Search

Background As COVID-19 continues to spread globally, it is important to understand psychological factors that may influence compliance with social distancing. Purpose The present study examined whether Theory of Planned Behavior (TPB) constructs were associated with social distancing, with a focus on exploring moderators of the intention–behavior relationship. Methods Using a longitudinal design, U.S. adults (N = 507) self-reported TPB constructs and social distancing behavior at baseline and 3 months later. Participants were from 48 U.S. States and the District of Columbia and were on average 50.39 years old (SD = 15.32, range = 18–80). The majority were Non-Hispanic White (71.6%), had a bachelor’s degree or higher (55.3%), and resided in suburban areas (55.8%). Results While positive attitudes toward social distancing increased over time (p = .002), subjective norms weakened (p < .001) and perceived behavioral control (PBC) remained stable (p = .22). Interestingly, despite an increase in intentions from baseline to follow-up (p < .001), there was a significant decrease in social distancing behavior over time (p < .001). Consistent with the TPB, baseline attitudes (p < .001), subjective norms (p < .001), and PBC (p < .001) for social distancing were all associated with baseline intentions to social distance. In turn, baseline intentions were significantly associated with social distancing behavior at follow-up (p < .001). Younger adults (p < .001) and non-White participants (p = .002) displayed a greater intention–behavior gap relative to older and White participants. In contrast, participants with more stable intentions over time displayed a stronger intention–behavior relationship (p < .001). Conclusions Targeting individuals’ attitudes, norms, and PBC may effectively promote protective behaviors intended to mitigate the spread of COVID-19 and similar viral outbreaks. Future research should examine effective strategies for translating social distancing intentions into actions., Social distancing attitudes, norms, perceived behavioral control, and intentions were associated with social distancing behavior at 3-month follow-up. Racial minorities and younger adults displayed larger intention-behavior gaps.

The current study sought to identify subgroups of adult drinkers who differ in their level of association between alcohol-related Theory of Planned Behavior (TPB) constructs (attitudes, perceived norms, self-efficacy, and intentions), and explore if distinct subgroup profiles relate to alcohol use two weeks later.Participants (N = 121) were recruited to participate in a two-week study about daily experiences with exercise and alcohol (Alcohol attitudes, subjective norms, alcohol refusal self-efficacy, and intentions were used to create class membership. Behavioral outcomes included (1) drinking frequency, (2) drinking quantity, and (3) drinking to get drunk.Two classes of drinkers were determined - Class 1 was categorized by moderate scores on all constructs, whereas Class 2 was categorized by moderate scores on attitudes and high scores on norms, alcohol refusal self-efficacy, and intentions. Class designation was associated with frequency, but not quantity of use.The current study suggests that a minority of individuals who score moderately across all constructs should receive intervention efforts that focus on just those included in the TPB, while the vast majority may require additional constructs to be addressed.

Justice-involved youth are at a higher risk of negative outcomes from sexual activity and alcohol use relative to their non-justice involved peers. In the current study, we tested the extent to which variability in neurocognitive response (i.e., activation in the right superior parietal lobule; rSPL) during a risky decision-making task moderated the success of a sexual risk reduction intervention. In a cluster randomized trial blocked by gender, justice-involved adolescents (N = 269) first completed a risky decision-making task during a magnetic resonance imaging (MRI) session, then were assigned to an information-only control (GINFO) or sexual risk reduction intervention incorporating alcohol risk reduction content (GPI + GMET) and then re-contacted every three months for one year. Youth in the GPI + GMET intervention reported less sexual risk behavior 12 months after intervention than those in the control. Although neurocognitive activation was associated with sexual risk behavior, it did not moderate intervention outcomes. This risk-reduction intervention appears to work equally well across a range of neurocognitive responses.

Background In August 2019, the U.S. Food and Drug Administration proposed a set of 13 new graphic warnings for cigarette packaging and advertisements. Purpose We evaluated these warnings relative to text-only equivalents for their ability to educate the public regarding harms of smoking and influence outcomes associated with quitting. Methods In an experimental within-subjects design, U.S. adult nonsmokers, smokers, and dual smoker/electronic cigarette (e-cigarette) users (N = 412) recruited from an online internet platform evaluated the newly proposed graphic warnings and corresponding text-only warnings on understandability, perceived new knowledge, worry elicited about the content of the warning, discouragement from smoking, and encouragement to use e-cigarettes. Results Graphic warnings were generally rated as providing better understanding, more new knowledge, eliciting more worry about harms of smoking, and providing more discouragement from smoking relative to text-only warnings. Conclusions The newly proposed graphic warnings could influence important responses to warnings associated with motivation to reduce smoking.

This study aims to determine the rate of chronic pain in a community sample of young adult cannabis users, assess the extent to which pain relief is an important motivation for cannabis use, and explore differences in consumption patterns and problem behaviors between users with and without chronic pain. The study design was cross-sectional. Self-selected community-dwelling young adults (ages 18–29 years; n = 143) who regularly use cannabis completed an online survey. Results revealed that approximately 40% of the sample met the criteria for chronic pain, and pain relief was their primary motivation for use. There were no differences between groups with respect to frequency of use or estimated potency of their preferred strains; however, users with chronic pain reported using a wider variety of administration methods and a greater quantity of cannabis with each use. Users with chronic pain also reported more extensive histories of use, with younger age at initiation and longer duration of regular use. Despite riskier consumption patterns, there were no between-group differences in negative consequences owing to use after controlling for gender and educational status. On average, the total sample reported approximately 8 problems in the past 30 days owing to use. These findings suggest that chronic pain is commonly experienced among young adult cannabis users and pain relief is the primary motivation for users with pain. For some users, clinically significant chronic pain and pain-related interference persist despite heavy use. Cannabis users with and without chronic pain report experiencing several negative consequences owing to their use. Perspective This article compares motivations for cannabis use and describes differences in consumption patterns among a community sample of young adult users with and without chronic pain. This information may be useful for providers who assess and treat pain in young adults, particularly in settings that have legalized recreational use.

Strong health messages may result in reactance, increasing unhealthy behaviors. Reactance is purported to be derived of both cognitive and affective factors. The current study investigated the extent to which these cognitive and affective reactance components accounted for the link between message exposure on intentions and behavior. Emerging adults who never attended college (N = 244) completed an online study assessing anger and negative cognitions towards high or low threat anti-binge drinking messages. Intentions to drink and binge drink in the next week and drinking behaviors 1 week later were assessed. High threat messages elicited more anger and negative cognitions than low threat messages. High threat messages had a significant total indirect effect on intentions but had no effect on drinking behaviors. These outcomes suggest that while immediate cognitive and affect reactance has an effect on intentions, it may not influence longer-term decision making and may not outweigh benefits of strong messages.

The COVID-19 global pandemic is an unprecedented health threat for which behavior is critical to prevent spread and personal factors could contribute to decisions for protective action. The purpose of this study was to describe associations of COVID-19 related behaviors capturing a snapshot in time during the height of the first wave of the pandemic. We tested perceptions of likelihood and severity of infection, worry, and their associations with behavior. We further explored relationships by demographic characteristics, and tested main and interactive relationships between these characteristics and beliefs and protective behaviors. Using an online cross-sectional survey, U.S. adults (N = 795) reported their perceptions of likelihood and severity of, and worry about, contracting COVID-19 for self and others, and engagement in protective behaviors. In bivariate tests, all cognitive and affective beliefs were positively associated with hygiene behaviors, but only worry and personal and others’ severity were associated with greater likelihood of social distancing. Controlling for other beliefs and demographic factors, perceived personal severity remained associated with social distancing, and worry with hygiene behaviors. How people think and feel about risk could have implications for communicating information about this novel health threat and motivating action to mitigate its spread. Supplementary Information The online version contains supplementary material available at 10.1007/s10865-021-00202-4.

Smokeless tobacco use among Indian women is increasing despite prevention efforts. Evolutionary theories suggest that reproductive-aged women should be more concerned about immediate threats to reproduction than threats to survival occurring late in life. This study therefore compared an anti-tobacco intervention that emphasized near-term reproductive harms to one involving general harms occurring later in life. Scheduled Tribal women (N = 92) from Karnataka, India participated in this study. At baseline, women reported tobacco use and knowledge of harms, provided a saliva sample to assess use, and randomly viewed either a general harms presentation (GHP) or reproductive harms presentation (RHP). At followup, women reported their use, knowledge of harms and intentions to quit, and provided another saliva sample. At baseline, participants were aware of general harms but not reproductive harms. Both interventions increased knowledge of harms. Women in the RHP condition did not list more harms than women in the GHP condition, however, and the RHP was not more effective in reducing tobacco use than the GHP. In the RHP condition fetal health was particularly salient. In the GHP condition, oral health was highly salient, aligning with the local disease ecology and research on tobacco use and attractiveness., Media summary: Providing information on tobacco’s reproductive harms might reduce tobacco use among Scheduled Tribal women in India.

Objective: This experiment examined whether people respond differently to information about where they stand relative to peer behaviour or to expert behavioural recommendations, and whether respons...

INTRODUCTION: Justice-involved adolescents are at high risk for sexually transmitted infections; one primary reason is co-occurring substance use. This study investigates the additive benefit of including alcohol and cannabis use content to a theory-based sexual risk reduction intervention, delivered using group-based motivational enhancement therapy. STUDY DESIGN: This study had a cluster randomized design, with randomization of single-sex clusters to one of three interventions. SETTING/PARTICIPANTS: Participants were male and female justice-involved adolescents (N=460) residing in youth detention facilities. Data were collected from 2010 to 2014; analyses were completed in 2018–2019. INTERVENTION: Adolescents were randomized to one of three motivational enhancement therapy interventions: sexual risk reduction intervention, sexual risk reduction intervention with alcohol content, or sexual risk reduction intervention with alcohol and cannabis content. MAIN OUTCOME MEASURES: The primary outcome was risky sexual behavior (aggregation of condom use and frequency of intercourse), measured every 3 months for 1 year. Secondary outcomes were theoretical mechanisms on which the intervention was based (condom use attitudes, self-efficacy, peer norms, and behavioral intentions), collected at baseline and post-test. RESULTS: Risky sexual behavior significantly decreased from baseline to 3-month follow-up (t=10.59, p0.29 for all). Comparisons to a historical information-only, sexual risk reduction control arm conducted with a similar juvenile justice sample confirm effectiveness of all three motivational enhancement therapy–based interventions. CONCLUSIONS: All three interventions were associated with decreased sexual risk up to 1 year later, suggesting that the intervention modality (motivational enhancement therapy) may resonate with this population beyond the specific substance use content. This single-session manualized intervention can be readily disseminated to juvenile justice settings. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT01170260.

Because adolescence is a period of heightened exploration of new behaviors, there is a natural increase in risk taking including initial use of alcohol and marijuana. In order to better understand potential differences in neurocognitive functioning among adolescents who use drugs, the current study aimed to identify the neural substrates of risky decision making that differ among adolescents who are primary users of alcohol or marijuana, primary users of both alcohol and marijuana, and controls who report primary use of neither drug. Participants completed the Balloon Analogue Risk Task (BART) while undergoing functional magnetic resonance imaging. Comparison of brain activation during risky decisions versus non-risky decisions across all subjects revealed greater response to risky decisions in dorsal anterior cinguate cortex (dACC), anterior insula, ventral striatum, and lateral prefrontal cortex. Group comparisons across non-using controls, primary marijuana, primary alcohol, and alcohol and marijuana users revealed several notable differences in the recruitment of brain regions. Adolescents who use both alcohol and marijauna show decreased response during risky decision making compared to controls in insula, striatum, and thalamus, and reduced differentiation of increasing risk in dACC, insula, striatum, and superior parietal lobe compared to controls. These results provide evidence of differential engagement of risky decision making circuits among adolescents with varying levels of alcohol and marijuana use, and may provide useful targets for longitudinal studies that explicitly address causality of these differences.

This research examined main and interactive associations of perceived risk and worry of health and appearance smoking consequences on motivation to quit and the relative importance of each of these. Hierarchical regressions controlling for other measures found that perceived conditional risk and worry of health consequences were associated with motivation to quit; only conditional risk of appearance consequences was associated with motivation to quit. Relative weights analysis indicated that perceived conditional risk of appearance consequences and worry about health consequences were the most important variables in the model. Consideration of appearance consequences may aid in motivating smokers to try quitting.

OBJECTIVE Although graphic cigarette warnings have important benefits that may aid in motivating smoking quit attempts and discouraging smoking initiation, 1 possible negative consequence might be psychological reactance to graphic warnings. Reactance to warnings might be shaped by stereotypical views of smokers. This research examined the associations of positive and negative smoker stereotypes with perceptions of the educational value of warnings as well as affective and motivational responses to them. METHOD Using a cross-sectional design, young adult smokers and nonsmokers (N = 396) completed an online questionnaire assessing positive and negative smoker stereotypes and then evaluated a series of graphic-plus-text and text-only cigarette warnings on perceived new knowledge gained from the warning, understandability of the warning, worry about the consequences of smoking elicited by the warning, and discouragement from smoking elicited by the warning. RESULTS Negative smoker stereotypes were associated with all warning perceptions-more negative stereotypes were associated with higher levels of perceived new knowledge, perceived understandability, worry, and discouragement from smoking. Positive smoker stereotypes were only associated with more perceived new knowledge. Neither smoking status nor warning type moderated the relationships between smoking stereotypes and warning evaluations. CONCLUSIONS Focusing on enhancing negative smoker portrayals, rather than reducing positive portrayals, may be more effective for antismoking campaigns. (PsycINFO Database Record

Importance Adolescents in the juvenile justice system are at high risk for sexually transmitted infections (STIs). Concurrent use of alcohol and cannabis increase this risk. Objective To determine whether a theory-based sexual risk-reduction intervention that included alcohol- and cannabis-focused content resulted in greater reductions in STIs than an intervention that included alcohol-related content only and an intervention that did not include substance use content. Design, Setting, and Participants Cluster randomized clinical trial with 3 conditions. Between July 1, 2010, and December 10, 2014, adolescents living at a juvenile detention facility in the southwestern United States were tested and treated for STI before randomization and again 12 months after the intervention. Data analyses were conducted in July and August 2017. Eligibility criteria included (1) being aged 14 to 18 years, (2) able to speak English, (3) having a remaining detention term of less than 1 month, and (4) signing a release granting access to STI results if tested at intake. Six hundred ninety-three adolescents were assessed for eligibility. Of these, 460 completed baseline assessments and were randomized to 1 of 3 intervention conditions. Data analysis was by intent-to-treat. Interventions There were 3 intervention conditions: sexual risk reduction intervention (SRRI); SRRI plus alcohol content (SRRI + ETOH); and SRRI + ETOH plus cannabis content (SRRI + ETOH + THC). Interventions were conducted in same-sex groups by trained clinicians and included video presentations with discussion, group activities, and active feedback by participants, consistent with the principles of motivational enhancement therapy. Main Outcomes and Measures Although not the outcome on which the study was originally powered, the main outcome variable presented herein is STI incidence (Chlamydia trachomatisand/orNeisseria gonorrhoeae) 12 months after the intervention. Results Of the 460 participants randomized, mean (SD) age was 15.8 (1.1) years, 347 participants (75.4%) were male, and 57.0% were of Hispanic ethnicity. Among the participants, 143 were randomized to SSRI, 155 to SRRI + ETOH, and 162 to SRRI + ETOH + THC. Attrition at 12-month follow-up was 99 (21.5%) for the STI outcome variable. Participants in the SRRI + ETOH + THC intervention had lower incidence of STI at follow-up (3.9%) than those in either the SRRI (12.4%; odds ratio, 0.29; 95% CI, 0.10-0.84) or the SRRI + ETOH (10.2%; odds ratio, 0.36; 95% CI, 0.12-1.05) interventions. Conclusions and Relevance An intervention delivered in a motivational enhancement therapy format that includes theory-based sexual risk reduction combined with alcohol- and cannabis-focused elements is effective at reducing STI incidence among justice-involved adolescents. This 1-session manualized intervention can be delivered in the context of short-term detention and is easily disseminated to juvenile justice agencies. Trial Registration clinicaltrials.gov Identifier:NCT01170260

A common criticism of social cognitive models predicting health behavior is their exclusion of affect—an important component of individual-level decision processes for behavior change. Yet the role of affect, and its interaction with cognitions, is complex. We provide an overview of affect and pathways through which it is proposed to influence outcomes. Then, we discuss several common social cognitive models of health behavior change. Next, we highlight specific affect-laden constructs (those that incorporate affective and cognitive components) related to health behavior change. We aim to provide clarity on terminology and measurement of the affect-laden constructs and evidence associating them with health behavior. Finally, we discuss strategies for incorporating these constructs within popular cognitive-based theories and provide suggestions for future work.

Juvenile justice involved youth are at great risk for negative outcomes of risky sexual behavior including HIV/AIDS. Given the strong connection between alcohol use and risky sex in this population, it is important to consider alcohol use in interventions designed to decrease risky sexual behavior.This paper provides support for an integrative translational model that incorporates psychosocial, neurobiological, and genetic factors to better predict alcohol-related sexual risk behavior. Specifically, we present the design, methods, and baseline data from a complex randomized control trial, Project SHARP (Sexual Health and Adolescent Risk Prevention) in order to illustrate how this broad array of factors can best predict alcohol-related sexual risk behavior. Participants were justice-involved adolescents (n=284) who completed an fMRI and self-report assessments prior to randomization to either a sexual risk plus alcohol risk reduction group intervention or to an information-only contact control group intervention. Structural equation modeling was utilized and findings supported the hypothesized relationships in the translational model. Preliminary data suggest that interventions among justice-involved adolescents targeting alcohol-related sexual risk behavior may be more effective if a biopsychosocial approach is considered.

Background The purpose of this research was to replicate a successful intervention to increase physical activity in a different region of the country, and explore genetic and physiological moderators of intervention efficacy drawn from a transdisciplinary theoretical framework. Method A randomized controlled trial comparing a print-based physical activity intervention (COSTRIDE) to a print-based health and wellness contact control (HW) intervention was conducted. Sedentary participants (n = 219) completed assessments at baseline and follow-up assessments at 3, 6, 9, and 12 months following the initiation of the intervention. Results Participants in both conditions significantly increased exercise behavior in the first six months, and then leveled off or decreased physical activity in the second six months of the study. Those in the COSTRIDE intervention increased significantly more than those in the HW intervention, and were better able to maintain their exercise behavior. Genetic factors (BDNF, rs6265; FTO, rs8044769), but not selected physiological (body temperature, blood lactate, systolic blood pressure, plasma norepinephrine, and heart rate) or subjective (perceived pain, affect) responses to physical activity, moderated response to the intervention. Conclusions There are underlying genetic factors that influence response to behavioral intervention, and a better understanding of these factors has the potential to influence the development, targeting and tailoring of behavioral interventions to increase physical activity. Trial registration Clinicaltrials.gov registration: NCT01091857.