Compliance with COVID-19 Physical Distancing Mandates in Oman: The Role of Health Literacy and Internal Health Locus of Control.

BACKGROUND: Research indicates that the effectiveness of coronavirus disease 2019 (COVID-19) physical distancing mandates is influenced by several individual factors, including health literacy; internal health locus of control (IHLOC), the belief that physical distancing can reduce COVID-19 risk; social norms; self-efficacy; and perceptions of the benefits and barriers associated with distancing. However, further investigation is needed to understand the links between these factors and compliance intentions. OBJECTIVE: This study investigates the mechanism linking these factors with the intentions to comply with physical distancing mandates. METHODS: A total of 759 participants (Mean age = 29.13, standard deviation [SD] = 8.33; 68.5% women) were surveyed online from September 2020 to October 2020. Data were analyzed using ANOVA (analysis of variance) and structural equation modeling. KEY RESULTS: Health literacy was associated with more perceived benefits (ß = .175, p = .001), greater self-efficacy (ß = .193, p < .001), and less perceived barriers (ß = -.391, p < .001). IHLOC was significantly associated with greater perceived benefits (ß = .156, p = .007) and self-efficacy (ß = .294, p < .001). Family descriptive norms were significantly associated with fewer perceived barriers (ß = -.276, p < .001), while injunctive norms were associated with more perceived benefits (ß = .202, p = .001) and higher self-efficacy (ß = .299, p < .001). Intentions to adhere to physical distancing mandates were significantly associated with past compliance (ß = .427, p < .001) and perceived barriers (ß = -.205, p < .001) and benefits (ß = .295, p < .001). Post-hoc mediation analyses revealed several small yet significant indirect effects, highlighting the complex pathways shaping adherence intentions. CONCLUSIONS: This study identifies how health literacy, IHLOC, social norms, perceived benefits and barriers, and self-efficacy intricately shape intentions to comply with physical distancing mandates. These findings offer valuable implications for public health policy and interventions. [HLRP: Health Literacy Research and Practice. 2024;8(2):e69-e78.].

PLAIN LANGUAGE SUMMARY: This study examined the factors associated with Omanis' intentions to comply with physical distancing mandates during COVID-19. Results revealed that individuals with higher health literacy perceived fewer barriers and more benefits to physical distancing, making them more willing to comply with mandates. Those who believed their actions could reduce the risk of contracting the virus also reported greater benefits and were more likely to comply.

Media Influence on Bystander Intervention for Health Protective Norms: The Integrative Model of Behavioral Prediction Perspective.

Drawing upon the Integrative Model of Behavioral Prediction (IM) and the Bystander Intervention Model, this study investigates the impact of media health information on individuals' intentions to address violations of health norms, specifically noncompliance with mask-wearing during the COVID-19 pandemic. Our survey results (n=1,426) indicate a positive correlation between seeking health information from the media and the intention to confront norm violators regarding mask-wearing. This correlation is mediated through three intermediary pathways: attitudes, normative beliefs, and perceived behavioral control. These discoveries address a previously unexplored area concerning pro-social health behaviors, bystander intervention, and contribute to the field of health communication by linking them to research on media influences. Combining media and peer interventions could lead to more effective health outcomes. The discussion covers both theoretical and practical implications.

Professional's Views on the 'Nordic Paradox' in a Low Intimate Partner Violence Prevalence Country.

The apparently contradictory co-existence of high levels of gender equality and intimate partner violence against women (IPVAW) found in Nordic countries has been termed the Nordic Paradox. The aim of this study was to examine how the Nordic Paradox is discussed and explained by Spanish professionals working in the IPVAW field. Five focus groups (n = 19) and interviews with key informants (n = 10) were conducted. Four main categories of possible explanations for the Nordic Paradox were identified: Macro-micro disconnect (i.e., discordance between individual beliefs and behaviors and macro-social norms of gender equality), IPVAW as multicausal (i.e., IPVAW defined as a multicausal phenomenon that does not necessarily have to be associated with gender equality), cultural patterns of social relationships (i.e., the role of social relationships and the way people relate to each other in the Nordic countries), and backlash effect (i.e., men's reaction to greater equality for women). Although this study does not provide a final explanation for the Nordic paradox, its results provide us with a better understanding of the phenomenon and can help to advance research in this field.

Tolerance for corruption and descriptive social norm: An experimental study of embezzlement.

Public tolerance for corruption within a society significantly influences the prevalence of corrupt practices, but less is known about how this tolerance evolves with social norms. This paper presents experimental evidences demonstrating that the descriptive social norm indicating widespread corruption can lead to increased tolerance for corruptive acts. We introduce an asymmetric information ultimatum game to simulate the interactions between embezzlers and citizens. Game theoretical analysis reveals that victims anticipating corruption will exhibit greater compliance with embezzlement when the offers are evaluated based on descriptive norms. To test the hypothesis, we employ a framing effect to induce variations in descriptive norms within a behavioral experiment. Although the treatment effect is significant only in the subgroup of student cadres, this subgroup demonstrated increased beliefs about embezzlement, greater tolerance for corruption, and a heightened propensity to embezzle when exposed to framings with hierarchical implications. This paper contributes to the corruption literature by examining the effects of descriptive norms on victims' responses to embezzlement. It offers a more comprehensive perspective on how social standards shape public opinions and corrupt actions, enhancing our understanding of the self-reinforcing nature of corruption.

Nudge-based misinformation interventions are effective in information environments with low misinformation prevalence.

Nudge-based misinformation interventions are presented as cheap and effective ways to reduce the spread of misinformation online. However, despite online information environments typically containing relatively low volumes of misinformation, most studies testing the effectiveness of nudge interventions present equal proportions of true and false information. As the effectiveness of nudges can be highly context-dependent, it is imperative to validate the effectiveness of nudge-based interventions in environments with more realistic proportions of misinformation. The current study (N = 1387) assessed the effectiveness of a combined accuracy and social-norm nudge in simulated social-media environments with varying proportions of misinformation (50%, 20%, and 12.5%) relative to true and non-news-based (i.e., "social") information. The nudge intervention was effective at improving sharing discernment in conditions with lower proportions of misinformation, providing ecologically valid support for the use of nudge-based interventions to counter misinformation propagation on social media.

Exploring the influence of context on social norms around Australian parents' food provision using story completion.

OBJECTIVE: To explore the differences in social norms around parents' food provision in different provision contexts and by demographics. DESIGN: Qualitative study using story completion methodology via an online survey in September 2021. Adults 18+ with or without children were randomised to one of three story stems focusing on food provision in different contexts; food provision at home (non-visitor), with visitors present and with the involvement of sport. Stories were coded and themed using thematic analysis. A content analysis was performed to determine count and frequency of codes in stories by participant demographics and story assumptions. SETTING: Australia. PARTICIPANTS: Adults (n 196). RESULTS: Nine themes were identified from the data resulting in four social norms around providing healthy foods and justifying non-adherence to healthy eating guidelines, evolution of family life and mealtime values, the presence of others influencing how we engage with food provision and unhealthy foods used as incentives/rewards in sport. Following content analysis, no differences of themes or norms by participant demographics or story assumptions were found. CONCLUSIONS: We identified pervasive social norms around family food provision and further identified how contextual factors resulted in variations or distinct norms. This highlights the impact context may have on the social norms parents face when providing food to their children and the opportunities and risks of leveraging these social norms to influence food choice in these contexts. Public health interventions and practitioners should understand the influence of context and social environments when promoting behaviour change and providing individualised advice. Future research could explore parents' experiences of these norms and to what extent they impact food choice.

I'll have what She's having (but not what They're having): The moderating role of group membership in the effect of social norms on food choice in an online environment.

The modern food-rich environment has contributed to the rise of unhealthy diets linked to noncommunicable diseases. Previous in-person research has found that the effect of social norms on food intake is greater when set by a perceived in-group member relative to an out-group member. Given recent increased social media use, we investigated whether this effect of group membership extends to food choices and to normative information presented remotely online. Participants (N = 179 female university students, 18-32 years) viewed a Facebook page pertaining to either their university (in-group) or a rival university (out-group). They were presented with either a healthy or an unhealthy norm via a post in which a student discussed their order at a café on the relevant campus. Food choice was assessed through an online menu where participants were asked to order one main, side, and dessert dish. As predicted, participants who viewed the healthy norm ordered a higher percentage of healthy items (especially in the desserts category) relative to those who viewed the unhealthy norm. However, this effect was significant only for those in the in-group condition; there was no such pattern for participants in the out-group condition. These findings provide insight into the role of group membership in the effect of social norms, and have practical implications regarding the design of identity-based social media health campaigns to promote healthier eating behaviours.

Neural Tracking of Perceived Parent, but Not Peer, Norms Is Associated with Longitudinal Changes in Adolescent Attitudes about Externalizing Behaviors.

Adolescents' perceptions of parent and peer norms about externalizing behaviors influence the extent to which they adopt similar attitudes, yet little is known about how the trajectories of perceived parent and peer norms are related to trajectories of personal attitudes across adolescence. Neural development of midline regions implicated in self-other processing may underlie developmental changes in parent and peer influence. Here, we examined whether neural processing of perceived parent and peer norms in midline regions during self-evaluations would be associated with trajectories of personal attitudes about externalizing behaviors. Trajectories of adolescents' perceived parent and peer norms were examined longitudinally with functional neuroimaging (n = 165; ages 11-16 years across three waves; 86 girls, 79 boys; 29.7% White, 21.8% Black, 35.8% Latinx, 12.7% other/multiracial). Behavioral results showed perceived parent norms were less permissive than adolescents' own attitudes about externalizing behaviors, whereas perceived peer norms were more permissive than adolescents' own attitudes, effects that increased from early to middle adolescence. Although younger adolescents reported less permissive attitudes when they spontaneously tracked perceived parent norms in the ventromedial and medial pFCs during self-evaluations, this effect weakened as they aged. No brain-behavior effects were found when tracking perceived peer norms. These findings elucidate how perceived parent and peer norms change in parallel with personal attitudes about externalizing behaviors from early to middle adolescence and underscore the importance of spontaneous neural tracking of perceived parent norms during self-evaluations for buffering permissive personal attitudes, particularly in early adolescence.

Ethnic differences in meat consumption attitudes, norms and behaviors: A survey of White, South Asian and Black ethnic groups in the UK.

A reduction in meat consumption is necessary to mitigate negative impacts of climate change and adverse health outcomes. The UK has an increasingly multi-ethnic population, yet there is little research on meat consumption habits and attitudes among ethnic groups in the UK. We ran a survey (N = 1014) with quota samples for ethnic groups and analyzed attitudes, behaviors and norm perceptions of White, South Asian and Black British respondents. Most respondents believe overconsumption of red and processed meat has negative impacts on health (73.3%) and the environment (64.3%).South Asian respondents were statistically significantly less likely to be meat eaters than White respondents (OR = 0.44, 95% CIs: 0.30-0.65, t = -4.15, p = 0.000), while there was no significant difference between White and Black respondents (OR = 1.06, 95% CIs: 0.63-1.76, t = 0.21, p = 0.834). Both South Asian (OR = 2.76, 95% CIs: 1.89-4.03 t = 5.25, p = 0.000) and Black respondents (OR = 2.09, 95% CIs: 0.1.30-3.35, t = 3.06, p = 0.002) were significantly more likely to express being influenced by friends and family in their food choices than White respondents. South Asian (OR = 3.24,95% CIs: 2.17-4.84, t = 5.74, p = 0.000) and Black (OR = 2.02,95% CIs: 1.21-3.39, t = 2.69, p = 0.007) respondents were also both significantly more likely to report they would want to eat similarly to their friends and family than White respondents. Statistical analyses suggested some gender and socioeconomic differences across and among ethnic groups, which are reported and discussed. The differences in meat consumption behaviors and norm conformity between ethnic groups raises the prospect that interventions that leverage social norms may be more effective in South Asian groups than Black and White groups in the UK.

The model of norm-regulated responsibility for proenvironmental behavior in the context of littering prevention.

Previous research suggests that descriptive norms positively influence proenvironmental behavior, including littering prevention. However, in some behavioral contexts, a weak descriptive norm may increase individuals' feelings of responsibility by signaling a need for action. We examined this effect in the context of litter prevention by conducting structural equation modeling of survey data from 1400 Singapore residents. The results showed that descriptive norms negatively predicted ascription of responsibility and were negatively related to littering prevention behavior via ascription of responsibility and personal norms. It also showed that strong injunctive norms can reduce the inhibitory effect of descriptive norms on ascription of responsibility. These findings were consistent with several hypotheses constituting the model of norm-regulated responsibility, a novel explanatory framework offering new insights and a more nuanced and comprehensive understanding of social norms' influence on proenvironmental behavior.

Electronic cigarette social norms among adolescents in New South Wales, Australia.

The use of electronic cigarettes (e-cigarettes) is common and increasing, especially among youth. In 2022/2023, 30% of 12- to 17-year-olds reported ever using e-cigarettes in Australia-a >50% increase from 2017 (14%). Several adverse e-cigarette health effects have been identified and most effects remain unknown. Social norms, rules that govern social behaviours, are associated with current and future adolescent e-cigarette use. Understanding social norms in Australian adolescents is critical to the development of targeted and effective e-cigarette prevention activities. This study aims to explore e-cigarette social norms among adolescents living in New South Wales, Australia. A total of 32 online single or paired semi-structured qualitative interviews were conducted involving 46 participants aged 14-17 years, as part of the Generation Vape project. Reflexive thematic analysis was applied within a constructivist perceptive. Adolescents perceived e-cigarettes use as prolific among their peers, with use considered common, acceptable and normal. Fuelled by social exposure to e-cigarettes, 'everyone' was generally thought to be using them (descriptive norms). E-cigarette use was considered so entrenched that it was part of adolescent identity, with abstinence regarded as atypical. Use was driven by an internalised desire to fit it (injunctive norm), rather than being attributed to overt/external 'peer-pressure'. Positive e-cigarette norms exist among Australian adolescents with norm formation strongly influenced by social exposure, including e-cigarette promotion. Prevention efforts should include limiting adolescent exposure to e-cigarette marketing to help redefine existing pro-e-cigarette social norms and protect health.

Persistent interaction patterns across social media platforms and over time.

Growing concern surrounds the impact of social media platforms on public discourse1-4 and their influence on social dynamics5-9, especially in the context of toxicity10-12. Here, to better understand these phenomena, we use a comparative approach to isolate human behavioural patterns across multiple social media platforms. In particular, we analyse conversations in different online communities, focusing on identifying consistent patterns of toxic content. Drawing from an extensive dataset that spans eight platforms over 34 years-from Usenet to contemporary social media-our findings show consistent conversation patterns and user behaviour, irrespective of the platform, topic or time. Notably, although long conversations consistently exhibit higher toxicity, toxic language does not invariably discourage people from participating in a conversation, and toxicity does not necessarily escalate as discussions evolve. Our analysis suggests that debates and contrasting sentiments among users significantly contribute to more intense and hostile discussions. Moreover, the persistence of these patterns across three decades, despite changes in platforms and societal norms, underscores the pivotal role of human behaviour in shaping online discourse.

Pornography Use and the Acceptance of Gender Norm Violation in a School Context.

Although media effect studies have quite extensively investigated the association between pornography use and gendered attitudes, some questions remain. The present study aimed to address two of these questions by exploring how gendered attitudes and gender beliefs may be influenced by gender typicality and pornography use. First, the literature has not yet accounted for individual differences based on gender typicality. Second, the influence of pornography use on gender beliefs going beyond pornography's script application is understudied. This online cross-sectional study (N = 1,440, Mage = 23.86, SD = 4.79) contributes to the field by investigating the indirect association between pornography use and acceptance of gender norm violation through gendered attitudes and the moderating role of gender typicality. Acceptance of gender norm violation was measured via vignettes describing a school context in which a teacher and a student violated gender norms. Findings indicated that gendered attitudes negatively relate to the acceptance of gender norm violation. Moreover, compared to women, men's pornography use indirectly relates to lower acceptance rates through gendered attitudes. Additionally, for men, specific levels of gender typicality and atypicality form a strengthening and buffering role, respectively. This applies to the association between pornography use and gendered attitudes as well as to the indirect relationship of pornography use with acceptance of gender norm violation. These findings suggest that pornography use may also affect gender beliefs that are unrelated to the scripts present in pornography. Future studies should take into account the type of preferred pornography and unravel the specific impact of women's pornography use.

One step too far: social cerebellum in norm-violating navigation.

Social norms are pivotal in guiding social interactions. The current study investigated the potential contribution of the posterior cerebellum, a critical region involved in perceiving and comprehending the sequential dynamics of social actions, in detecting actions that either conform to or deviate from social norms. Participants engaged in a goal-directed task in which they observed others navigating towards a goal. The trajectories demonstrated either norm-violating (trespassing forbidden zones) or norm-following behaviors (avoiding forbidden zones). Results revealed that observing social norm-violating behaviors engaged the bilateral posterior cerebellar Crus 2 and the right temporoparietal junction (TPJ) from the mentalizing network, and the parahippocampal gyrus (PHG) to a greater extent than observing norm-following behaviors. These mentalizing regions were also activated when comparing social sequences against non-social and non-sequential control conditions. Reproducing norm-violating social trajectories observed earlier, activated the left cerebellar Crus 2 and the right PHG compared to reproducing norm-following trajectories. These findings illuminate the neural mechanisms in the cerebellum associated with detecting norm transgressions during social navigation, emphasizing the role of the posterior cerebellum in detecting and signaling deviations from anticipated sequences.

Source-credibility information and social norms improve truth discernment and reduce engagement with misinformation online.

Misinformation on social media is a pervasive challenge. In this study (N = 415) a social-media simulation was used to test two potential interventions for countering misinformation: a credibility badge and a social norm. The credibility badge was implemented by associating accounts, including participants', with a credibility score. Participants' credibility score was dynamically updated depending on their engagement with true and false posts. To implement the social-norm intervention, participants were provided with both a descriptive norm (i.e., most people do not share misinformation) and an injunctive norm (i.e., sharing misinformation is the wrong thing to do). Both interventions were effective. The social-norm intervention led to reduced belief in false claims and improved discrimination between true and false claims. It also had some positive impact on social-media engagement, although some effects were not robust to alternative analysis specifications. The presence of credibility badges led to greater belief in true claims, lower belief in false claims, and improved discrimination. The credibility-badge intervention also had robust positive impacts on social-media engagement, leading to increased flagging and decreased liking and sharing of false posts. Cumulatively, the results suggest that both interventions have potential to combat misinformation and improve the social-media information landscape.

Changes in social norms during the early stages of the COVID-19 pandemic across 43 countries.

The emergence of COVID-19 dramatically changed social behavior across societies and contexts. Here we study whether social norms also changed. Specifically, we study this question for cultural tightness (the degree to which societies generally have strong norms), specific social norms (e.g. stealing, hand washing), and norms about enforcement, using survey data from 30,431 respondents in 43 countries recorded before and in the early stages following the emergence of COVID-19. Using variation in disease intensity, we shed light on the mechanisms predicting changes in social norm measures. We find evidence that, after the emergence of the COVID-19 pandemic, hand washing norms increased while tightness and punishing frequency slightly decreased but observe no evidence for a robust change in most other norms. Thus, at least in the short term, our findings suggest that cultures are largely stable to pandemic threats except in those norms, hand washing in this case, that are perceived to be directly relevant to dealing with the collective threat.

Effectiveness of combined interventions to empower girls and address social norms in reducing child marriage in a rural sub-district of Bangladesh: A Cluster Randomised Controlled Trial of the Tipping Point Initiative.

Background: Elimination of girl child marriage (CM) globally at the current pace is projected to take about 300 years. Thus, innovative and effective solutions are urgently warranted. Bangladesh reports one of the highest rates of CM in the world. We present the impact of Tipping Point Initiative (TPI), a combined intervention to empower girls and to address social norms on CM in Bangladesh. Methods: A three-arm non-blinded Cluster Randomised Controlled Trial was conducted in 51 villages/clusters in a sub-district of Bangladesh. Clusters were randomly assigned to the arms: Tipping Point Program (TPP), Tipping Point Program Plus (TPP+), and Pure Control. TPP conducted 40 weekly single-gender group sessions with never-married adolescent girls and boys recruited at 12 -<16 years; and 18-monthly gender-segregated group sessions with the parents. On top of TPP, TPP+ included cross-gender and -generation dialogues, girls' movement building and girl-led community sensitisation. Intention-to-treat analysis was performed to assess the impact of TPI on the hazard of CM, the primary outcome. The impact of girls' session attendance on CM was also assessed. At baseline 1275 girls (TPP = 412; TPP+ = 420; Control = 443) were interviewed between February-April 2019. At endline 1123 girls (TPP = 363; TPP + = 366; Control = 394) were interviewed and included in the analyses. Results: No intervention impact was detected on the full sample (TPP vs. Control: adjusted hazard ratio (aHR) = 1.14; 95% CI = 0.79-1.63, P = 0.47), (TPP + vs. Control: aHR = 1.24; 95% CI = 0.89-1.71, P = 0.19, (TPP vs. TPP+: aHR = 1.03; 95% CI = 0.72-1.47, P = 0.87). However, in the TPP arm, the hazard of CM was reduced by 54% (aHR = 0.46; 95% CI = 0.23-0.92, P = 0.03) among the girls in the highest tertile of session attendance, compared to the lowest. In the TPP+ arm, this hazard was reduced by 49% (aHR = 0.51; 95% CI = 0.23-0.92, P = 0.03) among girls in the highest tertile, compared to the lowest tertile. Conclusions: Although TPI did not show an effect on CM in any of the intervention arms, within each intervention arm, a positive effect was detected in reducing CM among girls in the highest tertile of session attendance despite implementation challenges due to COVID-19. Registration: Clinicaltrials.gov: NCT03965273; Date: 29 May 2019.

Peer effects in weight-related behaviours of young people: A systematic literature review.

Individual preferences and beliefs are perpetually shaped by environmental influences, with peers playing a key role in this dynamic process. Compelling evidence from qualitative and quantitative studies has highlighted the significant impact of peer influence on health-related decisions. This systematic literature review critically synthesises findings from 45 studies published between 2011 and 2022, providing a comprehensive understanding of the nature of peer effects on dietary, physical activity and sleep behaviours during youth. The majority of studies indicated that social norms drive directional changes in eating and physical activity. Yet, our analysis revealed a notable gap in exploring alternative mechanisms, including social comparison and social identity, despite their potential relevance. Studies, generally classified as moderate to high quality, predominantly relied on self-reported data, potentially affecting the validity and reliability of measures. Meta-regression analyses suggest a small, but significant association of sample size with the magnitude, sign and significance of the reported peer effects. Moreover, studies focusing on physical activity are more likely to report significant outcomes, whereas findings on peer influence on sleep-related studies tend to reveal less pronounced effects, compared to studies on dietary behaviours. Experimental designs do not appear to increase the likelihood of finding significant effects when compared to other study designs. In conclusion, this synthesis emphasises the need for further research into the underlying mechanisms on peer effects to better inform policy-makers in designing effective policies for improving weight-related behaviours in young people.

Situations of anomie and the health workforce crisis: Policy implications of a socially sensitive and inclusive approach to human resources.

Health systems in most jurisdictions are facing an unprecedented workforce crisis, manifesting as labour shortages, high staff turnover, and increasing rates of absenteeism and burnout. These issues affect professional and occupational groups in both health and social care and individuals at early and later stages of their career. The intensity and pervasiveness of the crisis suggests that it is a multicausal phenomenon. Studies have focused on the relationship between working environments and worker satisfaction and well-being. However, these are of limited use in understanding the deeper mechanisms behind the large-scale workforce crisis. The subjective experience of work, while rooted in a particular work context, is also shaped by broader social and cultural phenomena that put social norms and individuals' ability to conform to them in tension. The concept of anomie, initially developed by Durkheim and redefined by Merton, focuses on the way social norms that guide conduct and aspirations lose influence and become incompatible with each other or unsuited to contemporary work contexts. Understanding the workforce crisis from the perspective of anomie enables the development and implementation of novel policies based on co-production strategies where concerned publics engage collaboratively in framing the problem and searching for solutions.