A Social Psychological Perspective on the Role of Knowledge About AIDS in AIDS Prevention

Media Coverage of Alcohol-Use Disorders in German Newspapers and Magazines: A Topic-Specific Frame Analysis

Alcohol use disorders (AUD) are pressing social problems. News media play a key role in setting the agenda for the public discourse and framing these problems. They provide people affected and unaffected with health-related information on different facets of the disease and present the topic in various contexts. In doing so, they shape the public opinion and influence behaviors. On the basis of an explorative quantitative content analysis of N = 402 articles published in 2019 in nine German newspapers and magazines, this study provides information on the topic-specific framing with regard to AUD. The results show only scant contextualization of the topic in the German media. This deficiency has particular regard to causal relationships and treatment opportunities, leaving room for interpretation from the audience. The topic-specific framing analysis showed that articles on AUD mostly appear either in the context of celebrities, endorsing favorable presentations of recovered people, or in the context of crime and violence, which goes hand in hand with portraying acutely affected people as perpetrators. Increased news coverage that includes the portrayal of non-famous people who have successfully engaged in alcohol treatment and recovery is necessary.

Entrepreneurship and Sustainable Development Goals: A Multigroup Analysis of the Moderating Effects of Entrepreneurship Education on Entrepreneurial Intention

The role of entrepreneurs in attaining Sustainable Development Goals (SDGs) is paramount. Entrepreneurs with strong awareness and commitment to sustainable development help to attain almost all SDGs, as they create businesses that will help employment, eliminate poverty, provide decent work and economic growth, help to reduce hunger, assist in attaining good health and wellbeing, help to achieve affordable and clean energy, and enhance their industries. Realizing the importance of entrepreneurs and entrepreneurship, the government of Malaysia has taken proactive actions to develop and inculcate the entrepreneurial mindset through entrepreneurship education at higher education. This study aims to apply the Theory of Planned Behavior (TPB) to analyze the effect of an entrepreneurship course on entrepreneurial intentions of the engineering students at Universiti Teknologi Petronas, as entrepreneurial intention is effective in predicting behavior. A quantitative technique and descriptive cross-sectional study have been employed to collect data. The result of this study indicates that the TPB explains and predicts the entrepreneurial intention. However, the Multigroup Analysis (MGA) results show that attending the entrepreneurship course does not increase the strength of the relationship between the exogenous and endogenous construct compared to those who do not attend the course. The results of this study raise a positive implication toward the improvement of the course curriculum and the teaching pedagogy. An in-depth qualitative study to understand the issue will help to improve the curriculum and pedagogy of entrepreneurship education, and eventually enable a realization of the government’s aspirations.

The Effect of a Wordless, Animated, Social Media Video Intervention on COVID-19 Prevention: Online Randomized Controlled Trial

Background

Innovative approaches to the dissemination of evidence-based COVID-19 health messages are urgently needed to counter social media misinformation about the pandemic. To this end, we designed a short, wordless, animated global health communication video (the CoVideo), which was rapidly distributed through social media channels to an international audience.

Objective

The objectives of this study were to (1) establish the CoVideo’s effectiveness in improving COVID-19 prevention knowledge, and (2) establish the CoVideo’s effectiveness in increasing behavioral intent toward COVID-19 prevention.

Methods

In May and June 2020, we enrolled 15,163 online participants from the United States, Mexico, the United Kingdom, Germany, and Spain. We randomized participants to (1) the CoVideo arm, (2) an attention placebo control (APC) arm, and (3) a do-nothing arm, and presented 18 knowledge questions about preventive COVID-19 behaviors, which was our first primary endpoint. To measure behavioral intent, our second primary endpoint, we randomized participants in each arm to five list experiments.

Results

Globally, the video intervention was viewed 1.2 million times within the first 10 days of its release and more than 15 million times within the first 4 months. Knowledge in the CoVideo arm was significantly higher (mean 16.95, 95% CI 16.91-16.99) than in the do-nothing (mean 16.86, 95% CI 16.83-16.90; P<.001) arm. We observed high baseline levels of behavioral intent to perform many of the preventive behaviors featured in the video intervention. We were only able to detect a statistically significant impact of the CoVideo on one of the five preventive behaviors.

Conclusions

Despite high baseline levels, the intervention was effective at boosting knowledge of COVID-19 prevention. We were only able to capture a measurable change in behavioral intent toward one of the five COVID-19 preventive behaviors examined in this study. The global reach of this health communication intervention and the high voluntary engagement of trial participants highlight several innovative features that could inform the design and dissemination of public health messages. Short, wordless, animated videos, distributed by health authorities via social media, may be an effective pathway for rapid global health communication during health crises.

Trial Registration

German Clinical Trials Register DRKS00021582; https://tinyurl.com/6r4zkbbn

International Registered Report Identifier (IRRID)

RR2-10.1186/s13063-020-04942-7

The knowledge-risk-behaviour continuum among young Ugandans: what it tells us about SRH/HIV integration

Background

With a human immunodeficiency virus (HIV) prevalence of 2.1% among 15–24 year olds, opportunities for further integration of sexual and reproductive health (SRH) and HIV prevention services for young people in Uganda exist. We examine a range of factors that contribute to variance in risky sexual behaviour among young Ugandans.

Methods

A cross-sectional, nationally representative household survey was conducted between February and March 2016. The questionnaire used assessed knowledge, attitudes and practices related to SRH among young people aged 10–24 years. A composite indicator was constructed to assess risky sexual behaviour, defined as being involved in sexual relations under the influence of alcohol or drugs, engaging in sexual activities without a condom, and having multiple sexual partners in the 6 months preceding the survey. Exploratory analysis was conducted to provide descriptive statistics. Logistic regression was conducted to determine the factors associated with risky sexual behaviour. This analysis focuses on the sub-category aged 15–24 years, comprised of 2725 respondents.

Results

Knowledge levels of family planning (FP), sexually transmitted infections (STIs) and HIV across all respondents were high (above 82%). Self-reported perceived risk of STIs and pregnancy was consistently higher among 20–24 year old respondents, with 61.5% feeling at risk of STIs compared to 46.2% of 15–19 year olds. A total of 22.7% of respondents reported having been involved in risky sexual behaviour. Factors associated with risky sexual behaviour among the 15–19 years group included gender, single orphanhood, casual work, schooling status, FP knowledge and self-perceived risk of STIs/HIV. For the 20–24 year old respondents, significantly associated factors included gender, educational level, relationship to head of household, place of residence, and self-perceived risk of pregnancy.

Conclusions

Despite high general SRH/HIV knowledge and perceived risk of pregnancy and HIV, risky sexual behaviour among young Ugandans remains high. Effectiveness gaps in the integrated SRH/HIV response for young people should be addressed and targeted interventions focused on holistic prevention at individual level through information, risk awareness, and skill development should be combined with interventions targeting social structures affecting individual behaviour.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6809-y) contains supplementary material, which is available to authorized users.

Theory-based explanation as intervention

Cogent explanations are an indispensable means of providing new information and an essential component of effective education. Beyond this, we argue that there is tremendous untapped potential in using explanations to motivate behavior change. In this article we focus on health interventions. We review four case studies that used carefully tailored explanations to address gaps and misconceptions in people's intuitive theories, providing participants with a conceptual framework for understanding how and why some recommended behavior is an effective way of achieving a health goal. These case studies targeted a variety of health-promoting behaviors: (1) children washing their hands to prevent viral epidemics; (2) parents vaccinating their children to stem the resurgence of infectious diseases; (3) adults completing the full course of an antibiotic prescription to reduce antibiotic resistance; and (4) children eating a variety of healthy foods to improve unhealthy diets. Simply telling people to engage in these behaviors has been largely ineffective-if anything, concern about these issues is mounting. But in each case, teaching participants coherent explanatory frameworks for understanding health recommendations has shown great promise, with such theory-based explanations outperforming state-of-the-art interventions from national health authorities. We contrast theory-based explanations both with simply listing facts, information, and advice and with providing a full-blown educational curriculum, and argue for providing the minimum amount of information required to understand the causal link between a target behavior and a health outcome. We argue that such theory-based explanations lend people the motivation and confidence to act on their new understanding.

Utilizing Education and Perspective Taking to Remediate the Stigma of Taking Antidepressants

The incidence of depression has been increasing. One of the best interventions for depression is taking antidepressant medications. However, the stigma of taking antidepressants has been shown to be a barrier not only to seeking an antidepressant regimen but also adhering to it. This may have negative consequences for people who suffer from depression. Thus, in two studies, we investigate the incidence of felt stigma of taking antidepressants among clinically depressed individuals who take antidepressants and the effectiveness of two possible interventions to reduce this stigma among others. Study 1 revealed that stigma toward individuals who take antidepressants is a reality, either because people were not educated about depression and antidepressants, or because they did not show empathy or did not take on perspectives from the victim's point-of-view. Based on these results, we used an experimental design in Study 2 to investigate the effects of education and perspective-taking interventions in diminishing the stigma of taking antidepressants. These results suggest that participant gender played a moderating role in the effectiveness of education and perspective taking, such that a combination of the two interventions resulted in lower stigma for men but not for women. These results suggest that people can be trained (using a simple, low-fidelity intervention) to be more accepting of antidepressant use among their friends, family members, and colleagues, resulting in better outcomes for those who benefit from taking antidepressants.

Attitude Strength

Attitude strength has been the focus of a huge volume of research in psychology and related sciences for decades. The insights offered by this literature have tremendous value for understanding attitude functioning and structure and for the effective application of the attitude concept in applied settings. This is the first Annual Review of Psychology article on the topic, and it offers a review of theory and evidence regarding one of the most researched strength-related attitude features: attitude importance. Personal importance is attached to an attitude when the attitude is perceived to be relevant to self-interest, social identification with reference groups or reference individuals, and values. Attaching personal importance to an attitude causes crystallizing of attitudes (via enhanced resistance to change), effortful gathering and processing of relevant information, accumulation of a large store of well-organized relevant information in long-term memory, enhanced attitude extremity and accessibility, enhanced attitude impact on the regulation of interpersonal attraction, energizing of emotional reactions, and enhanced impact of attitudes on behavioral intentions and action. Thus, important attitudes are real and consequential psychological forces, and their study offers opportunities for addressing behavioral change.

Gender, Relationship Status, and Stereotyping about Sexual Risk

In this research, the authors integrated research on stereotyping and health to document relationship-status stereotyping about sexual risk. Drawing on research on relational schemas and implicit personality theories, the authors hypothesized that targets who were described as being in relationships would be perceived as having a lesser likelihood of risk for sexually transmitted diseases than would targets who were described as single. Gender of the targets and gender of the participants also were examined as potential moderating variables. In five vignette studies, people rated single targets as having more risky personality traits and higher probabilistic risk for STDs than partnered targets. They also reported a greater desire to be involved with someone similar to the partnered target. In general, male and female targets were perceived similarly; however, female targets were rated as having a lower probabilistic risk.

Re-examining the effectiveness of monogamy as an STI-preventive strategy

The utility of monogamy (in practice) as a strategy for preventing sexually transmitted infections (STIs) was investigated. By reviewing recent literature surrounding monogamous relationships and sexual behaviors, the authors determined that monogamy might not prevent against STIs as expected. First, the authors elucidate the ways in which public health officials and the general public define and interpret monogamy and discuss how this contributes to monogamy as an ineffectual STI prevention strategy. Second, the authors provide evidence that individuals' compliance with monogamy is likely to be low, similar to rates of compliance with other medical advice. Lastly, the authors draw upon recent research findings suggesting that people who label themselves as monogamous are less likely to engage in safer sex behaviors than people who have an explicit agreement with their partner to be non-monogamous. Future research and clinical directions to promote sexual health and destigmatize sexual behaviors are considered.

Increasing screening intentions for oral and pharyngeal cancer

Background

Oral and pharyngeal cancer is a serious health threat that goes unnoticed by most people. Increasing screenings for oral and pharyngeal cancer is essential to achieving early detection when the disease is most treatable.

Purpose

We tested the effectiveness of a media campaign designed to increase intentions to seek an oral and pharyngeal cancer screening. We further examined whether concern and knowledge of oral and pharyngeal cancer mediated screening intentions.

Methods

Participants in the intervention condition received messages on posters, handheld fans, pamphlets, and magnets displayed on the sides of cars or trucks. Participants in the intervention and comparison conditions (N = 1,790) were surveyed prior to and after the intervention.

Results

Intervention participants reported greater intentions to seek free oral and pharyngeal cancer screenings. Concern about oral and pharyngeal cancer partially mediated the effect whereas knowledge did not.

Conclusions

Our media campaign successfully increased screening intentions by heightening concerns.

Teaching young children a theory of nutrition: conceptual change and the potential for increased vegetable consumption

In two experiments, we used a novel approach to educating young children about nutrition. Instead of teaching simple facts, we provided a rich conceptual framework that helped children understand the need to eat a variety of healthy foods. Using the insight that children's knowledge can be organized into coherent belief systems, or intuitive theories, we (a) analyzed the incipient knowledge that guides young children's reasoning about the food-body relationship, (b) identified the prerequisites that children need to conceptualize food as a source of nutrition, and (c) devised a strategy for teaching young children a coherent theory of food as a source of diverse nutrients. In these two experiments, we showed that children can learn and generalize this conceptual framework. Moreover, this learning led children to eat more vegetables at snack time. Our findings demonstrate that young children can benefit from an intervention that capitalizes on their developing intuitive theories about nutrition.

Developing community-based preventive interventions in Hong Kong: a description of the first phase of the family project

Background

This paper describes the development of culturally-appropriate family-based interventions and their relevant measures, to promote family health, happiness and harmony in Hong Kong. Programs were developed in the community, using a collaborative approach with community partners. The development process, challenges, and the lessons learned are described. This experience may be of interest to the scientific community as there is little information currently available about community-based development of brief interventions with local validity in cultures outside the West.

Methods

The academic-community collaborative team each brought strengths to the development process and determined the targets for intervention (parent-child relationships). Information from expert advisors and stakeholder discussion groups was collected and utilized to define the sources of stress in parent-child relationships.

Results

Themes emerged from the literature and discussion groups that guided the content of the intervention. Projects emphasized features that were appropriate for this cultural group and promoted potential for sustainability, so that the programs might eventually be implemented at a population-wide level. Challenges included ensuring local direction, relevance and acceptability for the intervention content, engaging participants and enhancing motivation to make behavior changes after a brief program, measurement of behavior changes, and developing an equal partner relationship between academic and community staff.

Conclusions

This work has public health significance because of the global importance of parent-child relationships as a risk-factor for many outcomes in adulthood, the need to develop interventions with strong evidence of effectiveness to populations outside the West, the potential application of our interventions to universal populations, and characteristics of the interventions that promote dissemination, including minimal additional costs for delivery by community agencies, and high acceptability to participants.

Folkbiology meets microbiology: a study of conceptual and behavioral change

Health education can offer a valuable window onto conceptual and behavioral change. In Study 1, we mapped out 3rd-grade Chinese children's beliefs about causes of colds and flu and ways they can be prevented. We also explored older adults' beliefs as a possible source of the children's ideas. In Study 2, we gave 3rd- and 4th-grade Chinese children either a conventional cold/flu education program or an experimental "Think Biology" program that focused on a biological causal mechanism for cold/flu transmission. The "Think Biology" program led children to reason about cold/flu causation and prevention more scientifically than the conventional program, and their reasoning abilities dovetailed with their mastery of the causal mechanism. Study 3, a modified replication of Study 2, found useful behavioral change as well as conceptual change among children who received the "Think Biology" program and documented coherence among knowledge enrichment, conceptual change, and behavioral change.

Why Turks do not use seat belts? An interview study

Despite the effectiveness of seat belt use and legislation, seat belt use rate is low in Turkey. The aim of this study was to investigate the motives to use and not to use a seat belt in different traveling conditions in a sample of car drivers and passengers. Interviews were made face to face with 221 interviewees from different age and occupation groups. Frequently reported reasons for using a seat belt were traveling conditions, safety, situational conditions, habit of using a seat belt, and avoiding punishment. Frequently reported reasons for not using a seat belt were situational conditions, not believing in the effectiveness, discomfort and having no habit. Safety was the strongest predictor of reported seat belt use in both low and high risk traveling conditions. Findings suggest that seat belt campaigns should mainly emphasize seat belt's safety impact and aim at habit formation.

A meta-analytic review of obesity prevention programs for children and adolescents: the skinny on interventions that work

This meta-analytic review summarizes obesity prevention programs and their effects and investigates participant, intervention, delivery, and design features associated with larger effects. A literature search identified 64 prevention programs seeking to produce weight gain prevention effects, of which 21% produced significant prevention effects that were typically pre- to post effects. Larger effects emerged for programs that targeted children and adolescents (vs. preadolescents) and females, programs that were relatively brief, programs that solely targeted weight control versus other health behaviors (e.g., smoking), programs evaluated in pilot trials, and programs wherein participants must have self-selected into the intervention. Other factors, including mandated improvements in diet and exercise, sedentary behavior reduction, delivery by trained interventionists, and parental involvement, were not associated with significantly larger effects.

Knowledge about condoms among low-income pregnant Latina adolescents in relation to explicit maternal discussion of contraceptives

PURPOSE

To examine pregnant adolescents' conceptual knowledge about condom use and its relation to maternal implicit and explicit communication about contraceptives.

METHODS

Forty-five pregnant Latina adolescents (aged 14 to 18 years) were interviewed regarding their knowledge about how condoms prevent pregnancy. In addition, the adolescents were videotaped having a conversation with their mothers (23 English-speaking, 22 Spanish-speaking) about dating and sexuality, which was coded for maternal explicit and implicit messages about contraception.

RESULTS

A more detailed, accurate understanding of how condoms work, and the ability to explicitly describe that knowledge, was associated with adolescents reporting higher levels of confidence about using condoms, and increased comfort talking to partners about condoms. Mothers' explicit mention of contraception was related to their adolescents having detailed, accurate information about condoms. Among Spanish-speaking dyads only, maternal explicit messages were associated with adolescents using more explicit terminology in describing their knowledge.

CONCLUSIONS

Study results have implications for intervention with a high-risk population of Latina mothers and adolescents. The study also highlights the importance of examining specific aspects of knowledge, namely conceptual, biological knowledge.

Drug‐Using Women Need Comprehensive Sexual Risk Reduction Interventions

In the United States, drug users have dramatically reduced drug-related risk behaviors but continue sexual behaviors that place them at risk for human immunodeficiency virus (HIV) infection. Successful interventions are likely to be those that intervene at multiple levels, yet, historically, sexual interventions for drug users have primarily addressed only personal factors, such as condom use. Sexual risk arises from personal factors (e.g., perceived vulnerability and protective behaviors); interpersonal factors (e.g., relationship type and a partner's risk profile); social factors (e.g., gender roles and sexual mixing patterns among and between networks); and, finally, community-level factors (e.g., access to preventive methods and the prevalence of a sexually transmitted pathogen within a network). For female drug users, multiple sources of risk plus concurrent drug use during sex pose additional prevention challenges that disproportionately elevate their risk of sexually acquired HIV infection. New, multimodal interventions need to be developed and tested to more effectively address the many sources of sexual risk facing female drug users.

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

Three studies examined the impact of a treatment designed to instill resistance to deceptive persuasive messages. Study 1 demonstrated that after the resistance treatment, ads using illegitimate authority-based appeals became less persuasive, and ads using legitimate appeals became more persuasive. In Study 2, this resistance generalized to novel exemplars, persevered over time, and appeared outside of the laboratory context. In Study 3, a procedure that dispelled participants' illusions of invulnerability to deceptive persuasion maximized resistance to such persuasion. Overall, the present studies demonstrate that attempts to confer resistance to appeals will likely be successful to the extent that they install 2 conceptual features: perceived undue manipulative intent of the source of the appeal and perceived personal vulnerability to such manipulation.

Avoiding the boomerang: testing the relative effectiveness of antidrug public service announcements before a national campaign

OBJECTIVES

This study examined the relative perceived effectiveness of 30 antidrug public service announcements (PSAs) and assessed the extent to which judgments of effectiveness are related to judgments of realism, amount learned, and positive and negative emotional responses.

METHODS

Data were obtained from 3608 students in grades 5 through 12 in 10 schools. The ethnically diverse sample was 50.8% male. Students in 5 experimental conditions viewed sets of 6 antidrug PSAs and filled out a brief evaluation questionnaire following each PSA. Those in the control condition viewed a non-drug-related television program.

RESULTS

The relative perceived effectiveness of the 30 PSAs varied considerably. Sixteen were rated as significantly more effective, and 6 as significantly less effective, than the control program. Relative rated effectiveness was highly related to realism (r =.87), amount learned (r =.88), negative emotion (r =.87), and positive emotion (r = -.35).

CONCLUSIONS

Evaluative research is necessary to prevent broadcast of PSAs that could have a negative impact. PSAs should point out the negative consequences of drug use behavior rather than telling adolescents to "just say no."

Conducting meta-analyses of HIV prevention literatures from a theory-testing perspective

Using illustrations from HIV prevention research, the current article advocates approaching meta-analysis as a theory-testing scientific method rather than as merely a set of rules for quantitative analysis. Like other scientific methods, meta-analysis has central concerns with internal, external, and construct validity. The focus of a meta-analysis should only rarely be merely describing the effects of health promotion, but rather should be on understanding and explaining phenomena and the processes underlying them. The methodological decisions meta-analysts make in conducting reviews should be guided by a consideration of the underlying goals of the review (e.g., simply effect size estimation or, preferably theory testing). From the advocated perspective that a health behavior meta-analyst should test theory, the authors present a number of issues to be considered during the conduct of meta-analyses.

Increasing use of the female condom through video instruction

The female condom is effective in preventing sexually transmitted diseases and when used properly reduces risk of HIV infection among women. This field experiment evaluated the effect of a video presentation on reported use of and satisfaction with the female condom. Participants were 100 women tested for HIV infection in a community agency. Ages ranged from 17 to 62 years, and one fifth of the sample were African American or Hispanic. The 23 women who viewed an instructional video were significantly more likely than 13 of the control group of 50 to try the condom and report to the researcher. Video viewing was unrelated to liking the product and future intent to use. Almost three quarters of those who used the condoms reported they liked and would use them.