =.05 and P =.20 respectively). Conclusions and Relevance: The findings of this randomized clinical trial indicate that at-home COVID-19 self-test kit users relying on the authorized instructions may not follow the Centers for Disease Control and Prevention's quarantine recommendations, producing unintended risks and unnecessary disruptions. Redesigned instructions that follow decision science principles may improve compliance. Trial Registration: ClinicalTrials.gov Identifier: NCT04758299

The impact of over-the-counter availability of "Plan B" on teens' contraceptive decision making

In ruling on the over-the-counter status (OTC) of the emergency contraceptive, "Plan B", the US Food and Drug Administration (FDA) questioned whether younger adolescent females could adequately self-select and self-medicate. That determination requires a judgment of fact, regarding how increased emergency contraceptive availability would affect adolescents' behavior, and a judgment of values, regarding the acceptability of different outcomes. We present a general approach to such problems, using analytical and empirical methods grounded in behavioral decision research. We illustrate it with findings from 30 in-depth interviews and follow-up surveys, with adolescent females aged 13-19 in the Pittsburgh area reporting how Plan B availability would affect three decisions (having sex, choosing contraceptives, using Plan B). Although the FDA expressed concern about younger teens using Plan B as their primary form of contraception, neither younger nor older teens revealed such an intention. However, teens preferred easier availability, should emergency contraceptive be needed. Incorporating an understanding of teens' decision-related perspectives can make such policies more predictable and transparent.Adolescents Sexual behavior Emergency contraception Decision-making competence Drug regulation USA

PROTOCOL for at home self-testing kits for SARS-CoV-2: A randomized trial assessing how consumers interpret and act on hypothetical test results

A randomized trial to assess how consumers interpret hypothetical SARS-CoV-2 home test kit results and whether they report plans to take CDC-recommended actions to protect themselves and others, given their test results and two critical aspects of their clinical context: symptoms and recent close exposure

The Impact of Over-the-Counter Availability of "Plan B" on Teens' Contraceptive Decision Making

In ruling on the over-the-counter status (OTC) of the emergency contraceptive, “Plan B”, the US Food and Drug Administration (FDA) questioned whether younger adolescent females could adequately self-select and self-medicate. That determination requires a judgment of fact, regarding how increased emergency contraceptive availability would affect adolescents' behavior, and a judgment of values, regarding the acceptability of different outcomes. We present a general approach to such problems, using analytical and empirical methods grounded in behavioral decision research. We illustrate it with findings from 30 in-depth interviews and follow-up surveys, with adolescent females aged 13–19 in the Pittsburgh area reporting how Plan B availability would affect three decisions (having sex, choosing contraceptives, using Plan B). Although the FDA expressed concern about younger teens using Plan B as their primary form of contraception, neither younger nor older teens revealed such an intention. However, teens preferred easier availability, should emergency contraceptive be needed. Incorporating an understanding of teens' decision-related perspectives can make such policies more predictable and transparent

COVID-19 Information Sources and Health Behaviors During Pregnancy: Results From a Prenatal App-Embedded Survey

BackgroundPregnancy is a time of heightened COVID-19 risk. Pregnant individuals’ choice of specific protective health behaviors during pregnancy may be affected by information sources. ObjectiveThis study examined the association between COVID-19 information sources and engagement in protective health behaviors among a pregnant population in a large academic medical system. MethodsPregnant patients completed an app-based questionnaire about their sources of COVID-19 information and engagement in protective health behaviors. The voluntary questionnaire was made available to patients using a pregnancy app as part of their routine prenatal care between April 21 and November 27, 2020. ResultsIn total, 637 pregnant responders routinely accessed a median of 5 sources for COVID-19 information. The most cited source (79%) was the Centers for Disease Control and Prevention (CDC). Self-reporting evidence-based protective actions was relatively common, although 14% self-reported potentially harmful behaviors to avoid COVID-19 infection. The CDC and other sources were positively associated with engaging in protective behaviors while others (eg, US president Donald Trump) were negatively associated with protective behaviors. Participation in protective behaviors was not associated with refraining from potentially harmful behaviors (P=.93). Moreover, participation in protective behaviors decreased (P=.03) and participation in potentially harmful actions increased (P=.001) over the course of the pandemic. ConclusionsPregnant patients were highly engaged in COVID-19–related information-seeking and health behaviors. Clear, targeted, and regular communication from commonly accessed health organizations about which actions may be harmful, in addition to which actions offer protection, may offer needed support to the pregnant population