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The negative consequences of the COVID-19 pandemic on mental health have been widely reported, but less is known about how the impact of COVID-19 on others in one's social circle shapes these high distress levels. This study examines associations between social COVID-19 exposure-knowing someone who had a COVID-19 infection-and psychological functioning, as well as whether socio-demographic factors moderate these relationships. In June 2020, respondents (N = 343) from clinics in Tampa, Florida, U.S.A. reported whether they had social COVID-19 exposure, anxiety, depression, and stress, and other COVID-19-related concerns. Social COVID-19 exposure was associated with increased anxiety, stress, and concerns about a family member getting sick, and concerns about drinking and substance use. Several associations between exposure and psychological functioning were stronger in women, younger people, and people with lower income, implying these groups face elevated psychological risks due to the pandemic, and should be prioritized in mental health recovery efforts., Author(s): Malwina Lewicka [sup.1] , Jada G. Hamilton [sup.1] , Erika A. Waters [sup.2] , Heather Orom [sup.3] , Elizabeth Schofield [sup.1] , Marc T. Kiviniemi [sup.4] , Peter A. [...]

Background: Avoiding health information is relatively common and is associated with lower knowledge of health risks and lower engagement in protective health behaviour. Health information avoidance likely limits the effectiveness of health communication interventions. Objective: To identify beliefs associated with avoiding health information. Design: Two cross-sectional studies. Setting: Two representative samples of adults residing in the USA. Method: We tested whether low health agency beliefs and low perceptions of threat underlie the tendency to avoid diabetes or colorectal cancer health information in two samples. Results: An exploratory factor analysis (EFA) of our variables indicated that beliefs could be grouped into two sets of constructs that mapped onto agency (locus of control, fate) and two that mapped onto threat perception (dread, perceived risk). Information avoidance was common. In the two samples, 30% and 34% indicated they preferred to avoid information about diabetes and 20% and 19% indicated they preferred to avoid colorectal cancer information. Results were largely consistent across studies and diseases. In final adjusted regression models, beliefs indicating lower health agency were consistently associated with more avoidance. Some threat perception variables (worry about getting the disease and having a family history of the disease) were associated with less avoidance; absolute and comparative perceived risk were not. Conclusion: Given that health information avoidance likely undermines a wide range of health communication and self-regulation strategies, future health communication efforts might be advanced by developing intervention approaches that involve enhancing perceived control over health prior to delivering health messages.

Perceived risk is a common component of health decision making theory. When affective components of risk are assessed as predictors of a behavior, they are usually examined separately from cognitive components. Less frequently examined are more complex interplays between affect and cognition. We hypothesized that cognitive and affective risk components would both have direct effects on colonoscopy behavior/intentions and that affective components would mediate the relationship of cognitively-based perceived risk to colonoscopy screening. In two secondary analyses, participants reported their cognitive and affective perceived risk for colorectal cancer, past colonoscopy behavior, and future screening intentions. In both studies, cognitive and affective risk components were associated with increased screening behavior/intentions and cognitive risk components were mediated through affective risk. Given the impact of early detection on colorectal cancer prevention, educational strategies highlighting both components of risk may be important to increase screening rates., Author(s): Lynne B. Klasko-Foster [sup.1] , Marc T. Kiviniemi [sup.2] , Lina H. Jandorf [sup.3] , Deborah O. Erwin [sup.4] Author Affiliations: (1) grid.273335.3, 0000 0004 1936 9887, Department of [...]

Several studies suggest that 'don't know' (DK) responses to risk perception items may represent meaningful expressions of uncertainty about disease risk. However, researchers are often discouraged from including a DK response option in survey items due to concerns about respondents overusing it to minimize cognitive effort—a phenomenon often referred to as satisficing. Our objective was to investigate whether patterns of DK responses to risk perception survey items were consistent with satisficing behavior. We conducted a secondary analysis of survey data from 814 parents and guardians (hereafter caregivers) of children with asthma. Caregivers answered 18 items assessing their perceived risk of their child experiencing two types of poor asthma outcomes: asthma exacerbation, and low asthma control. We examined differences in the frequency and distribution of DK responses across all 18 items and by type of risk perception item (i.e. 2 vs. 5 response options, absolute vs. comparative risk). We found that 32% (n = 548) of respondents marked DK at least once. Of the 266 caregivers who provided any DK response, most did so for only 1 or 2 items (51.9%, n = 138), and only 6% (n = 15) answered DK to more than half of the items. Using random coefficient Poisson models, we found more DK responding for dichotomous absolute (30.1%) than ordinal absolute items (5.3%), b = 1.72, p<.001. We also found fewer DK responses to the ordinal absolute items than the comparative items (8.2%), b=-0.49, p<.001. Using Chi-square tests, we found that inattentive responding was not associated with responding DK. Our findings suggest that satisficing is unlikely to completely explain DK responding to perceived risk survey items. Researchers who exclude DK response options from risk perception survey items may obtain an incomplete understanding of their study sample's beliefs about risk. [ABSTRACT FROM AUTHOR]

Background: Two-thirds of adults aged 50 years and older are adherent to recommendations for colorectal cancer screening. Provider-patient communication and characteristics of the patient-provider relationship may relate to screening behavior. Methods: The association of provider communication quality, relationship, and colorectal cancer screening was examined within data from the 2007 Health Information National Trends Survey. Results: Perceived provider communication and relationship quality were associated with both adherence to colonoscopy and with ever having been screened. Predictive margins analyses indicated that increasing perceptions from lowest to highest levels of communication and relationship quality would be associated with increases in screening rates approaching 16 percentage points. Conclusion: Improving provider-patient communication and relationship quality could potentially improve colorectal cancer screening behaviors among adults aged 50 years and older. Future research and clinical practice should focus on understanding the role of these factors in screening behavior and enhance the provider-patient interaction. (Contains 5 tables.)

Assigned textbook readings are a common requirement in undergraduate courses, but students often do not complete reading assignments or do not do so until immediately before an exam. This may have detrimental effects on learning and course performance. Regularly scheduled quizzes on reading material may increase completion of reading assignments and therefore course performance. This study examined the effectiveness of compulsory, mastery-based, weekly reading quizzes as a means of improving exam and course performance. Completion of reading quizzes was related to both better exam and course performance. The discussion includes recommendations for the use of quizzes in undergraduate courses. (Contains 1 table.)

Affective associations with behavioral practices play an important role in individuals' uptake of a variety of health behaviors. Most work has looked at individual behavioral practices with a direct impact on health; because screening behaviors are conceptually distinct from such behaviors, it is important to examine the interplay of affect and cognition in screening decision making. The current research explored affective and cognitive predictors of testicular and breast self-examination behavior. Young adult participants (N = 184) reported cognitive beliefs and affective associations with testicular self-exam behavior (male participants) and breast self-exam behavior (female participants) and reported their own current screening behavior. In univariable models, affective associations were related to screening behavior for both testicular self-exams and breast self-exams. When examining affective associations and cognitive beliefs as simultaneous predictors, affective associations (but not cognitive beliefs) predicted testicular self-exams, and neither affective associations nor cognitive beliefs were uniquely related to breast self-exams. Moreover, for testicular self-exams, affective associations mediated the relation between cognitive beliefs and screening behavior; no mediation was present for breast self-exam behavior. These findings suggest three potential outcomes: first, that greater consideration of affective associations in testicular self-exam screening decisions may be warranted; second, that breast and testicular self-exams may have different antecedents; and third, that incorporation of affective factors in intervention design might have merit for increasing engagement in some cancer screening behaviors., Author(s): Carolyn R. Brown-Kramer[sup.1] [sup.2] , Marc T. Kiviniemi[sup.3] Author Affiliations: (1) Department of Psychology, Nebraska Wesleyan University, 5000 Saint Paul Ave., 68504-2794, Lincoln, NE, USA (2) Department of Psychology, [...]

Preventive health behaviors are believed to be motivated in part by a person's perception of risk for a particular health problem. Risk contains a cognitive component, beliefs about the chances of a health problem occurring, and an affective component, fear or worry about the health problem. Although both have been shown to influence behavior, the nature of their interrelation as an influence on behavior has not been examined. Data from the 2005 Health Information National Trends Survey, a US nationally-representative telephone survey was analyzed. Participants reported perceived absolute and comparative risk for skin cancer, feelings of worry about skin cancer, and sunscreen use behavior. Analyses examined main effects models for the relation between perceived risk, worry, and sunscreen use, as well as both moderated and mediated models. For both absolute and comparative risk, the relation between cognitively-based perceived risk for skin cancer and sunscreen use was fully mediated by feelings of worry, as evidenced by significant direct effects of worry (bs > 0.046, ps < 0.01) and indirect effects of risk through worry (bs > 0.19, ps < 0.01). When worry was included in the models, direct effects of risk perceptions were non-significant (bs < 0.11, ps < 0.10). No evidence was found for moderated effects of worry on the relation between risk and behavior. While cognitive risk appraisals do influence decision making and may be addressed by interventions, these findings demonstrate that affectively-based risk components play a key role in behavior regulation. Affectively-based risk might be an effective target for interventions and should be incorporated more fully in decision-making models. Keywords Perceived risk * Worry * Mediation * Risk perception and behavior, Introduction A central tenet of many models of health decision making is that preventive health behaviors are motivated in part by a person's perception that she or he could potentially [...]

Fewer than half of Americans meet current recommendations for fruit and vegetable intake. The behavioral affective associations model posits that feelings and emotions associated with a behavior are a proximal influence on decision making. Cross-sectional evidence supports the model and suggests that affective associations predict fruit and vegetable consumption. The purpose of this study was to test whether a causal relation exists between affective associations about fruits and future fruit consumption behavior, as measured by a snack selection task. Following a baseline assessment of cognitive and affective variables, participants' (N = 161) affective associations about fruits were experimentally manipulated with an implicit priming paradigm. Images of fruits were repeatedly paired with positive, negative, or neutral affective stimuli. The key outcome measure was a behavioral choice task in which participants chose between fruit and a granola bar. Participants in the positive prime condition were three times more likely than those in the negative condition to select a piece of fruit over the granola bar alternative in the snack selection task. They were also twice as likely as those in the neutral condition to select fruit. There were no changes in self-reported affective associations or cognitive beliefs. These findings provide further evidence of the implicit and direct influence of affective associations on behavior, suggesting the need to both incorporate the role of affect in health decision making models, as well as the potential utility of intervention strategies targeting affective associations with health-related behaviors. Keywords Health decision making * Affect/emotions * Evaluative conditioning * Fruit and vegetable consumption, Introduction Feeding a child Brussels sprouts, spinach, or other vegetables can elicit reactions of disgust or even fear (Birch & Marlin, 1982; Rozin, 2006). On the other hand, many people [...]

A challenge for health behavior science is to develop theory and best practices that take cultural diversity into account. Using data from Black, Hispanic, and White respondents to the 2003 Health Information National Trends Survey, we examined racial/ethnic differences in: (1) breast cancer risk perceptions/worry; (2) the associations between perceived risk/worry and ever having received a mammogram; and (3) perceived risk/worry and having had at least 2 mammograms over a 4-year period (consecutive mammography). Compared to White race/ethnicity, Black race/ethnicity was associated with lower perceived absolute risk and comparative risk for developing cancer. For the sample as a whole, higher perceived risk (both absolute risk and comparative risk) and worry predicted greater odds of mammography use; however, this was not true for Hispanics. In stratified analyses, perceived risk and worry were not associated with mammography use for either Hispanics or Blacks whereas they were for Whites; however, this interaction effect was significant only for Hispanics vs. Whites. Results support the need for formative research to identify determinants of health behavior prior to cancer prevention message planning for diverse audiences in order to accommodate racial/ethnic differences not only in the level of perceived risk, but also the association between risk perception to behavior change in that community. Keywords Race * Hispanic * African American * Mammography * Breast neoplasms * Perceived risk, Introduction Health education theory and practice recognize that intervention efforts should be designed to be acceptable and meaningful within the context of an audience's beliefs and values; however there remains [...]

In 2 studies, the authors tested the hypothesis that having information about another person can be a source of power in interpersonal interactions. In Study 1, the authors randomized participants to receive an expectation about an interaction partner, and the expectation provided an informational advantage for some participants but not for others. Participants with an advantage reported higher perceptions of power than did those who had information that did not confer an advantage; however, the effect was isolated to feelings of informational power. In Study 2, the authors examined whether the effect extended to different types of power when the information did not provide an explicit advantage. In this case, participants who received a more ambiguous expectation reported more diffuse feelings of power. The authors discuss implications for understanding the dynamics of power in social interactions. Key words: expectations, power, social information, social interactions, INTERPERSONAL INTERACTIONS OFTEN OCCUR in a context in which at least one of the participants in the interaction has an expectation about the other. For example, a person may go [...]

Individuals often have low rates of compliance with treatment recommendations. We examined the role that experienced affect at the time of illness diagnosis might play in influencing thoughts and feelings relating treatment compliance. Participants were randomly assigned to receive a positive, neutral, or negative affect induction after imagining they were diagnosed with kidney cancer. They then reported on thoughts and feelings about the illness and the treatment regimen. Participants also reported interest in additional information about the illness and behavioral intentions for complying with the treatment regimen. Affect significantly influenced interest in information and behavioral intentions. Both effects were mediated by the influence of affect on participants' self-efficacy beliefs. These mediational findings support a mood-as-resource interpretation of the role of affect in treatment compliance.

Since the middle of the 20th century, perceptions of risk have been critical to understanding engagement in volitional behavior change. However, theoretical and empirical risk perception research seldom considers the possibility that risk perceptions do not simply exist: They must be formed. Thus, some people may not have formulated a perception of risk for a hazard at the time a researcher asks them, or they may not be confident in the extent to which their perception matches reality. We describe a decade-long research program that investigates the possibility that some people may genuinely not know their risk of even well-publicized hazards. We demonstrate that indications of not knowing (i.e., "don't know" responses) are prevalent in the U.S. population, are systematically more likely to occur among marginalized sociodemographic groups, and are associated with less engagement in protective health behaviors. "Don't know" responses are likely indications of genuinely limited knowledge and therefore may indicate populations in need of targeted intervention. This body of research suggests that not allowing participants to indicate their uncertainty may threaten the validity and generalizability of behavior-change research. We provide concrete recommendations for scientists to allow participants to express uncertainty and to analyze the resulting data. [ABSTRACT FROM AUTHOR]

We discuss the implications of Seidenberg and colleagues' report confirming low levels of accurate awareness of the cancer harms associated with alcohol use, including wine, beer, and liquor consumption. The authors propose that academic and lay messaging describing consumption of wine and other forms of alcohol as reducing heart disease risk has created generalized beliefs about the health benefits of drinking alcohol. This "health halo" surrounding alcohol consumption leads the public to overgeneralize alcohol health benefits to other diseases, including cancer. We discuss the need to address high levels of perceived risk uncertainty to help the public distinguish between the impact of alcohol on heart disease versus cancer, and to overcome other barriers to including alcohol use reduction as a cancer prevention strategy. Given recent increases in U.S. population drinking rates, as well as morbidity and mortality associated with alcohol use, the time is right to marshal multilevel efforts to educate the public regarding the fact that alcohol is carcinogenic. If successful, these efforts will have multiple downstream benefits, including the ability of the lay public to use the most up-to-date scientific evidence to make informed decisions about whether, and how much, to engage in a risky behavior. [ABSTRACT FROM AUTHOR]

Abstract Background The US Preventive Services Task Force updated mammography recommendations in 2009, recommending against routine screening for women ages 40–49 and reducing recommended frequency for women 50+. The recommendation changes were highly controversial and created conflicting recommendations across professional organizations. This study examines overall awareness of the changes, accuracy of knowledge about changes, factors related to both overall awareness and accuracy, sources of knowledge about changes, and attitudes about the new recommendations. Method National telephone survey of 508 women, half aged 40–49 and half 50+, conducted one year after the update (November/December 2010; cooperation rate was 36%). Measures include awareness, accuracy, source of knowledge, interactions with providers, and attitudes about the changes. Results Fewer than half of women were aware of the guideline changes. Younger, more educated, and higher income women were more aware. Of those who were aware, only 12% correctly reported both change in age and frequency. Accuracy was not associated with demographics. The majority learned of changes through the media and the majority had negative attitudes about the changes. Conclusions Despite widespread coverage of the recommendation changes, overall awareness in the relevant population is low. Increasing awareness and addressing attitudes about the changes is necessary to ensure the use of recommendations to impact screening behavior.

Abstract Background Recommendations about precautionary behaviors are a key part of public health responses to infectious disease threats such as the 2009 H1N1 pandemic. Individuals' interpretation of recommendations, willingness to comply, and factors predicting willingness were examined. Methods A telephone survey of adult residents of New York State was conducted (N = 807). Respondents reported how they interpreted recommendations, willingness to engage in recommended actions, risk perceptions for H1N1 infection, and perceived efficacy of recommendations. Demographic characteristics were used to calculate sampling weights to obtain population-representative estimates. Results There was substantial variability in interpretation of preventive actions. Willingness to engage in preventive actions also varied substantially; vaccination willingness was substantially lower than other preventive actions. No pattern of demographic characteristics consistently predicted willingness. Perceived efficacy was associated with willingness for all recommendations, and perceived severity was associated with willingness for some recommendations. Conclusions Results suggest that individual interpretation of actions differ widely. The results suggest that current recommendations are not clear to laypeople and are open to different interpretations. These varying interpretations should be considered in crafting public health messages about precautionary behaviors.

An eight-member team of the Teaching Working Group of the Association of Schools and Programs of Public Health Scholarship of Teaching and Learning Task Force created a call to action advancing the use of evidence-based strategies for public health education. The goal of this article is threefold, to assess briefly the current status of evidence-based teaching in public health, strengthen the case for using evidence-based teaching practices in public health courses, and propose strategies for educators in public health to engage along a continuum of evidence-based teaching. In this article, we define evidence-based teaching (EBT) proposes that EBT is demonstrated by: student mastery of specific short-term learner outcomes (e.g., enhanced effectiveness such as represented by improved knowledge, skills, and/or attitudes); increases the likelihood of successfully completion of a particular public health degree or program, which represents an intermediate- or long-term outcome; and ultimately posits that effective teaching in public health aims to produce well-prepared graduates who contribute to a ready workforce (Impact 1) who are able to improve the health of the public (Impact 2), highlights effective evidence-based teaching practices that improve student learning outcomes, encourages both seasoned faculty and newcomers to the field to incorporate EBT into existing public health curricula and to begin by making small changes, and concludes with a call to action for EBT that improves student learning. [ABSTRACT FROM AUTHOR]

African Americans (AAs) have an elevated risk of developing dementia, yet are underrepresented in clinical research. This project uses a community-engaged photovoice approach to add to existing understanding of barriers and facilitators to AA participation in Alzheimer's disease research and identify strategies to enhance engagement. Three AA research advocates served as community facilitators to identify and guide groups of AA adults through an eight to nine session photovoice project. Group sessions involved discussions and sharing of images pertaining to various prompts in the area of brain health and research participation. Sessions were audiotaped and transcribed verbatim. Participants identified three categories of barriers to AA research participation: (a) Mistrust, (b) avoidance and fear of acknowledging problems, and (c) seeing the risks of research but not the need. Participants shared suggestions and approaches for ameliorating each of these barriers. This process revealed unique insights into barriers and opportunities for increasing AA engagement in aging and dementia research. [ABSTRACT FROM AUTHOR]

Objective: While early detection is an effective way to reduce mortality from colorectal cancer, screening rates are low. An underlying factor in screening completion failure may be experiences of disgust when learning about screening and/or dispositional disgust. Method: Participants recruited via Amazon MTurk (N = 296) read information about colonoscopy and completed an online survey assessing both dispositional forms of disgust (i.e. trait disgust and disgust sensitivity) and situational forms, including state disgust and disgust associated with colonoscopy. Participants reported intentions to discuss colonoscopy with a provider and to prepare for and complete screening. Results: Greater state disgust and the degree to which one associated disgust with colonoscopy predicted lower screening, preparation and provider discussion intentions. By contrast, neither trait disgust nor disgust sensitivity was associated with intentions. Both disgust sensitivity and trait disgust moderated the state disgust to intentions relation. Conclusions: This is one of few investigations of disgust examining the relation between specific types and colonoscopy intentions. Screening uptake may be improved by identifying specific components of disgust that have an effect on colonoscopy intentions. Future work focusing on the interplay between different disgust mechanisms as they relate to colonoscopy behaviour is important for intervention development. [ABSTRACT FROM AUTHOR]

The 2016–2017 Inaugural Class of the Society of Behavioral Medicine Leadership Institute (SBM LI) debuted to an eager team of 36 mid-career fellows led by energetic mentors, professional coaches, and career development experts. Fellows were divided into learning communities of eight participants for deeper engagement. Our "Green Team" learning community bonded quickly and actively committed to our collective progress and projects. Upon returning home from the in-person sessions, our activities included monthly team conference calls and consultation with our mentors and selected coaches. The Green Team regularly communicated throughout the year, giving feedback to each other about our projects to be presented at the 2017 SBM Annual Meeting. We also discussed our mentoring and coaching experiences, leadership skills put to use at our institutions, and personal development. Contact continued via social media, email, teleconferencing, and collaborations at other professional meetings. The Green Team utilized the Tuckman and Jensen model of small group development to describe how we developed into a high-functioning group that maximized the resources afforded by the SBM LI to yield successful leadership outcomes. This commentary will offer an example of how a productive SBM LI team works collaboratively to utilize its mentors and resources for professional development. [ABSTRACT FROM AUTHOR]

Individuals with different cultural worldviews conceptualise risks in distinct ways, yet this work has not extended to personal illness risk perception. The purpose of this study was to 1) examine the relationships between two types of cultural worldviews (Hierarchy-Egalitarian; Individualism-Communitarianism) and perceived risk (perceived severity and susceptibility) for diabetes and colon cancer, 2) test whether health literacy modifies the above relationships, and 3) investigate whether trust in government health information functions as a putative mediator of the relations between cultural worldviews and disease perceived risk. We recruited (N = 600) participants from a nationally-representative Internet survey panel. Results were weighted so the findings are representative of the general United States population. People with a more hierarchical worldview expressed lower perceived susceptibility to developing both diabetes and colon cancer, and perceived these diseases to be less severe, relative to those with a less hierarchical (more egalitarian) worldview. There was no significant association between individualistic worldview and perceived risk. Health literacy modified the relationships between hierarchical worldview and perceived risk; the associations between hierarchical worldview and lower perceived severity were stronger for those with limited health literacy. We did not observe indirect effects of cultural worldviews on perceived risk through trust in health information from government sources. It may be useful to identify specifically tailored risk communication strategies for people with hierarchical and individualistic worldviews, especially those with limited health literacy, that emphasise their important cultural values. Further research examining cultural components of illness risk perceptions may enhance our understanding of risk-protective behaviours. [ABSTRACT FROM AUTHOR]

We identified determinants of uncertainty about perceived risk judgments and demonstrated that uncertainty is associated with lower engagement in risk-reducing behavior. We found that people likely have metacognitive awareness of when their judgments are overly pessimistic, resulting in uncertainty and that question context (more constraints) and people's time orientation (future orientation) are associated with lower uncertainty. Uncertainty about conditioned risk judgments was associated with lower engagement in exercising and eating a healthy diet in order to reduce risk for heart disease. As a potential determinant of behavior, uncertainty about risk judgments merits further consideration for integration into theories of health behavior. [ABSTRACT FROM AUTHOR]