Longitudinal Pathways to Influenza Vaccination Vary With Socio-Structural Disadvantages.

BACKGROUND: Although influenza vaccination can prevent influenza-related deaths, uptake remains low, particularly in disadvantaged populations. PURPOSE: A theoretical model of psychological pathways to vaccination accounting for the direct and moderating role of socio-structural factors was tested. The study sought to understand the joint contributions of psychological (i.e., knowledge, attitudes, and intention) and socio-structural factors (i.e., income, education, and insurance) to influenza vaccination, prospectively. METHODS: A nationally representative empaneled sample of over 3,000 U.S. adults answered questions about vaccination knowledge, attitudes, and intentions, as well as actual vaccination across five timepoints from September 2018 to May 2019. Socio-structural factors were examined as moderators. RESULTS: Findings revealed strong positive associations between knowledge and attitudes, attitudes and intentions, as well as intentions and subsequent vaccination. Importantly, health insurance moderated the associations between attitudes and intentions and between intentions and vaccination, such that those without insurance had weaker associations between attitudes and intentions and between intentions and vaccination. In addition, education moderated the path from knowledge to attitude and from intentions to vaccination, such that people with lower educational attainment had weaker associations between knowledge and attitudes and between intentions and vaccination. CONCLUSIONS: Socio-structural factors act as barriers to the influence of knowledge on attitudes, attitudes on intentions, and intentions on behavior. Future research needs to be mindful of the specific paths disrupted by social disadvantages and examine ways to intervene to decrease those effects.

Naturalistically observing noncancer conversations among couples coping with breast cancer.

OBJECTIVE: This study revealed the landscape of noncancer conversations, identifying topics and types of everyday conversation, and examined links to psychological adjustment among couples coping with breast cancer. METHODS: Fifty-two couples wore the Electronically Activated Recorder (EAR) over 1 weekend and self-reported psychological adjustment while patients were on treatment. The EAR sampled 50 s of ambient sound every 9 minutes to estimate the frequency of noncancer conversation and reveal topics and types of conversation. RESULTS: Analyses revealed noncancer conversations comprised over 93% of conversations. The most common topic discussed was people. Substantive conversation was associated with better, while emotional disclosure was associated with worse, well-being for patients, but not spouses. CONCLUSIONS: Results revealed that ordinary conversations are frequent among couples who face breast cancer, and they are associated with patients' psychological adjustment, providing a foundation for potential interventions for coping with cancer that do not focus on illness.

Disease controllability moderates the effect of coping efficacy on positive affect.

OBJECTIVE: This study aims to test experimentally whether coping strategies (approach- vs. avoidance-oriented coping) have differential effects under conditions of high or low stressor controllability. DESIGN: Undergraduates (62 women, 30 men) participated in a 2 × 2 experimental study where they were introduced to a fictitious disease (tisomerase enzyme deficiency) said to be either controllable or uncontrollable and an approach- or avoidance-oriented coping behaviour induction. MAIN OUTCOME MEASURES: Changes in positive and negative affect. RESULTS: A significant disease control x coping interaction on positive affect (f(2) = .07, p = .011) revealed that approach-coping condition participants had higher positive affect than avoidance-coping condition participants when disease control was high (d = .94, p = .003), but not when it was low (d = .11, p = .93). The experimental conditions did not significantly influence negative affect. CONCLUSION: Results demonstrate that disease control moderates the salubrious effects of approach-oriented coping on positive affect. For controllable, but not uncontrollable, health stressors, promoting problem-focused approach-oriented coping strategies may be recommended.