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This study investigated whether misalignment between an individual and their community in partisan identity predicted psychological and behavioral distancing from local COVID-19 norms. A nationally representative sample of Republicans and Democrats provided longitudinal data in April ( N = 3,492) and June 2020 ( N = 2,649). Democrats in Republican communities reported especially heightened better-than-average estimates, perceiving themselves as more adherent to and approving of non-pharmaceutical interventions (NPI; e.g., mask wearing) than their community. Democrats’ better-than-average estimates reflected high approval and behavior in Republican communities and substantial norm underestimation. Republicans in Democratic communities did not evidence worse-than-average estimates. In longitudinal models, injunctive norms only predicted NPI behavior when individual and community partisan identity were aligned. The strong personal approval-behavior association did not depend on misalignment; there were no effects of descriptive norms. Normative messages may have limited efficacy for a sizable subpopulation in politically polarized contexts, such as the COVID-19 pandemic.

OBJECTIVE: We examined whether anti-Black cultural racism moderates the efficacy of psychotherapy interventions among youth. METHOD: We analyzed a subset of studies from a previous meta-analysis of five decades of youth psychotherapy randomized controlled trials. Studies were published in English between 1963 and 2017 and identified through a systematic search. The 194 studies (N = 14,081; ages 2–19) across 34 states comprised 2,678 effect sizes (ESs) measuring mental health problems (e.g., depression) targeted by interventions. Anti-Black cultural racism was operationalized using a composite index of 31 items measuring explicit racial attitudes (obtained from publicly available sources; e.g., General Social Survey), aggregated to the state level and linked to the meta-analytic database. Analyses were conducted with samples of majority (i.e., ≥50%) Black (n = 36 studies) and majority-White (n = 158 studies) youth. RESULTS: Two-level random effects meta-regression analyses indicated that higher anti-Black cultural racism was associated with lower ESs for studies with majority-Black youth (β = −0.2, 95% CI: −0.35, −0.04, p = .02) but was unrelated to ESs for studies with majority-White youth (β = 0.0004, 95% CI: −0.03, 0.03, p = .98), controlling for relevant area-level covariates. In studies with majority-Black youth, mean ESs were significantly lower in states with the highest anti-Black cultural racism (>1 SD above the mean; g = 0.19) compared to states with the lowest racism (

Objectives: Laboratory studies have contributed important information about the determinants of food and alcohol intake, and they have prompted the development of behavior change interventions that have been evaluated in randomized controlled trials conducted in the field. In this article we apply a recent experimental medicine (EM) framework to this body of research. Method: A conceptual review and focused discussion of the relevant literature is presented. Results: We illustrate how it is possible to translate findings from studies of food and alcohol intake in the laboratory into interventions that are effective for changing behavior in the real world. We go on to demonstrate how systematic failures can occur at different stages within the EM framework, and how these failures ultimately result in interventions that are ineffective for changing behavior. We also consider methodological issues that may constrain the external validity of findings from laboratory studies including demand effects, participant characteristics, and the timing and dose of behavioral interventions. Throughout, we make recommendations to improve the translation of findings from laboratory studies into behavior change interventions that are effective in the field. Conclusions: Consideration of the EM framework will help to ensure that promising candidate interventions for eating and drinking that are identified in laboratory studies can fulfill their translational promise. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

There has been substantial progress in research on the roles of stigma and discrimination in African Americans' health. Yet, Black-White health disparities persist. Research must, therefore, build on and address the heterogeneity that exists in stigma- and discrimination-related pathways, experiences, interventions, and research methodology. Specifically, research is needed that identifies the unique versus common mechanisms linking various forms of stigma and discrimination with African Americans' health. Moreover, beyond gender, the role of intersectionality in stigma's health effects remains unclear, and interventions are sorely needed that both enhance coping and eliminate the existence of stigma. Finally, experimental designs, though underutilized, hold promise as a method for examining mechanisms, intersectionality, and intervention efficacy.

As the older adult population increases, understanding the health effects of bias against older adults is increasingly important. Whether structural forms of age bias predict worse health has received limited attention.We hypothesized that communities with greater age bias would have higher mortality among residents aged 65 and older. We expected the association to be unique to age bias, rather than general bias (i.e., sexual minority and racial bias), and that the age bias-mortality association would be strongest in predominantly White and younger communities.Explicit and implicit attitudes toward older adults (N = 1,001,735), sexual minorities (N = 791,966), and Black Americans (N = 2,255,808) were drawn from Project Implicit. Post-stratification relative to U.S. Census demographics was executed to improve the representativeness of county-level explicit and implicit bias estimates. County older adult mortality, estimated cross-sectionally with and longitudinally relative to bias scores, served as outcomes. Models controlled for relevant county-level covariates (e.g., median age) and included all U.S. counties (N = 3142).Contrary to hypotheses but consistent with prior work, explicit age bias was cross-sectionally and longitudinally associated with lower mortality, over and above covariates and generalized community bias. The explicit age bias-lower mortality association only emerged in younger counties but did not depend on county ethnic composition. Implicit age bias was unassociated with outcomes. Post-hoc analyses supported that ageist communities may be associated with better health across the lifespan. Explicit age bias predicted lower mortality in young and middle adulthood; better mental health in middle adulthood, but not exercise or self-rated health, mediated the explicit age bias-older adult mortality association.Results highlight the uniqueness of older age relative to other stigmatized identities. Further examination of the association of community-level age bias with better health may improve longevity for all communities.

Rationale Individuals who choose to obtain genetic information may learn that their genetic profile confers health risks to themselves or offspring. Individuals may react more negatively to this information when personal attitudes, perceived norms, and/or the decision to receive results conflict with one another. Objective We predicted that holding more negative attitudes (personal evaluations) or injunctive norms (perceptions of others’ approval) toward obtaining genetic test results would prospectively predict greater conflict about the decision to undergo sequencing and less disclosure of sequencing results to family members. We also expected attitudes and norms to interact, such that attitudes would be negatively associated with decisional conflict and positively associated with disclosure when injunctive norms were positive, but weakly associated with outcomes when injunctive norms were negative. Method Participants (N=312) were enrolled in a genomic sequencing trial focused on identifying carrier genetic variants, reflecting a variant that might affect their biological children’s or grandchildren’s health. Participants reported attitudes and injunctive norms, underwent sequencing, and later received results indicating carrier status for at least one variant. Decisional conflict was assessed at immediate post-test, and 1- and 6-month follow-ups. Disclosure of results to children and siblings were assessed at 1 and 6 months. Results In structural equation models with covariates, attitudes were negatively associated with post-test and 1-month decisional conflict. Injunctive norms were negatively associated with decisional conflict at 1 and 6 months and positively associated with disclosure to children and siblings at 1 month. The significant attitudes by injunctive norms interaction predicting post-test decisional conflict supported lower decisional conflict when attitudes, norms, and the decision to receive results were all aligned. Exploratory analyses supported indirect effects of attitudes and norms on 6-month sibling disclosure via 1- month decisional conflict. Conclusion Results support roles of psychosocial factors in decisional conflict and disclosure after receiving sequencing results.

Heavy drinking in college increases risk for negative consequences. Among a national sample of high school abstainers and moderate drinkers, we hypothesized that the extent of heavy drinking among students on campus would be among the strongest predictors of first semester heavy drinking and consequences, relative to personal approval of alcohol use and sociability and impairment outcome expectancies. We expected these psychological factors to moderate effects of campus heavy drinking. Data from 90,455 abstainers and 97,168 moderate drinkers matriculating at 245 and 242 universities, respectively, were drawn from AlcoholEdu (EverFi, 2013), a web-based intervention completed by most first-year students at participating universities. Students reported alcohol use, approval, expectancies, and covariates prior to enrollment (Time 1). During the first semester (Time 2), abstinence, moderate drinking, or heavy drinking, and negative consequences experienced were reassessed. Campus heavy drinking reflected the percentage of other students attending the same school who engaged in heavy drinking at Time 2. In multilevel multinomial logistic regression models, campus heavy drinking was consistently among the strongest predictors of heavy drinking and consequences: It predicted an 83% and 82% increase in risk of heavy drinking and a 106% and 91% increase in risk of consequences among students who were abstainers and moderate drinkers at Time 1, respectively. There were few interactions among campus heavy drinking and psychological factors. Post hoc analyses supported that students did not self-select into heavier drinking environments. Campus heavy drinking is a key predictor of first semester alcohol use and an important intervention target. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Supplemental Material, NormsandGuilt_SPPS_SOM3 for Guilt Enhances the Persuasive Effects of Injunctive But Not Descriptive Social Norms by Ryan P. Jacobson, Kathryn J. L. Jacobson and Allecia E. Reid in Social Psychological and Personality Science

Level of drinking in the social network is strongly associated with college students' alcohol use. However, mechanisms through which networks are associated with personal drinking have been underexplored thus far. The present study examined theoretically derived constructs-sociability outcome expectancies, attitudes toward heavy drinking, self-efficacy for use of protective strategies, and descriptive norms-as potential mediators of the association between egocentric social network drinking and personal consumption. College students (N = 274) self-reported their social network's level of alcohol consumption, all mediators, drinks per week, and consequences at both baseline (Time 1) and a 1-month follow-up (Time 2). Autoregressive mediation models focused on the longitudinal associations between Time 1 network drinking and the Time 2 mediators and between the Time 1 mediators and the Time 2 outcomes. Consistent with hypotheses, Time 1 social network drinking was significantly associated with Time 2 drinks per week and consequences. Only attitudes significantly mediated social network associations with drinks per week and consequences, though the proportion of the total effects accounted for by attitudes was small. After accounting for the stability of constructs over time, social network drinking was generally un- or weakly related to sociability expectancies, self-efficacy, and descriptive norms. Results support reducing attitudes toward heavy drinking as a potential avenue for mitigating network effects, but also highlight the need to evaluate additional potential mechanisms of network effects. Intervention efforts that aim to address the social network have the potential to substantially reduce alcohol consumption, thereby enhancing the overall efficacy of alcohol risk-reduction interventions. (PsycINFO Database Record

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

OBJECTIVE: Racial/ethnic and socioeconomic disparities in infant development in the U.S. have lifelong consequences. Discrimination predicts poorer health and academic outcomes. This study explored for the first time intergenerational consequences of women’s experiences of discrimination reported during pregnancy for their infants’ social-emotional development in the first year of life. METHOD: Data come from a longitudinal study with predominantly Black and Latina, socioeconomically disadvantaged, urban young women (N = 704, M(age) = 18.53) across pregnancy through one year postpartum. Women were recruited from community hospitals and health centers in a Northeastern U.S. city. Linear regression analyses examined whether women’s experiences of everyday discrimination reported during pregnancy predicted social-emotional development outcomes among their infants at six months and one year of age, controlling for potentially confounding medical and sociodemographic factors. Path analyses tested if pregnancy distress, anxiety, or depressive symptoms mediated significant associations. RESULTS: Everyday discrimination reported during pregnancy prospectively predicted greater inhibition/separation problems and greater negative emotionality, but did not predict attention skills or positive emotionality, at six months and one year. Depressive symptoms mediated the association of discrimination with negative emotionality at six months, and pregnancy distress, anxiety, and depressive symptoms mediated the association of discrimination with negative emotionality at one year. CONCLUSION: Findings support that there are intergenerational consequences of discrimination, extending past findings to infant social-emotional development outcomes in the first year of life. It may be important to address discrimination before and during pregnancy and enhance support to mothers and infants exposed to discrimination to promote health equity across the lifespan.

A growing body of research has examined self-reported measures of social network alcohol use, such as the Important People Instrument (IPI), among college students. However, it remains unknown whether IPI judgments of friends' alcohol use are accurate. We hypothesized that judgments of friends' drinking status (e.g., heavy drinker) and maximum drinks per day would primarily reflect friends' self-report (accuracy), rather than projection of participants' self-report (assumed similarity) or a systematic tendency to under- or overestimate behavior (directional bias). We also expected that accuracy would be stronger when participants were women, had more contact with friends, or drank less each week or when friends drank less each week. In all, 654 randomly selected, 1st-year students indicated their 5 closest friends in their class, yielding 111 friendship dyads. Participants judged each friend's drinking status and maximum drinks per day and rated these items for themselves. Gender, frequency of contact, and typical drinks per week were assessed. Results indicated that judgments of drinking status and maximum drinks per day were highly accurate. Accuracy effects were consistently stronger than was assumed similarity; directional bias was nonsignificant. Accuracy did not depend on gender or participants' weekly consumption but was stronger for both outcomes when contact was more frequent and, for maximum drinks per day, when friends' weekly consumption was relatively low. Results support validity of the IPI for assessing social network alcohol use among students. Given that perceptions are accurate, research is needed on intervention strategies that facilitate management of risky peers. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Objectives Social conformity negatively affects health. Exposure to peers who model unhealthy alcohol or food consumption increases personal consumption. Self-affirmation alters processes related to the motivations underlying conformity. We therefore tested whether self-affirmation reduces conformity to unhealthy behaviour and does so by reducing affiliation needs and/or increasing self-regulation. Design In two studies, participants were randomized to one of four conditions in a 2 (low vs. high peer modelling) × 2 (self-affirmed vs. not) design. Methods In Study 1 (N = 153), a confederate modelled low or high alcohol consumption. Participants' alcohol consumption was recorded; mimicry of confederates' sips was coded. In Study 2 (N = 122), written information indicated others' snack food intake during the study. Participants' food consumption was recorded. Affiliative interest was assessed in both studies. Inhibitory control and private self-awareness were assessed in Studies 1 and 2, respectively. Results In Study 1, participants exposed to heavy drinking consumed significantly more alcohol and mimicked the confederate more frequently than participants exposed to the light drinking model. Self-affirmation did not reduce this tendency, nor did it affect affiliative interest or inhibitory control. Exploratory analysis supported that mimicry mediated the peer modelling-consumption relationship. In Study 2, participants ate more when they believed others had eaten a lot, as opposed to little. Self-affirmation did not reduce this tendency and did not affect affiliative interest. Self-affirmed participants had higher private self-awareness than those who were not self-affirmed, but self-awareness did not affect consumption. Conclusion Peer behaviour strongly influences personal consumption. Self-affirmation did not reduce behavioural conformity. Statement of contribution What is already known on this subject? Exposure to peers who engage in high consumption of alcohol and unhealthy foods is associated with increased personal consumption. Few studies have examined strategies to reduce conformity to consumption behaviours. What does this study add? Across two studies, self-affirmation did not reduce behavioural conformity, despite its' positive effects on private self-awareness. Conformity in face-to-face interactions is largely driven by mimicry.

Rationale Excessive weight gain during pregnancy is a major determinant of later life obesity among both Black and Latina women and their offspring. However, psychosocial determinants of this risk, including everyday discrimination, and potential moderators of such effects remain unexplored. Objective We examined the influence of discrimination, a culturally relevant stressor, on odds of gaining weight beyond Institute of Medicine recommendations during pregnancy. Whether the effect was moderated by race/ethnicity, age, or depressive symptoms was also examined. Method Participants were 413 Black and Latina pregnant young women, ages 14–21 years. Experience with discrimination and all moderators were assessed in the second trimester. Last weight recorded in the third trimester was abstracted from medical records and used to determine excessive weight gain. Results Ever experiencing discrimination was associated with a 71% increase in the odds of excessive weight gain. The effect of discrimination was primarily present among women who attributed this treatment to membership in a historically oppressed group (e.g., ethnic minority, female) or to membership in other stigmatized groups (e.g., overweight). The effect of ever experiencing discrimination was not moderated by race/ethnicity or age but was moderated by depressive symptoms. Supporting the perspective of the environmental affordances model, discrimination strongly predicted excessive weight gain when women were low in depressive symptoms but had no effect when women were high in depressive symptoms. The moderating role of depressive symptoms was equivalent for Black and Latina women. Conclusion Results highlight the role of discrimination in perpetuating weight-related health disparities and suggest opportunities for improving health outcomes among young pregnant women.

The focus theory of normative conduct asserts that distinct processes are involved in responding to injunctive norms versus descriptive norms. This research tested the prediction that guilt would be more strongly involved in motivating conformity to injunctive than descriptive norms. Study 1 demonstrates that people anticipate feeling guiltier following injunctive than descriptive norm violations. Studies 2 and 3 demonstrate that guilt proneness and state-level guilt enhance the persuasiveness of messages framed with injunctive norms but not control-framed or descriptive norm–framed messages. Finally, Study 4 shows that a guilt-arousing public service announcement is more effective if framed using an injunctive norm than a descriptive norm or a control message. These results augment understanding of the different ways that injunctive and descriptive norms influence behavior and have applied implications for social norms marketing interventions.

OBJECTIVE. Brief Motivational Interventions (BMI) reduce drinking in the short term, but these initial effects often decay. We tested the hypothesis that theory-based email boosters would promote maintenance of change after a BMI. METHOD. Participants were students (N = 568; 72% male) who violated campus alcohol policy and were mandated to participate in an alcohol risk reduction program. Participants provided baseline data, received a BMI, and then completed a 1-month post-BMI survey. Next, they were randomized to receive 12 booster emails that contained either (a) alcohol norms, or (b) structurally equivalent general health information (control). Alcohol consumption and alcohol-related consequences were assessed at baseline, 1-, 3-, 5-, 8-, and 12-months. RESULTS. As expected, we observed significant reductions in both consumption and consequences after the BMI (ps < .01), and groups were equivalent at baseline and at 1-month post-BMI, prior to randomization (ps > .05). Latent growth curve models revealed no condition effects on changes in the latent consumption variable from 1- to 12-month follow-ups (B = .01, SE = .01, p > .05). Unexpectedly, a main effect of the condition emerged for self-reported consequences (B = .03, SE = .01, p = .01); we observed more consequences after boosters containing alcohol norms than general health information. Outcomes were not moderated by sex, consumption at baseline or 1-month, or email exposure, and there was no mediation by descriptive norms, injunctive norms, or peer communication. CONCLUSIONS. Contrary to predictions, email boosters with corrective norms content did not improve outcomes after a BMI.

Interventions to reduce college student drinking, although efficacious, generally yield only small effects on behavior change. Examining mechanisms of change may help to improve the magnitude of intervention effects by identifying effective and ineffective active ingredients. Informed by guidelines for establishing mechanisms of change, we conducted a systematic review of alcohol interventions for college students to identify (a) which constructs have been examined and received support as mediators, (b) circumstances that enhance the likelihood of detecting mediation, and (c) the extent of evidence for mechanisms of change. We identified 61 trials that examined 22 potential mediators of intervention efficacy. Descriptive norms consistently mediated normative feedback interventions. Motivation to change consistently failed to mediate motivational interviewing interventions. Multiple active ingredient interventions were not substantially more likely to find evidence of mediation than single ingredient interventions. Delivering intervention content remotely reduced likelihood of finding support for mediation. With the exception of descriptive norms, there is inadequate evidence for the psychosocial constructs purported as mechanisms of change in the college drinking literature. Evidence for mechanisms will be yielded by future studies that map all active ingredients to targeted psychosocial outcomes and that assess potential mediators early, inclusively, and at appropriate intervals following interventions.

OBJECTIVE: To determine whether (a) social networks influence the extent to which college students initiate and/or maintain reductions in drinking following an alcohol intervention and (b) students with riskier networks respond better to a counselor-delivered, vs. a computer-delivered, intervention. METHOD: Mandated students (N = 316; 63% male) provided their perceptions of peer network members' drinking statuses (e.g., heavy drinker) and how accepting each friend would be if the participant reduced his or her drinking. Next, they were randomized to receive a brief motivational intervention (BMI) or Alcohol Edu for Sanctions (EDU). In latent growth models controlling for baseline levels on outcomes, influences of social networks on 2 phases of intervention response were examined: initiation of reductions in drinks per heaviest week, peak blood alcohol content (BAC), and consequences at 1 month (model intercepts) and maintenance of reductions between 1 and 12 months (model slopes). RESULTS: Peer drinking status predicted initiation of reductions in drinks per heaviest week and peak BAC; peer acceptability predicted initial reductions in consequences. Peer Acceptability × Condition interactions were significant or marginal for all outcomes in the maintenance phase. In networks with higher perceived acceptability of decreasing use, BMI and EDU exhibited similar growth rates. In less accepting networks, growth rates were significantly steeper among EDU than BMI participants. For consumption outcomes, lower perceived peer acceptability predicted steeper rates of growth in drinking among EDU but not BMI participants. CONCLUSIONS: Understanding how social networks influence behavior change and how interventions mitigate their influence is important for optimizing efficacy of alcohol interventions. (PsycINFO Database Record (c) 2014 APA, all rights reserved). Language: en

Social cognitive factors such as perceived norms and personal attitudes toward alcohol consumption are reliable predictors of alcohol use and related problems. The current study aimed to evaluate the relative importance of one’s attitude toward alcohol use as a unique and important predictor of drinking related outcomes when directly compared to perceived descriptive and injunctive norms. Participants were mandated students (n = 568; 28% female) who violated a campus alcohol policy and received a Brief Motivational Intervention. Analyses included the use of linear regression for prospective predictions to evaluate the relative importance of predictors which included perceived descriptive norms and injunctive norms, and attitudes toward moderate and heavy alcohol use. Overall, the results indicate that one’s attitude toward heavy alcohol use is a stronger predictor of drinks per week, binge frequency, as well as alcohol related problems when directly compared to norms. Thus, the findings of the current study provide a compelling rationale for incorporating attitudes in the development and refinement of intervention strategies.

OBJECTIVE: Brief motivational interventions (BMIs) effectively reduce problematic drinking in college students. However, not all students benefit, and little is known about the subgroups of students for whom BMIs are most effective. In the present study, we examined 2 factors that may influence BMI efficacy: gender and depression. METHOD: We reanalyzed data from a clinical trial in which heavy drinking students (N = 330; 65% female) were randomized to a BMI (n = 165) or an assessment only control (n = 165). Depression was assessed at baseline; past-month typical drinks per week, heavy drinking frequency, and consequences were assessed at baseline and 1 month. Three- and 2-way interactions among intervention condition (BMI vs. control), gender (male vs. female), and depression (low vs. high) were tested. RESULTS: We observed 3-way interaction effects on 2 outcomes: (a) typical drinks per week and (b) frequency of heavy drinking at 1 month. Relative to controls and adjusting for baseline drinking, low-depression women reduced their drinking more after a BMI whereas high-depression women did not show differential improvement. In contrast, high-depression men showed significant reductions in weekly drinks following the BMI whereas low-depression men did not show differential improvement. In addition, higher levels of depression were associated with higher levels of consequences at follow-up across conditions. CONCLUSIONS: BMIs are indicated for heavy drinking, depressed men, consistent with recommendations for implementing screening and brief intervention in mental health settings. However, BMIs may need to be refined to enhance their efficacy for depressed women. (PsycINFO Database Record (c) 2014 APA, all rights reserved). Language: en

This study examined the relationship between the traditional masculine norms (“status,” “toughness” and “antifemininity”) of 296 ethnically and racially diverse, young men transitioning to fatherhood and substance use (smoking, alcohol, marijuana, hard drugs) and health behaviors (diet, exercise). Participants were recruited from urban obstetric clinics in the Northeast United States. Logistic and multiple regression equations were constructed to examine the relationship between masculine norms and health behaviors. Moderator effects were also examined. Masculine norm “status” was most endorsed and “antifemininity” was least endorsed. African American young men had higher masculine norm scores than Latino and Whites. Different masculine norms were associated with health-promoting and health-undermining behaviors. Different racial groups who had higher scores on some masculine norms were more likely to engage in either health-promoting or health-undermining behaviors when compared with other ethnic groups in this study. These results observed different relationships between the traditional masculine norms measured and the substance use and health behaviors of diverse, young men transitioning to fatherhood. This may have implications for intervention strategies and future research.

Few studies have examined whether and how receiving an sexually transmitted disease (STD) diagnosis while in a romantic relationship relates to condom use and psychosocial sexual outcomes. Using dyadic data, we examined associations of a personal or a partner's STD diagnosis during a relationship with condom use, monogamy intentions, condom intentions and attitudes, and STD susceptibility and communication. Because beliefs about how the STD was acquired may shape associations with behavior and cognitions, gender and suspecting that one's partner had other sexual partners (i.e., partner concurrency) were examined as moderators. Participants were 592 individuals in 296 couples expecting a baby; 108 individuals had been diagnosed with an STD during the relationship. Personal STD diagnosis was unrelated to outcomes or was associated with increased risk. A partner's diagnosis related to more positive condom intentions and attitudes. Among men who suspected concurrency, both a personal and a partner's STD diagnosis were associated with less condom use. Receiving the STD diagnosis during pregnancy was associated with greater susceptibility and marginally greater condom use. Results suggest potential benefits of enhancing communication and encouraging joint risk reduction counseling among couples, engaging men more fully in preventive efforts, and capitalizing on the short window during which risk reduction occurs.

Relatively little research has examined how peer communication influences alcohol consumption. In a sample of mandated college students, we differentiate conversations about drinking among from conversations about harm prevention and provide evidence for the validity of these communication constructs. Students who violated campus alcohol policies and were referred for alcohol sanctions (N = 345) reported on drinking patterns, use of protective behavioral strategies, perceived descriptive norms for close friends and serving as social leader among their friends; they also reported on the frequency of conversations about drinking, about drinking safety, and about risk reduction efforts. Predicted correlations were found among types of communication and conceptually related variables. General communication was related to consumption but not protective behavioral strategies, whereas safety/risk reduction conversations correlated positively with all protective behavioral strategies. Both types of communication were associated with social leadership. Safety communication moderated the relationship between peer descriptive norms and drinks per week; more frequent talking about safety attenuated the norms-consumption relationship. Peer communication about both drinking and safety may serve as targets for change in risk reduction interventions for mandated college students.

Objectives. We aimed to contribute to growing research and theory suggesting the importance of examining patterns of change over time and critical life periods to fully understand the effects of discrimination on health, with a focus on the period of pregnancy and postpartum and mental health outcomes. Methods. We used hierarchical linear modeling to examine changes across pregnancy and postpartum in everyday discrimination and the resulting consequences for mental health among predominantly Black and Latina, socioeconomically disadvantaged young women who were receiving prenatal care in New York City. Results. Patterns of change in experiences with discrimination varied according to age. Among the youngest participants, discrimination increased from the second to third trimesters and then decreased to lower than the baseline level by 1 year postpartum; among the oldest participants, discrimination decreased from the second trimester to 6 months postpartum and then returned to the baseline level by 1 year postpartum. Within-subjects changes in discrimination over time predicted changes in depressive and anxiety symptoms at subsequent points. Discrimination more strongly predicted anxiety symptoms among participants reporting food insecurity. Conclusions. Our results support a life course approach to understanding the impact of experiences with discrimination on health and when to intervene.

Persons infected with HIV can now routinely expect to live longer and healthier lives. With extended longevity, however, comes the challenge of adopting safer sexual practices for many years. Evidence suggests that the majority of HIV+ persons do reduce their risk behavior once they learn that they are infected with HIV. For example, Weinhardt et al.’s [1] meta-analysis of HIV counseling and testing (HIV-CT) programs found that, subsequent to HIV-CT, HIV+ participants increased condom use and reduced unprotected intercourse more so than did HIV− and untested participants. A more recent survey of 3,723 HIV+ people yielded similarly encouraging results. In this study, nearly 85% of HIV+ persons reported that they did not engage in risk behavior with uninfected partners [2]. Although many HIV+ persons reduce risk behaviors subsequent to learning that they are infected, a minority of HIV+ persons find this challenge difficult. For example, in Weinhardt et al.’s [2] sample, 13–19% reported unprotected vaginal or anal intercourse with partners whose serostatus was negative or unknown. Moreover, 18% of injection drug users reported that they had shared injection needles with other partners. Other studies have reported that a minority of HIV+ persons continue risky sexual or drug-use practices [3]; other individuals who are not aware of their serostatus may also transmit the disease. The route of sexual transmission is the leading cause of the approximately 40,000 new infections in the US annually [4–5]; sexual intercourse between men and women results in most HIV-1 infections acquired by adults in sub-Saharan Africa [6]. Transmission through blood transfusions, injections with infected needles, and scarification are thought to represent only a few infections [6]. Risk reduction programs for HIV+ persons have been implemented in many settings but an evaluation of these programs provides mixed evidence of their efficacy. For example, Cleary et al. [7] tested an informational and supportive intervention promoting behavior change with 271 HIV+ blood donors, and reported no advantage of the risk-reduction intervention relative to a control condition. In contrast, Rotheram-Borus et al. [8] evaluated a multi-session group-based intervention for HIV+ adolescents, and reported that adolescents reduced the number of HIV− sexual partners by 50% and decreased the number of unprotected sexual acts by 82%. The current meta-analysis integrates the available evidence to determine the degree to which prevention programs for HIV+ persons are efficacious. We located controlled intervention studies that addressed risk reduction in samples that included HIV+ persons, and obtained effect size estimates of intervention efficacy. Our primary goal was to determine whether sexual risk reduction programs for HIV+ persons help participants to reduce the number of sexual partners and/or increase condom use. Our secondary goals were to identify moderators of intervention efficacy including intervention components that warrant inclusion and sub-groups for whom the interventions need further tailoring. Such information can provide needed guidance for intervention development and prevention research.

A number of alcohol interventions designed for college students attempt to correct exaggerated perceptions of alcohol use on college campuses through the use of personalized normative feedback. Personalized normative feedback has been shown effective in reducing drinking both as a stand-alone intervention and as a part of a multi-component intervention. Typically, this feedback is targeted to heavier drinkers, in order to create a discrepancy between their personal beliefs and behavior and the actual lower levels of use on campus. However, little is known about how this form of normative feedback might affect lighter drinkers who learn that they are drinking less than the typical student at their school. The risk is a potential boomerang effect, or an increase in drinking among lighter drinkers receiving personalized feedback. The current study examined four samples from three geographic locations, two employing computer delivered personalized normative feedback alone and two delivering personalized feedback in the context of a brief motivational intervention. We found no evidence for a boomerang effect among lighter drinkers receiving personalized normative feedback in any of the four samples. These findings help to assuage fears of increasing drinking among lighter drinkers through widespread implementation of normative interventions for college students in the absence of screening for current drinking status.

OBJECTIVE: Discrimination predicts increased risk for many negative health outcomes, helping explain a variety of racial and socioeconomic health disparities. Recent research suggests discrimination may play a role in disparities in HIV and other sexually transmitted infections (STIs); however, this research has focused on risk behaviors and has yet to establish a link between discrimination and STI diagnosis specifically. This investigation tested whether discrimination predicted condom use, risky sexual partners, and self-reported STI diagnosis among a population disproportionately affected by HIV and STIs in the U.S.: young, pregnant, socioeconomically disadvantaged, women of color. METHOD: During second and third trimesters, 885 mostly Latina and Black pregnant women, 14-21 years old, attending 14 hospitals and health centers in New York City for prenatal care, completed interviews. RESULTS: Greater discrimination during second trimester predicted greater odds of STI diagnosis and having a risky sexual partner during third trimester, but not condom use. Whether discrimination was attributed to race, identifying as Black, or identifying as Latina did not moderate effects. CONCLUSION: This is the first investigation establishing a link between discrimination and STI diagnosis, not just risk behavior. It does so among a sample of at-risk, young, pregnant, women of color. Findings suggest implications for sexual risk during pregnancy and across the life span, and risks for the pregnancy and fetus. It is vital to reduce discrimination to eliminate disparities in HIV and STIs. Future research should continue examining the role of discrimination in sexual risk among different populations and work to uncover potential mechanisms. (PsycINFO Database Record (c) 2014 APA, all rights reserved). Language: en

Students mandated for intervention following an alcohol-related sanction event often reduce their drinking prior to intervention. Knowing the determinants of self-initiated change may help identify intervention targets for individuals who do not reduce their drinking. Guided by self-regulation theory, we tested whether fewer past alcohol consequences and higher descriptive and injunctive norms would be associated with higher levels of postsanction drinking. College students referred for a campus alcohol violation (N = 658, 64% male) reported on their drinking during the month before and after their sanction event. Results show that postsanction drinking was significantly lower than presanction drinking across 4 outcomes: (a) drinks per drinking day, (b) drinks per week, (c) peak drinks, and (d) peak blood alcohol concentration. Hypothesized social influence variables (i.e., descriptive and injunctive norms) were consistently associated with all 4 drinking outcomes; that is, students who perceived that their friends drank more and held more accepting views of drinking were less reactive to alcohol-related sanctions. Past consequences of drinking did not consistently predict subsequent drinking. Therefore, we conclude that alcohol interventions for mandated students should target both descriptive and injunctive norms to optimize their efficacy. (PsycINFO Database Record (c) 2013 APA, all rights reserved). Language: en

Despite long-standing social psychological research supporting the influence of injunctive norms (i.e., what is commonly approved or disapproved) on behavior, support for this influence on health behaviors is limited. We examined the utility of correcting misperceptions of injunctive norms for improving sun protection and whether changes in attitudes mediated the injunctive norm-intention relationship.At baseline 263 community residing primarily White women, aged 37 to 77 years, reported their beliefs about sun protection and tanning and their perceptions of "typical women's" approval of sun protection versus tanning. Women underestimated approval of sun protection and overestimated approval of tanning. In a randomized trial, 189 of these women received either information about sun protection or information plus personalized normative feedback (PNF). PNF compared each woman's own perceptions of typical women's approval of tanning and sun protection with actual normative values, both measured at baseline. PNF communicated that most women approve of others who sun protect.PNF led to more positive sun protection injunctive norms, attitudes, and intentions at immediate posttest and more positive intentions and self-reported behavior at 4-week follow-up. Baseline discrepancy between a woman's beliefs and actual normative values related negatively to changes in sun protection in the control condition but positively in the PNF condition. As hypothesized, changes in attitudes partially mediated the influence of PNF on changes in intentions.The present research demonstrates the utility of correcting injunctive norm misperceptions for promoting healthy behaviors. That attitudes changed in response to PNF and mediated the norm-intention relationship suggests a method for influencing attitudes that may limit reactance.

Objective CenteringPregnancy group prenatal care has been demonstrated to improve pregnancy outcomes. However, there is likely variation in how the model is implemented in clinical practice, which may be associated with efficacy, and therefore variation, in outcomes. We examined the association of fidelity to process and content of the CenteringPregnancy group prenatal care model with outcomes previously shown to be affected in a clinical trial: preterm birth, adequacy of prenatal care, and breast-feeding initiation. Study Design Participants were 519 women who received CenteringPregnancy group prenatal care. Process fidelity reflected how facilitative leaders were and how involved participants were in each session. Content fidelity reflected whether recommended content was discussed in each session. Fidelity was rated at each session by a trained researcher. Preterm birth and adequacy of care were abstracted from medical records. Participants self-reported breast-feeding initiation at 6 months postpartum. Results Controlling for important clinical predictors, greater process fidelity was associated with significantly lower odds of both preterm birth (B = –0.43, Wald χ 2 = 8.65, P = .001) and intensive utilization of care (B = –0.29, Wald χ 2 = 3.91, P = .05). Greater content fidelity was associated with lower odds of intensive utilization of care (B = –0.03, Wald χ 2 = 9.31, P = .001). Conclusion Maintaining fidelity to facilitative group processes in CenteringPregnancy was associated with significant reductions in preterm birth and intensive utilization of care. Content fidelity also was associated with reductions in intensive utilization of care. Clinicians learning to facilitate group care should receive training in facilitative leadership, emphasizing the critical role that creating a participatory atmosphere can play in improving outcomes.

Interventions to improve public health may benefit from consideration of how environmental contexts can facilitate or hinder their success. We examined the extent to which efficacy of interventions to improve African Americans' condom use practices was moderated by two indicators of structural stigma-Whites' attitudes toward African Americans and residential segregation in the communities where interventions occurred. A previously published meta-analytic database was re-analyzed to examine the interplay of community-level stigma with the psychological processes implied by intervention content in influencing intervention efficacy. All studies were conducted in the United States and included samples that were at least 50% African American. Whites' attitudes were drawn from the American National Election Studies, which collects data from nationally representative samples. Residential segregation was drawn from published reports. Results showed independent effects of Whites' attitudes and residential segregation on condom use effect sizes. Interventions were most successful when Whites' attitudes were more positive or when residential segregation was low. These two structural factors interacted: Interventions improved condom use only when communities had both relatively positive attitudes toward African Americans and lower levels of segregation. The effect of Whites' attitudes was more pronounced at longer follow-up intervals and for younger samples and those samples with more African Americans. Tailoring content to participants' values and needs, which may reduce African Americans' mistrust of intervention providers, buffered against the negative influence of Whites' attitudes on condom use. The structural factors uniquely accounted for variance in condom use effect sizes over and above intervention-level features and community-level education and poverty. Results highlight the interplay of social identity and environment in perpetuating intergroup disparities. Potential mechanisms for these effects are discussed along with public health implications.

Background Racial/ethnic disparities in birth weight persist within the USA. Purpose The purpose of this study is to examine the association between maternal everyday discrimination and infant birth weight among young, urban women of color as well as mediators (depressive symptoms, pregnancy distress, and pregnancy symptoms) and moderators (age, race/ethnicity, and attributions of discrimination) of this association. Methods A total of 420 women participated (14–21 years old; 62 % Latina, 38 % Black), completing measures of everyday discrimination and moderators during their second trimester of pregnancy and mediators during their third trimester. Birth weight was primarily recorded from medical record review. Results Path analysis demonstrated that everyday discrimination was associated with lower birth weight. Depressive symptoms mediated this relationship, and no tested factors moderated this relationship. Conclusions Given the association between birth weight and health across the lifespan, it is critical to reduce discrimination directed at young, urban women of color so that all children can begin life with greater promise for health.

The purpose of this research was to select from the health belief model (HBM), theories of reasoned action (TRA) and planned behaviour (TPB), information-motivation-behavioural skills model (IMB) and social cognitive theory (SCT) the strongest longitudinal predictors of women's condom use and to combine these constructs into a single integrated model of condom use. The integrated model was evaluated for prediction of condom use among young women who had steady versus casual partners. At Time 1, all constructs of the five models and condom use were assessed in an initial and a replication sample (n = 193, n = 161). Condom use reassessed 8 weeks later (Time 2) served as the main outcome. Information from IMB, perceived susceptibility, benefits, and barriers from HBM, self-efficacy and self-evaluative expectancies from SCT, and partner norm and attitudes from TPB served as indirect or direct predictors of condom use. All paths replicated across samples. Direct predictors of behaviour varied with relationship status: self-efficacy significantly predicted condom use for women with casual partners, while attitude and partner norm predicted for those with steady partners. Integrated psychosocial models, rich in constructs and relationships drawn from multiple theories of behaviour, may provide a more complete characterisation of health protective behaviour.

Despite the long history of research on social norms in psychology, sociology, and other disciplines, social norms remain relatively underutilized as a mechanism for changing health behaviors. However, normative influence is a powerful motivator of behavior that can and should be brought to bear in health promotion research. Accordingly, research that has examined the role of social norms in characterizing, predicting, and ultimately altering health behaviors is reviewed. First, an important distinction between descriptive and injunctive norms is addressed and a brief review of literature that has examined norms as correlates of health behaviors is provided. The remainder of the chapter focuses on applications of normative information to behavior change, with an emphasis on social norms theory. The social psychological phenomena that form the basis of the theory, as well as a number of applications of the theory to behavior change are discussed. Alternative applications of norms to the promotion of health behavior and influences of the media on health are also addressed.