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Abstract Per- and polyfluoroalkyl substances (PFAS) are a large class of synthetic compounds, many of which are persistent, mobile and toxic (PMT). The sheer number of PFAS makes a substance-by-substance based approach to regulating this group unfeasible. Given the known risks of many PFAS, a precautionary approach (i.e., the Essential Use Concept; EUC) has been called for, whereby any substance is assumed to be harmful and should be phased out, unless it is shown that: (a) the use of this substance is necessary for health and safety, or is critical for the functioning of society and (b) there are no available technically and economically feasible alternatives. While experts, including chemists and toxicologists, are well-placed to assess the second criteria, determining what is necessary for the “functioning of society” requires a wider consideration of societal beliefs and preferences and greater involvement of various interested and affected parties, especially those whose voices are less heard but may be most vulnerable. The aim of the current paper is to provide a preliminary framework and research agenda outlining why and at what points in the essential use decision-making process broader societal perspectives are required, and how such ‘social data’ can be collected. The ultimate goal is to improve chemicals management by supporting citizens in becoming more informed and engaged participants in relevant debates and policies, including in how to operationalise the EUC.

Abstract End users of single‐use plastics can help minimize their contribution to plastic pollution via mindful purchasing and waste management. These behaviors can be impacted via behavior change interventions in various key sectors of society. This review set out to summarize recent (2015–2023) peer‐reviewed evidence on interventions aimed at changing the plastic consumption, recycling, and/or littering behaviors of individuals across four sectors: business and retail, tourism and leisure, schools and education, and communities. Systematic literature searches were conducted across multiple databases and resulted in the inclusion of 92 intervention studies. Information on intervention strategy and effectiveness was extracted, and the studies were assessed for risk of bias. Intervention descriptions and outcomes were coded into five intervention categories (informational, contextual, prompts, social, and personal strategies) and synthesized qualitatively to inform future practice in an accessible manner. Although nearly half of the reviewed studies were assessed as having moderate‐to‐high risk of bias (e.g., lacked reliability assessment of outcome measures), limiting confidence in the documented findings, the review concludes that different strategies work in different sectors. For example, informational strategies showed mostly promising results in most sectors, but had mixed effectiveness in the education sector, while contextual modifications were effective across sectors.

Abstract Plastics have become an integral component in agricultural production as mulch films, nets, storage bins and in many other applications, but their widespread use has led to the accumulation of large quantities in soils. Rational use and reduction, collection, reuse, and innovative recycling are key measures to curb plastic pollution from agriculture. Plastics that cannot be collected after use must be biodegradable in an environmentally benign manner. Harmful plastic additives must be replaced with safer alternatives to reduce toxicity burdens and included in the ongoing negotiations surrounding the United Nations Plastics Treaty. Although full substitution of plastics is currently not possible without increasing the overall environmental footprint and jeopardizing food security, alternatives with smaller environmental impacts should be used and endorsed within a clear socio-economic framework. Better monitoring and reporting, technical innovation, education and training, and social and economic incentives are imperative to promote more sustainable use of plastics in agriculture.

Abstract Concern about plastic pollution, including microplastics, is high amongst European citizens, and effective actions are needed to reduce microplastic pollution. However, there is still uncertainty and debate about the major sources, impacts, and in particular the solutions. The aim of the current study was to gather expert perceptions about the risks of different microplastic sources to the natural environment and human health (measured as the likelihood and severity of negative impacts resulting from exposure), as well as the feasibility and effectiveness of different solutions. Experts were identified as scientists working on plastic. Usable responses were received from 73 experts with an average of 5 years’ experience in plastic research. Experts thought that there was currently stronger evidence for microplastic impacts on the natural environment than on human health, that, accordingly, the risks were higher, and they were more worried about impacts on the natural environment than on human health. Experts perceived tyre particles and textile fibres to be the main sources of microplastics presenting risk for both natural environment and human health. Various solutions were rated as relatively effective and feasible overall. Solutions that were rated as above-average in terms of effectiveness and feasibility included education and awareness programmes, washing machine filters, bans of plastic items, simplified design of products, and circular economy approaches. However, experts were uncertain about the effectiveness and feasibility of recovery and clean-up solutions, with overall ratings for these being below-average in comparison to other solutions earlier in the plastic life cycle. An improved understanding of expert views on these matters could inform the distribution of limited research resources and help prioritise research questions, especially with regard to potential solutions and interventions which will be critical for the success of the UN Plastics Treaty.

Nature-based solutions including urban forests and wetlands can help communities cope better with climate change and other environmental stressors by enhancing social-ecological resilience. Natural ecosystems, settings, elements and affordances can also help individuals become more personally resilient to a variety of stressors, although the mechanisms underpinning individual-level nature-based resilience, and their relations to social-ecological resilience, are not well articulated. We propose ‘nature-based biopsychosocial resilience theory’ (NBRT) to address these gaps. Our framework begins by suggesting that individual-level resilience can refer to both: a) a person’s set of adaptive resources; and b) the processes by which these resources are deployed. Drawing on existing nature-health perspectives, we argue that nature contact can support individuals build and maintain biological, psychological, and social (i.e. biopsychosocial) resilience-related resources. Together with nature-based social-ecological resilience, these biopsychosocial resilience resources can: i) reduce the risk of various stressors (preventive resilience); ii) enhance adaptive reactions to stressful circumstances (response resilience), and/or iii) facilitate more rapid and/or complete recovery from stress (recovery resilience). Reference to these three resilience processes supports integration across more familiar pathways involving harm reduction, capacity building, and restoration. Evidence in support of the theory, potential interventions to promote nature-based biopsychosocial resilience, and issues that require further consideration are discussed.

IntroductionThis study investigates the effectiveness of using an educational comic book to facilitate the intergenerational transfer of knowledge and intentions concerning dynamite fishing in Borneo, Malaysia. The aim is to explore how children can influence their parents' understanding of the issue and their willingness to address it within the community. Additionally, the research examines unintended reactions within the participant groups.MethodsThe study employed a controlled experimental design with two groups: a treatment group exposed to the educational comic book and a control group without this intervention. Participants were families residing in communities where dynamite fishing is still practiced. Data collection included pre- and post-intervention surveys and follow-up measurements to assess short-term and long-term effects on knowledge and intentions.ResultsThe findings revealed a successful intergenerational transfer of knowledge from children to parents, evident both in the short and long term. Furthermore, the intergenerational transfer of intentions demonstrated a two-fold pattern. The intention to discuss the dynamite fishing problem within the community was transferred from children to their parents at the second measurement point, highlighting the time required for the development of new intentions. A boomerang effect was observed for the intention to cease dynamite fishing among individuals reliant on fishing for their livelihood. This rebound effect was solely observed in the control group but was effectively mitigated in the treatment group, where engagement with the comic book influenced positive outcomes.DiscussionThe study's results underscore the power of intergenerational transfer of knowledge and intentions from younger to older generations, facilitated by educational comic books as a communication tool for addressing environmental issues. Moreover, a boomerang effect seen in the control group highlights the complexity of behavior change in economically motivated practices like dynamite fishing. Engaging interventions, such as educational materials, can play a crucial role in curbing these behaviors. Furthermore, the study emphasizes the necessity of carefully monitoring unintended reactions within participant groups, particularly in research related to sensitive topics.

IntroductionMarine biodiversity loss has direct and indirect effects on human health and wellbeing. Recent European data suggest that the public is aware of this, identifying marine biodiversity protection as its top research priority in terms of oceans and human health, rated higher than issues such as plastic, chemical, and microbial pollution.MethodsThe current study aimed to better understand key sociodemographic and personality predictors of concern about marine biodiversity loss and the desire for more research into marine biodiversity protection, in an attempt to support communication efforts targeting specific sectors in society. Data were drawn from nationally representative samples of 14 European countries (n = 14,167).ResultsResults show greater concern about marine biodiversity loss and support for more research into marine biodiversity protection by older adults, females, and individuals: (i) without (vs. with) a university degree; (ii) with lower (vs. middle) incomes; (iii) who identified as politically left-wing; (iv) who visited the coast more often; and (v) those with more open, agreeable and conscientious personalities.DiscussionThese results suggest that, although concern and research support are generally high among European citizens, policy makers and communicators need to take into consideration individual-level variation.

This article details a correction to: Landrigan PJ, Raps H, Cropper M, et al. The Minderoo-Monaco Commission on Plastics and Human Health. Annals of Global Health. 2023; 89(1): 23. DOI: https://doi.org/10.5334/aogh.4056.

Background: Plastics have conveyed great benefits to humanity and made possible some of the most significant advances of modern civilization in fields as diverse as medicine, electronics, aerospace, construction, food packaging, and sports. It is now clear, however, that plastics are also responsible for significant harms to human health, the economy, and the earth’s environment. These harms occur at every stage of the plastic life cycle, from extraction of the coal, oil, and gas that are its main feedstocks through to ultimate disposal into the environment. The extent of these harms not been systematically assessed, their magnitude not fully quantified, and their economic costs not comprehensively counted. Goals: The goals of this Minderoo-Monaco Commission on Plastics and Human Health are to comprehensively examine plastics’ impacts across their life cycle on: (1) human health and well-being; (2) the global environment, especially the ocean; (3) the economy; and (4) vulnerable populations—the poor, minorities, and the world’s children. On the basis of this examination, the Commission offers science-based recommendations designed to support development of a Global Plastics Treaty, protect human health, and save lives. Report Structure: This Commission report contains seven Sections. Following an Introduction, Section 2 presents a narrative review of the processes involved in plastic production, use, and disposal and notes the hazards to human health and the environment associated with each of these stages. Section 3 describes plastics’ impacts on the ocean and notes the potential for plastic in the ocean to enter the marine food web and result in human exposure. Section 4 details plastics’ impacts on human health. Section 5 presents a first-order estimate of plastics’ health-related economic costs. Section 6 examines the intersection between plastic, social inequity, and environmental injustice. Section 7 presents the Commission’s findings and recommendations. Plastics: Plastics are complex, highly heterogeneous, synthetic chemical materials. Over 98% of plastics are produced from fossil carbon- coal, oil and gas. Plastics are comprised of a carbon-based polymer backbone and thousands of additional chemicals that are incorporated into polymers to convey specific properties such as color, flexibility, stability, water repellence, flame retardation, and ultraviolet resistance. Many of these added chemicals are highly toxic. They include carcinogens, neurotoxicants and endocrine disruptors such as phthalates, bisphenols, per- and poly-fluoroalkyl substances (PFAS), brominated flame retardants, and organophosphate flame retardants. They are integral components of plastic and are responsible for many of plastics’ harms to human health and the environment. Global plastic production has increased almost exponentially since World War II, and in this time more than 8,300 megatons (Mt) of plastic have been manufactured. Annual production volume has grown from under 2 Mt in 1950 to 460 Mt in 2019, a 230-fold increase, and is on track to triple by 2060. More than half of all plastic ever made has been produced since 2002. Single-use plastics account for 35–40% of current plastic production and represent the most rapidly growing segment of plastic manufacture. Explosive recent growth in plastics production reflects a deliberate pivot by the integrated multinational fossil-carbon corporations that produce coal, oil and gas and that also manufacture plastics. These corporations are reducing their production of fossil fuels and increasing plastics manufacture. The two principal factors responsible for this pivot are decreasing global demand for carbon-based fuels due to increases in ‘green’ energy, and massive expansion of oil and gas production due to fracking. Plastic manufacture is energy-intensive and contributes significantly to climate change. At present, plastic production is responsible for an estimated 3.7% of global greenhouse gas emissions, more than the contribution of Brazil. This fraction is projected to increase to 4.5% by 2060 if current trends continue unchecked. Plastic Life Cycle: The plastic life cycle has three phases: production, use, and disposal. In production, carbon feedstocks—coal, gas, and oil—are transformed through energy-intensive, catalytic processes into a vast array of products. Plastic use occurs in every aspect of modern life and results in widespread human exposure to the chemicals contained in plastic. Single-use plastics constitute the largest portion of current use, followed by synthetic fibers and construction. Plastic disposal is highly inefficient, with recovery and recycling rates below 10% globally. The result is that an estimated 22 Mt of plastic waste enters the environment each year, much of it single-use plastic and are added to the more than 6 gigatons of plastic waste that have accumulated since 1950. Strategies for disposal of plastic waste include controlled and uncontrolled landfilling, open burning, thermal conversion, and export. Vast quantities of plastic waste are exported each year from high-income to low-income countries, where it accumulates in landfills, pollutes air and water, degrades vital ecosystems, befouls beaches and estuaries, and harms human health—environmental injustice on a global scale. Plastic-laden e-waste is particularly problematic. Environmental Findings: Plastics and plastic-associated chemicals are responsible for widespread pollution. They contaminate aquatic (marine and freshwater), terrestrial, and atmospheric environments globally. The ocean is the ultimate destination for much plastic, and plastics are found throughout the ocean, including coastal regions, the sea surface, the deep sea, and polar sea ice. Many plastics appear to resist breakdown in the ocean and could persist in the global environment for decades. Macro- and micro-plastic particles have been identified in hundreds of marine species in all major taxa, including species consumed by humans. Trophic transfer of microplastic particles and the chemicals within them has been demonstrated. Although microplastic particles themselves (>10 µm) appear not to undergo biomagnification, hydrophobic plastic-associated chemicals bioaccumulate in marine animals and biomagnify in marine food webs. The amounts and fates of smaller microplastic and nanoplastic particles (MNPs

Scenarios can be used to communicate potential future changes and engage and connect different audiences in exploring sustainable solutions. Communicating scenarios using creative visualisation, co-creation and a focus on local contexts are especially promising. This research is conducted on the island of Palawan in the Philippines as part of the GCRF Blue Communities project. With a quasi-experimental design, we investigate the psychological and emotional effects of the engagement with future scenarios as a tool for communicating sustainability. Together with local stakeholders and community members, three distinct, locally relevant scenario narratives (Business as Usual, Best Case, and Worst Case) have been co-created. Subsequently, a sample of N = 109 local high school students was asked to creatively engage with these scenario narratives. Intentions to engage in sustainable behaviour, perceived behavioural control, ascription of responsibility, consideration of future consequences, six basic emotions and connectedness to place were assessed before and after the activity via paper-pencil administrated questionnaires. A mixed-model analysis showed significant increases in intentions to engage in sustainable behaviour, however, this increase disappeared when consideration of future consequences was added as a covariate, suggesting a mediating effect. The level of consideration of future consequences also increased significantly after engaging with any of the future scenarios, which questions the common interpretation of consideration of future consequences as a trait variable. Perceived behavioural control significantly increased following the engagement with each of the scenarios whereas ascription of responsibility and connectedness to place did not show any changes. Overall, the two most emotion-evoking scenarios, Best Case Scenario and Worst Case Scenario, turn out as superior over the Business as Usual Scenario, which points to the relevance of emotional framing for effective messaging in our sample. This is the first systematic, quantitative assessment of the effects of future scenarios as a communication tool.

Despite the potentially huge contributions that coastal communities might make in marine resource management and sustainability, their participation in such efforts have only been recognized recently, particularly in Southeast Asia. Involving community perceptions can offer new insights for policy makers and resource managers and can elicit strong commitment and support from the communities themselves. This article aims to understand the perceptions of coastal communities of local environmental issues, specifically how these have developed over time, to understand the expectations and perceptions of trends. Sixteen marine environmental issues were identified during stakeholder meetings in Palawan, Philippines. A co-developed survey was administered to 431 respondents from coastal communities in two municipalities (Taytay and Aborlan) and in the city of Puerto Princesa in Palawan. The results show variation in the perceptions and expectations across issues. We find that communities expect positive trends for mangrove coverage, beach tree cover, and seagrass coverage as well as for seaweed farming and quality of drinking water. The amount of plastic litter, wild fish and shellfish, and the severity of sewage pollution are perceived to get slightly worse. The aquaculture sector is expected to remain unchanged in the future as it had been in the past. We also find significant differences in how people from different areas of residence perceive their marine environment. In the discussion, we mapped these different community perceptions on existing policies and their implementation. We further recommend how community perceptions can be integrated into resource management and policy making in the future.

The COVID-19 pandemic has caused (and continues to cause) severe disruption in global and local economies and has forced countries, societies, and individuals to adapt quickly to the unprecedented and unpredictable situations. Despite the obvious negative consequences of the pandemic, many have called for efforts to identify transformative opportunities for sustainable development throughout this disorderly time. In the present paper, we explore such potential opportunities in the context of an interdisciplinary, international research project, which is focusing on sustainable marine management in biosphere reserves and marine parks in Southeast Asia. During a virtual workshop conducted as part of the GCRF (Government’s Global Challenges Research Fund) Blue Communities Project, future scenarios were developed depicting the potential effects of the COVID-19 pandemic on five case study sites. All of these sites are in areas of internationally recognized outstanding ecological value (Taka Bonerate Kepulauan-Selayar Biosphere Reserve, Indonesia; Tun Mustapha Park, Sabah, Malaysia; Palawan Biosphere Reserve, Philippines; North Devon Biosphere Reserve, United Kingdom; Cu Lao Cham-Hoi An Biosphere Reserve, Vietnam). At the macro-level, economies, governance structures, and societal norms are undergoing big changes. At the micro-level, the livelihoods, lifestyles, and backyards of local residents have to adapt. Collaboratively, we explored how COVID-19 posed challenges in our five case study sites, but we also focused on the potential COVID-19-related windows of opportunity for future sustainable development. Opportunities could be identified in all three pillars of sustainable development: the environment, the society, and the economy. Although remarkable similarities can be found across all five sites, we conclude that there cannot be a “one-size-fits-all” solution to turn the tide toward achieving sustainable development. Just as before the pandemic, sustainable development starts with engaging with and understanding local environments, challenges, and situations; building on local knowledge; and developing tailor-made solutions for the communities in situ.

In the wake of the current global pandemic, international travel is restricted. This poses substantial challenges for research relationships aiming to build capacity and foster co-creation to achieve the Sustainable Development Goals, where global collaboration and communication is paramount. This is especially challenging when it comes to interactive dialogues that go beyond the typical one-way structure of online learning. Considerations on structural, technical and behavioral levels are needed to not only deal with these challenges but rather to take advantage of the new situation. This commentary outlines the lessons learned from an internationally operating project, co-developed to cope with travel restrictions. We discuss implications for future reduction of international travel to reduce carbon in the context of climate change.

Concerns about climate change associated with the combustion of fossil fuels urge a call for widespread reductions in household energy use. Determining means of achieving this is a key challenge faced by environmental scientists. The current research presents insights gained from a 12-month empirical trial of new serious game for energy, ‘EnergyCat’; which was designed to encourage household energy reductions in the UK social housing sector. Effects of gameplay on consumption behaviours and energy awareness were explored using 82 UK social housing households (versus a no-game control). Results indicated the intervention did not lead to any substantive changes in awareness or consumption practices. However, post-intervention feedback highlighted several issues in terms of game design and usability that may explain why the game failed to change behaviour in this instance. We provide a framework of suggestions as to how the game design process could be improved in order to engage residents in future, including use of adaptive fonts for older residents, and provision of clearer instructions on gameplay objectives at the outset. In addition, researchers should ensure close collaboration is maintained with residents throughout the design process in future efforts, in order to maximise likelihood of ongoing engagement from this population.

Progress on changing human behaviour to meet the challenges of regional and global sustainability has been slow. Building on theory as well as small-scale survey and experimental evidence that exposure to nature may be associated with greater pro-environmentalism, the aim of the current study was to quantify relationships between exposure to nature (operationalised as neighbourhood greenspace, coastal proximity, and recreational nature visits) as well as appreciation of the natural world, and self-reported pro-environmental behaviour for the adult population of England. Using data from a nationally representative sample (N = 24,204), and controlling for potential confounders, a structural equation model was used to estimate relationships. Indirect effects of neighbourhood exposures via nature visits and nature appreciation were accounted for. We found positive relationships between both recreational nature visits and nature appreciation and pro-environmental behaviour across both the whole sample and key socio-demographic groups. The more individuals visited nature for recreation and the more they appreciated the natural world, the more pro-environmental behaviour they reported. Although rural and coastal dwellers tended to also be more pro-environmental on average, patterns were complex, potentially reflecting situational constraints and opportunities. Importantly, positive associations between pro-environmental behaviours and high neighbourhood greenspace and coastal proximity were present for both high and low socio-economic status households. Improving access to, and contact with, nature, e.g., through better urban planning, may be one approach for meeting sustainability targets. Keywords: Nature contact, Natural environment exposure, Green space, Pro-environmental behavior, Sustainable behavior, Green lifestyle

The integrated study of ocean health and human health is an emerging area of increasing global importance. Growing evidences demonstrate that the health of the ocean and the health of humans have always been and will continue to be, inextricably linked. Our actions toward the oceans will significantly influence the future of the whole planet and, in turn, our own health. The current review of these issues arose from a summer school in San Sebastian (Spain), from 5th to 7th June, 2019. An interdisciplinary group of researchers discussed key risks (e.g., microbial pollution, pharmaceuticals, harmful algal blooms, plastic pollution) and benefits (e.g., bathing waters, recreation, tourism) of the seas and global ocean for humanity; and debated the future priorities and potential actions for a joint Oceans and Human Health research and governance programme in Europe. The aim of this review is to contribute to the emerging scientific agenda on ocean health and human health, as well as coordinate efforts with stakeholders, policy makers and the general public. This agenda operates within the larger context of the upcoming United Nations Decade of Ocean Science for Sustainable Development: 2021–2030, which strives to achieve the Sustainable Development Goals (SDG), including healthy (human) lives and well-being (SDG3) and conserving and sustainably using the oceans (SDG14), among others. In addition to summarizing some of the key risks and benefits, therefore, we describe the governance of oceans and health interactions (especially in Europe), and we finish by proposing a list of elements for potential future research priorities on oceans and human health.

Assessment of environmental literacy and ocean literacy focus on increasing knowledge and awareness. The goal of ocean literacy initiatives is ultimately to enable behavior change (whereby citizens take direct and sustainable action) to achieve sustainable solutions to marine environment issues. The application of social and behavioral research methods provides powerful tools for assessing if ocean literacy initiatives are effective at increasing participant's knowledge and awareness of an issue, its causes and consequences and behaviors or actions required to enable sustainable solutions. Social and behavioral research methods also provide a means of assessing changes in attitude, a key predictor of behavior change, and ultimately a means of assessing changes in a participants intended and reported behaviors. We present a framework to integrate social and behavioral research methods within assessment of the effectiveness of ocean literacy initiatives. The before and after assessment we undertake develops existing environmental literacy and ocean literacy assessment approaches by integrating social and behavioral research methods to assess key predictors of behavior change. We structured the assessment methodology within a Theory of Change logic model, to provide a protocol for systematic evaluation of ocean literacy initiatives and tools. Specifically those aimed at promoting specific behavior change objectives for pre-identified actors. Assessment of educational training courses for professionals entering the shipping industry (targeting behaviors to reduce the spread of invasive species), and educational workshops for school students (aged 11–15 and 16–18), on problems related to marine litter and microplastics and potential solutions were assessed using the framework. Through before and after surveys, an increase in awareness, knowledge and an increase in attitudes supporting action to reduce impacts on the marine environment were reported by participants, after interaction with sets of tools developed by the Horizon 2020 Ocean Literacy project ResponSEAble. Results supported the importance of targeting specific audiences with tailored ocean literacy tools and the importance of informing actors of issues and solutions within the context of wider ocean literacy principles.

Climate change and other long-term environmental issues are often perceived as abstract and difficult to imagine. The images a person associates with environmental change, i.e. a person’s environmental mental images, can be influenced by the visual information they come across in the public domain. This paper reviews the literature on this topic across social, environmental, and cognitive psychology, and the wider social sciences; thereby responding to a call for more critical investigations into people’s responses to visual information. By integrating the literature we come to a better understanding of the lack in vivid and concrete environmental mental imagery reported by the public, the link between environmental mental images and goals, and how affectively charged external images could help in making mental imagery less abstract. Preliminary research reports on the development of a new measure of environmental mental imagery and three tests of the relationship between environmental mental imagery, pro-environmental goals and behaviour. Furthermore, the paper provides a programme of research, drawing upon approaches from different disciplines, to set out the next steps needed to examine how and why we should encourage the public to imagine environmental change.

Excess choice has previously been shown to have detrimental effects on decisions about consumer products. As the number of options increases, people are more likely to put off making an active choice (i.e., defer) and show less satisfaction with any purchase actually made. We extend this line of enquiry to choosing a charitable organisation to volunteer for. The issue is important because the number of voluntary organisations is enormous and the impact of such a decision may be greater than for consumer decisions in terms of time commitment and benefits to the volunteer and society. Study 1 asked students to examine a real volunteering website and record how many organisations they considered, decision difficulty and whether or not they would like to sign up for a chosen organisation or prefer to defer a decision. Study 2 presented either a relatively small (10) or large (30) choice set of hypothetical organisations and measured deferment likelihood and decision difficulty. In both studies the more options considered, the greater the likelihood to defer. This effect was mediated by decision difficulty. This research is the first to find that detrimental effects of excess choice extend to volunteering. Implications for volunteer recruitment are discussed.

Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a) builds on evidence that natural scenery is beneficial for patients, and b) uses a Virtual Reality (VR) representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c) we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions). Participants (n = 69) took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control). In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3×2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive) showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people's previous experiences affect their behaviour for future events.