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In May 2021, U.S. states began implementing "vaccination lotteries" encouraging COVID-19 vaccination. Drawing from Prospect Theory and math cognition research, we tested several monetary lottery structures and their framing to determine which would best motivate unvaccinated adults.In two online experiments, U.S. adults were asked to imagine that their state implemented a vaccination lottery. In Experiment 1, participants (Intentions did not differ across conditions (Experiment 1:Multiple lottery structures could be equally (un)motivating for unvaccinated adults. Structures that distribute incentives across more people or alternative public health strategies should be considered. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

During the COVID-19 pandemic, the U.S. public was encouraged to practice good hand hygiene, such as hand washing or the use of hand sanitizer. Young adults reported lower levels of hand hygiene compared to adults of other ages. The aim of the current study was to test the effectiveness of different messages to promote hand sanitizer use among young adults.Over a 6-week period, we examined whether 3 brief messages (gain-frame, static descriptive norms, dynamic descriptive norms), placed next to sanitizer dispensers in university residence halls, predicted dispenser use in comparison to dispensers with no sign. Amount of sanitizer usage was measured 3 times per week via the weight of dispenser units. We tracked and controlled for the number of positive COVID-19 cases in residence halls because we expected it might influence sanitizer usage.Compared to no signage, dispensers with signs had 35% greater usage, with the static descriptive norms sign associated with greatest usage (46% compared to no sign), although differences did not reach conventional levels of significance. The strongest predictor of sanitizer use was a residence hall's degree of COVID-19 risk based on the hall's case positivity.Dispensers with signs had higher use than those without signs, but this difference was not statistically significant. We conclude that compared to prior research, "nudges" such as evidence-based messaging may have had less of an effect on health behavior engagement due to methodological differences across studies or characteristics of the COVID-19 context. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective: Appetitive risk behaviors (ARB), including tobacco use, alcohol consumption, consumption of calorie dense/nutrient-poor foods, and sexual risk behavior contribute substantially to morbidity and mortality. Affective states that arise from a wide array of unrelated circumstances (i.e., incidental affect) may carry over to influence ARB. A meta-analysis is needed to systematically examine causal evidence for the role of incidental affect (including specific emotions) in influencing ARB. Method: Integrating effect sizes from 91 published and unpublished experimental studies that include both an incidental-affect induction and neutral-control condition (k = 271 effect sizes: k = 183 negative affect, k = 78 positive affect), this meta-analysis examines how negative and positive affective states influenced ARB and related health cognitions (e.g., intentions, evaluations, craving, perceived control). Results: Negative affective states reliably increased ARB, in analyses where all negative affective states were analyzed (d = .29) and in stratified analyses of just negative mood (d = .30) and stress (d = .48). These effects were stronger among study populations coded as clinically at risk. Positive affective states generally did not influence ARB or related health cognitions, except in the presence of a craving cue. Design issues of extant literature largely precluded conclusions about the effects of specific positive and negative affective states. Conclusion: Taken together, findings suggest the importance of strategies to attenuate negative affect incidental to ARB to facilitate healthier behavioral patterns, especially among clinically at-risk individuals. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

OBJECTIVE Genomic sequencing is becoming increasingly accessible, highlighting the need to understand the social and psychological factors that drive interest in receiving testing results. These decisions may depend on perceived descriptive norms (how most others behave) and injunctive norms (what is approved of by others). We predicted that descriptive norms would be directly associated with intentions to learn genomic sequencing results, whereas injunctive norms would be associated indirectly, via attitudes. These differential associations with intentions versus attitudes were hypothesized to be strongest when individuals held ambivalent attitudes toward obtaining results. METHOD Participants enrolled in a genomic sequencing trial (n = 372) reported intentions to learn medically actionable, nonmedically actionable, and carrier sequencing results. Descriptive norms items referenced other study participants. Injunctive norms were analyzed separately for close friends and family members. Attitudes, attitudinal ambivalence, and sociodemographic covariates were also assessed. RESULTS In structural equation models, both descriptive norms and friend injunctive norms were associated with intentions to receive all sequencing results (ps < .004). Attitudes consistently mediated all friend injunctive norms-intentions associations, but not the descriptive norms-intentions associations. Attitudinal ambivalence moderated the association between friend injunctive norms (p ≤ .001), but not descriptive norms (p = .16), and attitudes. Injunctive norms were significantly associated with attitudes when ambivalence was high, but were unrelated when ambivalence was low. Results replicated for family injunctive norms. CONCLUSIONS Descriptive and injunctive norms play roles in genomic sequencing decisions. Considering mediators and moderators of these processes enhances ability to optimize use of normative information to support informed decision making. (PsycINFO Database Record

Dispositional optimism and risk perceptions (single-event optimism) both assess a type of optimism, but are conceptually distinct and not highly correlated (e.g., Radcliffe & Klein, 2002). Risk perceptions may interact with dispositional optimism to influence health-related intentions, behaviors, and information seeking, although little research has examined interactions among multiple types of optimism (Klein & Zajac, 2009). We examined the interaction of dispositional optimism and risk perceptions in the context of deciding to receive genome sequencing feedback. Dispositional optimism is a personality trait indicating the degree to which individuals have positive expectations about their future (Carver & Scheier, 2002). Greater dispositional optimism is typically associated with beneficial health outcomes (Carver & Scheier, 2014; Nes & Segerstrom, 2006; Rasmussen, Scheier, & Greenhouse, 2009). These beneficial outcomes may occur because optimists exert more effort and are more persistent when striving toward goals and use more active than avoidant coping strategies (Aspinwall & Taylor, 1992; Carver & Scheier, 2014; Nes & Segerstrom, 2006; Taylor et al., 1992). Optimists also may be more receptive to threatening information (Aspinwall & Brunhart, 1996) and responsive to the utility and personal relevance of health information (Aspinwall, Richter, & Hoffman, 2001), suggesting that they may be more likely to seek out information to make informed decisions. People also can be optimistic, or have positive expectations, about a single event. In the context of health, these expectations can be measured by assessing perceived risk (Klein & Zajac, 2009). People can be said to display optimistic risk perceptions when they rate their risk of disease as being relatively low, regardless of how accurate their perceptions are. Perceived risk is a component of many health behavior theories (Rosenstock, 1990; Witte, 1992), and perceiving greater disease risk is posited to motivate behaviors intended to mitigate risk. However, in practice, risk perceptions are often only weakly or moderately associated with intentions and behavior (Brewer et al., 2007; McCaul, Branstetter, Schroeder, & Glasgow, 1996), although moderating factors may strengthen the association (Sheeran, Harris, & Epton, 2014). An important health behavior is opting to learn potentially threatening, health-relevant information such as genome sequencing results indicating disease risk. Genome sequencing is a rapidly emerging technology for early risk identification (Bick & Dimmock, 2011). Research is needed to determine how people make decisions about and respond to genome information (Berg, Khoury, & Evans, 2011; Collins, Green, Guttmacher, & Guyer, 2003). Just as greater perceived risk tends to promote greater health behaviors to reduce risk (albeit weakly); it also tends to promote health information seeking. This occurs because risk information is more likely to be health relevant and important when disease risk is high (Sweeny, Melnyk, Miller, & Shepperd, 2010; Wiebe & Black, 1997). However, because risk information conferring elevated risk is more likely to obligate unwanted action or to result in negative emotion, greater perceived risk can also be associated with avoiding health information (Persoskie, Ferrer, & Klein, 2014; Sweeny et al., 2010). That greater perceived risk promotes both information seeking and avoidance is consistent with evidence that perceived risk inconsistently predicts genetic testing uptake (Sweeny, Ghane, Legg, Huynh, & Andrews, 2014). We tested the interactive effects of dispositional optimism and perceived risk among adults who reported intentions to learn their actual genome sequencing results and to change their lifestyle and health behaviors in response. For participants with high perceived risk of learning negative information from their sequencing results, optimism may be necessary to promote willingness to learn information and to take action to mitigate risks. This effect may occur for two reasons: (1) Dispositional optimism prompts attention to the utility of information, such as when disease risk is high (Aspinwall et al., 2001); and (2) personal psychological resources can reduce information avoidance (Howell, Crosier, & Shepperd, 2014; Taber, Klein, Ferrer, Lewis, et al., 2014). Two studies have tested interactive effects of dispositional optimism and risk perceptions on health-related outcomes. Among dispositionally optimistic undergraduates, those with higher perceived comparative risk increased exercise more and retained relatively more information about coronary heart disease than those with lower perceived risk (Davidson & Prkachin, 1997), and when given false feedback indicating high risk for dental health problems, participants reported greater perceived credibility and importance of the feedback and dental hygiene information, respectively (Geers, Wellman, & Fowler, 2013). In both studies, perceived comparative risk was unassociated with outcomes for those low in dispositional optimism. Neither study examined the interaction of dispositional optimism with other types of risk perceptions. In the present study, we assessed three distinct types of risk perceptions. Absolute perceived risk is the subjective likelihood of developing disease, independent of context. Comparative perceived risk is the likelihood of developing disease compared to the likelihood of people with similar characteristics, such as gender and age. Experiential perceived risk (also known as “feelings of risk”) is the extent to which individuals feel at risk for disease (e.g., “I feel that I am vulnerable to cancer”) and is thought to be based on intuitive assessments and the experience of risk (Slovic, Peters, Finucane, & MacGregor, 2005; Weinstein et al., 2007). These different risk perception measures likely capture different constructs, as they are reported to be only moderately correlated (Dillard, Ferrer, Ubel, & Fagerlin, 2012; Lipkus, Klein, Skinner, & Rimer, 2005; Zajac, Klein, & McCaul, 2006). Comparative (Portnoy, Kaufman, Klein, Doyle, & de Groot, 2014) and experiential risk perceptions (Dillard et al., 2012; Janssen, Waters, van Osch, Lechner, & de Vries, 2014; Weinstein et al., 2007) are often more predictive of behavior than absolute risk. Because individuals attend greatly to comparative information (Suls & Wheeler, 2012), comparative risk perceptions may better reflect how individuals evaluate risk (Klein, 2003; Radcliffe & Klein, 2002). Experiential risk perceptions also may reflect how individuals evaluate risk because such perceptions encompass affect, which is a major influence on decision making (Loewenstein, Weber, Hsee, & Welch, 2001). Further, absolute risk perceptions may have lower predictive validity due to general difficulty interpreting numerical information (Nelson, Reyna, Fagerlin, Lipkus, & Peters, 2008). We tested several hypotheses. First, we predicted that greater perceived experiential risk would be more associated with intentions to learn genome information than absolute or comparative risk. Second, we predicted that greater dispositional optimism would be associated with greater intentions to learn genome information and to use this information to change lifestyle/health behaviors given optimists’ greater attention to threatening health information and employment of active coping strategies (Aspinwall & Brunhart, 1996; Aspinwall et al., 2001). Third, we expected that optimism and risk perceptions would interact to predict intentions to learn sequencing results—particularly for medically actionable disease—such that higher risk perceptions would be linked to greater intentions to receive results only for individuals high in dispositional optimism. We had no a priori predictions as to whether the three types of risk perceptions would interact differently with optimism to influence outcomes.