Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence

Effect of communicating community immunity on COVID-19 vaccine-hesitant people from ethnically diverse backgrounds: an experimental vignette study in the UK

OBJECTIVES

Achieving high vaccination coverage is vital to the efforts of curbing the impact of the COVID-19 pandemic on public health and society. This study tested whether communicating the social benefit through community protection for friends and family members versus overall society, affects vaccination intention and perception among a sample enriched with respondents from black and ethnic minority backgrounds.

DESIGN

A web-based experimental survey was conducted. Eligible participants were individually randomised, with equal probability, to one of the three experimental vignettes.

SETTING

England.

PARTICIPANTS

We recruited 512 (212 white, 300 ethnically diverse) vaccine-hesitant members from an online panel.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was the intention to get vaccinated against COVID-19. The secondary outcome consisted of a behavioural measure in the form of active interest in reading more about the COVID-19 vaccine. Additional measures included the perceived importance and expected uptake in others, as well as the attitudes towards vaccination.

RESULTS

Logistic regression models did not show an effect of the messages on intentions for the overall sample (society: adjusted OR (aOR): 128, 95% CI 0.88 to 1.88 and friends and family: aOR 1.32, 95% CI 0.89 to 1.94). The role of vaccination in achieving community immunity yielded higher vaccination intentions among study participants with white ethnic background (society: aOR: 1.94, 95% CI 1.07 to 3.51 and friends and family: aOR 2.07, 95% CI 1.08 to 3.96), but not among respondents from ethnically diverse backgrounds (society: aOR: 0.95, 95% CI 0.58 to 1.58 and friends and family: aOR 1.06, 95% CI 0.64 to 1.73). The messages, however, did not affect the perceived importance of the vaccine, expected vaccination uptake and active interest in reading more about the vaccine.

CONCLUSIONS

Thus, although highlighting the social benefits of COVID-19 vaccinations can increase intentions among vaccine non-intenders, they are unlikely to address barriers among ethnically diverse communities.

Can High Exposure Help to Close Gaps? The Influence of COVID-19 Preventive Messages on Behavioral Intentions by Educational Attainment in Chile

The literature in the field of health communication has shown the existence of gaps between groups of different socioeconomic levels both in exposure to health campaign messages and in the influence these messages exert on individuals' health decisions. In this article, we examine the association between educational attainment and exposure to messages promoting COVID-19 preventive behaviors, namely, physical distancing, handwashing, and masks wearing in Chile. In addition, we model the association between exposure to these messages and the intentions to carry out the behaviors, as well as the differences attributable to educational attainment in the influence of exposure. A cross-sectional population survey combining online and telephone techniques was conducted among 3,592 adults in Chile. Regression analysis revealed that lower educational level and frequency of television use were positively associated with greater exposure to preventive messages. Exposure to preventive messages, in turn, was positively associated with intentions to maintain the three behaviors examined. Individuals in the lower educational attainment group had lower intentions to engage in two of the three behaviors, but those in these segments who were more exposed to preventive messages were as likely as their more educated counterparts to intend wearing masks and adhering to physical distance. The findings of this study underscore the importance of reaching the least educated segments with campaign messages in the context of public health crisis, since these messages can close gaps between the more and less educated group in their intentions to engage in preventive behaviors.

Descriptive, Injunctive, and Collective Norms: An Expansion of the Theory of Normative Social Behavior (TNSB)

We propose and test several hypotheses derived from the expanded theory of normative social behavior (TNSB) that also includes collective norms (with descriptive and injunctive norms). Data come from a quasi-experiment intervention to promote safer driving among adolescents in Serbia. The intervention was administered among high school students, most of whom were on the verge of receiving their driver's licenses. Longitudinal data were collected from treatment and control schools at baseline (N = 1,449) and four months later at end line (N = 1,072). Descriptive norms at baseline predicted six-month changes in safer-driving intentions among women (β = .010 p < .05) but not among men. Main-effects of injunctive and collective norms were not significant. However, a significant interaction between descriptive norms and collective norms emerged among men (though not among women) and injunctive norms interacted with both collective norms and descriptive norms among women (but not among men). Initial evidence adds credence to the idea of enhancing the TNSB by adding both injunctive and collective (together with descriptive) norms as drivers of behaviors.

An experimental COVID-19 messaging study in a representative sample of the Scottish population: Increasing physical distancing intentions through self-efficacy

OBJECTIVES

Self-efficacy is important for adherence to transmission-reducing behaviours (e.g., physical distancing) as also shown in the CHARIS project. We aimed to show that a theory-based short message can increase physical distancing self-efficacy and intentions to keep physical distance.

DESIGN

Structured telephone surveys with a randomly selected nationally representative sample of adults in Scotland (N = 497).

METHODS

Participants were randomly assigned to one of two experimental conditions: message condition (short message to increase self-efficacy via vicarious experiences, verbal persuasion and emotional arousal) or control condition (no message). Followed by measures for self-efficacy and intention for physical distancing on 4-point scales. Adherence to physical distancing was assessed on a 5-point frequency scale (never - always).

RESULTS

Using mediation analyses with bootstrapping procedures, we first confirmed that self-efficacy was associated indirectly with adherence, via higher intentions in a partial mediation (unstandardized indirect effect .21, 95% CI .18-.25). The message increased self-efficacy; participants receiving the message reported higher self-efficacy (M = 4.23, SD = .80) compared to participants in the control condition (M = 4.08, SD = .77; standardized regression coefficient = .19, p < .05) and self-efficacy affected intention (.48, p < .001). There was a small significant indirect effect of the message on intention via self-efficacy (unstandardized indirect effect .07, CI .01-.14).

CONCLUSIONS

Increasing self-efficacy for physical distancing with a short message can successfully increase intention to physical distance via increased self-efficacy. As both self-efficacy and intentions are important predictors of adherence to transmission-reducing behaviours short messages have potential to limit the spread of COVID-19.

The Effect of Governmental Health Measures on Public Behaviour During the COVID-19 Pandemic Outbreak

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic resulted in radical changes in many aspects of life. To deal with this, each country has implemented continuous health measures from the beginning of the outbreak. Discovering how governmental actions impacted public behaviour during the outbreak stage is the purpose of this study.

METHODS

This study uses a hybrid large-scale data visualisation method to analyse public behaviour (epidemic concerns, self-protection, and mobility trends), using the data provided by multiple authorities. Meanwhile, a content analysis method is used to qualitatively code the health measures of three countries with severe early epidemic outbreaks from different continents, namely China, Italy, and the United States. Eight dimensions are coded to rate the mobility restrictions implemented in the above countries.

RESULTS

(1) Governmental measures did not immediately persuade the public to change their behaviours during the COVID-19 epidemic. Instead, the public behaviour proceeded in a three-phase rule, which is typically witnessed in an epidemic outbreak, namely the wait-and-see phase, the surge phase and the slow-release phase. (2) The strictness of the mobility restrictions of the three countries can be ranked as follows: Hubei Province in China (with an average score of 8.5 out of 10), Lombardy in Italy (7.125), and New York State in the United States (5.375). Strict mobility restrictions are more likely to cause a surge of population outflow from the epidemic area in the short term, whereas the effect of mobility restrictions is positively related to the stringency of policies in the long term.

CONCLUSION

The public showed generally lawful behaviour during regional epidemic outbreaks and blockades. Meanwhile public behaviour was deeply affected by the actions of local governments, rather than the global pandemic situation. The contextual differences between the various countries are important factors that influence the effects of the different governments' health measures.

Promoting Healthcare Workers' Adoption Intention of Artificial-Intelligence-Assisted Diagnosis and Treatment: The Chain Mediation of Social Influence and Human-Computer Trust

Artificial intelligence (AI)-assisted diagnosis and treatment could expand the medical scenarios and augment work efficiency and accuracy. However, factors influencing healthcare workers' adoption intention of AI-assisted diagnosis and treatment are not well-understood. This study conducted a cross-sectional study of 343 dental healthcare workers from tertiary hospitals and secondary hospitals in Anhui Province. The obtained data were analyzed using structural equation modeling. The results showed that performance expectancy and effort expectancy were both positively related to healthcare workers' adoption intention of AI-assisted diagnosis and treatment. Social influence and human-computer trust, respectively, mediated the relationship between expectancy (performance expectancy and effort expectancy) and healthcare workers' adoption intention of AI-assisted diagnosis and treatment. Furthermore, social influence and human-computer trust played a chain mediation role between expectancy and healthcare workers' adoption intention of AI-assisted diagnosis and treatment. Our study provided novel insights into the path mechanism of healthcare workers' adoption intention of AI-assisted diagnosis and treatment.

How Does Self-Control Promote Health Behaviors? A Multi-Behavior Test of Five Potential Pathways

BACKGROUND

Self-control is generally defined as the capacity to override impulses and is a robust predictor of health behaviors. This paper integrates trait, reasoned action, and habit approaches to develop and test a mechanistic account of how self-control influences health actions.

PURPOSE

We tested five potential pathways from self-control to behavior, termed the valuation, prioritization, habituation, translation, and inhibition routes.

METHODS

At baseline, participants (N = 663 adults) completed survey measures of reasoned action approach variables and habits in relation to eight health behaviors and the Brief Self-Control Scale. Three months later, participants reported their behavior. Multi-level modeling was used to test pathways across behaviors.

RESULTS

Supporting the valuation route, affective attitude, cognitive attitude, descriptive norms, and perceived behavioral control mediated the self-control-intention relation, and intentions and perceived behavioral control mediated the relationship between self-control and health behaviors. Self-control also predicted the priority accorded to different considerations during intention formation. Higher self-control was associated with stronger prediction by cognitive attitudes and perceived behavioral control and weaker prediction by habits and injunctive norms. Self-control predicted habit formation, and habits mediated the self-control-behavior relation. Finally, self-control was associated with the improved translation of intentions into health behaviors and with greater inhibition of affective and habitual influences. Findings for the different pathways were not moderated by whether approach (health-protective behaviors) or avoidance responses (health-risk behaviors) were at issue.

CONCLUSIONS

The present research offers new insights into why self-control promotes health behavior performance, and how deficits in self-control might be offset in future behavior-change interventions.

Effects of a Narrative-Based Psychoeducational Intervention to Prepare Patients for Responding to Acute Myocardial Infarction: A Randomized Clinical Trial

IMPORTANCE

Despite decades of educational efforts, patients' prolonged delays in seeking care for symptoms of acute myocardial infarction (AMI) remain the greatest obstacle to successful management of the condition.

OBJECTIVE

To compare the effects of a narrative-based psychoeducational intervention with a didactic educative approach on AMI survivors' intention to seek care for AMI symptoms and on AMI knowledge.

DESIGN, SETTING, AND PARTICIPANTS

A multisite randomized clinical trial recruited community-dwelling patients aged 18 years or older with a history of AMI from 4 hospitals in Hong Kong from January 1, 2018, to January 22, 2021, and followed up participants for 1 year.

INTERVENTIONS

An 8-week narrative-based psychoeducational intervention aimed to create a vivid cognitive experience of complex decision-making and modeled desirable behavioral changes through nurse-led, interactive video sessions using model patients. The control group received 4 nurse-led sessions comprising education about AMI and care seeking delivered using a didactic approach.

MAIN OUTCOMES AND MEASURES

The primary outcome was the behavioral intention between the 2 groups, reflected by participants' attitudes and beliefs about care seeking for AMI measured using the Acute Coronary Syndrome Response Index-Chinese version. The secondary outcome was AMI knowledge.

RESULTS

Six hundred and eight participants (mean [SD] age, 67.2 [8.3] years; 469 [77.1%] male) were randomized to either the narrative-based psychoeducation group (n = 304) or the didactic education group (n = 304). The psychoeducational intervention group reported greater positive changes than the control group in their attitudes (β = -1.053 [95% CI, -1.714 to -0.391]; P < .001) and beliefs (β = -0.686 [95% CI, -1.354 to -0.180]; P = .04) toward care seeking at the 3-month follow-up, and the difference was sustained at 12 months for both attitudes (β = -0.797 [95% CI, -1.477 to -0.117]; P = .02) and beliefs (β = -0.692 [95% CI, -1.309 to -0.012]; P = .047). There were no significant differences in AMI knowledge between the 2 study groups at the 3-month and 12-month time points.

CONCLUSIONS AND RELEVANCE

The results of this randomized clinical trial found that a novel approach of narrative-based psychoeducation was effective in improving patients' behavioral intention to seek care for AMI symptoms. Longer-term follow-up to evaluate actual care-seeking behavior and clinical outcomes in patients with AMI is warranted to determine the sustained effects of this intervention.

TRIAL REGISTRATION

ChiCTR Identifier: ChiCTR-IIC-17010576.

Applying the Reasoned Action Approach and Planning to Understand Diabetes Self-Management Behaviors

Individuals managing diabetes are required to adhere to self-management behaviors to ensure the optimal regulation of their blood glucose levels. This study examined the psychological determinants underlying three important diabetes self-management behaviors (e.g., physical activity, diet, and blood glucose monitoring) using the reasoned action approach (RAA) and planning. A cross-sectional design was used, with participants (N = 273) completing measures of RAA constructs (e.g., experiential and instrumental attitude, descriptive and injunctive norm, and capacity and autonomy) and planning (e.g., action and control planning) at time 1 and participation in the behaviors one week later at time 2. Regressions showed that RAA constructs accounted for good variance in intention and behavior in all behaviors. Intention towards diet and blood glucose monitoring was significantly predicted by instrumental attitude, injunctive norm, and capacity. Intention towards physical activity was significantly predicted by instrumental attitude, experiential attitude, injunctive norm, capacity, and autonomy. All behaviors were significantly predicted by intention, action planning, and coping planning. Additionally, capacity significantly predicted physical activity and autonomy significantly predicted diet and blood glucose monitoring. Successfully intervening in the influential psychological constructs identified in the study could ensure optimal blood glucose regulation in those managing diabetes.

Using social cognition models to understand why people, such as perfectionists, struggle to respond with self-compassion

Responding with self-compassion to lapses in goal pursuit helps people to achieve their goals, yet evidence suggests that some people struggle to respond with self-compassion. The current research proposes that social cognition models such the Theory of Planned Behaviour and the Prototype Willingness Model could explain why some people, such as those high in perfectionistic concerns, struggle to respond with self-compassion. We therefore conducted a pre-registered prospective study that measured participants' beliefs about self-compassion, difficulties enacting self-compassionate responding, perfectionistic concerns, and then tested their ability to be self-compassionate in response to a recalled and future lapse. The results showed that participants were less likely to respond with self-compassion to lapses if they held negative beliefs about self-compassion and experienced difficulties enacting self-compassion. Participants high in perfectionistic concerns were more likely to have negative beliefs about self-compassion and experience difficulties enacting self-compassion. Together, these findings provide evidence that social cognition models can be used to understand self-compassionate responding and identify why some people struggle to respond with self-compassion to goal lapses.

Behavioral strategies for periodontal health

The impact of lifestyle factors has been increasingly studied and discussed in oral healthcare. Positive lifestyle factors are important in maintaining oral health or controlling disease, but they are not easy to adopt over the long term. Along with public health initiatives within communities and groups, there is a role for behavior change interventions delivered in dental practice settings to improve the periodontal health of individuals. Behavior management is now seen as a part of both prevention and therapy of periodontal diseases. This article summarizes the evidence on behavioral strategies for periodontal health to inform and assist oral healthcare professionals in implementing behavior change in their practice. In addition, strategies for education and training in communication and behavior change techniques are considered.

Teen Dating Violence Help-Seeking Intentions and Behaviors Among Ethnically and Racially Diverse Youth: A Systematic Review

Teen dating violence (TDV) affects millions of youth in the United States and globally each year. A systematic review was conducted to examine the help-seeking intentions and behaviors of youth between the ages of 12 and 19 based on racial and ethnic differences. Considering the high prevalence of TDV among racially and ethnically diverse youth, previous systematic reviews have recommended that future scholarship address help-seeking intentions and behaviors among racially and ethnically diverse youth. The methodologies and results of TDV and help-seeking studies published since 2000 were reviewed and analyzed. A systematic search of peer-reviewed journal articles published in English was conducted using an electronic search. The rigorous search identified 10 studies that addressed help-seeking intentions and behaviors and racial and ethnic differences in youth meeting eligibility requirements. The search yielded few studies, indicating a need to conduct future research in this area. The strength of the studies' methodologies limited generalizability and external validity. The studies primarily addressed differences among African American and Latino youth. Youth relied on informal sources of support, with youth from both groups preferring to seek help from parents and friends. Mistrust, lack of closeness, and feelings of mistrust, shame, and embarrassment informed youths' help-seeking intentions and behaviors. Racially and ethnically specific factors such as negative perceptions of father figures, familism, acculturation, and traditional gender role notions were identified as barriers to help-seeking. As part of appraising and synthesizing the evidence, recommendations for research, practice, and policy are presented.

Bystander intervention among secondary school pupils: Testing an augmented Prototype Willingness Model

This study augmented the Prototype Willingness Model (PWM) to assess reactive and deliberative decision-making underpinning bystander intervention in gender-based violence contexts. There were 2079 participants (50% male, 49% female, and 1% unreported), aged 11-15 years old (M = 12.32, SD = 0.91), attending 19 secondary schools across Scotland. Participants self-reported the augmented PWM variables, then their intervention behaviour approximately 1 month later. Path analyses mostly supported the predicted relationships between positive and negative bidimensional attitudes, subjective norms, prototype perceptions, perceived behavioural control, and self-efficacy on intentions and willingness. Willingness predicted positive (speaking with a teacher) and negative (doing nothing) intervention in less serious violence. Self-efficacy predicted negative intervention in more serious violence. Subjective norms positively moderated the attitudes-intentions relationship. Overall, the results suggested that reactive (willingness) more so than deliberative (intention) decision-making account for intervention when young people witness gender-based violence. Additionally, the findings highlight the complexity of bystander intervention decision-making, where adding control perceptions, bidimensional attitudes, and moderators have independent contributions. Furthermore, self-comparison to the typical bystander who positively intervenes (prototype perceptions) was the strongest predictor of intentions and willingness, highlighting in a novel way the importance of image and group membership on decision-making.

Thinking about drinking: Acculturation and alcohol-related cognitions among college-bound Latinas

Objective: This study examined acculturation with positive alcohol expectancies (PAE) and alcohol use intentions among college-bound Latinas using a bidimensional (ie U.S. acculturation/enculturation) and bidomain (ie behaviors/values) acculturation framework. Participants: A total of 298 Latina young adults between 18 and 20 years old were included in this analysis. Methods: Data were collected the summer before participants began college for the first time. We used an online survey to assess acculturation, PAE, and alcohol use expectancies. Results: Path analyses showed that U.S. acculturation values were related to more PAE and alcohol use intentions. U.S. acculturation behaviors were related to more alcohol use intentions, and the pathway was moderated by PAE. There was also an interaction between U.S. acculturation and enculturation behaviors predicting alcohol use intentions. Conclusion: This study sheds light on how acculturating Latina young women think about alcohol use prior to beginning college, which is an opportune window for targeted prevention programs.

The way forward to achieve high COVID-19 vaccination and revaccination coverage in a city amid a period of tranquility

Background

Amid the current COVID-19 pandemic, there is an urgent need for both vaccination and revaccination ("boosting"). This study aims to identify factors associated with the intention to receive a booster dose of the coronavirus (COVID-19) vaccine among individuals vaccinated with two doses and characterize their profiles in Hong Kong, a city with a low COVID-19 incidence in the initial epidemic waves. Among the unvaccinated, vaccination intention is also explored and their profiles are investigated.

Methods

From December 2021 - January 2022, an online survey was employed to recruit 856 Hong Kong residents aged 18 years or over from an established population-based cohort. Latent class analysis and multivariate logistic regression modeling approaches were used to characterize boosting intentions.

Results

Of 638 (74.5%) vaccinated among 856 eligible subjects, 42.2% intended to receive the booster dose. Four distinct profiles emerged with believers having the highest intention, followed by apathetics, fence-sitters and skeptics. Believers were older and more likely to have been vaccinated against influenza. Older age, smoking, experiencing no adverse effects from a previous COVID-19 vaccination, greater confidence in vaccines and collective responsibility, and fewer barriers in accessing vaccination services were associated with higher intentions to receive the booster dose. Of 218 unvaccinated, most were fence-sitters followed by apathetics, skeptics, and believers.

Conclusion

This study foretells the booster intended uptake lagging initial vaccination across different age groups and can help refine the current or future booster vaccination campaign. Given the fourth COVID-19 vaccine dose may be offered to all adults, strategies for improving boosting uptake include policies targeting young adults, individuals who experienced adverse effects from previous doses, fence-sitters, apathetics, and the general public with low trust in the health authorities.

Use IT again? Dynamic roles of habit, intention and their interaction on continued system use by individuals in utilitarian, volitional contexts

This paper employs a longitudinal perspective to examine continued system use (CSU) by individuals in utilitarian, volitional contexts when alternative systems are present . We focus on two key behavioural antecedents of CSU - habit and continuance intention - and theorise how the relationships between CSU and these antecedents evolve over time. In addition, we hypothesise how the interaction effect of habit and intention on CSU evolves temporally. Our theorising differs from extant literature in two important respects: 1) In contrast to the widespread acceptance of the diminishing effect of continuance intention on CSU in the information systems (IS) literature, we hypothesise that in our context, its impact increases with time; and 2) In contrast to the negative moderation effect of habit on the relationship between intention and CSU proposed in the literature, we posit a positive interaction effect. We collect longitudinal survey data on the use of a higher education IS from students in a European university. Our results suggest that the impact of continuance intention on CSU as well as the interaction effect between habit and intention are increasing over time. We further introduce a methodological innovation - the permutation approach to conduct the multi-group analysis with repeated measures - to the literature.

Study protocol for the description and evaluation of the "Habit Coach" - a longitudinal multicenter mHealth intervention for healthy habit formation in health care professionals

BACKGROUND

The adoption of a healthy lifestyle plays a crucial role for the health and well-being of health care professionals. Previous e- and mHealth interventions relied on deliberative psychological processes (e.g., intention, planning) to target lifestyle changes, while revealing mixed efficacy. The additional potential of non-deliberative, automatic processes (i.e., habits) for behavior change has been understudied in interventions so far. The Habit Coach mHealth intervention combines deliberative and non-deliberative processes to support health care professionals in forming healthy physical activity, nutrition and mindfulness habits in daily life. The aim of this paper is to outline the study protocol including a detailed description of the mHealth intervention, evaluation plan, and study design. The purpose of this trial is to understand healthy habit formation in health care professionals over time.

METHODS

A one-arm, multicenter mHealth intervention study will be conducted. Behavioral and psychosocial predictors will be collected via within-app questionnaires across a 100-day period at baseline, post, as well as at weekly assessments. To understand habit formation across time, linear mixed models will be used.

DISCUSSION

This trial aims to unravel the role of motivational and volitional determinants for healthy habit formation across multiple health behaviors in health care professionals embedded in a mHealth intervention.

TRIAL REGISTRATION

This trial is registered in the German Clinical Trials Register, DRKS-ID DRKS00027156. Date of registration 17 November 2021.

Measuring “Nudgeability”: Development of a Scale on Susceptibility to Physical Activity Nudges among College Students

Background: The current college lifestyle create more opportunities for students to develop unhealthy behaviors, especially physical inactivity. Nudging could be an effective tool to improve physical activity behaviors by changing college settings. One-nudge-fits-all leads to ineffective nudges, so it is necessary to develop a reliable and valid instrument capable of measuring the “nudgeability” of physical activity nudges for college students, which is for a higher level of nudge efficacy. Method: Developing the College Physical Activity Nudges Susceptibility Scale (CPANSS) that integrated the nudge method with the Likert scale, which is the first attempt to measure the susceptibility to nudges directly by a scale. There are four steps for developing CPANSS, including Scale Dimensions, Item Generation, Exploratory Factor Analysis (n = 294), and Confirmatory Factor Analysis (n = 293) with appropriate procedures. Results: The five-factor 21-item CPANSS with good reliability and validity fitted the data reasonably well. Conclusion: The CPANSS was to provide a new tool for policymakers to design effective nudges in changing and promoting physical activity in college settings, and to provide a method for scholars to promote other healthy behaviors for different target groups.

The utility of the integrated behavior change model as an extension of the theory of planned behavior

Introduction

There are several widely used theories of health behavior change, which mostly utilize the social cognitive approach. These theories tend to posit that intention is a direct predictor of behavior, do not include automatic influences on behavior, and propose a one-size-fits-all theory for both initiators and maintainers. However, the intention-behavior gap is a well-observed phenomenon, researchers have highlighted that both automatic and reflective factors promote behavioral engagement, and predictors of behavior have been shown to differ between initiators and maintainers—three issues that necessitate theory advancement. To that end, the present research compares the utility of the Integrated Behavior Change Model (IBCM) – a social cognitive model that includes automatic factors involved in behavioral engagement and a moderator of the intention-behavior gap – to its theoretical predecessor, the Theory of Planned Behavior (TPB). Further, the relevance of the IBCM factors for predicting exercise behavior is compared in initiators versus maintainers.

Method

Participants were 494 US undergraduates. Participants reported on variables from the IBCM (and TPB) at baseline and reported on their exercise behavior in two surveys at seven- and 14-days post-baseline.

Results

Findings supported the first hypothesis that the IBCM would be more relevant for initiators in comparison with maintainers, using structural equation modeling. Specifically, only the paths between intrinsic motivation and affective attitude, affective attitude and intention, and intention and behavior were reliably found for maintainers. For initiators, the aforementioned paths were also reliably supported and the additional following paths were also supported: intrinsic motivation and perceived behavioral control, perceived behavioral control and intention, and intention and action planning. However, results did not support the second hypothesis that the IBCM would predict significantly more variance in behavior than its theoretical predecessor, the TPB. Specifically, the addition of action planning, implicit attitude, implicit motivation, and the interaction between intention and action planning only predicted an additional 0.3% (p < 0:05) of the variance in exercise behavior above and beyond intention.

Conclusion

Results highlight the continued need for theoretical refinement in terms of delineating mechanisms of initiation and maintenance and the need for further development in terms of improving upon current predictions of behavior engagement and change.

E-cigarette use and intentions related to psychological distress among cigarette, e-cigarette, and cannabis vape users during the start of the COVID-19 pandemic

Background

This study examines associations between psychological distress, intentions to use e-cigarettes, and cigarette smoking, e-cigarette use, and cannabis consumption through e-cigarette use among a diverse sample of U.S. young adults.

Procedures

Young adults (N = 314; 72.5% female) were recruited to complete an online survey during the first few months of the COVID-19 pandemic.

Results

Associations between psychological distress and cigarette smoking, e-cigarette use, cannabis vaping, and intentions to use e-cigarettes were found. Current e-cigarette use (OR = 1.23, 95% CI 1.17, 1.28, p < .001; 7.5%) and cannabis vaping (OR = 2.03, 95% CI 1.88, 2.18, p < .001; 10%) was higher among female, possibly due to the significantly higher psychological distress reported among females. Interactions between intentions to use e-cigarettes and psychological distress variables were found for all smoking and vaping behaviors.

Conclusions

Public health efforts should increase focus on providing psychological services for young adults to improve coping strategies that are alternative to smoking and vaping behaviors.

Intentions and confidence as predictors of mental health first aid: Findings from a longitudinal study

BACKGROUND

Mental health first aid (MHFA) training can improve confidence and intention to help a person with a mental health problem, but there is limited research exploring whether this results in better support provided. This study aims to evaluate the relationship between a person's confidence and intention to help with the quality of support provided.

METHODS

Australian public servants who had received MHFA training or Physical First Aid training (n = 152) completed questionnaires exploring attitudes and skills for assisting someone at work with a mental health problem. Data on confidence and intention to help was used to predict quality of support provided at 1 and 2-year follow-up. Data were analysed using linear and logistic regression.

RESULTS

Intention to help predicted the quality of support for assisting someone at work at follow-up (rs=0.15-0.20, p < .0.05), while confidence in providing help only predicted quality of support 1-year later (rs = 0.42, p = .032). These relationships were significantly attenuated after controlling for personal stigma, desire for social distance, gender, age, language spoken at home, level of education and whether participant managed staff. Furthermore, there were some large associations between intentions to perform specific first aid actions and carrying out the same action at follow-up such as for encouraging professional help at 2-year follow-up (OR=8.20, p < 0.05).

CONCLUSION

Findings indicate that intended actions to support a person with a mental health problem can predict the quality of support provided up to 2 years later. Future research should clarify whether this support benefits the mental health of recipients.

Higher Collective Responsibility, Higher COVID-19 Vaccine Uptake, and Interaction with Vaccine Attitude: Results from Propensity Score Matching

Providing both personal and social benefits, vaccination may be motivated by collective responsibility (CR). Some previous studies have indicated the relationship between CR and vaccination but could not exclude confounding bias and had little knowledge about the boundary conditions. This study aimed to examine the association between CR and COVID-19 vaccine uptake and its boundary conditions in an extended version of the theory of planned behavior. A cross-sectional survey with 608 participants from six tourism satellite industries in Macao was conducted from 28 July 2021 to 20 August of 2021. Respondentss in CR-lower and CR-higher groups were 1:1 paired using propensity score matching (PSM) to control the potential confounding factors. Results showed participants in the CR-higher group reported significantly higher COVID-19 vaccine uptake than those in the CR-lower group (64.7% vs. 49.7%, p = 0.005). Multivariate logistic regression results indicated a positive association between CR and COVID-19 vaccine uptake (p = 0.012, OR = 2.070, 95% CI= 1.174 to 3.650) and its interaction effect with COVID-19 vaccine attitude (p = 0.019, OR = 0.922, 95% CI = 0.861 to 0.987). Spotlight analysis further illustrated that CR was more effective among individuals with a more negative COVID-19 vaccine attitude. These findings may help promote understanding of vaccine hesitancy, and hence optimize vaccination communication strategies during the COVID-19 pandemic.

Communicating about COVID-19 vaccine development and safety

Purpose

Beliefs that the risks from a COVID-19 vaccine outweigh the risks from getting COVID-19 and concerns that the vaccine development process was rushed and lacking rigor have been identified as important drivers of hesitancy and refusal to get a COVID-19 vaccine. We tested whether messages designed to address these beliefs and concerns might promote intentions to get a COVID-19 vaccine.

Method

We conducted an online survey fielded between March 8–23, 2021 with US Veteran (n = 688) and non-Veteran (n = 387) respondents. In a between-subjects experiment, respondents were randomly assigned to a control group (with no message) or to read one of two intervention messages: 1. a fact-box styled message comparing the risks of getting COVID-19 compared to the vaccine, and 2. a timeline styled message describing the development process of the COVID-19 mRNA vaccines.

Results

Most respondents (60%) wanted a COVID-19 vaccine. However, 17% expressed hesitancy and 23% did not want to get a COVID-19 vaccine. The fact-box styled message and the timeline message did not significantly improve vaccination intentions, F(2,358) = 0.86, p = .425, ηP2 = .005, or reduce the time respondents wanted to wait before getting vaccinated, F(2,306) = 0.79, p = .453, ηP2 = .005, compared to no messages.

Discussion

In this experimental study, we did not find that providing messages about vaccine risks and the development process had an impact on respondents’ vaccine intentions. Further research is needed to identify how to effectively address concerns about the risks associated with COVID-19 vaccines and the development process and to understand additional factors that influence vaccine intentions.

Understanding the intention-behavior gap: The role of intention strength

This manuscript overviews recent research on the intention-behavior gap, focusing on moderators of the intention-behavior relationship. The manuscript draws on the concept of intention strength to make two important points. First, strong intentions provide better predictions of behavior, thereby reducing the intention-behavior gap. However, strong intentions have the additional features of being more stable over time, less pliable in the face of interventions to change them, and more likely to bias information processing about engaging in the behavior. These four features of intention strength are not independent. For example, stable intentions are likely to provide better predictions of behavior. Second, various predictors of strength (e.g., importance, certainty, extremity) may also constitute important, but little studied, moderators of the intention-behavior relationship. Moreover, the effects of these moderators of the intention-behavior relationship may be mediated through intention stability (and perhaps other features of intention strength). Future research on the intention-behavior gap would benefit from a more systematic consideration of a broad range of moderators of the intention-behavior relationship both individually and in combination. In addition, future research could usefully explore how these moderating effects might be explained. Such a systematic approach may further our understanding of the intention-behavior gap in relation to physical activity and other behaviors.

Prosociality and Social Responsibility Were Associated With Intention of COVID-19 Vaccination Among University Students in China

BACKGROUND

Coronavirus disease 2019 (COVID-19) vaccination is expected to end the pandemic; a high coverage rate is required to meet this end. This study aimed to investigate the prevalence of behavioral intention of free/self-paid COVID-19 vaccination and its associations with prosociality and social responsibility among university students in China.

METHODS

An anonymous online cross-sectional survey was conducted among 6922 university students in five provinces in China during November 1-28, 2020. With informed consent, participants filled out an online survey link distributed to them via WeChat study groups. The response rate was 72.3%.

RESULTS

The prevalence of behavioral intentions of free COVID-19 vaccination was 78.1%, but it dropped to 57.7% if the COVID-19 vaccination involved self-payment (400 RMB; around 42 USD). After adjusting for background factors, prosociality (free vaccination: adjusted odds ratio [ORa] = 1.10, 95% CI: 1.09-1.12; self-paid vaccination: ORa = 1.08, 95% CI: 1.07-1.09) and social responsibility (free vaccination: ORa = 1.17, 95% CI: 1.14-1.19; self-paid vaccination: ORa = 1.13, 95% CI: 1.11-1.14) were positively associated with the two variables of COVID-19 vaccination intention.

CONCLUSION

The present study demonstrated the positive effects of prosociality and social responsibility on the intention of COVID-19 vaccination. Accordingly, modification of prosociality and social responsibility can potentially improve COVID-19 vaccination. Future longitudinal and intervention studies are warranted to confirm such associations across populations and countries.

Using infographics to reduce the negative effects of jargon on intentions to vaccinate against COVID-19

Guided by feelings-as-information theory, this experiment (N = 643), based in the United States, tested whether the use of jargon and infographics within messages designed to explain the COVID-19 mRNA vaccines affected behavioral intentions to vaccinate. The results revealed that the presence of jargon was associated with a difficult processing experience, message resistance, decreased perceptions of message credibility, and reduced intentions to get the COVID-19 vaccine. That said, when an infographic was integrated into the jargon message, these negative relationships went away and the presence of jargon no longer indirectly impacted intention to vaccinate. This experiment demonstrates that in contexts where jargon use exists, the use of an infographic can counteract some of the negative effects of a difficult processing experience.

An integrated dual-process model for coping behaviour

Stress management interventions have traditionally aimed to change coping behaviour with little attention to mechanisms that drive behaviour change. We sought to test an integrated dual-process model, accounting for reasoned and automatic processes, for predicting problem-focussed coping behaviour. The study adopted a two-wave prospective correlational design with a 1-week follow-up. University students aged 17-25 (N = 272) completed survey measures online. At Time 1, participants completed self-report measures of attitude, subjective norm, perceived behavioural control, intention, behavioural automaticity, and past problem-focussed coping behaviour. At Time 2, participants completed follow-up measures of behavioural automaticity and problem-focussed coping behaviour. Structural equation modelling testing the hypothesised dual-process model exhibited a good fit to the data, accounting for 50.0% and 45.4% of the variance in intentions and problem-focussed coping behaviour, respectively. Attitude, subjective norm, perceived behavioural control, and past behaviour directly predicted intention. Intention, past behaviour, and behavioural automaticity directly predicted problem-focussed coping behaviour. Past behaviour also indirectly predicted problem-focussed coping behaviour via behavioural automaticity. Results suggest that problem-focussed coping behaviour tends to be regulated by reasoned psychological processes, and more strongly by automatic psychological processes. Future research aiming to increase problem-focussed coping should utilise behaviour change methods known to influence these processes.

Contexts, beliefs and health behaviour: Are individuals who engage in risky sexual behaviour likely to wear facemasks against COVID-19?

Beside age, underlying comorbidities and availability of sanitation facilities, individual health beliefs and behaviour are critical in combating the sustained prevalence of Covid-19. Behaviour has, however, been shown to be consistent but could be context- dependent based on the individual’s beliefs. To investigate whether or not individuals’ protective behaviour against coronavirus is associated with their behaviour in a previous health context. Facemask usage and engagement in risky sexual behaviour (RSB) were employed as corollaries of Covid-19 protective behaviour and a previous health context respectively. Data on them and other sociodemographic correlates of health behaviour were collected on 522 Nigerians via a web-based survey. The data were analyzed using frequency, Chi Square and Binary Logistics Regression. About 31% of the population wore facemasks in public, 48.1% believed Covid existed and was severe, and 31.6% had engaged in RSB. Individuals who engaged in RSB had lower odds of wearing facemasks in public in both the general population and across the rural-urban divide. The relationship was, however, only statistically significant (OR:0.642, p<0.05) in the adjusted regression model. Other significant determinants of facemask use were gender, place of residence, employment status and beliefs about Covid. The similarity of individual beliefs and behaviours in different health contexts provides an opportunity to model behaviour change communication policies for preventing and combating the spread of coronavirus and other infectious diseases.

Effectiveness of electronic learning for continuing interprofessional education on behavior change of healthcare professionals: A scoping review

Electronic learning (e-learning) for continuing professional education (CPE) in healthcare has been shown to improve learners' satisfaction, attitudes, and performance. E-learning outcomes for continuing interprofessional education (CIPE) are less known, and the features of electronic CIPE programs that promote behavior change are unclear. In this scoping review, we sought to identify the program features and areas of behavior change in healthcare professionals using e-learning for CIPE. PubMed, CINAHL, ERIC, PsycINFO, Cochrane Library databases, and Google/Google Scholar were searched for all English articles published in the last 10 years. From the 32 studies included in our review, eight types of e-learning methods were identified. More than 35,542 healthcare professionals of different professions had participated in the programs. Thirty studies demonstrated positive behavior changes, with four areas of behavior changes identified. The most common area of change was in patient care practices. Five common program features facilitating behavior change were also identified. Most successful programs provided interactive and authentic learning experiences, which promoted direct clinical application. Future researche should include monitoring of sustained behavior changes at work, linked to patient outcomes.

Attitudes in an interpersonal context: Psychological safety as a route to attitude change

Interpersonal contexts can be complex because they can involve two or more people who are interdependent, each of whom is pursuing both individual and shared goals. Interactions consist of individual and joint behaviors that evolve dynamically over time. Interactions are likely to affect people’s attitudes because the interpersonal context gives conversation partners a great deal of opportunity to intentionally or unintentionally influence each other. However, despite the importance of attitudes and attitude change in interpersonal interactions, this topic remains understudied. To shed light on the importance of this topic. We briefly review the features of interpersonal contexts and build a case that understanding people’s sense of psychological safety is key to understanding interpersonal influences on people’s attitudes. Specifically, feeling psychologically safe can make individuals more open-minded, increase reflective introspection, and decrease defensive processing. Psychological safety impacts how individuals think, make sense of their social world, and process attitude-relevant information. These processes can result in attitude change, even without any attempt at persuasion. We review the literature on interpersonal threats, receiving psychological safety, providing psychological safety, and interpersonal dynamics. We then detail the shortcomings of current approaches, highlight unanswered questions, and suggest avenues for future research that can contribute in developing this field.

Chinese Residents' Healthy Eating Intentions and Behaviors: Based on an Extended Health Belief Model

Unhealthy eating is one cause of obesity and some chronic non-communicable diseases. This study introduces self-efficacy and health consciousness to construct an extended health belief model (HBM) to examine the factors influencing healthy eating intentions and behaviors of Chinese residents and explore the moderating effect of perceived barriers and the mediating effect of healthy eating intentions. Through the survey platform “Questionnaire Star”, this study collected quantitative data from 1281 adults, and partial least squares structural equation modeling was used for confirmatory factor analysis, path analysis, importance-performance map analysis, and multi-group analysis. Results showed that perceived susceptibility, perceived severity, perceived benefits, self-efficacy, and health consciousness had a significant positive effect on residents’ healthy eating intentions. Perceived barriers had a significant negative effect on residents’ healthy eating intentions. Healthy eating intentions had a significant positive effect on healthy eating behaviors. Perceived barriers played a significant negative moderating effect between healthy eating intentions and behaviors. Healthy eating intentions had a positive and significant mediating effect. The multi-group analysis showed that extended HBM has relative generalization ability. The extended HBM has good explanatory and predictive power for healthy diet and provides a new framework for understanding the influencing factors of individuals’ healthy eating intentions and behaviors.

The unappreciated relevance of auxiliary assumptions for evaluating theory-based interventions in health psychology

The use of theory in health behavior change interventions has been recently questioned with mixed results found for theory-based intervention effectiveness. But theory testing in intervention depends on not only theoretical assumptions, but on auxiliary assumptions too. Specifically, auxiliary assumptions are required to traverse the distance from nonobservational terms in theories and observational terms at the level of the empirical hypotheses in interventions. We believe intervention failures are often due to flaws in auxiliary assumptions rather than assumptions at the theoretical level. We use the theory of planned behavior to illustrate how the consideration of these auxiliary assumptions is important to appraise the effectiveness of interventions informed by theory. We hope that bringing attention to the importance of auxiliary assumptions provides a more nuanced and accurate appraisal of theory utility.

The Determinants of Consumers’ E-Waste Recycling Behavior through the Lens of Extended Theory of Planned Behavior

Cutting-edge technological advancements have turned many electronic devices into waste within a short time of usage. Electronic waste (e-waste) has become a global problem. Due to the adverse impact of e-waste on the environment and human health, a regulatory system for effective collection and treatment of e-waste disposed of by the community and business sectors is in dire need. In an attempt to address the setbacks and cope with e-waste issues, this study determined factors that influence e-waste recycling intentions (ERIs) and e-waste recycling behavior (ERB) among consumers in Malaysia through the lens of an extended theory of planned behavior (TPB) model. Via an online survey, 159 questionnaires were collected from targeted respondents in Malaysia aged 18 years and above identified using the purposive sampling method. The structural equation modeling (SEM) approach was deployed for data analysis. As a result, moral obligation (MO) emerged as the most significant factor toward ERI, followed by perceived convenience (PC). Next, ERI displayed a significant effect on ERB. The multi-group analysis (MGA) outcomes revealed significant group differences in education variables, signifying that the lower/middle education group was more easily influenced to perform ERB than the higher education group. Essentially, this study contributes to many aspects especially in enhancing the awareness of e-waste issues and emphasizing the broad knowledge about e-waste recycling. This study provides practical implications for the government, the policymakers and all stakeholders, including consumers, non-government agencies, collectors, retailers, and recycling facilities. The study outcomes may be considered when formulating laws and regulations to enhance e-waste recycling efforts that guarantee a sustainable ecosystem in the future.

Multilevel theorizing in health communication: Integrating the Risk Perception Attitude (RPA) framework and the Theory of Normative Social Behavior (TNSB)

Research testing the risk perception attitudes (RPA) framework has demonstrated that efficacy can moderate the effect of risk perceptions on behavior. This effect of efficacy has also been seen at the social-level through tests of the theory of normative social behavior (TNSB). We tested if efficacy could bridge normative factors at a social-level and risk perception at an individual-level. Data for this study come from the Reduction in Anemia through Normative Innovations (RANI) project’s baseline survey in Odisha, India. We used hierarchical regressions to analyze interactions between predictors at various levels and efficacy to predict behavioral intention. Efficacy beliefs moderated the effect of injunctive norms (β = 0.07, p < 0.01), collective norms (β = 0.06, p < 0.01), and risk perception (β = 0.04, p < 0.01) on intentions. This study provides preliminary evidence for a multilevel theoretical framework.

Implementation intentions to express gratitude increase daily time co-present with an intimate partner, and moderate effects of variation in CD38

Close social connections drive mental and physical health and promote longevity. Positive, other-focused behavior like expressing gratitude may be a key mechanism for increasing close bonds. Existing evidence consistent with this claim is predominantly correlational, likely driven by challenges in causally influencing and sustaining behavior change in the context of ongoing relationships. This 5-week field experiment with daily data from couples provides the first evidence for a brief, low-cost behavioral technique to increase everyday expressed gratitude to a romantic partner. Random assignment to the gratitude expression treatment (GET) increased the amount of time couples spent co-present in everyday life, from the weeks before GET to the weeks after, relative to the control condition. This effect was mediated by the change in expressed gratitude. Voluntary co-presence is an important behavioral indicator of close bonds in non-human animals. Further analyses with a functional genotype related to the oxytocin system (rs6449182) suggest a neurochemical pathway involved in the effects of expressing gratitude. Together, this evidence bridges animal and human research on bonding behavior and sets up future experiments on biopsychosocial mechanisms linking close bonds to health.

A Participatory Sensing Study to Understand the Problems Older Adults Faced in Developing Medication-Taking Habits

Past research has demonstrated that older adults tend to use daily activities as cues to remember to take medications. However, they may still experience medication non-adherence because they did not select adequate contextual cues or face situations that interfere with their medication routines. This work addresses two research questions: (1) How does the association that older adults establish between their daily routines and their medication taking enable them to perform it consistently? (2) What problems do they face in associating daily routines with medication taking? For 30 days, using a mixed-methods approach, we collected quantitative and qualitative data from four participants aged 70–73 years old about their medication taking. We confirm that older adults who matched their medication regimens to their habitual routines obtained better results on time-based consistency measures. The main constraints for using daily routines as contextual cues were the insertion of medication taking into broad daily routines, the association of multiple daily routines with medication taking, the lack of strict daily routines, and the disruption of daily routines. We argue that the strategies proposed by the literature for forming medication-taking habits should support their formulation by measuring patients’ dosage patterns and generating logs of their daily activities.

Self-reported health behaviors and risk perceptions following the COVID-19 vaccination rollout in the USA: an online survey study

OBJECTIVES

Concerns have been raised that mass vaccination campaigns might lead to reduced engagement with other recommended health behaviors. We assessed self-reported behaviors and risk perceptions following the COVID-19 vaccine rollout in the USA.

STUDY DESIGN

Between December 2, 2020, and March 23, 2021, we conducted three online survey studies with US adult respondents.

METHODS

Respondents self-reported their COVID-19 vaccination status, their frequency of engaging in risk-increasing behaviors and wearing a mask when in public places, and their COVID-19 risk perceptions (i.e., perceived likelihood of getting COVID-19 and of being hospitalized if they got COVID-19).

RESULTS

Our analytical sample included 832 respondents who had completed the first and final surveys and had received either 0 or 2 doses of a COVID-19 vaccine. Most respondents were non-Hispanic White (75%), male (77%), and US Veterans (64%), with the median age between 55 and 74 years. Overall, respondents reported frequently wearing masks when in public and rarely engaging in risk-increasing behaviors. Regardless of vaccination status, respondents reported more frequently engaging in risk-increasing behaviors and lower risk perceptions in March 2021 than in December 2020. Mask wearing did not change over the study period, with vaccinated respondents consistently reporting more frequent mask wearing than unvaccinated respondents.

CONCLUSIONS

Taken together, our findings indicate that the COVID-19 vaccine rollout in the USA did not result in the rapid abandonment of protective behaviors or dramatic uptake of risk-increasing behaviors. Additional studies are needed to monitor how mass vaccination might impact public behaviors and risk perceptions as coverage widens.

The effects of feedback valance and progress monitoring on goal striving

The current paper explores how people’s goal strivings are influenced by feedback (positively valenced vs. negatively valenced), progress monitoring (remaining vs. accumulated) and goal specificity (vague vs. specific). Two laboratory-based experiments were performed. Experiment 1 reveals that, after receiving positively valenced feedback, participants who focus on accumulated progress show larger boosts in persistence than participants who focus on remaining progress. In contrast, after receiving negatively valenced feedback, participants who focus on remaining progress show larger boosts in persistence than participants who focus on accumulated progress. Experiment 2 extends the scope of the paper from understanding the effects of progress monitoring on goal striving to the effects goal specificity on goal striving. Experiment 2 shows that after receiving negatively valenced feedback, participants asked to consider specific goals (and so likely focus on remaining progress) show more persistence than participants asked to consider vague goals (and so likely focus on accumulated progress). These findings have important implications for motivation theory and applied practice.

Social cognition theories and behavior change in COVID-19: A conceptual review

The COVID-19 pandemic has had unprecedented health, economic, and social consequences worldwide. Although contact reductions and wearing face coverings have reduced infection rates, and vaccines have reduced illness severity, emergence of new variants of the coronavirus that causes COVID-19, and the shift from pandemic to endemic patterns of infection, highlights the importance of ongoing preventive behavior adherence to manage future outbreaks. Research applying social cognition theories may assist in explaining variance in these behaviors and inform the development of efficacious behavior change interventions to promote adherence. In the present article, we summarize research applying these theories to identify modifiable determinants of COVID-19 preventive behaviors and the mechanisms involved, and their utility in informing interventions. We identify limitations of these applications (e.g., overreliance on correlational data, lack of long-term behavioral follow-up), and suggest how they can be addressed. We demonstrate the virtue of augmenting theories with additional constructs (e.g., moral norms, anticipated regret) and processes (e.g., multiple action phases, automatic processes) to provide comprehensive, parsimonious behavioral explanations. We also outline how the theories contribute to testing mechanisms of action of behavioral interventions. Finally, we recommend future studies applying these theories to inform and test interventions to promote COVID-19 preventive behavior adherence.

Effects of implementation intentions on subthreshold binge eating

Binge eating disorder (BED) and bulimia nervosa (BN) are characterized by binge eating. Frequently related to negative affect, binge eating is considered unwanted eating behavior. It is often preceded by a shift away from the goal of a healthy eating pattern. Implementation intentions are 'if-then' plans that may prevent such shifts in goals. In a students' sample with subthreshold binge eating, two implementation intention conditions were compared to a control condition in which only goals were formed. In the behavior-focused condition, implementation intentions targeted binge eating; in the emotion-focused condition, implementation intentions targeted negative affect preceding binge eating. All participants received three sessions and kept food diaries for four weeks, followed by a post-test and a one-month, three-months, and six-months follow-up. Compared to the control condition, both implementation intention conditions showed significant and large reductions in binge eating lasting for six months. Effects did not differ between both implementation intention conditions. Three implementation intention sessions reduced subthreshold binge eating. This continued for six months after the final session. Contrary to expectations, behavior-focused and emotion-focused implementation intentions were equally effective, possibly due to other triggers than negative affect. Future research should address their usefulness in BED and BN.

mediación de la pasión armoniosa por el trabajo en la relación entre el liderazgo de servicio y las intenciones laborales: Un estudio longitudinal

El estudio evaluó la relación entre el liderazgo de servicio y las intenciones laborales, mediadas por la pasión por el trabajo, en un estudio longitudinal. Los datos se recopilaron en tres oleadas, con intervalos de tres meses entre ellos, totalizando un período de recopilación de datos de seis meses. La muestra total estuvo constituida por 479 trabajadores de todas las regiones brasileñas y de ambos sexos (70,4% mujeres). Los resultados del análisis de panel rezagado cruzado mostraron que el liderazgo de servicio predijo positivamente las intenciones de trabajo. Además, la pasión por el trabajo medió parcialmente la relación entre el liderazgo de servicio y las intenciones laborales. Sin embargo, contrariamente a lo esperado, esta mediación fue negativa. Los resultados se discuten a la luz del Modelo de Evaluación de la Pasión por el Trabajo, que brindó soporte teórico para la investigación.

Countering vaccine hesitancy through medical expert endorsement

Scientists and medical experts are among the professionals trusted the most. Are they also the most suitable figures to convince the general public to get vaccinated? In a pre-registered experiment, we tested whether expert endorsement increases the effectiveness of debunking messages about COVID-19 vaccines. We monitored a sample of 2,277 people in Italy through a longitudinal study along the salient phases of the vaccination campaign. Participants received a series of messages endorsed by either medical researchers (experimental group) or by generic others (control). In order to minimise demand effects, we collected participants’ responses always at ten days from the last debunking message. Whereas we did not find an increase in vaccination behaviour, we found that participants in the experimental group displayed higher intention to vaccinate, as well as more positive beliefs about the protectiveness of vaccines. The more debunking messages the participants received, the greater the increase in vaccination intention in the experimental group compared to control. This suggests that multiple exposure is critical for the effectiveness of expert-endorsed debunking messages. In addition, these effects are significant regardless of participants’ trust toward science. Our results suggest that scientist and medical experts are not simply a generally trustworthy category but also a well suited messenger in contrasting disinformation during vaccination campaigns.

Tobacco Dependence Among French University Students: A Cluster Analytic Approach to Identifying Distinct Psychological Profiles of Smokers

This study investigates the combination of several psychological factors related to tobacco smoking to identify smokers’ psychological profiles among French university students. A cluster analysis was performed on smoking motives, psychosocial variables, and the smoker identity ( N = 909). Five profiles were identified and then compared regarding tobacco dependence and motivations to quit. “Normative” and “sociohedonist smokers” are characterized by two distinct social factors (normative influences and social motives) and moderate dependence. “Dependent identified smokers” have higher levels of dependence motives, smoker identity and tobacco dependence associated with low motivations to quit. “Inconsistent smokers” have weak smoker identity and weak smoking motives, a strong perceived control over resisting smoking, low dependence and motivations to quit. “Coping smokers” have strong sedative and addictive motives and exhibit moderate dependence and motivations to quit. This research encourages prevention programs to consider the diversity of student smokers with strategies adapted to their psychological profiles.

teen Mental Health First Aid: 12-month outcomes from a cluster crossover randomized controlled trial evaluation of a universal program to help adolescents better support peers with a mental health problem

Background

teen Mental Health First Aid (tMHFA) is a universal mental health literacy, stigma reduction, help-seeking, and suicide prevention program designed for adolescents in Years 10–12 of secondary school (16–18 years). tMHFA is delivered by trained instructors, in a regular classroom setting, to increase the knowledge, attitudes and behaviours that adolescents’ require to better support peers with mental health problems or mental health crises.

Methods

To explore the efficacy of tMHFA, a cluster crossover randomised controlled trial was conducted with Year 10 students in four schools in Victoria, Australia, using physical first aid training as the control intervention. Of the 1942 eligible students, 1,624 completed baseline and 894 completed follow-up surveys. Online surveys, administered one week before training and again 12-months later, included vignettes depicting peers John (depression and suicide risk) and Jeanie (social anxiety/phobia), measures of mental health first aid (quality of first aid intentions, confidence, first aid behaviours provided, and first aid behaviours received), mental health literacy (beliefs about adult help, help-seeking intentions), and stigma (social distance, weak-not-sick, dangerous/unpredictable, and would not tell anyone).

Results

The primary outcome—quality of first aid intentions towards the John vignette—showed statistically significant group x time interactions, with tMHFA students reporting more helpful and less unhelpful first aid intentions, than PFA students did over time. Confidence in providing first aid also showed significant interactions. First aid behaviours—both those provided to a peer with a mental health problem and those received from a peer—showed null results. Ratings of both beliefs about adult help and help-seeking intentions were found to be significantly improved among tMHFA students at follow-up. A group x time interaction was found on one stigma scale (would not tell anyone).

Conclusions

This trial showed that, one year after training, tMHFA improves first aid intentions towards peers with depression and suicide risk, confidence in helping peers with mental health problems, willingness to tell someone and seek help from an adult or health professional if experiencing a mental health problem.

Trial registration

This research was registered with Australia New Zealand Clinical Trials Registry: ACTRN12614000061639.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13554-6.

The effectiveness of animal welfare-, environmental-, and health-focused video appeals on implicit and explicit wanting of meat and intentions to reduce meat consumption

The production of meat and its consumption are associated with negative consequences for the environment, the animals raised and slaughtered for food, and the health of those who consume animal-based foods. We investigated whether video appeals that addressed these topics affected participants' wanting of meat and intentions to reduce meat relative to a control video. Results indicated only the environmental video led to increased intentions to reduce meat relative to controls. Nevertheless, implicit wanting of meat was lower in all three experimental conditions compared to the control condition. Additionally, moral emotions and agreement with the video's message mediated the relationships between condition and implicit wanting and intentions for the animal welfare and environment conditions. For the health condition, only agreement with the message served as a mediator. These results suggest that although animal welfare-, environmental-, and health-focused video appeals may be effective at shifting immediate desire to consume meat, environmental video appeals may be the most effective for increasing intentions to change future meat intake.

Impact of video-led educational intervention on uptake of influenza vaccine among the elderly in western China: a community-based randomized controlled trial

BACKGROUND

Influenza vaccination coverage rate among the elderly is low in China. We aimed to evaluate the impact of video-led educational intervention on influenza vaccine uptake among the Chinese elderly.

METHODS

A randomized controlled trial was conducted in 8 communities of Xi'an, a representative city in western China. Elderly aged over 60 years were randomized to the control group and intervention group (12-minute video education on influenza and its vaccination). Participants' knowledge, attitudes, and practices (KAP) of influenza was assessed by using a questionnaire survey before and after the intervention. The primary outcomes were participants' willingness to get influenza vaccinated and their actual uptake rates in the 2020-21 flu season. Secondary outcomes were the variations of pre- and post-intervention KAP scores. Intention-to-treat analysis was performed to analyze the data, and sensitivity analyses were conducted to examine the robustness of the results.

RESULTS

A total of 350 people were enrolled, with 175 individuals for each group. Participants in the intervention group were more willing to receive influenza vaccination than those in the control group (64.6% vs. 51.4%, p<0.05). The influenza vaccination uptake rate occurred in 10.3% of participants in the intervention group and 3.4% in the control group (odds ratio, 3.23; 95% CI 1.25-8.32, p<0.001). The post-intervention KAP scores in the intervention group were significantly higher compared to those in the control group (p<0.001).

CONCLUSION

Video-led education was an effective and feasible approach to improve old people's willingness and uptake of influenza vaccination in western China.