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RationaleMitigating the spread of COVID-19 requires that people understand the need for and engage in protective behaviors. Given the complexity and rapid progression of media information about the pandemic, health literacy could be essential to acquiring the accurate beliefs, concern for societal risks, and appreciation of restrictive policies needed to motivate these behaviors. Yet with the increasingly politicized nature of COVID-related issues in the United States, health literacy could be an asset for those with more liberal views but less so for those with more conservative views.ObjectiveThis study tested a hypothesized model proposing that political views moderate the associations of health literacy with COVID-19 protective behaviors as well as the mediational roles of accurate and inaccurate COVID-19 beliefs, concern for society, and governmental control attitudes.MethodsWe surveyed residents in three diverse regions of California in June 2020 (N = 669) and February 2021 (N = 611). Participants completed measures of health literacy, political views, and COVID-19 beliefs and behaviors.ResultsModerated mediational analyses largely supported the proposed model with both samples. Health literacy was associated with more accurate COVID-19 beliefs, less inaccurate COVID-19 beliefs, greater concern for societal risks, more positive attitudes regarding restrictive government control, more protective behavior, less risky behavior, and stronger vaccine intentions; beliefs, concern for society, and governmental control attitudes mediated the health literacy-behavior relationships. As predicted, however, these associations of health literacy with adaptive beliefs, attitudes, and behaviors varied according to political views. The direct and mediated relationships were held for participants with more liberal views and, to a lesser extent, for those with moderate views, but they were weaker or absent for participants with more conservative views.ConclusionsThese findings contribute new evidence of processes linking health literacy with adaptive beliefs, attitudes, and behaviors and how social and political contexts can shape those processes.

ObjectiveTo understand the extent to which people who smoke, people who vape and nonsmokers would switch between smoking cigarettes and vaping in response to policies (price increases, restrictions on nicotine, places, and information on addictiveness and/or health risks) aimed at decreasing tobacco use by people who smoke and vaping by nonsmokers.DesignA total of 525 adults aged 18 to 88 years completed a discrete choice survey of 16 choices between two smoking/vaping alternatives. Analysis was conducted using conditional logistic regression for the entire sample and stratified by nonsmokers, people who smoke, and people who vape.ResultsThe results suggest that most people who vape also smoke. Nonsmokers were more favorable to vaping and were concerned about long-term health risks and cost associated with vaping. Marginal analysis suggests that price increases will have only modest success in moving people who smoke to start vaping or encouraging people who vape to vape rather than use cigarettes. Nonsmokers are not very sensitive to price changes but are sensitive to information about health impacts.ConclusionsFindings indicate that increasing the price of cigarettes would lead to a limited increase in the probability of people who smoke switch to vaping. The study advances our understanding of the views of current nonsmokers toward cigarettes and vaping, suggesting that price increases and increased knowledge of addiction would likely deter nonsmokers from vaping. Changing the amount of nicotine associated with smoking would increase the probability of vaping slightly and have little impact on nonsmokers or vaping preferences, but the most significant change would come from increasing the perceptions of the risk of smoking.

Marijuana use among pregnant and breastfeeding women is on the rise and carries risks for infant health and well-being. Decisions to use marijuana while pregnant and breastfeeding are motivated by beliefs that use poses minimal risk to infants and offers benefits to maternal users. Misperceptions and usage trend higher among disadvantaged populations. This study surveyed 401 community residents on beliefs about risks and benefits of marijuana use by pregnant and breastfeeding women. The study utilized techniques to enhance recruitment of Latino and disadvantaged residents of rural communities in California, a state where recreational marijuana use is legal. Analyses revealed substantial endorsement of beliefs about benefits and low risks of marijuana use while pregnant and breastfeeding, many of which run counter to current evidence. Misperceptions were particularly prevalent for cannabis users and male respondents. Trends in valid beliefs, while modest, were higher for Latinos and parents.

Climate change poses a multifaceted, complex, and existential threat to human health and well-being, but efforts to communicate these threats to the public lag behind what we know how to do in communication research. Effective communication about climate change's health risks can improve a wide variety of individual and population health-related outcomes by: (1) helping people better make the connection between climate change and health risks and (2) empowering them to act on that newfound knowledge and understanding. The aim of this manuscript is to highlight communication methods that have received empirical support for improving knowledge uptake and/or driving higher-quality decision making and healthier behaviors and to recommend how to apply them at the intersection of climate change and health. This expert consensus about effective communication methods can be used by healthcare professionals, decision makers, governments, the general public, and other stakeholders including sectors outside of health. In particular, we argue for the use of 11 theory-based, evidence-supported communication strategies and practices. These methods range from leveraging social networks to making careful choices about the use of language, narratives, emotions, visual images, and statistics. Message testing with appropriate groups is also key. When implemented properly, these approaches are likely to improve the outcomes of climate change and health communication efforts.

Risk perception is an important construct in many health behavior theories. Smoking risk perceptions are thoughts and feelings about the harms associated with cigarette smoking. Wide variation in the terminology, definition, and assessment of this construct makes it difficult to draw conclusions about the associations of risk perceptions with smoking behaviors. To understand optimal methods of assessing adults' cigarette smoking risk perceptions (among both smokers and nonsmokers), we reviewed best practices from the tobacco control literature, and where gaps were identified, we looked more broadly to the research on risk perceptions in other health domains. Based on this review, we suggest assessments of risk perceptions (1) about multiple smoking-related health harms, (2) about harms over a specific timeframe, and (3) for the person affected by the harm. For the measurement of perceived likelihood in particular (ie, the perceived chance of harm from smoking based largely on deliberative thought), we suggest including (4) unconditional and conditional items (stipulating smoking behavior) and (5) absolute and comparative items and including (6) comparisons to specific populations through (7) direct and indirect assessments. We also suggest including (8) experiential (ostensibly automatic, somatic perceptions of vulnerability to a harm) and affective (emotional reactions to a potential harm) risk perception items. We also offer suggestions for (9) response options and (10) the assessment of risk perception at multiple time points. Researchers can use this resource to inform the selection, use, and future development of smoking risk perception measures.ImplicationsIncorporating the measurement suggestions for cigarette smoking risk perceptions that are presented will help researchers select items most appropriate for their research questions and will contribute to greater consistency in the assessment of smoking risk perceptions among adults.

Author(s): Renee E. Magnan [sup.1] , Anna V. Song [sup.2] [sup.3] , Linda D. Cameron [sup.2] [sup.3] Author Affiliations: (1) grid.502359.8, 0000 0000 8936 4310, Department of Psychology, Washington State [...], Evidence supports the use of graphic warnings to educate the public about the health harms of smoking and suggests warnings eliciting negative emotional responses may be more effective. This study aimed to replicate a preliminary theory-based model whereby perceived new knowledge promotes discouragement from smoking through its impact on worry about smoking with a different sample and using a new set of cigarette graphic warnings. We explored if the pattern extended to encouragement to use e-cigarettes, and if age and user group moderated the indirect effects of these models. Exclusive smokers, dual/e-cigarette users and nonusers (N = 412) evaluated graphic cigarette warnings on perceived new knowledge and worry about health harms of smoking, discouragement to smoke, and encouragement to use e-cigarettes. Perceived new knowledge was both directly and indirectly associated with discouragement to smoke through worry about health harms of smoking, and did not vary as a function of age or user group. In contrast, perceived new knowledge was not directly or indirectly associated with encouragement to use e-cigarettes, and this pattern largely did not vary as a function of age or user group. Graphic cigarette warnings that enhance knowledge may discourage smoking both directly and indirectly through worry elicited by them, and may have less impact on encouraging e-cigarette use. These findings replicate prior work and generalize to different user groups and new warnings planned for implementation in the U.S.

An expanded Common-Sense Model (CSM) contextualised to the self-regulation of cancer recurrence risk identifies risk representational attributes and recurrence worry as primary processes motivating protective behaviours in cancer survivors. A systematic review examined evidence for CSM hypotheses regarding how these processes influence diet and physical activity (PA) among survivors. A research agenda is outlined and used to evaluate the evidence base. Common databases were searched for eligible, peer-reviewed, English language reports, yielding 18 studies quantitatively testing hypothesised relationships among representations of prior cancer, recurrence risk representations, recurrence worry, and diet and PA. The findings provide promising, but mixed and limited evidence for some of the hypothesised associations of specific risk recurrence attributes with recurrence worry, and risk recurrence attributes and recurrence worry with diet and PA. Findings support the distinction of recurrence risk representations and illness representations of the prior cancer, with each showing different relationships with recurrence worry and behaviours. We discuss the status of the evidence base in relation to assessment, design, and analysis priorities and propose strategies that can yield more sensitive, rigorous tests of the CSM for cancer recurrence risk as applied to diet and PA.

Conceptual frameworks are useful in research because they can highlight priority research domains, inform decisions about interventions, identify outcomes and factors to measure, and display how factors might relate to each other to generate and test hypotheses. Discovery, translational, and implementation research are all critical to the overall mission of genomic medicine and prevention, but they have yet to be organized into a unified conceptual framework. To fill this gap, our diverse team collaborated to develop the Genomic Medicine Integrative Research (GMIR) Framework, a simple but comprehensive tool to aid the genomics community in developing research questions, strategies, and measures and in integrating genomic medicine and prevention into clinical practice. Here we present the GMIR Framework and its development, along with examples of its use for research development, demonstrating how we applied it to select and harmonize measures for use across diverse genomic medicine implementation projects. Researchers can utilize the GMIR Framework for their own research, collaborative investigations, and clinical implementation efforts; clinicians can use it to establish and evaluate programs; and all stakeholders can use it to help allocate resources and make sure that the full complexity of etiology is included in research and program design, development, and evaluation.

The current study tested contextual features (product design, imagery, and use) of e-cigarette advertisements on responses to the mandated U.S. FDA addiction text warning. In a within-subjects experimental design, young adults (aged 18–24) living in California were categorized into those who use e-cigarettes (n = 149), use cigarettes (n = 66), and dual use (n = 204). They provided affective and cognitive responses to the addiction warning and e-cigarette products in advertisements. Cognitive and affective responses overall were moderately strong, and this pattern was generally consistent across product design and imagery. Those who use cigarettes (versus dual use) reported stronger feelings that they learned new information and lower perceptions that e-cigarettes help reduce cigarette consumption. Those who smoke also reported greater worry, discouragement, and perceived health benefits associated with e-cigarettes and lower perception of harmfulness of e-cigarettes than those who dual use, and evaluated the warning lowest on eliciting encouragement to use and feeling e-cigarettes are a healthy alternative to smoking. Few differences emerged between those who use e-cigarettes and dual use or smoke. The varied response patterns by the use group underline the regulatory challenges of developing strong e-cigarette warnings to deter e-cigarette use. [ABSTRACT FROM AUTHOR]

Author(s): Isaac M. Lipkus [sup.1] , Darren Mays [sup.2] , Paschal Sheeran [sup.3] , Wei Pan [sup.1] , Linda D. Cameron [sup.4] , Felipe De Brigard [sup.5] Author Affiliations: (1) [...], The desire to engage in waterpipe tobacco smoking (WTS) may occur when smokers and nonsmokers conjure positive mental simulations of WTS. However, effects of these simulations on desire to smoke waterpipe tobacco and potential mediators are unexplored. This research addressed these effects among young adult waterpipe tobacco smokers and nonsmokers. Two online studies were conducted with adults ages 18-30. In Study 1, 200 smokers, 190 susceptible nonsmokers, and 182 nonsusceptible nonsmokers were randomized to mentally simulate or not WTS in the future. In Study 2, 234 smokers and 241 susceptible nonsmokers were randomized to four arms: no simulation or simulations that varied valence of experience (positive, negative or no valence provided). Main outcomes were immediate desire to smoke waterpipe tobacco, cognitive and affective attitudes, and perceived harms. In Study 1, mental simulations increased the desire to smoke waterpipe tobacco among smokers. In Study 2, asking participants to simulate WTS positively or with no valence instruction increased desire to smoke relative to negative valence instruction or no simulation. Negative simulations reduced perceived probability of smoking within a month compared to positive simulations. Effects on desire to engage in WTS were mediated by cognitive and affective attitudes among susceptible nonsmokers and by cognitive attitudes among smokers. These findings suggest that exploring when and how often mental simulations about WTS are evoked and their potency for promoting prevention and cessation of WTS merit further attention.

BackgroundAn integration of message framing and sociocultural literature suggests that ethnic health disparities may be reduced by incorporating minority groups' cultural values into persuasive health messages. Framing messages with metaphors represents one promising strategy for harnessing cultural values to change health outcomes. Still, the effectiveness of metaphoric health messages in minority populations has received virtually no empirical attention.PurposeTo fill this gap, the present study tested whether a health message using a cancer-screening metaphor targeting collectivism and familism values would engage individual differences in these values to predict Papanicolaou (Pap) smear intentions among Latinas.MethodsLatina women (N = 168) completed an online survey including measures of collectivism and familism. They were randomized to read a message about Pap smears featuring the metaphor the body is a family or no metaphor before reporting their Pap smear intentions.ResultsRegression analyses revealed a pattern of interactions suggesting metaphoric messages engage targeted cultural values: For Latinas reading the family metaphor message, collectivism and familism positively predicted Pap smear intentions, whereas for Latinas reading the no-metaphor message, these values did not predict intentions.ConclusionsThis study offers a foundation for further examination of the potential for metaphoric health messages that connect to cultural values to reduce ethnic health disparities. Implications and directions for future research are discussed.

Health communicators publicize messages that use metaphors to compare abstract health-related concepts to concrete concepts in other domains. Such messages aim to change health attitudes and behavior, but do they work? According to Conceptual Metaphor Theory, metaphors can shape thought by transferring personalized knowledge of a concrete concept to understand and relate to an abstraction, despite their superficial differences. The authors extend this claim to specify emotional and cognitive factors potentially moderating the productivity (and counter-productivity) of metaphoric health messages. A source resonance hypothesis predicts that when a message frames a health risk metaphorically in terms of a concrete hazard (versus literally), individual differences in fear surrounding that particular hazard will differentially predict risk-related worry and thus prevention intentions. A metaphoric fit hypothesis predicts that a risk metaphor will be more persuasive when the recommended prevention response is itself framed metaphorically as addressing the concrete hazard (versus literally). These hypotheses were supported in three experiments conducted with online, undergraduate, and community samples (N = 539). With skin cancer as a case study, the studies tested the impact of messages framing sun exposure and sun-safe practices with or without metaphors of enemy combat. Findings illuminate how, when, and for whom metaphoric messages are persuasive, with theoretical and practical implications for health communication and metaphoric construal.

Advances in theory and research on self-regulation and decision-making processes have yielded important insights into how cognitive, emotional, and social processes shape risk perceptions and risk-related decisions. We examine how self-regulation theory can be applied to inform our understanding of decision-making processes within the context of genomic testing, a clinical arena in which individuals face complex risk information and potentially life-altering decisions. After presenting key principles of self-regulation, we present a genomic testing case example to illustrate how principles related to risk representations, approach and avoidance motivations, emotion regulation, defensive responses, temporal construals, and capacities such as numeric abilities can shape decisions and psychological responses during the genomic testing process. We conclude with implications for using self-regulation theory to advance science within genomic testing and opportunities for how this research can inform further developments in self-regulation theory.

BackgroundThe technologies currently available to detect the presence of foetal genetic abnormalities are complex, and undergoing prenatal diagnostic testing can have wide-ranging repercussions. Before individuals can decide with certainty whether or not to take these tests, they first need to grasp the many psychosocial and clinical dimensions of prenatal genetic testing.ObjectiveTo test a model integrating key psychosocial and clinical factors as predictors of decisional conflict in decisions about whether or not to undergo prenatal genetic testing.MethodAdults (n = 457) read one of four hypothetical scenarios asking them to imagine expecting a child and considering the option of a prenatal test able to detect a genetic condition; age of condition onset (birth vs. adulthood) and its curability (no cure vs. curable) were manipulated. Participants completed measures of decisional conflict, perceived benefits from normal results, test response efficacy, condition coherence, child-related worry, perceived disagreement with the other parent's preference, motivation to comply with doctors' perceived preferences, and parity.ResultsPrenatal testing decisional conflict was positively predicted by perceiving normal results as beneficial, doubting the test's reliability, lacking understanding of the genetic condition, worrying about the health of the foetus, perceiving differences of opinion from partner/spouse, wanting to follow doctors' preferences, and being childless.DiscussionThese results, of growing relevance given the increasing availability of new technologies in pregnancy care, can inform communication strategies that facilitate couples' decision making.ConclusionThis study provides insights into factors that might complicate prenatal testing decision making.

ContextSickle cell disease (SCD) and thalassemia are rare but chronic blood disorders. Recent literature showed impaired quality of life (QOL) in people with these blood disorders. Assessing one of the determinants of QOL (i.e. illness perceptions) therefore, is an important next research area.ObjectiveWe aimed to explore illness perceptions of people with a blood disorder with drawings in addition to the Brief Illness Perception Questionnaire (Brief IPQ). Drawings are a novel method to assess illness perceptions and the free-range answers drawings offer can add additional insight into how people perceive their illness.MethodWe conducted a cross-sectional study including 17 participants with a blood disorder. Participants' illness perceptions were assessed by the Brief IPQ and drawings. Brief IPQ scores were compared with reference groups from the literature (i.e. people with asthma or lupus erythematosus).ResultsParticipants with SCD or thalassemia perceived their blood disorder as being more chronic and reported more severe symptoms than people with either asthma or lupus erythematosus. In the drawings of these participants with a blood disorder, a greater number of blood cells drawn was negatively correlated with perceived personal control (P

Two key processes in romantic relationships—power and dominance—can contribute to relationship disruption, but the association between these variables is complex. Elucidating the association between power and dominance during the COVID‐19 pandemic is particularly important given the economic, social, and health‐related stressors that pose a risk to relationship health. We examined associations between power, stress, and dominance by recruiting 1813 participants to complete an initial online survey at the beginning of the COVID‐19 pandemic. Participants were contacted 10 and 22 months later to complete follow‐up surveys. Results revealed two main effects: individuals who had greater relationship power and experienced more COVID‐19‐related stressors than other people engaged in more dominance behaviors. A significant curvilinear effect revealed that at low levels of power, power was not associated with dominance behaviors. However, once power surpassed low levels, individuals with more power engaged in more dominance behaviors. Finally, people engaged in more dominance behaviors when they experienced more power and stress compared to their own average (i.e., within‐person effects) during the pandemic. Implications for theories of power, dominance, and relationship disruption and distress are discussed. [ABSTRACT FROM AUTHOR]

Author(s): Kerry A. Sherman[sup.1] [sup.3] , Linda D. Cameron[sup.2] Author Affiliations: (1) Department of Psychology, Centre for Emotional Health, Macquarie University, 2109, Sydney, NSW, Australia (2) Westmead Breast Cancer Institute, [...], The aim of this special section is to showcase research contributing to our understanding of factors influencing decisions to undergo genetic testing and the impact of the genetic testing process on health-related behaviors of tested individuals. The first two articles report studies investigating factors associated with interest in genetic testing and acceptance of test results (Sherman et al. in J Behav Med doi:10.1007/s10865-015-9630-9, 2015 (See CR100); Taber et al. in J Behav Med doi:10.1007/s10865-015-9642-5, 2015b (See CR101)). The next two papers address the unique contribution of genetic risk information to understanding risk beyond genetic counseling alone (Heiniger et al. in J Behav Med doi10.1007/s10865-015-9632-7, 2015 (See CR103); Taber et al. in J Behav Med doi:10.1007/s10865-015-9648-z, 2015a (See CR102)). The final three articles investigate the effects of genetic risk information on beliefs about disease control and prevention (Aspinwall et al. in J Behav Med doi:10.1007/s10865-015-9631-8, 2015 (See CR104); Kelly et al. in J Behav Med doi10.1007/s10865-014-9613-2, 2014 (See CR105); Myers et al. in J Behav Med doi:10.1007/s10865-015-9626-5, 2015 (See CR106)). Collectively, the special section of papers highlights the diverse ways in which behavioural medicine contributes to our understanding of genetic testing for disease risk, and points to the value of further research to better understand ways in which individuals perceive, interpret and respond to genetic risk information.

Introduction Advances in genomics have paved the way for the development of prenatal genetic tests for health conditions through the use of diagnostic procedures such as amniocentesis and chorionic villus [...], Decisions to undergo invasive prenatal diagnostic procedures can be anxiety provoking. Individuals receive information about these procedures in one of three modalities: written text, audio (verbal description), or video. We examined whether modality influences emotional responses and testing decisions, and whether trait anxiety, a disposition linked with heightened sensitivity to threatening information, moderates these effects. New Zealand adults (N = 176) completed a trait anxiety measure before random allocation to view a text, audio, or video message about amniocentesis and chorionic villus sampling. Participants completed measures of child related worry, anticipated emotional distress, anticipated coping efficacy, perceived likelihood of miscarriage, and testing interest. High-anxious individuals reported greater distress and lower coping efficacy in response to the video message compared to the audio message. They also reported greater miscarriage likelihood in response to the video message compared to the text message. These findings suggest that use of video, assumed to be most informative for educating patients, could induce greater distress about prenatal testing in individuals prone to anxiety. Keywords Prenatal testing * Genetic testing * Trait anxiety * Information modality * Health communications * Risk communications

Background: A variety of intervention strategies to improve Human Papillomavirus (HPV) vaccination rates in adults exist; however, they have shown varying efficacy and inconsistent outcomes. Purpose: This meta-analysis tested the efficacy of HPV vaccination interventions for adults in increasing vaccine intentions, rates of initiation of the vaccine series, and completion rates. The study also tested potential moderators (intervention strategy, theory-based versus nontheory-based interventions, race/ethnicity, gender, study quality) of relationships between intervention receipt and vaccine intentions. Method: Electronic databases (PsychINFO, Web of Science, Scopus, EBSCO, JSTOR, PubMed) were searched for English-language articles published up to September 2021. Eligible studies included outcomes of vaccine intentions, receipt of the first dose, or vaccine series completion and included intervention and comparison conditions. Results: The search yielded 38 eligible studies reporting 78 effect sizes. Random effects, multilevel, meta-analytic models revealed a significant, small effect of interventions on vaccine intentions (OR = 0.36, 95% CI [0.07, 0.65]); a nonsignificant effect on vaccine initiation rates (OR = 1.29; 95% CI [0.87, 1.91]); and significant effects on vaccine completion rates (OR = 1.58, 95% CI [1.18, 2.11]). Race/ethnicity, gender, intervention strategy, theory-based interventions, and study quality did not moderate the intervention effects on vaccine intentions. Conclusion: Evidence supports the efficacy of interventions to increase intentions to receive the HPV vaccine and completion of the HPV vaccine series in adults. However, evidence did not support the efficacy of interventions to increase HPV vaccine initiation. Findings highlight directions for developing more efficacious HPV vaccine interventions for adults. HPV vaccination interventions are efficacious at increasing intentions to receive the vaccine and completion of the HPV vaccine series among adults. [ABSTRACT FROM AUTHOR]