The Adoption of a COVID-19 Contact-Tracing App: Cluster Analysis.

BACKGROUND: During the COVID-19 pandemic, there was limited adoption of contact-tracing apps (CTAs). Adoption was particularly low among vulnerable people (eg, people with a low socioeconomic position or of older age), while this part of the population tends to have lesser access to information and communication technology and is more vulnerable to the COVID-19 virus. OBJECTIVE: This study aims to understand the cause of this lagged adoption of CTAs in order to facilitate adoption and find indications to make public health apps more accessible and reduce health disparities. METHODS: Because several psychosocial variables were found to be predictive of CTA adoption, data from the Dutch CTA CoronaMelder (CM) were analyzed using cluster analysis. We examined whether subgroups could be formed based on 6 psychosocial perceptions (ie, trust in the government, beliefs about personal data, social norms, perceived personal and societal benefits, risk perceptions, and self-efficacy) of (non)users concerning CM in order to examine how these clusters differ from each other and what factors are predictive of the intention to use a CTA and the adoption of a CTA. The intention to use and the adoption of CM were examined based on longitudinal data consisting of 2 time frames in October/November 2020 (N=1900) and December 2020 (N=1594). The clusters were described by demographics, intention, and adoption accordingly. Moreover, we examined whether the clusters and the variables that were found to influence the adoption of CTAs, such as health literacy, were predictive of the intention to use and the adoption of the CM app. RESULTS: The final 5-cluster solution based on the data of wave 1 contained significantly different clusters. In wave 1, respondents in the clusters with positive perceptions (ie, beneficial psychosocial variables for adoption of a CTA) about the CM app were older (P<.001), had a higher education level (P<.001), and had higher intention (P<.001) and adoption (P<.001) rates than those in the clusters with negative perceptions. In wave 2, the intention to use and adoption were predicted by the clusters. The intention to use CM in wave 2 was also predicted using the adoption measured in wave 1 (P<.001, ß=-2.904). Adoption in wave 2 was predicted by age (P=.022, exp(B)=1.171), the intention to use in wave 1 (P<.001, exp(B)=1.770), and adoption in wave 1 (P<.001, exp(B)=0.043). CONCLUSIONS: The 5 clusters, as well as age and previous behavior, were predictive of the intention to use and the adoption of the CM app. Through the distinguishable clusters, insight was gained into the profiles of CM (non)intenders and (non)adopters. TRIAL REGISTRATION: OSF Registries osf.io/cq742; https://osf.io/cq742.

Can we have a second helping? A preregistered direct replication study on the neurobiological mechanisms underlying self-control.

Self-control is of vital importance for human wellbeing. Hare et al. (2009) were among the first to provide empirical evidence on the neural correlates of self-control. This seminal study profoundly impacted theory and empirical work across multiple fields. To solidify the empirical evidence supporting self-control theory, we conducted a preregistered replication of this work. Further, we tested the robustness of the findings across analytic strategies. Participants underwent functional magnetic resonance imaging while rating 50 food items on healthiness and tastiness and making choices about food consumption. We closely replicated the original analysis pipeline and supplemented it with additional exploratory analyses to follow-up on unexpected findings and to test the sensitivity of results to key analytical choices. Our replication data provide support for the notion that decisions are associated with a value signal in ventromedial prefrontal cortex (vmPFC), which integrates relevant choice attributes to inform a final decision. We found that vmPFC activity was correlated with goal values regardless of the amount of self-control and it correlated with both taste and health in self-controllers but only taste in non-self-controllers. We did not find strong support for the hypothesized role of left dorsolateral prefrontal cortex (dlPFC) in self-control. The absence of statistically significant group differences in dlPFC activity during successful self-control in our sample contrasts with the notion that dlPFC involvement is required in order to effectively integrate longer-term goals into subjective value judgments. Exploratory analyses highlight the sensitivity of results (in terms of effect size) to the analytical strategy, for instance, concerning the approach to region-of-interest analysis.

The Role of Agency and Threat Immediacy in Interactive Digital Narrative Fear Appeals for the Prevention of Excessive Alcohol Use: Randomized Controlled Trial.

BACKGROUND: Serious games for the training of prevention behaviors have been widely recognized as potentially valuable tools for adolescents and young adults across a variety of risk behaviors. However, the role of agency as a distinguishing factor from traditional health interventions has seldom been isolated and grounded in the persuasive health communication theory. Fear appeals have different effects on intentions to perform prevention behaviors depending on the immediacy of the consequences. Looking into how to increase self-efficacy beliefs for health behavior with distant consequences is the first step toward improving game-based interventions for adverse health outcomes. OBJECTIVE: This study aimed to investigate the effect of agency on self-efficacy and the intention to drink less alcohol in an interactive digital narrative fear appeal. Furthermore, the communicated immediacy of threat outcomes was evaluated as a potential moderator of the effect of agency on self-efficacy. METHODS: A web-based experimental study was conducted with university students (N=178). The participants were presented with a fear appeal outlining the consequences of excessive alcohol use in a fully automated web-based interactive narrative. Participants either had perceived control over the outcome of the narrative scenario (high agency) or no control over the outcome (low agency). The threat was either framed as a short-term (high immediacy) or long-term (low immediacy) negative health outcome resulting from the execution of the risk behavior (drinking too much alcohol). RESULTS: A total of 123 valid cases were analyzed. Self-efficacy and intention to limit alcohol intake were not influenced by the agency manipulation. Self-efficacy was shown to be a significant predictor of behavioral intention. The immediacy of the threat did not moderate the relationship between agency and self-efficacy. CONCLUSIONS: Although agency manipulation was successful, we could not find evidence of an effect of agency or threat immediacy on self-efficacy. The implications for different operationalizations of different agency concepts, as well as the malleability of self-efficacy beliefs for long-term threats, are discussed. The use of repeated versus single interventions and different threat types (eg, health and social threats) should be tested empirically to establish a way forward for diversifying intervention approaches. TRIAL REGISTRATION: ClinicalTrials.gov NCT05321238; https://www.clinicaltrials.gov/ct2/show/NCT05321238.

Using Virtual Reality to Stimulate Healthy and Environmentally Friendly Food Consumption among Children: An Interview Study.

Since habits formed during childhood are predictive of adult behaviour, children form an important target group when it comes to improving healthy and environmentally friendly food consumption. To explore the potential of immersive virtual reality (VR) in this respect, we conducted a semi-structured interview study (N = 22) among children aged 6-13 years. This study consisted of two parts: (1) a VR experience and (2) a semi-structured interview to investigate (1) to what extent children are able to recall and understand information about the impact of food products on their health and the environment when provided to them as pop-ups in a VR supermarket; (2) what rational and emotional processes are triggered by this information; and (3) what children's expectations about the real-life application and impact of the pop-ups are, and why. Interview data were analysed using the framework method. Results showed that although all participants were able to recall the information, only children from an average age of ten years old also understood the information. When participants understood the information, they were often aware of and felt sorry for their negative behavioural impact. Most participants expected their behaviour to positively change when imagining real-life application of the pop-ups.

Recruitment of Participants for a 3D Virtual Supermarket: Cross-sectional Observational Study.

BACKGROUND: Virtual supermarkets offer a practical and affordable setting to test the efficacy of different pricing and nudging strategies before they are implemented in the real world. Despite the advantages of using virtual supermarkets for this purpose, conducting studies in online settings is challenging with regard to recruitment and retention of sufficient and suitable participants. OBJECTIVE: To describe cost, time, and retention with regard to participants recruited using various strategies and potential sociodemographic differences between participants recruited via different strategies. METHODS: This cross-sectional study used data from a randomized controlled trial in which 455 Dutch adults with low and high educational levels were invited to shop 5 times in a 3D virtual supermarket. Participants were recruited via social media and flyers. A log that tracked the costs of and time spent on the different recruitment strategies was kept by the study team. Outcome measures included the cost of recruitment strategies, the time investment by researchers, and recruitment and attrition rates of participants in the study. RESULTS: The median age of study completers was 31.0 (IQR 25.0) and 157 out of 346 study completers (45.4%) were highly educated. Out of the 455 included participants, 235 (51.6%) were recruited via social media campaigns, 131 (28.8%) via home-delivered flyers, 38 (8.4%) via flyers directly distributed by the study team, and 46 (10.1%) via word-of-mouth. Of all paid recruitment strategies, social media campaigns were the cheapest and least time-consuming, whereas the distribution of flyers by the study team was the most expensive and time-consuming recruitment strategy. Age, sex, overweight status, employment situation, and number of adults within the household varied by recruitment strategy. CONCLUSIONS: Using different recruitment strategies resulted in the efficient recruitment of a representative study sample and retention of participants was relatively high. While "word-of-mouth" was the most cost- and time-effective recruitment strategy, using only one type of recruitment strategy could result in a demographically skewed study population.

Neural correlates of gender congruence in audiovisual commercials for gender-targeted products: An fMRI study.

This article explores neural and self-report responses to gender congruence in product-voice combinations in commercials. An fMRI study was carried out in which participants (n = 30) were presented with gender-targeted pictures of characteristic male or female products accompanied by either gender congruent or incongruent voices. The findings show that attitudes are more positive toward commercials with gender congruent than with gender incongruent product-voice combinations. fMRI analyses revealed that primary visual brain areas, namely calcarine and cuneus, responded stronger to congruent than incongruent combinations suggesting that participants enhanced their endogenous attention toward congruent commercials. Incongruent combinations, by contrast, elicited stronger activation in areas related to the perception of conflicts in information processing and error monitoring, such as the supramarginal, inferior parietal gyri and superior, and middle temporal gyri. Interestingly, increased activation in the posterior cingulate cortex (an area related to value encoding) predicted more positive attitudes toward congruent commercials. Together, these results advance our understanding of the neural correlates of processing congruent and incongruent audiovisual stimuli. These findings may advice advertising professionals in designing successful campaigns of everyday products, namely by making use of congruent instead of incongruent product-voice combinations.

Activation in inhibitory brain regions during food choice correlates with temptation strength and self-regulatory success in weight-concerned women.

Food choices constitute a classic self-control dilemma involving the trade-off between immediate eating enjoyment and the long term goal of being slim and healthy, especially for weight-concerned women. For them, decision-making concerning high (HE) and low energy (LE) snacks differs when it comes to the need for self-control. In line, our first study aim was to investigate which brain regions are activated during food choices during HE compared to LE energy snacks in weight-concerned women. Since it is particularly difficult to resist HE snacks when they are very tasty, our second aim was to investigate in which brain regions choice-related activation varies with the food's tastiness. Our third aim was to assess in which brain regions choice-related activation varies with individual differences in self-regulatory success. To this end, 20 weight-concerned women indicated for 100 HE or LE snacks whether they wanted to eat them or not, while their brains were scanned using fMRI. HE snacks were refused more often than equally-liked LE snacks. HE snack choice elicited stronger activation in reward-related brain regions [medial to middle orbitofrontal cortex (OFC), caudate]. Highly tasty HE snacks were more difficult to resist and, accordingly, activation in inhibitory areas (inferior frontal gyrus, lateral OFC) was negatively associated with tastiness. More successful self-controllers showed increased activation in the supplementary motor area during HE food choices. In sum, the results suggest that HE snacks constitute a higher reward for weight-concerned women compared to (equally-liked) LE snacks, and that activation during food choice in brain regions involved in response inhibition varied with tastiness and individual differences in self-regulatory success. These findings advance our understanding of the neural correlates of food choice and point to new avenues for investigating explanations for self-regulatory failure.