Dispelling the illusion of invulnerability: the motivations and mechanisms of resistance to persuasion

The search for the missing link between health misinformation & health disparities

Relative to the rapid increase in available health information, little has been published on the differential impact misinformation has on the health of communities. Observations during the height of the COVID-19 pandemic indicated there were communities that made decisions that negatively impacted health outcomes beyond expectations; we propose that health misinformation was a contributor to poor health outcomes. Health misinformation exposure varies across communities and preliminary research suggests that some communities are more vulnerable to the impact of health misinformation than others. However, few studies have evaluated the connection between health misinformation and healthcare disparities. In this paper, we (a) review the current literature on misinformation and its impact on health disparities, (b) expand on prior epidemiological models to explain the communal spread of misinformation and the link to disparate health outcomes, (c) identify gaps in knowledge about communal misinformation spread (d) review promising interventions to halt the adverse impact of misinformation.

Protecting against misinformation: Evaluating the effectiveness of three techniques to reduce memory conformity

The memory conformity effect occurs when people witness a given incident (e.g. a crime) then talk to each other about it, and the statement of one person affects the memory account of the other person with respect to this incident. The aim of this article is to improve the quality of witness testimony by verifying the effectiveness of three methods that aim to reduce memory conformity effect: (1) an extended warning against misinformation; (2) a method based on information about memory functioning and its fallibility and (3) a method consisting in motivating participants to resist influence and demonstrating their individual vulnerability to it. In the presented experiment, the innovative MORI technique was used to study the memory conformity effect. This technique allows a pair of participants to sit beside each other, look at the same screen and see a different version of the same criminal event. In the next stages, the subjects are asked to answer a series of questions about different details, thereby introducing mutual misinformation; then, the participants perform an individual memory test. In the experimental conditions, this test was preceded by one of the three tested methods in each group, with the aim of determining their effectiveness in reducing memory conformity. It turns out that the implementation of an extended warning against misinformation eliminated the memory conformity effect, while the application of two other methods led to a reduction (but not complete elimination) of the studied phenomenon.

Youth Perspectives on the Effects of a Family-centered Media Literacy Intervention to Encourage Healthier Eating

A pretest-posttest field test with control group (N = 189 parent-child dyads) tested a structural model representing youths' (ages 9-14) perspectives to examine the efficacy of a family-centered, media literacy-oriented intervention promoting fruit and vegetable consumption. The intervention facilitated critical discussion about nutrition and media, mentored by the parent. Results showed that youths' increases in fruit and vegetable consumption flowed from parent-child discussion of nutrition labels, which was predicted by child-initiated discussion, critical thinking about media sources, and critical thinking about media content. Multivariate analyses revealed that the intervention was productive for all participating age groups and for all dependent variables. The results suggest that a developmental progression from critical thinking about source to critical thinking about content affects behavior change and can be catalyzed through media literacy education and encouragement to discuss media messages (i.e. practice) with parents.

Developing communication tools on rotavirus vaccination to support family paediatricians in Italy

BACKGROUND

Universal rotavirus (RV) vaccination for newborns was introduced in Italy in 2018, but national vaccination coverage is still suboptimal. Effective communication between the family paediatrician (FP) and parents/caregivers is essential to promote vaccination acceptance. This project aimed to support FPs in communicating RV vaccination to parents/caregivers through the development and implementation of demonstrative videos and training modules.

METHODS

A working group composed of two FPs, two communication professionals, a medical expert from GSK and a clinical psychologist, was formed to establish the key scientific information to be communicated to parents/caregivers and develop the demonstrative videos. Four videos depicting four communication styles (I to IV) were developed based on the Social Styles Theory. Thirty FPs were then asked to pilot test the videos and provide feedback. In addition, two training modules with scientific information were developed to learn how to respond to parents'/caregivers' objections.

RESULTS

A total of 23 FPs provided feedback after using one or more videos at least five times. Twenty FPs (87.0 %) used mostly-one style, and most (60.0 %) used Style IV. Overall, the feedback was positive, as the majority of FPs (82.6 %, n = 19/23) indicated that the proposed videos were 'useful' or 'extremely useful' for introducing the RV vaccination to parents/caregivers in their actual practice. Based on this feedback, shorter versions of each video were also produced, and two training modules were developed to support FPs in responding to parental objections. Most FPs 75 % (n = 9/12) found Module 1 'very useful', and all found Module 2 'very useful' (100 %, n = 12/12).

CONCLUSIONS

The communication tools developed were well appreciated by the FPs and are expected to support FPs in communicating RV vaccination thereby increasing its coverage. Practicing RV communication may also prove beneficial for FPs to communicate other critical topics to parents/caregivers.

How Media Literacy, Trust of Experts and Flu Vaccine Behaviors Associated with COVID-19 Vaccine Intentions

PURPOSE

To assess how previous experiences and new information contributed to COVID-19 vaccine intentions.

DESIGN

Online survey (N = 1264) with quality checks.

SETTING

Cross-sectional U.S. survey fielded June 22-July 18, 2020.

SAMPLE

U.S. residents 18+; quotas reflecting U.S. Census, limited to English speakers participating in internet panels.

MEASURES

Media literacy for news content and sources, COVID-19 knowledge; perceived usefulness of health experts; if received flu vaccine in past 12 months; vaccine willingness scale; demographics.

ANALYSIS

Structural equation modelling.

RESULTS

Perceived usefulness of health experts (b = .422, P < .001) and media literacy (b = .162, P < .003) predicted most variance in vaccine intentions (R-squared=31.5%). A significant interaction (b = .163, P < .001) between knowledge (b = -.132, P = .052) and getting flu shot (b = .185, P < .001) predicted additional 3.5% of the variance in future vaccine intentions. An increase in knowledge of COVID-19 associated with a decrease in vaccine intention among those declining the flu shot.

CONCLUSION

The interaction result suggests COVID-19 knowledge had a positive association with vaccine intention for flu shot recipients but a counter-productive association for those declining it. Media literacy and trust in health experts provided strong counterbalancing influences. Survey-based findings are correlational; thus, predictions are based on theory. Future research should study these relationships with panel data or experimental designs.

Technique-based inoculation against real-world misinformation

In recent years, numerous psychological interventions have been developed to reduce susceptibility to misinformation. Inoculation theory has become an increasingly common framework for reducing susceptibility to both individual examples of misinformation (issue-based inoculation) and to the techniques and strategies that are commonly used to mislead or misinform people (technique-based inoculation). In this study, we address two open questions related to technique-based inoculation in two separate experiments (total n = 2188; convenience sample recruited via the Bad News online game platform): (i) can technique-based inoculation effectively reduce susceptibility to real-world misinformation that went viral on social media? and (ii) can technique-based inoculation confer cross-protection against misinformation that does not make use of any of the techniques against which people were inoculated? We find that playing a 15 min game confers psychological resistance against real-world misinformation that makes use of manipulation techniques against which people were inoculated (Cohen's d = 0.37, Cohen's U ₃ = 64.4%, p < 0.001), and that cross-protection is achieved but at a reduced effect size (d = 0.10, U ₃ = 54.0%, p = 0.001).

Technique-based inoculation against real-world misinformation

In recent years, numerous psychological interventions have been developed to reduce susceptibility to misinformation. Inoculation theory has become an increasingly common framework for reducing susceptibility to both individual examples of misinformation (issue-based inoculation) and to the techniques and strategies that are commonly used to mislead or misinform people (technique-based inoculation). In this study, we address two open questions related to technique-based inoculation in two separate experiments (total n = 2188; convenience sample recruited via the Bad News online game platform): (i) can technique-based inoculation effectively reduce susceptibility to real-world misinformation that went viral on social media? and (ii) can technique-based inoculation confer cross-protection against misinformation that does not make use of any of the techniques against which people were inoculated? We find that playing a 15 min game confers psychological resistance against real-world misinformation that makes use of manipulation techniques against which people were inoculated (Cohen's d = 0.37, Cohen's U 3 = 64.4%, p < 0.001), and that cross-protection is achieved but at a reduced effect size (d = 0.10, U 3 = 54.0%, p = 0.001).

How do we raise media bias awareness effectively? Effects of visualizations to communicate bias

Media bias has a substantial impact on individual and collective perception of news. Effective communication that may counteract its potential negative effects still needs to be developed. In this article, we analyze how to facilitate the detection of media bias with visual and textual aids in the form of (a) a forewarning message, (b) text annotations, and (c) political classifiers. In an online experiment, we randomized 985 participants to receive a biased liberal or conservative news article in any combination of the three aids. Meanwhile, their subjective perception of media bias in this article, attitude change, and political ideology were assessed. Both the forewarning message and the annotations increased media bias awareness, whereas the political classification showed no effect. Incongruence between an articles’ political position and individual political orientation also increased media bias awareness. Visual aids did not mitigate this effect. Likewise, attitudes remained unaltered.

Health Care Clinicians and Product Promotion by Industry

Medical pharmaceutical and device manufacturers are essential in making products that benefit patients, and collaboration between health care clinicians and the industry is necessary for the design and manufacture of these medical products. However, health care clinicians must recognize that their duties and the interests of the industry may at times diverge. Relationships with the industry, even seemingly minor ones, have the potential to shape the decisions made on behalf of patients. The marketing divisions of pharmaceutical and medical device firms view health care clinicians as targets of their efforts, and some of the interactions that occur between the industry and health care clinicians have the potential to alter decision making in ways that may not necessarily benefit patients. Health care clinicians have an ethical duty to recognize situations and marketing strategies that are designed to influence their choice of diagnostic and therapeutic options for their patients. At a minimum, health care clinicians should be aware of the techniques used to attempt to alter their behavior and guard against them.

Misinformation: susceptibility, spread, and interventions to immunize the public

The spread of misinformation poses a considerable threat to public health and the successful management of a global pandemic. For example, studies find that exposure to misinformation can undermine vaccination uptake and compliance with public-health guidelines. As research on the science of misinformation is rapidly emerging, this conceptual Review summarizes what we know along three key dimensions of the infodemic: susceptibility, spread, and immunization. Extant research is evaluated on the questions of why (some) people are (more) susceptible to misinformation, how misinformation spreads in online social networks, and which interventions can help to boost psychological immunity to misinformation. Implications for managing the infodemic are discussed.

Focus Within or On Others: The Impact of Reviewers’ Attentional Focus on Review Helpfulness

When reviewers write online reviews, they differ in the focus of their attention: some focus on their own experiences, whereas some direct their attention to others—prospective consumers who may read the reviews in the future. This paper explores how, why, and when reviewers’ attentional focus can influence the helpfulness evaluation of reviews beyond the impact of substantive review content. Drawing on the attentional focus and persuasion literatures, we develop a theoretical model proposing that reviewers’ attentional focus may influence consumers’ perception of review helpfulness through opposing processes, and that its overall effect is contingent on the review’s two-sidedness. Results of one archival analysis and five controlled experiments provide consistent support for our hypotheses. This work challenges the predominant view of the positive impact of other-focus (vs. self-focus), explores the interpersonal impact of a reviewer’s attentional focus on prospective consumers who are total strangers, and reveals an important, context-specific boundary condition.

How Can Psychological Science Help Counter the Spread of Fake News?

In recent years, interest in the psychology of fake news has rapidly increased. We outline the various interventions within psychological science aimed at countering the spread of fake news and misinformation online, focusing primarily on corrective (debunking) and pre-emptive (prebunking) approaches. We also offer a research agenda of open questions within the field of psychological science that relate to how and why fake news spreads and how best to counter it: the longevity of intervention effectiveness; the role of sources and source credibility; whether the sharing of fake news is best explained by the motivated cognition or the inattention accounts; and the complexities of developing psychometrically validated instruments to measure how interventions affect susceptibility to fake news at the individual level.

How Media Literacy and Science Media Literacy Predicted the Adoption of Protective Behaviors Amidst the COVID-19 Pandemic

Individuals must navigate complex media environments filled with frequently changing and varyingly credible information to acquire and apply health information during times of uncertainty and danger. A process model tested in two U.S. national surveys in spring (N = 1220) and summer (N = 1264) of 2020 tested how three media literacy constructs (about sources, content, and science information) predicted the adoption of behaviors protective for COVID-19. Results showed that the three media literacy constructs were mediated by knowledge of COVID-19 (wave 1 TE = 0.190; wave 2 TE = 0.190) and expectancies (wave 1 TE = 0.496; wave 2 TE = 0.613). The model was confirmed as largely consistent across the two waves of data collection with independent samples. Results show the importance of expectancies for mediating the effects of media literacy, efficacy, and knowledge on behavior. The study suggests that media literacy and science media literacy skills aid health behavior adoption by contributing to knowledge gain and expectancies.

Effective forewarning requires central route processing: Theoretical improvements on the counterargumentation hypothesis and practical implications for scam prevention

Financial scams have caused tremendous financial damage globally. In Japan, the police forewarn people by equipping them with scam-prevention techniques or providing awareness regarding examples of previous scams; however, this does not appear to effectively prevent the damage, as many scam victims do not remember these warnings when faced with actual scam encounters. Considering that scammers often use appeal to emotion techniques, peripheral processing during scam attempts might disturb people’s abilities to recall the warnings on scammers’ modus operandi, thus leading to failed counter-arguing efforts. We verified this hypothesis in an experimental setting by asking 162 participants to remember given forewarnings and resist deceptive advertisements. The results showed that participants gave the advertisers’ manipulative intent a higher rating only when they processed the advertisement through a central route, in addition to being forewarned. This means that forewarning had no effect when participants processed the advertisement through a peripheral route. Moreover, forewarning recollection levels mediated the effect of processing route on this rating, which suggests that remembering forewarnings is necessary to generate counterarguments. This result expands the theory on forewarning effects and explains why people are susceptible to scam victimization. Furthermore, it provides implications for scam prevention.

A positive Shift in the Public Acceptability of a Low-Carbon Energy Project After Implementation: The Case of a Hydrogen Fuel Station

Public acceptability of low-carbon energy projects is often measured with one-off polls. This implies that opinion-shifts over time are not always taken into consideration by decision makers relying on these polls. Observations have given the impression that public acceptability of energy projects increases after implementation. However, this positive shift over time has not yet been systematically studied and is not yet understood very well. This paper aims to fill this gap. Based on two psychological mechanisms, loss aversion and cognitive dissonance reduction, we hypothesize that specifically people who live in proximity of a risky low-carbon technology—a hydrogen fuel station (HFS) in this case—evaluate this technology as more positive after its implementation than before. We conducted a survey among Dutch citizen living nearby a HFS and indeed found a positive shift in the overall evaluation of HFS after implementation. We also found that the benefits weighed stronger and the risks weaker after the implementation. This shift did not occur for citizens living further away from the HFS. The perceived risks and benefits did not significantly change after implementation, neither for citizens living in proximity, nor for citizens living further away. The societal implications of the findings are discussed.

Moralized Health-Related Persuasion Undermines Social Cohesion

Integrating theory and research on persuasion, moralization, and intergroup relations, the present research aims to highlight the far-reaching impact of health-related persuasion on society. I propose that governments’ health-related persuasion leads to the emergence of new social norms, and in particular moral norms. Importantly, moral norms provide strong behavioral imperatives and are seen as binding for group members. This suggests that moralized persuasion has a strong potential to divide society along the lines of citizens who conform to and citizens who deviate from health-related moral norms. Thus, departing from the traditional focus on targets of persuasion, the present research focuses on those holding a moralized view on health and lifestyle. Key aspects of social cohesion as defined by the OECD (2011) have been tested across four studies. The main hypothesis tested is that those conforming to the norm (e.g., non-smokers, normal weight people, people with healthy lifestyles) will stigmatize those deviating from the norm (e.g., smokers, overweight people, people with unhealthy lifestyles). Flowing from stigmatization, less inclusion, lower solidarity with and greater endorsement of unequal treatment of those deviating from the moral norm are predicted. Four survey studies (total N = 1568) examining the proposed associations among non-smokers, normal weight people, and employees with healthy lifestyles are presented. The studies provide unanimous support for the hypothesis, with meta-analysis providing further support for the reliability of the findings. Consistent across studies, social cohesion indicators were negatively affected by health moralization through stigmatization of those deviating from health-related moral norms. Findings highlight an under-acknowledged potential of moralized health-related persuasion to divide society, thereby undermining cohesion and the achievement of important societal goals. In the discussion, limitations and relevant routes for future research are highlighted. Recommendations are derived for policy makers, institutions, employers, and individuals.

How the Media Effects Schema and the Persuasion Ethics Schema Affect Audience Responses to Antismoking Campaign Messages

This study examines the roles that the media effects and persuasion ethics schemas play in people's responses to an antismoking ad in South Korea. An online experiment was conducted with 347 adults. The media effects schema was manipulated with news stories on an antismoking campaign's effectiveness, while the persuasion ethics schema was measured and median-split. Analysis of Variance (ANOVA) tests were performed for issue attitudes (Iatt), attitude toward the ad (Aad), and behavioral intention (BI). Results show significant main effects of the media effects schema on the three dependent variables. People in the weak media effects condition had significantly lower Iatt, Aad, and BI than those in either the strong media effects condition or the control condition. This pattern was more pronounced among smokers. While there was no significant main effect of the persuasion ethics schema on any of the dependent variables, a significant interaction effect for persuasion ethics schema and smoking status was found on behavioral intention (BI). Nonsmokers' BI was significantly higher than smokers' in the low-persuasion ethics schema condition, but it was not significant in the high-persuasion ethics schema condition.

The Effects of a Nutrition Media Literacy Intervention on Parents' and Youths' Communication about Food

Interventions addressing links between media exposure and obesity risk for school-age youth have not explicitly addressed the role of family communication about media. Youths' influence attempts on parents to purchase advertised foods can create conflict and negatively affect parental food choices. This study tested whether a family-based media literacy curriculum improves parents' media management skills and decreases youths' susceptibility to appealing but unrealistic food marketing. A matched-group pretest/posttest field experiment of parent-youth dyads with control group (N = 100 dyads, youth M = 11 years of age) tested the six-session curriculum. Hypotheses were analyzed using a Bayesian structural equation model. The curriculum increased parents' active negative mediation to foster youths' critical thinking about food marketing, b* = 0.35, 95% CCI [0.17, 0.50], increased parent Efficacy for making healthy dietary changes for their families, b* = 0.59, 95% CCI [0.41, 0.75], and fostered family discussion about nutrition labels (total effect = 0.22). Additionally, cumulative influences of Perceived Desirability and Wishful Identification on youths' requests for marketed foods were reduced (total effect = 0.04). Media literacy education can empower parents and improve youths' critical thinking to reduce effects of food marketing on families and improve use of media to obtain nutrition information.

Child psychiatry and its relationship with the pharmaceutical industry: theoretical and practical issues

The pharmaceutical industry is primarily responsible to its shareholders and so making profit is its primary motivation. The industry's marketing techniques affect not only prescribing habits of doctors but also concepts of mental health. This editorial examines the impact this has had on both theory and practice in child and adolescent psychiatry. Undue influence by the pharmaceutical industry contributes to a skewing of the literature towards biological disease models of childhood mental health in order to support the use of the pharmaceutical companies' products. Using fluoxetine and stimulants as two case examples, the article illustrates how pharmaceutical companies have contributed to widespread acceptance of erroneous beliefs about the safety and efficacy of using psychotropic drugs in children and adolescents. Suggestions are made on how child psychiatrists, both individually and collectively, can incorporate this knowledge into their professional development and practice.

Conflict of Interest Policies at French Medical Schools: Starting from the Bottom

BACKGROUND

Medical faculties have a role in ensuring that their students are protected from undue commercial influence during their training, and are educated about professional-industry interactions. In North America, many medical faculties have introduced more stringent conflict of interest (COI) policies during the last decade. We asked whether similar steps had been taken in France. We hypothesized that such policies may have been introduced following a 2009-2010 drug safety scandal (benfluorex, Mediator) in which COIs in medicine received prominent press attention.

METHODS

We searched the websites of all 37 French Faculties of Medicine in May 2015 for COI policies and curriculum, using standardized keyword searches. We also surveyed all deans of medicine on institutional COI policies and curriculum, based on criteria developed in similar US and Canadian surveys. Personal contacts were also consulted. We calculated a summary score per faculty based on 13 criteria. [range 0-26; higher scores denoting stronger policies].

RESULTS

In total, we found that 9/37 (24%) of French medical schools had either introduced related curriculum or implemented a COI-related policy. Of these, only 1 (2.5%) had restrictive policies for any category. No official COI policies were found at any of the schools. However, at 2 (5%), informal policies were reported. The maximum score per faculty was 5/26, with 28 (76%) scoring 0.

CONCLUSION

This is the first survey in France to examine COI policies at medical faculties. We found little evidence that protection of medical students from undue commercial influence is a priority, either through institutional policies or education. This is despite national transparency legislation on industry financing of health professionals and limits on gifts. The French National Medical Students Association (ANEMF) has called for more attention to COI in medical education; our results strongly support such a call.

Identifying General Cognitive Abilities Involved in Argument Comprehension and Evaluation

Das Verständnis und die Evaluation von Argumenten: Zur Rolle allgemeiner kognitiver Fähigkeiten

Zusammenfassung. Personen, denen die notwendigen Fähigkeiten für die korrekte Bewertung von Argumenten fehlen, ziehen ein Leben lang daraus Nachteile. Forschungsbefunde zeigen, dass einfache Tutorien für viele Studierende (ca. 30 %) keinen Nutzen bringen. Wir berichten Daten zur Frage, wie sich durch allgemeine Fähigkeiten (z. B. Vokabelwissen, Leseverständnis, analytisches Schlussfolgern) das Erlernen der Argumentevaluation vorhersagen lässt. In Studie 1 konnte gezeigt werden, dass – obwohl alle drei kognitiven Fähigkeiten einige Aspekte von Argumentverständnis und Evaluationsfähigkeit vorhersagen – das Vokabelwissen sowohl die Argumentationsfähigkeit und nicht durch das Wissen um die Bedeutung einer spezifischen Aussage, die in der Aufgabe gestellt wurde, erklärt. Die Ergebnisse zeigen auf, dass der gezielte Einsatz von Vokabelwissen und allgemeiner lexikalischer Qualität diesen Studierenden, die nicht von einem einfachen Tutorium profitieren, helfen könnte.

Examining How Media Literacy and Personality Factors Predict Skepticism Toward Alcohol Advertising

To examine the potential effectiveness of media literacy education in the context of well-established personality factors, a survey of 472 young adults, focused on the issue of alcohol marketing messages, examined how individual differences in personality associate with constructs representing aspects of media literacy. The results showed that need for cognition predicted social expectancies and wishful identification with media portrayals in alcohol advertising only through critical thinking about media sources and media content, which are foci of media literacy education. Need for affect did not associate with increased or diminished levels of critical thinking. Critical thinking about sources and messages affected skepticism, represented by expectancies through wishful identification, consistent with the message interpretation process model. The results support the view that critical thinking about media sources is an important precursor to critical thinking about media messages. The results also suggest that critical thinking about media (i.e., media literacy) reflects more than personality characteristics and can affect wishful identification with role models observed in media, which appears to be a key influence on decision making. This adds support to the view that media literacy education can improve decision making across personality types regarding alcohol use by decreasing the potential influence of alcohol marketing messages.

Strategies and motives for resistance to persuasion: an integrative framework

Persuasion is an important element of human communication. But in many situations, we resist rather than embrace persuasive attempts. Resistance to persuasion has been studied in many different disciplines, including communication science, psychology, and marketing. The present paper reviews and connects these diverse literatures, and provides an organizing framework for understanding and studying resistance. Four clusters of resistance strategies are defined (avoidance, contesting, biased processing, and empowerment), and these clusters are related to different motivations for resisting persuasion (threat to freedom, reluctance to change, and concerns of deception). We propose that, while avoidance strategies may be triggered by any of these motivations, contesting strategies are linked primarily to concerns of deception, while empowerment and biased processing strategies are most common when people are reluctant to change.

[Nursing and industry relations: literature review and conflicts of interest survey]

BACKGROUND

Advanced competencies and tasks of nurses go along with an increasing interest of pharmaceutical companies and manufacturers in nurses as a marketing target.

OBJECTIVE

To identify nurses' attitudes, perceptions and behavior regarding industry and marketing strategies.

METHODS

1) Systematic literature search in Medline via PubMed and CINAHL for international studies on nurses' conflict of interests towards pharmaceutical companies; 2) analysis of a survey with PhD students from two Nursing Science doctoral programs.

RESULTS

The review including 16 publications published between 1999 and 2014 and the survey among 82 PhD students revealed comparable results. The majority of nurses already had contact with pharmaceutical companies. Nurses are often uncritical in their attitudes, and suggestibility is claimed to be low. The majority of nurses were not - or at least not sufficiently - provided with conflict of interest training, neither as part of their vocational training nor their continuing education.

CONCLUSION

Conflict of interest seems to be an important topic for nurses. Increasing relevance in the future underpins the need for making nurses more sensitive towards this issue, especially through professional training programs.

The Role of Parents' Critical Thinking About Media in Shaping Expectancies, Efficacy and Nutrition Behaviors for Families

A convenience survey completed online by 137 4-H parents in Washington state explored their orientation toward critical thinking regarding media sources and content and its implications for family dietary behaviors. Parents' critical thinking toward media sources predicted their information efficacy about content. Critical thinking toward media content predicted information efficacy about sources, expectancies for parental mediation, and expectancies for family receptiveness to lower-fat dietary changes. Expectancies for receptiveness to dietary changes and expectancies for parental mediation predicted efficacy for implementing healthy dietary practices; this strongly predicted healthy dietary practices. Media-related critical thinking, therefore, indirectly but consistently affected self-reported family dietary behaviors through its effects on efficacy for managing media and expectancies for the family's receptiveness to healthy dietary changes. The results suggest parents' media literacy skills affect their family's dietary behavior. Health campaigns that help parents interpret and manage the media environment may benefit all family members.

Building sense out of situational complexity

There is growing consensus among scholars that the organizational environment has become increasingly complex, dynamic, and socially demanding. Leaders and followers navigate through a cognitive paradox where assessments of the situation can be at once cognitively overpowering and cognitively deceiving. In this article, we propose that complex situations can lead to ambivalence, a psychological state caused by contrasting evaluative orientations toward an object or situation. We propose that ambivalence can become a functional cognitive process that provides cognitive discomfort and fluidity for joint contextual interpretation when leaders and followers share ambivalent cognitive states. We develop a theoretical model of how this process unfolds, highlighting how and when situational complexity can trigger leader and follower ambivalence leading to distinct interpretative processes. Taken together, we explain how ambivalence can facilitate collaborative contextual interpretation within complex situations. In so doing, we advance the current understanding of ambivalence by explicating its role in creating functional leadership processes.

Forewarning reduces fraud susceptibility in vulnerable consumers

Telemarketing fraud is pervasive and older consumers are disproportionally targeted. Given laboratory research showing that forewarning can effectively counter influence appeals, we conducted a field experiment to test whether forewarning could protect people who had been victimized in the past. A research assistant with prior experience as a telemarketer pitched a mock scam two or four weeks after participants were warned about the same scam or an entirely different scam. Both warnings reduced unequivocal acceptance of the mock scam although outright refusals (as opposed to expressions of skepticism) were more frequent with the same scam warning than the different scam warning. The same scam warning, but not the different scam warning, lost effectiveness over time. Findings demonstrate that social psychological research can inform effective protection strategies against telemarketing fraud.

Transportation into narrative worlds: implications for entertainment media influences on tobacco use

AIMS

A growing body of research suggests that smoking portrayals in movies influence adolescent tobacco use. However, the mechanism for this influence remains unclear. The aim of this paper is to provide an overview of research on narrative transportation theory, particularly as applied to movies and smoking. We propose that this theory can provide a valuable framework for guiding research on the role of entertainment media in smoking and other addictive behaviors.

METHODS

We review empirical work on transportation theory and highlight the psychological mechanisms underlying transportation effects. 'Transportation into narrative worlds' refers to cognitive, emotional and imagery engagement into a narrative (including movies and entertainment media). We link this work with research on the effects of movie smoking.

RESULTS

Research suggests that individuals who are more highly transported into narratives show greater attitude, belief and behavior change. Transportation effects work through reducing counterarguing, creating connections (identification and liking) with characters and increasing perceptions of realism and emotional involvement. We propose several future directions and research challenges for applying a transportation framework to the issue of entertainment media effects on smoking and tobacco disparities. Understanding factors contributing to transportation may provide a more nuanced view of who will be affected by movie smoking, and understanding the psychological processes underlying narrative persuasion may guide intervention efforts.

CONCLUSIONS

Narrative transportation theory suggests that individuals' cognitive, emotional and imagery immersion in a narrative is a key mechanism of attitude, belief and behavior change. This theory provides a potentially generative and psychologically grounded framework for increasing knowledge about the boundary conditions and processes underlying the effects of entertainment media on tobacco use.

Physicians under the influence: social psychology and industry marketing strategies

Pharmaceutical and medical device companies apply social psychology to influence physicians' prescribing behavior and decision making. Physicians fail to recognize their vulnerability to commercial influences due to self-serving bias, rationalization, and cognitive dissonance. Professionalism offers little protection; even the most conscious and genuine commitment to ethical behavior cannot eliminate unintentional, subconscious bias. Six principles of influence - reciprocation, commitment, social proof, liking, authority, and scarcity - are key to the industry's routine marketing strategies, which rely on the illusion that the industry is a generous avuncular partner to physicians. In order to resist industry influence, physicians must accept that they are vulnerable to subconscious bias and have both the motivation and means to resist industry influence. A culture in which accepting industry gifts engenders shame rather than gratitude will reduce conflicts of interest. If greater academic prestige accrues to distant rather than close relationships with industry, then a new social norm may emerge that promotes patient care and scientific integrity. In addition to educating faculty and students about the social psychology underlying sophisticated but potentially manipulative marketing and about how to resist it, academic medical institutions should develop strong organizational policies to counteract the medical profession's improper dependence on industry.

Media Literacy Interventions: A Meta-Analytic Review

Although numerous media literacy interventions have been developed and delivered over the past 3 decades, a comprehensive meta-analytic assessment of their effects has not been available. This study investigates the average effect size and moderators of 51 media literacy interventions. Media literacy interventions had positive effects (d=.37) on outcomes including media knowledge, criticism, perceived realism, influence, behavioral beliefs, attitudes, self-efficacy, and behavior. Moderator analyses indicated that interventions with more sessions were more effective, but those with more components were less effective. Intervention effects did not vary by the agent, target age, the setting, audience involvement, the topic, the country, or publication status.

Student feedback about The Skeptic Doctor, a module on pharmaceutical promotion

Pharmaceutical promotion is an integral part of modern medical practice. Surveys show that medical students have a positive attitude towards promotion. Pharmaceutical promotion is not adequately taught in medical schools. A module based on the manual produced by Health Action International was conducted for second year medical students at KIST Medical College, Lalitpur, Nepal. Student feedback on various aspects of the module was obtained using a semi-structured questionnaire. Eighty-six of the 100 students (86%) provided feedback about the module. Forty-five (52.3%) were female and 39 (45.3%) were male. Participant feedback about the module was positive. Small group work and role plays were appreciated, and the ratings of the module and the manual were satisfactory. Respondents felt pharmaceutical promotion will play an important role in their future practice and that the module prepared them to respond appropriately to promotion and select and use medicines properly. The module further developed on issues covered during pharmacology practical and majority felt the module was of relevance to Nepal. Students appreciated the module though there were suggestions for improvement. The module should be considered during the years of clinical training (third and fourth years) and internship and in other medical schools.

[Choice based on plausible reasons]

This study tested the prediction that preferences induced by hidden factors would be justified and even accelerated by other factors that seem to be plausible determinants as causes but, in fact, do not have any influence on the preferences. Participants were repeatedly exposed to a variety of product logos of detergents and then asked to choose one from a pair of detergents with different logos. For half of the participants, information on product quality was available at choice; for the other half, only logos were available. The participants showed a tendency to prefer detergents with the logos that were more frequently exhibited, and this tendency was stronger when information was available about the product quality. The participants seemed to believe that they based their decisions on the relative superiority of quality between the pairs as well as their logos. Provided with convincing, but incorrect, reasons to make a choice, the participants were encouraged to select the detergents whose attractiveness had actually been manipulated by exposing the participants to their logos.