Internet Panel Research Articles

Fathers’ participation in the HPV vaccination decision-making process doesn’t increase parents’ intention to make daughters get the vaccine

ABSTRACT Introduction The HPV vaccination rate in Japan has been dismally low. Our previous survey work found that mothers in Japan, who have a strong influence over their daughters, often are receptive to the fathers’ participation in the family’s decision-making process about getting their daughter HPV vaccinated. Methods We conducted a survey to investigate the nature of the influence of fathers’ participation on the mother’s decision-making process. From an internet survey panel, we selected a pool of 1,499 eligible mothers who had 12–18 years old daughters. The mothers were randomized into three Groups. To the mothers in Group A, we gave an educational leaflet regarding HPV vaccination and a second leaflet which recommended that they talk with their husbands about the vaccination. To Group B, we gave only the educational leaflet. No leaflets were sent to Group C. A structured survey questionnaire was then distributed through the internet to the mothers. Results In Groups A, B, and C, their intention to have their daughter receive the HPV vaccine was 21.6%, 20.7% and 8.2%, respectively. The percent of Group A mothers who thought their husband’s opinion was important for when they made the decision was significantly higher (70%) than in Group B (56.6%) or Group C (47.1%). Conclusions The fathers’ participation in the mothers’ decision-making does not increase the likelihood of HPV vaccination for their daughters. On the other hand, the educational leaflet proved to be effective for this cause.

The relations between materialism, consumer decisions and advertising perception

Abstract The goal of the study was to explore whether materialism, defined as being overly interested in money and material goods and attributing them too big a role in life, is related to consumer financial decisions and advertising perception. The study was conducted among members of an internet research panel on a nationwide random quota sample (n=1.062). The results showed that many consumer decisions depend on the level of materialism as measured by the Material Values Scale (MVS) [1]. More materialistic people showed a higher inclination to spending money over saving. Materialism is also influencing consumer decisions relating to borrowing money: people with higher materialistic attitudes take out credits or loans and do so irresponsibly more often. Moreover, nonmaterialists while confronted with a marketing offer which is beyond their financial capabilities more often choose to resign, whereas materialists rather decide on finding additional money (from extra work or loans). Materialists also react differently to advertising communication referring to materialistic values. An advertising message referring to materialistic values decreases the perception of the product and company in the eyes of nonmaterialists, while materialists react to such communication less negatively.

Integrating Large-Scale Online Surveys and Aggregate Data at the Constituency Level: The Estimation of Voter Transitions in the 2015 British General Elections

What have been the underlying voter shifts that led to the victory of the Con-servative Party in the 2015 British general election – against all predictions bypollsters? Analyses of voter transitions based on (online) surveys and recall ques-tions are plagued by sampling and response biases, whereas aggregate data analysesare suspect of the well-known ecological fallacy. We propose a systematic statisticalcombination of individual and aggregate data at the constituency level to identifyregional electoral shifts between the 2010 to 2015 British general elections, with aparticular focus on England. Large-scale individual data collected by the BritishElection Study Internet Panel (BESIP) allow us to locate more than 28,000 respon-dents in their constituencies. We estimate transitions based on a recently developedBayesian Hierarchical Hybrid Multinomial Dirichlet (HHMD) model. We discovera clear deviance from pure RxC ecological inference and from pure online panel-based estimations of transition matrices. Convergence diagnostics corroborate thesuperiority of the hybrid models.

Preferences Over Taxation of High-Income Individuals: Evidence from a Survey Experiment

Mobility of high-income individuals across borders puts pressure on governments to lower taxes. A central tenet of the corresponding textbook argument is that mobile individuals react to tax differentials through migration, and in turn immobile individuals vote for lower taxes. We investigate to which extent this argument is complete. In particular, political ideology may influence voting on taxes. We vary mobility and foreign taxes in a survey experiment within the German Internet Panel (GIP), with more than 3,000 individuals participating. We find that while the treatment effects qualitatively confirm model predictions how voters take mobility of high-income earners into account when choosing domestic taxes, ideology matters: left-leaning high-income individuals choose higher taxes and emigrate less frequently than right-leaning ones. These findings are in line with the comparative-static predictions of a simple model of inequality aversion when the aversion parameters vary with ideology.

Tetanus, Diphtheria, and Acellular Pertussis and Influenza Vaccinations among Women With a Live Birth, Internet Panel Survey, 2017-2018.

Objectives:Pregnant women are at increased risk of complications from influenza, and infants are at increased risk of pertussis. Maternal influenza and Tdap (tetanus, diphtheria, and acellular pertussis) vaccination can reduce risk of these infections and related complications. Our objective was to estimate vaccination coverage with influenza and Tdap vaccines during pregnancy among women with a recent live birth.Methods:An opt-in Internet panel survey was conducted from March 28 to April 10, 2018 among pregnant and recently pregnant women. Respondents with a live birth from August 1, 2017 through the date in which the participant completed the survey were included in the analysis. Receipt of influenza vaccination since July 1, 2017 and Tdap vaccination during pregnancy were assessed by sociodemographic characteristics, receipt of a health care provider (HCP) recommendation and/or offer of vaccination, and vaccination-related knowledge, attitudes, and beliefs.Results:Less than a third (30.3%) of women with a live birth were unvaccinated during their pregnancy with both Tdap and influenza vaccines. Almost a third (32.8%) of the women reported being vaccinated with both vaccines. The majority (73.0%) of women reported receiving an HCP recommendation for both vaccines, and 54.2% of women were offered both vaccines by an HCP. Reasons for nonvaccination included negative attitudes toward influenza vaccine and lack of awareness about Tdap vaccination during pregnancy.Conclusions:Maternal Tdap and influenza vaccinations can prevent morbidity and mortality among infants and their mothers, yet many pregnant women are unvaccinated with either Tdap or influenza vaccines. Clinic-based education, along with interventions, such as standing orders and provider reminders, are strategies to increase maternal vaccination.

Factors associated with perceptions of influenza vaccine safety and effectiveness among adults, United States, 2017–2018

BackgroundAnnual vaccination against seasonal influenza is widely recognized as the primary intervention method in preventing morbidity and mortality from influenza, but coverage among adults is suboptimal in the United States. Safety and effectiveness perceptions regarding vaccines are consistently cited as factors that influence adults’ decisions to accept or reject vaccination. Therefore, we conducted this analysis in order to understand sociodemographic, attitude, and knowledge factors associated with these perceptions for influenza vaccine among adults in three different age groups. MethodsProbability-based Internet panel surveys using nationally representative samples of adults aged ≥19 years in the United States were conducted during February–March of 2017 and 2018. We asked respondents if they believed the influenza vaccine was safe and effective. We calculated prevalence ratios using chi-square and pairwise t-tests to determine associations between safety and effectiveness beliefs and sociodemographic variables for adults aged 19–49, 50–64, and ≥65 years. ResultsSurvey completion rates were 58.2% (2017) and 57.2% (2018); we analyzed 4597 combined responses. Overall, most adults reported the influenza vaccine was safe (86.3%) and effective (73.0%). However, fewer younger adults reported positive perceptions compared with older age groups. Respondents who believed the vaccine was safe also reported it was effective. ConclusionsGenerally, adults perceived the influenza vaccine as safe and effective. Considering this, any improvements to these perceptions would likely be minor and have a limited effect on coverage. Future research to understand why, despite positive perceptions, adults are still choosing to forego the vaccine may be informative.

An Internet-Based Survey of Influenza Vaccination Coverage in Healthcare Workers in China, 2018/2019 Season.

Influenza vaccination coverage was low among healthcare workers (HCWs) in China. In October 2018, the National Health Commission of China began to require all hospitals to provide free influenza vaccination for HCWs to increase vaccine uptake, and no study on vaccine coverage among HCWs at the national level after the announcement of new policy. This evaluation aims to investigate self-reported influenza vaccination coverage among HCWs and factors that may affect vaccine receipt during the 2018/2019 influenza season. We delivered an opt-in internet panel survey among registered HCWs of DXY forum (the biggest online forum for HCWs in China). The survey was self-administered using a standard questionnaire to collect information on demographics, occupational characteristics, policy implementation, influenza vaccination and influence factors. We conducted multivariate logistic regression analysis to assess factors associated with receipt of influenza vaccine. The response rate of this online survey was 3.6%. The seasonal influenza vaccine coverage reported among HCWs surveyed during the 2018/2019 season was 11.6% (472/4078). Only 19.0% (774/4078) of HCWs surveyed reported free policy in their workplace. Combing free policy and workplace requirement proved to be effective to improve influenza vaccination coverage in HCWs (PR = 6.90, 95% CI: 6.03–7.65). The influenza vaccination coverage among surveyed HCWs in China was low during the 2018/2019 season. To increase future vaccination uptake, we recommend a multi-faceted strategy that include free policy, workplace requirement and promotion, on-site vaccination, and monitoring.

Explaining Gender Differences in Turnout Using Panel Data Across Elections

ObjectivesThe current study offers the first systematic analysis of the impact of citizens’ interest in and perceptions of specific elections on gender differences in turnout.MethodsUsing an Internet panel survey conducted by the Making Electoral Democracy Work project covering the 2013 state, 2013 federal, and 2014 European elections in Bavaria (Germany), our probit models examine mediation and moderation effects of three election‐related characteristics: the issues that citizens consider most central in the elections, citizens’ interest in the elections, and the perceived influence among citizens of the policies of the different levels of policy making on their well‐being.ResultsThe results indicate an overall gender difference in turnout in Bavaria with women being less likely to vote compared with men. Yet, this gender effect ceases to be significant once citizens’ attitudes toward and perceptions of specific elections are controlled for. Interest in the election at hand has a particularly strong and positive effect on the likelihood of voting. We find no significant gender interactions.ConclusionCitizens' interest in and perceptions of specific elections have a strong impact on turnout and gender differences therein.

The Happy American Body 2.0: Predictors of affective body satisfaction in two U.S. national internet panel surveys

The first national study of body image was reported four decades ago in the article The Happy American Body (Berscheid et al., 1973). To provide a modern follow-up to this study, we used two Internet panel surveys of U.S. adults to examine feelings about appearance (Survey 1: Married N = 1095; Single N = 5481) and weight, appearance, body, and muscle size/tone (Survey 2: N = 1601). Mean ages across samples for men and women ranged from 42-53. On the positive side, many men and women were somewhat-to-very satisfied with their appearance (67 %; 57 %), overall body (61 %; 46 %), weight (54 %; 42 %), and muscle tone/size (56 %; 41 %). Mean gender differences were small (Cohen’s ds = 0.18–0.32), as were sexual orientation differences within each gender (ds = |0.00-0.25|). Looking at negative body image, fewer men than women were somewhat-to-very unhappy with their appearance among married (19 %; 29 %) and single participants (29 %; 35 %), and fewer men were somewhat-to-extremely dissatisfied with their appearance (18 %; 24 %), body (27 %; 39 %), weight (36 %; 49 %), muscle tone/size (27 %; 41 %). Nearly one-fifth of men (18 %) and one-fourth of women (27 %) were very-to-extremely dissatisfied with at least one of these traits, highlighting the importance of body image interventions.

Acceptance of the Automated Online Collection of Geographical Information

The ease at which online paradata can be captured in web surveys seems to increase social researchers’ desire to collect such data. Yet little attention is paid to whether respondents actually approve of their collection. This article, therefore, studies online survey respondents’ acceptance of automatically collecting their geographical locations. In wave 4 of the German Internet Panel, we asked respondents for their consent to automatically track their location using a JavaScript. Respondents were also asked to report their location in a set of traditional survey questions. About 62 percent of respondents consented to the automated collection of their location whereas 97 percent provided their location manually. With respect to consent biases, we find evidence that the composition of the achieved sample of geo-located respondents is biased and that the personal characteristics associated with respondents’ willingness to be geo-located differ between the automated tracking and manual provision of geo-information.

The Financial Knowledge Scale: New Analyses, Findings, and Development of a Short Form

We use data from the Understanding America Study (UAS) internet panel to build upon the Knoll and Houts Financial Knowledge Scale (FKS). Specifically, we provide practitioners with a shorter 10‐item scale, describe additional analyses on both the full‐ and short‐form versions of the scales, and explore the relationship between FKS scores and a variety of retirement‐related outcome variables. Importantly, the full‐ and short‐form scales are developed using a statistical model that accounts for guessing, which allows us to provide more accurate estimates of financial knowledge than similar scales that do not account for guessing. The paper also provides conversion tables that can aid in the analysis and interpretation of FKS scores in practice. With the development of a 10‐item short form that accounts for guessing, we hope to provide practitioners and researchers with a tool that will enable them to reliably measure financial knowledge more parsimoniously and accurately than other measures currently in use.

A Process for Decomposing Total Survey Error in Probability and Nonprobability Surveys: A Case Study Comparing Health Statistics in US Internet Panels

Abstract As survey methods evolve, researchers require a comprehensive understanding of the error sources in their data. Comparative studies, which assess differences between the estimates from emerging survey methods and those from traditional surveys, are a popular tool for evaluating total error; however, they do not provide insight on the contributing error sources themselves. The Total Survey Error (TSE) framework is a natural fit for evaluations that examine survey error components across multiple data sources. In this article, we present a case study that demonstrates how the TSE framework can support both qualitative and quantitative evaluations comparing probability and nonprobability surveys. Our case study focuses on five internet panels that are intended to represent the US population and are used to measure health statistics. For these panels, we analyze the total survey error in two ways: (1) using a qualitative assessment that describes how panel construction and management methods may introduce error and (2) using a quantitative assessment that estimates and partitions the total error for two probability-based panels into coverage error and nonresponse error. This work can serve as a “proof of concept” for how the TSE framework may be applied to understand and compare the error structure of probability and nonprobability surveys. For those working specifically with internet panels, our findings will further provide an example of how researchers may choose the panel option best suited to their study aims and help vendors prioritize areas of improvement.

Study Profile: The Japan "Society and New Tobacco" Internet Survey (JASTIS): A Longitudinal Internet Cohort Study of Heat-Not-Burn Tobacco Products, Electronic Cigarettes, and Conventional Tobacco Products in Japan.

BackgroundJapan became the first country where heat-not-burn tobacco products were sold. Therefore, there was no information for actual status on the actual use status or the harms of heat-not-burn tobacco products. The objectives of the study profile are to generate data that can be freely available to external researchers, and to create collaborative research projects in the future.MethodsThe Japan “Society and New Tobacco” Internet Survey (JASTIS) is a longitudinal internet cohort study which investigates perception, attitude, and use of heat-not-burn tobacco, electronic cigarettes (e-cigarettes), and conventional tobacco products in Japan. The survey also includes demographic, health-related, and socioeconomic factors. Participants were randomly selected and invited from internet panelists. The baseline survey was closed when the target number of respondents who had answered the questionnaire was met.ResultsThe study includes three cohorts (1–3) from the 2015 baseline survey and a cohort (4) from the 2017 baseline survey: cohorts 1 and 4 were recruited based on sex and age: men and women aged 15–69 years (n = 8,240 for cohort 1 and n = 5,897 for cohort 4); cohorts 2 and 3 were created using status-based recruiting: e-cigarette and/or heat-not-burn tobacco ever users (n = 2,188; cohort 2) and combustible cigarette smokers without e-cigarette/heat-not-burn tobacco experience (n = 724; cohort 3). The completion rates were 8.5% to 9.9%. All subjects were followed and assessed annually. Response rates for the follow-up survey were 65.5% in 2016, 55.3% in 2017, and 50.9% in 2018. Because Internet-based responders are not a representative sample of the general population of Japan, we conducted adjustment to account for “being an internet survey respondent” and reported tobacco product use in Japan. A recent JASTIS study reported that prevalence of IQOS current-use among Japanese adults had rapidly increased from 0.3% in 2015 to 3.6% in 2017.ConclusionThe JASTIS study provides the first estimates for heat-not-burn tobacco use in the world and e-cigarette use in Japan. For information on collaboration, please contact the corresponding author.

‘What do we have to lose?’: Local economic decline, prospect theory, and support for Brexit

The Brexit referendum confronted British voters with a choice that could have profound consequences for the British economy in a context of high uncertainty. Drawing on important lessons from prospect theory, I argue that citizens who were in the domain of economic losses were more likely to take a risk and vote in favor of Brexit. On the contrary, I hold that citizens who were in the domain of economic gains tended to be more risk averse and were more likely to support ‘Remain’ in the referendum. Using data from several waves of the British Election Study 2014–2019 Internet Panel, I find strong support for these theoretical expectations. British voters who lived in declining areas were significantly more likely to think that leaving the EU would lead to improvements in the national economy. These prospective economic evaluations (captured about a month prior to the referendum) in turn are related to the ‘Leave’ vote in the Brexit referendum.

Vital Signs: Burden and Prevention of Influenza and Pertussis Among Pregnant Women and Infants - United States.

IntroductionVaccinating pregnant women with influenza vaccine and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) can reduce influenza and pertussis risk for themselves and their infants.MethodsSurveillance data were analyzed to ascertain influenza-associated hospitalization among pregnant women and infant hospitalization and death associated with influenza and pertussis. An Internet panel survey was conducted during March 27–April 8, 2019, among women aged 18–49 years who reported being pregnant any time since August 1, 2018. Influenza vaccination before or during pregnancy was assessed among respondents with known influenza vaccination status who were pregnant any time during October 2018–January 2019 (2,097). Tdap receipt during pregnancy was assessed among respondents with known Tdap status who reported a live birth by their survey date (817).ResultsFrom 2010–11 to 2017–18, pregnant women accounted for 24%–34% of influenza-associated hospitalizations per season among females aged 15–44 years. From 2010 to 2017, a total of 3,928 pertussis-related hospitalizations were reported among infants aged <2 months (annual range = 262–743). Maternal influenza and Tdap vaccination coverage rates reported as of April 2019 were 53.7% and 54.9%, respectively. Among women whose health care providers offered vaccination or provided referrals, 65.7% received influenza vaccine and 70.5% received Tdap. The most commonly reported reasons for nonvaccination were believing the vaccine is not effective (influenza; 17.6%) and not knowing that vaccination is needed during each pregnancy (Tdap; 37.9%), followed by safety concerns for the infant (influenza =15.9%; Tdap = 17.1%).Conclusions and Implications for Public Health PracticeMany pregnant women do not receive the vaccines recommended to protect themselves and their infants, even when vaccination is offered. CDC and provider organizations’ resources are available to help providers convey strong, specific recommendations for influenza and Tdap vaccination that are responsive to pregnant women’s concerns.

The Effect of Including Quantitative Information on Multiple Endpoints in Direct-to-Consumer Prescription Drug Television Advertisements.

Background. Previous research found that adding a single piece of quantitative information about prescription drug benefits to direct-to-consumer (DTC) ads helps consumers understand how well the drug works. However, drug information often includes quantitative information on multiple benefit outcomes and risks. Thus, we examined whether consumer understanding was similarly improved when DTC television ads include varying amounts of quantitative information. Methods. We randomly assigned participants (945 Internet panelists ≥ 60 years old) to view 1 of 9 fictitious prescription drug television ads that varied the presentation of quantitative information for benefits (none, single outcome, 2 outcomes) and risks (none, 1 risk category, 3 risk categories) and then measured gist and verbatim recall/estimation and drug perceptions. Results. Adding a single benefit outcome and a single risk category replicated past results. Compared with an ad containing no quantitative information, presenting 2 benefit outcomes and multiple risk categories increased gist and verbatim recall and affected drug perceptions. Compared with presenting a single benefit outcome, presenting 2 benefit outcomes increased verbatim recall for the second outcome but decreased verbatim recall for the first outcome. Likewise, compared with presenting a single risk category, presenting multiple risk categories increased gist and verbatim recall for the multiple risk categories but decreased gist recall for a concept more closely associated with the single risk category. Adding multiple risk categories decreased risk perceptions even more than did the single risk category. Limitations. This study may have limited generalizability because it examined an ad for only 1 medical condition. Conclusions. There are tradeoffs to adding multiple quantitative benefit outcomes in DTC ads. However, presenting multiple quantitative risk categories helps consumers better understand a drug's risks.

Influenza Vaccination Coverage among Registered Nurses in China during 2017-2018: An Internet Panel Survey.

Influenza vaccination is recommended for nurses in China but is not mandatory or offered free of charge. The main objective of this study was to determine influenza vaccination coverage and the principal factors influencing influenza vaccination among nurses in China. During 22 March–1 April 2018, we conducted an opt-in internet panel survey among registered nurses in China. Respondents were recruited from an internet-based training platform for nurses. Among 22,888 nurses invited to participate, 4706 responded, and 4153 were valid respondents. Overall, 257 (6%) nurses reported receiving the seasonal influenza vaccine during the 2017/2018 season. Vaccination coverage was highest among nurses working in Beijing (10%, p < 0.001) and nurses working in primary care (12%, p = 0.023). The top three reasons for not being vaccinated were lack of time (28%), not knowing where and when to get vaccinated (14%), and lack of confidence in the vaccine’s effectiveness (12%). Overall, 41% of nurses reported experiencing at least one episode of influenza-like illness (ILI) during the 2017/2018 season; 87% of nurses kept working while sick, and 25% of nurses reported ever recommending influenza vaccination to patients. Compared with nurses who did not receive influenza vaccination in the 2017/2018 season, nurses who received influenza vaccination were more likely to recommend influenza vaccination to patients (67% vs. 22%, p < 0.001). Influenza vaccination coverage among nurses was low, and only a small proportion recommended influenza vaccine to patients. Our findings highlight the need for a multipronged strategy to increase influenza vaccination among nurses in China.

Mode and Frame Matter: Assessing the Impact of Survey Mode and Sample Frame in Choice Experiments.

Background. Choice experiments (CE) are applied in health economics to elicit public preferences and willingness to pay (WTP). CEs are frequently administered as Internet-based surveys. Internet surveys have recognized advantages, but concerns exist about the representativeness of Internet samples, data quality, and the impact on elicited values. Aim. We conducted the first study in health comparing an Internet-based CE survey with the more traditional general population mail survey. We also compared the Internet-based and mail CE surveys with computer-assisted personal interviews (CAPIs), which are commonly used to elicit health state valuations. Methods. Two separate samples were drawn from 2 United Kingdom (UK) volunteer Internet panels (IPs), CAPIs were undertaken with respondents sampled from UK Census Output Areas, and mail surveys were sent to UK households drawn from the postcode address file (PAF). Each mode received more than 1000 respondents. We compared modes and frames using objective measures (response rate, sample representativeness of the UK population, elicited values, theoretical validity, and cost per response) and subjective/self-reported measures (time taken to complete the study, perceived study consequentiality, and stated attribute nonattendance). This study intentionally confounded the survey modes and sample frame by choosing sample frames that are typically used by researchers for each mode. Results. Estimated WTP differs across mode-frame pairs. On most measures, CAPIs dominated. They are more expensive, however. On all measures, except response rates, Internet surveys dominated the mail survey. They were also cheaper. Conclusion. Researchers using IPs should pay attention to response rates and be aware that the quality of IPs differs. Given the importance of perceived consequentiality and attribute attendance in CEs, future research should address their impact across modes and frames.

Zika knowledge and prevention practices among U.S. travelers: a large cross-sectional survey study

BackgroundThe aim of this study was to investigate what factors predict knowledge about Zika transmission, symptomology, and treatment among U.S. travelers and, additionally, to evaluate how Zika knowledge influences the adoption of personal protective behaviors.MethodsData were collected as part of a cross-sectional survey study using a probability-based internet panel of U.S. travelers in June 2017. We ran logistic regression models of factors predicting Zika knowledge (high vs. low) and of knowledge predicting adoption of personal protective measures.ResultsWe found that traveling to a Zika endemic country and travelers’ gender were both significantly predictive of higher Zika knowledge (odds ratio (OR): 1.48, 95% confidence interval (CI): 1.14–1.93 and OR: 1.44, 95% CI: 1.08–1.92), adjusting for age, race, education, income, and trip purpose. Additionally, among travelers to Zika endemic countries, individuals with higher Zika knowledge had significantly higher odds of engaging in preventive behaviors compared to those with lower knowledge. However, few travelers knew about the sexual transmission of Zika and adopted sexual prevention measures.ConclusionsOur findings suggest that there are gaps in knowledge about the risks and transmission of Zika and travelers with low knowledge are less likely to engage in the appropriate prevention methods. Significantly, few U.S. travelers have knowledge of the sexual transmission of Zika and, accordingly, there is less overall engagement with prevention measures for this transmission mechanism than for vector-borne transmission.

Fossil fuels are harming our brains: identifying key messages about the health effects of air pollution from fossil fuels

BackgroundPrevious research suggests that providing generalized information about the health implications of air pollution from fossil fuels may be effective at promoting public support for a transition to cleaner sources of energy. We sought to extend that work by identifying the specific messages about the health implications of air pollution from fossil fuels that are most and least concerning to people, and whether rankings of concern vary among different audiences. We also hypothesized that reading the statements would influence people’s attitudes and behavioral intentions in a manner supportive of a transition to cleaner sources of energy.MethodsWe conducted a survey with a diverse sample of U.S. adults (n = 1644) from a non-probability internet panel. Using maximum difference scaling, participants ranked a set of ten statements that revealed which statements were the most and least concerning to them. We also measured attitudes about air pollution and energy use before and after the ranking exercise to assess changes in opinion caused by cumulative exposure to the messages.ResultsAcross all sub-groups examined, participants were most concerned by a message about the neurological impacts of air pollution on babies and children. After the ranking exercise, participants expressed increases in perceived health harm of air pollution and fossil fuels, a desire for more clean energy, and intention to engage in consumer advocacy to support clean energy.ConclusionsTo our knowledge, this study is the first to assess how people respond to information about the neurological health harms of air pollution from fossil fuels. While efforts to communicate the cardio-pulmonary health harms of air pollution are well established, our study suggests that efforts should now be organized to communicate the neurological effects of air pollution from fossil fuels, especially the neuro-developmental effects on babies and children.