Implementation processes of social network interventions for physical activity and sedentary behavior among children and adolescents: a scoping review

BACKGROUND

The characteristics of the implementation process of interventions are essential for bridging the gap between research and practice. This scoping review aims to identify the implementation process of social network interventions (SNI) to address physical activity and sedentary behaviors in children and adolescents.

METHODS

The scoping review was conducted adhering to the established guidelines. The search was carried out in the ERIC, EBSCO, EMBASE, SCOPUS, and Lilacs databases in April 2023. Social network intervention studies in children and adolescents were included, addressing physical activity or sedentary behaviors. Replicability (TIDieR), applicability (PRECIS-2), and generalizability (RE-AIM) were the explored components of the implementation process. Each component was quantitatively and separately analyzed. Then, a qualitative integration was carried out using a narrative method.

RESULTS

Most SNI were theoretically framed on the self-determination theory, used social influence as a social mechanism, and used the individual typology of network intervention. Overall, SNI had strong replicability, tended to be pragmatic, and three RE-AIM domains (reach, adoption (staff), and implementation) showed an acceptable level of the generalizability of findings.

CONCLUSIONS

The analyzed SNI for physical activity and sedentary behaviors in adolescents tended to be reported with high replicability and were conducted pragmatically, i.e., with very similar conditions to real settings. The RE-AIM domains of reach, adoption (staff), and implementation support the generalizability of SNI. Some domains of the principles of implementation strategies of SNI had acceptable external validity (actor, action targets, temporality, dose, and theoretical justification).

The detection of self-group conflicts in exercise behaviors differs with social network centrality: ERP evidence

BACKGROUND

The influence of social norms on exercise behaviors has been explored in studies over the years. However, little is known about whether an individual's role (central or peripheral) in his or her social network, which is associated with social skills, could shift his or her susceptibility to normative effects on exercise behaviors. To that end, event-related potentials (ERPs) were recorded to examine the underlying cognitive mechanism of the effects of network centrality on normative social influence.

METHODS

We manipulated network centrality by assigning participants to exercise support groups, with group members who were their nominated friends (high centrality) or nonnominated classmates (low centrality). Participants were asked to evaluate their willingness to engage in various exercises, after viewing discrepant group ratings (peer influence) or not viewing (no-influence).

RESULTS

Peer influence evoked a larger negative-going feedback-related negativity (FRN) wave, which was linked to automatic social conflict detection, and a larger positive-going P3 wave, which was linked to subsequent conformity behavioral changes. However, effects on the FRN, not the P3, were observed only in the high-centrality group.

CONCLUSION

Our results highlight the important roles of network centrality in encoding self-group exercise attitude discrepancy rather than in decision-making regarding exercise attitude adjustments. Interventions aimed at promoting exercise behaviors should be considered in a broader social environmental framework.

Reshapping agriculture technology adoption thinking: Malthus, Borlaug and Ghana's fail green revolution

Previous research on green revolution established the effect of farmers' socio-economics characteristics on technology adoption; however, the impact of culture and religion is unclear. This research collected data through a survey from January to April 2019. Participants were rice farmers from three ethnic groups (Mole-Dagbani, Gurma and Guan) and three religious' denominations (Christianity, Islam and Christianity). After analysing the data to identify critical societal values affecting the adoption of improved rice varieties, we realised that our results appropriately explained Prospect theory. We find that cultural and religious values significantly influence rice farmers' adoption decisions. Christian faith has a positive relationship with the adoption of improved rice seeds, while the Islamic religion has a negative connection. The fact that culture and religion affect adoption suggest agriculture technology societal standard integration. Based on the findings, we recommend the all-inclusive approach in the diffusion of agricultural technology.

The influence of social norms on anticipated snacking: An experimental study comparing different types of social norms

Previous studies have found that social norms affect eating behavior for different types of social norm measures and manipulations as well as different types of eating behavior. The current study investigated the effects of descriptive, injunctive, and liking norms on intentions to consume healthy snacks and anticipated snack choice, compared to a no-norm control condition. Moreover, we distinguished between descriptive norms that stress the frequency versus the quantity of food consumption. An experiment was conducted among 189 young adults. It was hypothesized that participants who received a descriptive quantity or frequency norm would intend to consume, and make an anticipated selection of, more low-calorie snacks than participants who received a no-norm control message. Due to inconsistency or lacking evidence regarding the effects of the other types of norms on eating behavior, no hypotheses were formulated for the injunctive and liking norm conditions. The hypothesis was partly confirmed. Descriptive quantity and frequency norms did not result in a stronger intention to consume healthy snacks in the upcoming week, but they did result in lower-calorie snack choices when people were asked to select three snacks that they planned to eat on the following day. No other differences between the conditions were found. These findings show that emphasizing both how much and how often most other people consume healthy foods affects anticipated healthy food choices. This can provide health professionals more options to mobilize the power of descriptive social norms for affecting health behavior change.

Understanding the individuals' motivators and barriers of e-waste recycling: A mixed-method approach

The increasing amount of e-waste and poor participation of individuals in proper recycling or disposal has become a big concern for policymakers. Therefore, it is essential to understand the factors that may facilitate or inhibit individuals from adopting e-waste recycling. The present research examines the attitude and intentions of individuals by applying the theoretical lens of Behavioral Reasoning Theory (BRT). The study uses a mixed-method approach and has been conducted in two phases: Phase 1- qualitative study (one-to-one interview: 30 respondents) and Phase 2: quantitative study (survey-based questionnaire- 348 responses). The qualitative part employs thematic analysis, and the quantitative study has been analyzed using SEM. Through the qualitative research, the study has identified self-image perceived negative effect and salvage value as the 'reasons for', whereas inconvenience, lack of support system, and emotional attachment have been identified as the 'reasons against' e-waste recycling. The findings show that moral and social norms significantly impact individual reasoning ('reason for'/'reason against') and attitude toward e-waste recycling. The result has also confirmed the moderation effect on self-efficacy among reasoning, attitude, and intention. The findings offer interesting insights to the government and policymakers for increasing individuals' participation in e-waste recycling.

Children's judgments of interventions against norm violations: COVID-19 as a naturalistic case study

The coronavirus pandemic has had a significant influence on social interactions, introducing novel social norms such as mask-wearing and social distancing to protect people's health. Because these norms and associated practices are completely novel, it is unknown how children assess what kinds of interventions are appropriate under what circumstances and what principles they draw on in their decisions. We investigated children's reasoning about interventions against individuals who failed to adhere to COVID-19 norms. In this pre-registered study (N = 128), 4- to 7-year-olds heard stories about a norm violator, that is, a person who refuses to wear a mask in class (COVID condition) or wear indoor shoes in class when his or her shoes are muddy (Muddy Shoes condition). Children evaluated four different interventions-giving a mask/indoor shoes (Giving), preventing the person from entering (Exclusion), throwing a paper ball at the person (Throwing), and not intervening (Doing Nothing)-in terms of their rightness, niceness, and effectiveness. We found that across measures children evaluated Giving most positively, whereas they viewed Throwing most negatively. Doing Nothing and Exclusion received mixed evaluations across measures, revealing nuanced judgments of these interventions in children. In most measures, there was no difference between the COVID and Muddy Shoes conditions, suggesting that children's evaluations are not specific to the novel COVID-19 context. Together, our results show that children dynamically evaluate each intervention, taking multiple factors into account. The current study has implications for the development of interventions against norm violations.

Salient knowledge that others are also evaluating reduces judgment extremity

As companies increasingly conduct marketing research online (e.g., through social networking sites or their brand community platforms), the knowledge that others are also filling out the same surveys becomes increasingly salient to respondents. This research examines how the salience of this knowledge influences consumer judgments. Two important characteristics of our research paradigm are especially relevant to digital contexts: (1) judgements made by the consumers are neither observable nor subject to others' disapproval; and (2) consensus is not observable or verifiable. Nevertheless, in six main studies and one auxiliary study (Web Appendix), we found that high knowledge salience of others also evaluating reduced judgment extremity. Judgment extremity is quantified by the degree or strength of an evaluation or numeric estimate about a judgment target. This effect was driven by consumers' tendency to predict a moderate consensus and to conform to this perception. Implications for marketing research and crowdsourcing are discussed.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11747-021-00807-w.

Factors Influencing Family Forest Owners' Interest in Community-led Collective Invasive Plant Management

Effective invasive plant management requires collective action. However, little is known about what motivates individuals to work collectively. We conducted a mail survey of 2,600 randomly selected family forest owners in Indiana, USA to examine factors associated with community-led collective action. Specifically, we examined the role of perceived self-efficacy, perceived collective efficacy, concerns about invasive plants, and social norms associated with invasive plant management in shaping family forest owners' self-reported likelihood to work with their neighbors to remove invasive plants. We found that past experience talking to others or working with neighbors to remove invasive plants were important predictors of landowners' intention to work collectively, as were perceived self-efficacy in their own ability to manage invasive plants, perceived need for collective action, social norms, and concerns about invasive plants on neighboring or nearby properties. However, most socio-demographic characteristics (e.g., age, gender, education level, income) and land ownership characteristics (e.g., residence status, having a written forest management plan) were not statisically significant predictors of family forest owners' likelihood to work with their neighbors. Our findings suggest that building individual sense of competence, facilitating neighbor interactions, and strengthening shared concerns may facilitate community-led collective action to manage invasive plants.

How effective are social norms interventions in changing the clinical behaviours of healthcare workers? A systematic review and meta-analysis

BACKGROUND

Healthcare workers perform clinical behaviours which impact on patient diagnoses, care, treatment and recovery. Some methods of supporting healthcare workers in changing their behaviour make use of social norms by exposing healthcare workers to the beliefs, values, attitudes or behaviours of a reference group or person. This review aimed to evaluate evidence on (i) the effect of social norms interventions on healthcare worker clinical behaviour change and (ii) the contexts, modes of delivery and behaviour change techniques (BCTs) associated with effectiveness.

METHODS

Systematic review and meta-analysis of randomised controlled trials. Searches were undertaken in seven databases. The primary outcome was compliance with a desired healthcare worker clinical behaviour and the secondary outcome was patient health outcomes. Outcomes were converted into standardised mean differences (SMDs). We performed meta-analyses and presented forest plots, stratified by five social norms BCTs (social comparison, credible source, social reward, social incentive and information about others' approval). Sources of variation in social norms BCTs, context and mode of delivery were explored using forest plots, meta-regression and network meta-analysis.

RESULTS

Combined data from 116 trials suggested that social norms interventions were associated with an improvement in healthcare worker clinical behaviour outcomes of 0.08 SMDs (95%CI 0.07 to 0.10) (n = 100 comparisons), and an improvement in patient health outcomes of 0.17 SMDs (95%CI 0.14 to 0.20) (n = 14), on average. Heterogeneity was high, with an overall I² of 85.4% (healthcare worker clinical behaviour) and 91.5% (patient health outcomes). Credible source was more effective on average, compared to control conditions (SMD 0.30, 95%CI 0.13 to 0.47, n = 7). Social comparison also appeared effective, both on its own (SMD 0.05, 95%CI 0.03 to 0.08, n = 33) and with other BCTs, and seemed particularly effective when combined with prompts/cues (0.33, 95%CI 0.22 to 0.44, n = 5).

CONCLUSIONS

Social norms interventions appeared to be an effective method of changing the clinical behaviour of healthcare workers and have a positive effect on patient health outcomes in a variety of health service contexts. Although the overall result is modest and variable, there is the potential for social norms interventions to be applied at large scale.

TRIAL REGISTRATION

PROSPERO CRD42016045718 .

Social norm nudges in shopping trolleys to promote vegetable purchases: A quasi-experimental study in a supermarket in a deprived urban area in the Netherlands

BACKGROUND

Supermarkets are a key point of purchase for groceries and can therefore have a considerable influence on eating behaviours. Evidence suggests that descriptive social norm nudges in shopping trolleys can be effective in stimulating vegetable purchases in supermarkets.

OBJECTIVE

We investigated the effect of a combination of two nudging strategies in shopping trolleys - a social norm about vegetable purchases and a designated place to put vegetables - on the amount of vegetables purchased in a supermarket in a deprived urban area in the Netherlands.

DESIGN

A quasi-experimental study was conducted with two conditions: 1) intervention days on which the shopping trolleys in the supermarket had a green nudge inlay indicating a place for vegetables and a social norm message and 2) control days on which the regular shopping trolleys (no inlay or social norm) were used in the supermarket. During both the intervention and control days, vegetable purchases were measured by means of the cash receipts collected from customers at the checkouts. In addition, individual and purchase characteristics were assessed by means of short surveys.

RESULTS

In total, 244 customers participated in the study. Ordinal logistic regression analyses showed that customers on the intervention days (n = 123) were in a higher tertile for grams of vegetables purchased compared to the customers on the control days (OR: 1.66, 95% CI: 1.03-2.69, p = 0.03), especially those who bought groceries for less than three days (OR: 3.24, 95% CI: 1.43-7.35, p = 0.003). Sensitivity analyses also showed that intervention customers who noticed the green inlay were even more likely to purchase more vegetables (OR: 1.86, 95% CI: 1.06-3.25, p = 0.02).

CONCLUSIONS

This quasi-experimental study showed that a nudge inlay in shopping trolleys communicating a social norm on vegetable purchases and indicating a distinct place to put vegetables in the trolley increased vegetable purchases among supermarket customers.

Individual and social predictors of smoking and obesity: A panel study in Germany

This is a longitudinal study of changes in smoking behaviour as well as becoming overweight/obese (OW/OB) and the strength of their association with personal factors such as self-control, mental health, and socioeconomic status (SES) versus their connection with the behaviour of other household members. Furthermore, we investigate that in terms of roles within a household, who is more vulnerable towards the behaviour of others. We used a hybrid model that followed individual adults (person-level fixed-effect) who participated in a national representative panel survey in Germany, SOEP, between 2008 and 2016 and answered all SF-12 items (N = 6874). The count of members in a household showing the associated adverse health behaviour was the nested random-effect. Compared with other predictors, the likelihood of a person becoming OW/OB had the strongest association with the number of cohabits who were also OW/OB and it became worse as this number increased (OR 7.18, 95% CI: 2.10-24.54 and 12.44, 95% CI: 1.53-100.85, for men and women respectively, e.g. compared with being married 2.83, 95% CI: 2.28-3.53 and 1.82, 95% CI: 1.42-2.34). However, for smoking the same rapid trend was not observed. Particularly, becoming OW/OB in female (adult) children was strongly associated with the behaviour of others (compared with household head or partner). For smoking the strongest link with others was among women who were head of the household. For both behaviours, we found neither mental health nor self-control to be strong predictors. Our findings indicate that various factors do not play equal roles in changes in health behaviour and particularly for women, becoming OW/OB is strongly connected with the behaviour of others. We further discuss the potential importance of social norms that might be helpful in developing more effective policies incorporating social connections as well as norms.

Sekentei and objectively-measured physical activity among older Japanese people: a cross-sectional analysis from the NEIGE study

Background

The concept of sekentei (social appearance), defined as sensitivity about one’s reputation, reflects Japanese behavioral principles and involves pressure to conform to social norms, particularly among people living in rural areas. However, data regarding the relationship between sekentei and health behaviors are sparse. In this study, we examined the relationship between sekentei and objectively-measured physical activity among community-dwelling older people in Japan.

Methods

We used data from the Neuron to Environmental Impact across Generations Study (NEIGE Study), which is a prospective cohort study of randomly-sampled community-dwelling individuals aged 65–84 years living in Tokamachi City, Niigata Prefecture, Japan. The baseline survey was conducted in 2017 and included 527 independent older people. We analyzed the baseline data cross-sectionally. To measure activity behaviors, participants wore a tri-axial accelerometer for seven consecutive days. Physically active individuals were defined based on the World Health Organization recommendation guidelines on physical activity. Sekentei was measured using the 12-item Sekentei Scale (score range: 12–60).

Results

After excluding 15 people for whom we had three or fewer days of valid accelerometer-assessed activity data, we used data from 512 participants in our analysis (average 73.4 years old; 46.9% men). Physically active individuals made up 22.3% of the sample, and the proportion of physically active men was higher than that of women. A logistic regression analysis showed that higher levels of sekentei were inversely associated with physical activity after adjusting for demographic factors, socioeconomic status, and health conditions (odds ratio [95% confidence interval]: 0.58 [0.36–0.91] for every 10-point increase in the Sekentei Scale score). This association was stronger in women than in men (0.66 [0.34–1.26] for men and 0.51 [0.26–1.00] for women).

Conclusions

Our findings indicate that an individual’s sense of sekentei may be an important socio-cultural factor affecting their level of physical activity. Culturally appropriate approaches may be beneficial in addressing insufficient physical activity in older adults.

The impact of social norms interventions on clinical behaviour change among health workers: protocol for a systematic review and meta-analysis

BACKGROUND

Health workers routinely carry out clinical behaviours, such as prescribing, test-ordering or hand-washing, which impact on patient diagnoses, care, treatment and recovery. Social norms are the implicit or explicit rules that a group uses to determine values, beliefs, attitudes and behaviours. A social norms intervention seeks to change the clinical behaviour of a target health worker by exposing them to the values, beliefs, attitudes or behaviours of a reference group or person. This study aims to find out whether or not social norms interventions are effective ways of encouraging health workers to carry out desired behaviours and to identify which types of social norms intervention, if any, are most effective.

METHODS

A systematic review will be conducted. The inclusion criteria are a population of health professionals, a social norms intervention that seeks to change a clinical behaviour, and randomised controlled trials. Searches will be undertaken in MEDLINE, EMBASE, CINAHL, British Nursing Index, ISI Web of Science, PsycINFO and Cochrane trials. Titles and abstracts will be reviewed against the inclusion criteria to exclude any that are clearly ineligible. Two reviewers will independently screen all the remaining full texts to identify relevant papers. For studies which meet our inclusion criteria, two reviewers will extract data independently, code for behaviour change techniques and assess quality using the Cochrane risk of bias tool. The primary outcome measure will be compliance with desired behaviour. To assess the effect of social norms on the behaviour of health workers, we will perform fixed effects meta-analysis and present forest plots, stratified by behaviour change technique. We will explore sources of variation using meta-regression and may use multi-component-based network meta-analysis to explore which forms of social norms are more likely to be effective, if our data meet the necessary requirements.

DISCUSSION

The study will provide evidence regarding the effectiveness of different methods of applying social norms to change the clinical behaviour of health professionals. We will disseminate the research to academics, health workers and members of the public and use the findings from the review to plan future research on the use of social norms with health workers.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42016045718. Future protocol changes will be clearly stated in PROSPERO.

The interaction between HIV testing social norms and self-efficacy on HIV testing among Chinese men who have sex with men: results from an online cross-sectional study

BACKGROUND

Increasing human immunodeficiency virus (HIV) testing is critical for HIV control. This study aimed to evaluate the interaction between social norms and self-efficacy on HIV testing among Chinese men who have sex with men (MSM).

METHODS

We conducted an online survey in eight Chinese cities in Shandong and Guangdong Provinces in July 2016. We included participants who were born as a male, at least 16 years old, currently living in one of the designated cities, and had ever engaged in anal sex with a man. We collected information regarding socio-demographics, high-risk behaviors, and history of HIV and other STI testing. We coded sensitivity to social norms using six items asking participants about their perceived social norm regarding HIV testing. We coded HIV testing self-efficacy using a separate six-item scale. We interpreted higher mean scores as higher sensitivity to social norms and higher self-efficacy, respectively. We conducted logistic regressions to evaluate the interaction between self-efficacy and social norms on HIV testing.

RESULTS

A total of 2105 men completed the survey. The mean age of the participants was 25.97 ± 6.42 years. Over four-fifths (85.9%) of participants were unmarried, 22.7% were students, and 64.6% at least had a college degree. 62.5 and 32.6% of participants ever and tested HIV in the last three months, respectively. With respect to uptake of HIV testing in the last three months, the adjusted odds ratio was 1.01(95% CI: 0.96-1.06) for higher sensitivity to social norms and 1.09 (95% CI: 1.05-1.14) for higher self-efficacy, with an interaction effect of 1.02 (95% CI: 1.01-1.03), respectively. With respect to uptake of lifetime HIV testing, the adjusted odds ratio was 1.03(95% CI: 0.99-1.07) for higher sensitivity to social norms and 1.15 (95% CI: 1.11-1.19) for higher self-efficacy, with an interaction effect of 1.02 (95% CI: 1.01-1.04), respectively.

CONCLUSIONS

Our survey demonstrated that there is a significant association between the uptake of HIV testing with sensitivity to the social norm, higher self-efficacy, as well as the interaction between them. Tailored studies for improving HIV testing among MSM in China can combine these two interventions together.

Multi-group Causal Model of Health Literacy and Behaviors on Family Well-being among Thai Adults at Risk of Non-Communicable Diseases (NCDs)

BACKGROUND

We aimed to develop a causal model of family well-being with health literacy (HL) as a mediator and to compare models between male and female spouses in urban and rural communities.

STUDY DESIGN

A cross-sectional study.

METHODS

The samples included 2000 spouses at risk of non-communicable diseases (NCDs) by stratified randomly sampled in 2018. Data were collected Likert questionnaires with reliability of 0.79-0.93, and analyzed via confirmatory factor analysis (CFA), and multi-group structural equation modeling (MSEM).

RESULTS

A causal model for the overall group was consistent with the data. Causal factors had direct effects on health behavior including social norms, positive attitude toward health, psychological capital, and HL (β=0.11, 0.14, 0.30, and 0.41, P<0.05 respectively). Health behavior and positive attitudes towards health had direct effects on family well-being (β=0.36 and 0.42, P<0.05, respectively). All factors could predict health behavior and family well-being with variance of 70% and 50%. Invariance analysis of models showed no difference between male and female spouses. In addition, the mean comparison of latent variables showed that the positive attitudes towards health were lower in women than men. HL and positive attitudes towards health of spouses in urban were lower than in rural communities.

CONCLUSION

Thai adult families in cities were at higher risk with NCDs. Therefore, health providers need to address HL and positive attitude toward health which were the main causal factors.

Social influence fosters the use of a reusable takeaway box

The severe ecological and economic consequences of disposable takeaway containers call for the implementation of effective interventions: namely, the use of reusable takeaway boxes. The present field study examined how social influence determined whether customers chose a reusable or a disposable takeaway box at a takeaway restaurant. We unobtrusively recorded the takeaway packaging choices (reusable vs. disposable) of customers over lunchtimes during a period of four weeks. We operationalized social influence in two ways. First, we manipulated social norms. For half of the field days, we added a normative message to the existing informational material on the counter of the takeaway outlet. Second, we observed social modeling by recording whether the takeaway packaging choice took place in the presence of other customers using a reusable takeaway box. The results were mixed: On one hand, we found no effect from the manipulated social norm, which we discuss in the light of past interventions using social norm messages. On the other hand, we found an effect of the observed social modeling: witnessing others using a reusable takeaway box increased the odds of choosing one oneself. This finding demonstrates the importance of getting customers to perform the desired behavior, to serve as social role models for others.

Normative prompts reduce consumer food waste in restaurants

This field study demonstrates that prompts reduce food waste in a restaurant. Based on the behavioral change literature, it was hypothesized that (1) informational prompts encourage consumers to reduce food waste, and that (2) an informational prompt with a normative message is more effective than a prompt with only an informative message. The results were mixed. As expected, diners who were exposed to prompts asked to take away their leftovers more frequently than diners who were exposed to no prompts. However, prompts with an informative and normative message were no more powerful than prompts with only an informative message.

Measurement of sexual health outcomes among people who inject drugs: pilot study in Catalonia, Spain and Barnaul, Russia

BACKGROUND

The main objective of this study was to test some of the draft sexual health indicators developed by the World Health Organization as part of a comprehensive indicator framework to monitor progress in universal access to reproductive health.

METHODS

Cross-sectional studies among people who inject drugs were conducted in Catalonia (n = 734) and Barnaul (n = 500). 'Sexual competency' was measured using three indicators: sexual satisfaction, sexual safety, and sexual autonomy. Individual social norms on sexuality were also collected. The construct validity of the sexual safety and sexual autonomy items were assessed. Multivariate logistic regression models explored factors associated with sexual dissatisfaction.

RESULTS

In Catalonia, sexual competency was higher among males than females who inject drugs (60.4% versus 33.3%). In both Catalonia and Barnaul, differences by sex in social norms on sexuality were seen. Mean scores on sexual safety (4.15 in Catalonia and 3.54 in Barnaul) were lower among participants who reported not using condoms. Mean scores on sexual autonomy (4.42 in Catalonia and 3.97 in Barnaul) were lower among those who had experienced some form of sexual assault. Perceived sexual safety, sexual autonomy, and social norms on sexuality were associated with sexual dissatisfaction.

CONCLUSIONS

The sexual health indicators tested are valid, feasible, and reliable tools to monitor and evaluate sexual health programs and activities. The results confirm that sexual satisfaction depends on safe sexual experiences, free from coercion and violence. Social norms and individual perceptions about sexual health need to be considered when developing national disease prevention programs.

Determinants of human papillomavirus vaccination uptake among adolescent girls: A theory-based longitudinal study among Hong Kong Chinese parents

Human papillomavirus (HPV) vaccination uptake among Chinese adolescent girls remains extremely low. This two-year longitudinal study examined theoretical predictors of adolescent girls' HPV vaccination uptake using an extended Theory of Planned Behaviour (TPB). Between February and November 2014, a random sample of 1996 (response rate 60%) Hong Kong Chinese parents of 12- to 17-year-old HPV unvaccinated girls completed baseline telephone interviews assessing attitudes and intention towards HPV vaccination. Six and 12months later 1255 and 979 parents reported their daughters' HPV vaccination status, respectively. Structural equation modelling tested data fit to an TPB-derived hypothesized model of baseline factors predicting parental decisionmaking for adolescent girls' subsequent HPV vaccination uptake. Overall, at 1-year follow-up, only 9.8% (97/988) of participants' daughters received at least one dose of HPV vaccines. Descriptive norms (β=0.28), perceived greater benefits of HPV vaccination (β=0.17), anticipated affective consequences (β=0.32), and attitude to general optional vaccines (β=0.09) were associated with parental vaccination intention. Barriers to HPV vaccination (β=-0.31), descriptive norms (β=0.17), perceived self-efficacy (β=0.73), and vaccination intention (β=0.11) were associated with vaccination planning. Vaccination intention (β=0.31) and planning (β=0.18) modestly predicted vaccination uptake. The lack of government-organized HPV vaccination programme may result in persistent low HPV vaccination uptake and many young women may remain vulnerable to future cervical cancer risk in Hong Kong.

Personal and perceived peer use and attitudes towards the use of nonmedical prescription stimulants to improve academic performance among university students in seven European countries

BACKGROUND

Overestimations of non-prescribed stimulant use of peers are well documented in the USA and have also been identified as predictive of personal stimulant consumption. This study aimed to examine whether overestimations of peer use and approval of the use are associated with personal use and attitude towards the use of non-prescribed stimulants among European university students.

METHOD

The EU funded 'Social Norms Intervention for the prevention of Polydrug usE (SNIPE)' study was conducted in seven European countries. In a web-based questionnaire, 4482 students were asked about their personal use and their attitude towards non-prescribed stimulant use, as well as the perceived peer use and peer attitude.

RESULTS

59% of students thought that the majority of their peers used non-prescribed stimulants more frequently than themselves, and only 4% thought that the use of the majority was lower than their personal use. The perception that the majority of peers had used non-prescribed stimulants at least once was significantly associated with higher odds for personal use of non-prescribed stimulants (OR: 3.30, 95% CI: 2.32-4.71). In addition, the perception that the majority of peers approved of the non-prescribed use of stimulants was associated with a 4.03 (95% CI: 3.35-4.84) times higher likelihood for personal approval.

DISCUSSION

European university students generally perceived the non-prescribed use of stimulants of peers to be higher than their personal use. This perception, as well as a perception of higher approval in the peer group, was associated with a higher likelihood of personal non-prescribed stimulant medication use and approval.

Supply of alcohol to underage drinkers: Misperceptions of community norms

RATIONALE

Adult approval and acceptance of alcohol use is highly correlated with underage drinking. Social norms influence young people's decisions to drink alcohol. While there is a dearth of studies to date, it is likely that social norms also influence adults' decisions to provide adolescents with alcohol.

OBJECTIVE

The current study explored the (in)consistencies between own and perceptions of others' views of underage drinking and the provision of alcohol to underage drinkers.

METHODS

Computer assisted telephone survey of 1160 adults in two communities in New South Wales, Australia.

RESULTS

Parents and community members were generally opposed to underage drinking and supply of alcohol to adolescents. Females, older respondents, and those who were parents were significantly more likely to disapprove of both underage drinking and supply of alcohol. However, across all of the behaviours, parents and non-parents alike perceived general community attitudes to be more liberal than their own.

CONCLUSION

There is a need for community-based interventions that target parental misperceptions about the prevalence of youth drinking and the acceptability of drinking and supply of alcohol within their local community.

Impact of alcohol checks and social norm on driving under the influence of alcohol (DUI)

This study investigated the influence of alcohol checks and social norm on self-reported driving under the influence of alcohol above the legal limit (DUI). The analysis was based on the responses of 12,507 car drivers from 19 European countries to the SARTRE-4 survey (2010). The data were analysed by means of a multiple logistic regression-model on two levels: (1) individual and (2) national level. On the individual level the results revealed that driving under the influence (DUI) was positively associated with male gender, young age (17-34), personal experience with alcohol checks, the perceived likelihood of being checked for alcohol, perceived drunk driving behaviour of friends (social norm) and was negatively associated with higher age (55+). On a national level, the results showed a negative association with a lower legal alcohol limit (BAC 0.2g/l compared with BAC 0.5g/l) and the percentage of drivers checked for alcohol. DUI was positively associated with the percentage of respondents in the country that reported that their friends drink and drive (social norm). The comparison of the results obtained on national and individual levels shows a paradoxical effect of alcohol checks: Countries with more alcohol checks show lower DUI (negative association) but respondents who have been personally checked for alcohol show a higher chance of DUI (positive association). Possible explanations of this paradox are discussed. The effects of the social norm variable (perceived drunk driving behaviour of friends) are positively associated with DUI on both levels.

Privacy, technology, and norms: the case of Smart Meters

Norms shift and emerge in response to technological innovation. One such innovation is Smart Meters - components of Smart Grid energy systems capable of minute-to-minute transmission of consumer electricity use information. We integrate theory from sociological research on social norms and privacy to examine how privacy threats affect the demand for and expectations of norms that emerge in response to new technologies, using Smart Meters as a test case. Results from three vignette experiments suggest that increased threats to privacy created by Smart Meters are likely to provoke strong demand for and expectations of norms opposing the technology and that the strength of these normative rules is at least partly conditional on the context. Privacy concerns vary little with actors' demographic characteristics. These findings contribute to theoretical understanding of norm emergence and have practical implications for implementing privacy protections that effectively address concerns of electricity users.

You did not mean it: Perceived good intentions alleviate sense of unfairness

Previous research has reported that feedback-related negativity (FRN) may represent the degree of perceived unfairness in the ultimatum game (UG). However, few studies have incorporated intention-related consideration in examining the neural correlates of fairness perception. To address this issue, the present study introduced an intentional UG paradigm to disentangle the effect of perceived intention from fairness concerns, using an event-related potential (ERP) analysis. Consistent with the hypothesis, the behavioral results indicated that good intention could markedly reduce rejection rates, and this intention effect was modulated by the degree of fairness, which was more prominent under unfair scenarios. Further electrophysiological results showed that, for the unfair division schemes, FRN and P300 amplitudes were significantly different between offers proposed with good intention and those with bad intention, while such discrepancies were not observed for the fair condition. In summary, converging results demonstrated that perceived intention can modulate the effect of fairness in social decision-making.

The conflict of social norms may cause the collapse of cooperation: indirect reciprocity with opposing attitudes towards in-group favoritism

Indirect reciprocity is a cooperation maintaining mechanism based on the social evaluation of players. Here, we consider the case of a group in which two social norms with opposing attitudes towards in-group favoritism are mixed. One norm, called Bushido (the way of warriors), regards cooperation with outsiders as betrayal, whereas the second norm, called Shonindo (the way of merchants), regards cooperation with outsiders as desirable. Each member of the group, irrespective of being a Bushido or a Shonindo player, is evaluated in two different ways and assigned two different labels: "ally" or "enemy" according to the Bushido evaluation; "good" or "bad" according to the Shonindo evaluation. These labels change in response to the action taken (cooperation or defection) when acting as a donor, as well as the label attached to the recipient. In addition to Bushido players, who cooperate with an ally and defect from an enemy, and Shonindo players, who cooperate with a good recipient and defect from a bad recipient, the group contains a third kind of players--unconditional defectors. The fractions of the three types of players follow the replicator dynamics. If the probability of interacting with outsiders is small, and if the cost-to-benefit ratio of cooperation is low, we observe several important patterns. Each social norm is able to maintain a high level of cooperation when dominant. Bushido and Shonindo players evaluate each other unfavorably and engage in a severe conflict. In the end, only one norm permeates the whole group driving the other to the extinction. When both social norms are equally effective, a rare occurrence of unconditional defectors may lead to a successful invasion.

Mammography Screening according to Breast Cancer Disease and Social Network Characteristics of Married Korean Women

PURPOSE

This study was done to examine differences in mammography screening according to breast cancer and social network characteristic.

METHODS

Data were collected from 187 married women 35 years and older who were using public health centers, health promotion centers, cultural centers, obstetrics and gynecology hospitals or other relevant community sites. Data were collected between October 24 and December 4, 2008. Data were analyzed using the SPSS/WIN 15.0 program.

RESULTS

The participation rate for mammography screening was 35.3%. The following general and breast cancer characteristics showed statistically significant differences: religion, family incomes, regular medical-care, general health examinations during past 2 years, and history of breast disease. The following social network characteristics showed statistically significant differences: social norms and subjective norms. Using logistic regression analysis, regular medical-care, breast cancer risk appraisal, social norm, and subjective norms were highly predictive of subsequent mammography.

CONCLUSION

The results of this study indicate that it is important to develop and provide tailored intervention programs through integrated socially mediated programs. By consciously including social network and support systems, breast cancer detection efforts would not end as a one-time event, but naturally build on network structure of adults women, thus facilitating regular mammography screening.