The 2020 presidential election brought expanded vote-by-mail opportunities, a rise in attacks on this process’s integrity, and the implementation of novel programs such as California’s Where’s My Ballot? system to ensure confidence in mail balloting. Can heightening awareness of this ballot-tracking system and other election protections alleviate fraud concerns and raise turnout? We assess whether messages reinforcing election integrity increased participation in the 2020 election through a large-scale voter mobilization field experiment. California registrants were mailed a letter that described either existing safeguards to prevent vote-by-mail fraud or the ability to track one’s ballot and ensure that it was counted. Analysis of state voter records reveals that neither message increased turnout over a simple election reminder or even no contact, even among subgroups where larger effects might be expected. In the context of a high-profile, high-turnout presidential election, assurances about ballot and electoral integrity did not increase turnout.

Political campaigns frequently emphasize the material stakes at play in election outcomes to motivate participation. However, field-experimental academic work has given greater attention to other aspects of voters' decisions to participate despite theoretical models of turnout and substantial observational work signaling that a contest's perceived importance affects the propensity to vote. We identify two classes of treatments that may increase the material incentive to participate and test these messages in a large-scale placebo-controlled field experiment in which approximately 24,500 treatment letters were delivered during Connecticut's 2013 municipal elections. We find some evidence that these messages are effective in increasing participation, as well as that some of them may be more effective than typical nonpartisan get-out-the-vote appeals. While these results remain somewhat preliminary, our findings have important implications for our understanding of how voters decide whether to participate and how best to mobilize citizens who would otherwise sit out elections.

Introduction: Continued smoking by cancer patients causes adverse cancer treatment outcomes, but few patients receive evidence-based smoking cessation as a standard of care.

Aim: To evaluate practical strategies to promote wide-scale dissemination and implementation of evidence-based tobacco cessation services within state cancer centers.

Methods: A Collaborative Learning Model (CLM) for Quality Improvement was evaluated with three community oncology practices to identify barriers and facilitate practice change to deliver evidence-based smoking cessation treatments to cancer patients using standardized assessments and referrals to statewide smoking cessation resources. Patients were enrolled and tracked through an automated data system and received follow-up cessation support post-enrollment. Monthly quantitative reports and qualitative data gathered through interviews and collaborative learning sessions were used to evaluate meaningful quality improvement changes in each cancer center.

Results: Baseline practice evaluation for the CLM identified the lack of tobacco use documentation, awareness of cessation guidelines, and awareness of services for patients as common barriers. Implementation of a structured assessment and referral process demonstrated that of 1,632 newly registered cancer patients,1,581 (97%) were screened for tobacco use. Among those screened, 283 (18%) were found to be tobacco users. Of identified tobacco users, 207 (73%) were advised to quit. Referral of new patients who reported using tobacco to an evidence-based cessation program increased from 0% at baseline across all three cancer centers to 64% (range = 30%–89%) during the project period.

Conclusions: Implementation of quality improvement learning collaborative models can dramatically improve delivery of guideline-based tobacco cessation treatments to cancer patients.

Prior research predicts that election administration changes that increase voting costs should decrease participation, but it fails to consider that some interpret those changes as attacking their franchise. Drawing on psychological reactance theory, this study tests whether such perceived attacks might instead activate those citizens. It leverages the State of Florida’s multi-stage effort in 2012 to purge suspected non-citizens from its voter rolls, comparing the voting rates of suspected non-citizens whose registration was and was not formally challenged by the state. Within-registrant difference-in-difference and matching analyses estimate a positive, significant participatory effect of being challenged, particularly for Hispanics (the vast majority of the sample). Placebo tests show that those challenged were no more likely than those not challenged to vote in previous elections.

Recent elections have witnessed substantial debate regarding the degree to which state governments facilitate access to the polls. Despite this newfound interest, however, many of the major reforms aimed at increasing voting convenience (i.e., early voting and no-excuse absentee voting) were implemented over the past four decades. Although numerous studies examine their consequences (on turnout, the composition of the electorate, and/or electoral outcomes), we know significantly less about the factors leading to the initial adoption of these policies. We attempt to provide insights into such motivations using event history analysis to identify the impact of political and demographic considerations, as well as diffusion mechanisms, on which states opted for easier ballot access. We find that adoption responded to some factors signaling the necessity of greater voting convenience in the state, and that partisanship influenced the enactment of early voting but not no-excuse absentee voting procedures.