Performance-Based Measurement of eHealth Literacy: Systematic Scoping Review.

BACKGROUND: eHealth literacy describes the ability to locate, comprehend, evaluate, and apply web-based health information to a health problem. In studies of eHealth literacy, researchers have primarily assessed participants' perceived eHealth literacy using a short self-report instrument, for which ample research has shown little to no association with actual performed eHealth-related skills. Performance-based measures of eHealth literacy may be more effective at assessing actual eHealth skills, yet such measures seem to be scarcer in the literature. OBJECTIVE: The primary purpose of this study was to identify tools that currently exist to measure eHealth literacy based on objective performance. A secondary purpose of this study was to characterize the prevalence of performance-based measurement of eHealth literacy in the literature compared with subjective measurement. METHODS: We conducted a systematic scoping review of the literature, aligning with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, in 3 stages: conducting the search, screening articles, and extracting data into a summary table. The summary table includes terminology for eHealth literacy, description of participants, instrument design, health topics used, and a brief note on the evidence of validity for each performance-based measurement tool. A total of 1444 unique articles retrieved from 6 relevant databases (MEDLINE; PsycINFO; CINAHL; Library and Information Science Abstracts [LISA]; Library, Information Science & Technology Abstracts [LISTA]; and Education Resources Information Center [ERIC]) were considered for inclusion, of which 313 (21.68%) included a measure of eHealth literacy. RESULTS: Among the 313 articles that included a measure of eHealth literacy, we identified 33 (10.5%) that reported on 29 unique performance-based eHealth literacy measurement tools. The types of tools ranged from having participants answer health-related questions using the internet, having participants engage in simulated internet tasks, and having participants evaluate website quality to quizzing participants on their knowledge of health and the web-based health information-seeking process. In addition, among the 313 articles, we identified 280 (89.5%) that measured eHealth literacy using only a self-rating tool. CONCLUSIONS: This study is the first research synthesis looking specifically at performance-based measures of eHealth literacy and may direct researchers toward existing performance-based measurement tools to be applied in future projects. We discuss some of the key benefits and drawbacks of different approaches to performance-based measurement of eHealth literacy. Researchers with an interest in gauging participants' actual eHealth literacy (as opposed to perceived eHealth literacy) should make efforts to incorporate tools such as those identified in this systematic scoping review.

Exploring Proximal LGBTQ+ Minority Stressors Within Physical Activity Contexts from a Self-determination Theory Perspective.

BACKGROUND: LGBTQ+ (lesbian, gay, bisexual, transgender, queer, etc.) individuals experience challenges such as discrimination and marginalization (referred to as minority stressors) that are detrimental to their mental and physical health. Specifically, proximal or internalized LGBTQ+ minority stressors may influence motivation for and willingness to participate in physical activity. PURPOSE: To explore whether proximal LGBTQ+ minority stressors relate to the basic psychological needs-motivation-physical activity pathway, as per self-determination theory. METHODS: An online cross-sectional survey was completed by 778 self-identified LGBTQ+ adults. Structural equation modelling analyses were used to examine how proximal LGBTQ+ minority stressors relate to the motivational sequence. RESULTS: Findings support that proximal LGBTQ+ minority stressors are negatively associated with psychological need satisfaction within physical activity (ß = -.36), which in turn is positively associated with autonomous motivation (ß = .53) and reported physical activity participation (ß = .32). Overall, the final model accounted for 13% of variance in need satisfaction (small effect size), 53% of variance in autonomous motivation (moderate-large effect size), and 10% of variance in moderate-to-vigorous physical activity levels (small effect size). CONCLUSIONS: Future research focused on increasing LGBTQ+ participation in physical activity should investigate the effects of (a) reducing proximal LGBTQ+ minority stressors and (b) better supporting LGBTQ+ adults' autonomy, competence, and relatedness within physical activity contexts.

A systematic review of treatment approaches for compulsive exercise among individuals with eating disorders.

Individuals with eating disorders often experience compulsive exercise which, if left untreated, can lead to longer treatment and worsened symptoms. Compulsive exercise must be addressed within eating disorder treatment to help individuals establish a healthy relationship with exercise. However, there are currently no standardized guidelines for treating compulsive exercise or a consensus on which forms of treatment are most effective. Therefore, the purpose of this review was to examine interventions that address compulsive exercise and their impact on treating compulsive exercise among individuals with eating disorders. A systematic review of the literature was conducted. Eleven studies testing treatments for compulsive exercise were included in this review. Participants were diagnosed with anorexia nervosa, bulimia nervosa, or EDNOS, and a small portion had BED. Improvements in compulsive exercise and eating psychopathology were observed across all studies. The interventions focused on exercise psychoeducation and often incorporated exercise sessions. The findings highlight the positive impact of treating compulsive exercise, suggesting it should be a standard component of eating disorder treatment. Future studies should examine differences in treatment approaches and outcomes specific to each eating disorder, and specific to males. More consistency across studies in the conceptualization and measurement of compulsive exercises is also needed.

"Compulsive exercise is a socially acceptable prison cell": Exploring experiences with compulsive exercise across social media.

OBJECTIVE: Investigations into online eating disorder (ED) communities have allowed for a rich exploration of lived experiences focused on a number of aspects, such as recovery and support groups. There is a lack of understanding around compulsive exercise (CE), which is often a characterizing condition of EDs. Exploring the lived experiences of CE as discussed online could provide helpful insight towards a better understanding of CE. Therefore, the purpose of this study was to explore experiences around CE and EDs shared on social media sites. METHOD: Social media posts related to CE and EDs from Reddit, Twitter, Instagram, and forums were collected for 12 months. A thematic analysis of 881 posts was used to identify common themes among individuals' lived experiences with CE. RESULTS: Five themes (and three subthemes) were identified across the social media posts: (1) seeking control, but ultimately CE takes hold, (2) burning off binges, but at what expense?, (3) recovery is a battle, but worth it, (4) is my exercise healthy?, and (5) frustration with comments about CE. DISCUSSION: The lived experiences of CE among individuals with EDs have provided support for current definitions of CE and shared novel insight into the recovery experience. Individuals online also highlighted the need for improvement in treatment around CE specifically, and greater awareness around CE for the general public and healthcare providers.

"This is just how I cope": An inductive thematic analysis of eating disorder recovery content created and shared on TikTok using #EDrecovery.

OBJECTIVE: To explore eating disorder (ED) recovery-related content created and shared on the social media platform TikTok. METHOD: A systematic review and inductive thematic analysis of 150 TikTok posts catalogued under hashtag (#) EDrecovery. Two coders independently analyzed the posts and a critical peer facilitated discussions about the resulting codes and themes. RESULTS: Creators on TikTok used #EDrecovery to share their personal experiences with recovery through the use and cooption of popular (or viral) video formats, succinct storytelling, and the production of educational content. Five themes were interpreted across the data: (a) ED awareness, (b) inpatient story time: "ED unit tings", (c) eating in recovery, (d) transformations: "how about a weight gain glow up?", and (e) trendy gallows humor: "let's confuse people who have a good relationship with food". DISCUSSION: TikTok as a user-friendly, creative media may provide the artistic and social tools for some creators to add their distinct voice to the ED recovery narrative and foster some semblance of community. Although all of the analyzed content was catalogued under #EDrecovery, some of the posts reified the increasingly blurred boundary that exists between ED recovery and pro-ED content on TikTok.

Locker-Room Experiences Among LGBTQ+ Adults.

Locker rooms operate as pivotal access points to physical activity across sports, physical education, and fitness facilities. However, locker rooms are predicated on cis-heterosexual assumptions that can be isolating to LGBTQ+ individuals. Using an online cross-sectional survey, LGBTQ+ adults (N = 1,067) were asked open-response questions about their past and present locker-room experiences. The resulting texts were independently coded by two researchers using thematic analysis and compared. All discrepancies were discussed with and rectified by a third researcher who acted as a critical peer. The results present distinct experiences across three intersecting aspects of embodiment: self-conscious-"I hate(d) being seen," sexual transgression, and gender transgression. The findings provide insight into how harmful LGBTQ+ stereotypes influence locker-room experiences and support the redesign of locker rooms to challenge the binary organization of these spaces.

An Experimental Test of the Efficacy of Gain- and Loss-Framed Messages for Doping Prevention in Adolescent Athletes.

Background: Doping is a prevalent issue, not only among Olympians and professional athletes; young athletes and those at the sub-elite level have reported doping as well. Doping programs have been developed to target adolescent athletes and prevent doping initiation. The efficacy of primary doping prevention initiatives may be enhanced with health communication strategies, such as message framing. To date, there have been very few studies examining message framing among adolescents and none in the context of doping prevention. Objectives: The purpose of this study was to compare the efficacy of gain-framed and loss-framed messages on key psychological antecedents of doping among adolescent athletes. Methods: In a randomized controlled trial, 133 athletes aged 12 to 16 years old (Mage=13.73; 53% boys) from a variety of sports viewed either a gain- or loss-framed video. Intentions, attitudes, self-efficacy, and perceived norms were all assessed immediately before and after the videos. Results: Mixed between-within subjects ANOVAs revealed no differential influence for either message frame on changes in any of the outcomes. Attitudes, self-efficacy, and perceived norms all increased significantly over time for participants in both conditions. Conclusions/Importance: Overall, the findings suggest that a brief messaging intervention may have a beneficial influence on psychosocial constructs related to doping. There is no strong evidence to support definitive recommendations regarding optimal message framing for doping prevention among adolescent athletes.

Understanding the Effects of Message Framing on Physical Activity Action Planning: the Role of Risk Perception and Elaboration.

PURPOSE: This study aimed to determine the effects of action planning, risk perception, and message elaboration on the creation and quality of physical activity action plans. Risk perception was hypothesized as a potential moderator and elaboration as a potential mediator of the message framing-action planning relationship. METHOD: Inactive adults (N = 180; 44% women; Mage = 29.7, SD = 9.92) were randomized to one of two framed action planning messages and responded to an online questionnaire pre- and post-message. Participants were asked about two types of risk perception towards action planning: emotional and plan creation risk perception. Post-message participants were asked about their elaboration regarding the message and presented with the opportunity to create action plans, which were scored for quality. A moderation model and a moderated mediation model were tested. RESULTS: Emotional risk perception moderated the message framing-action plan creation relationship. Individuals with increased emotional risk perception, as opposed to increased plan creation risk perception, were more likely to create an action plan when given a gain-framed message, as opposed to a loss-framed message. The moderated mediation model was not significant, but message elaboration predicted action plan creation. Individuals with greater message elaboration were more likely to create an action plan, regardless of the message frame. CONCLUSION: Gain-framed messages may be more effective than loss-framed messages at promoting action plan creation in individuals with greater emotional risk perception. One's elaboration of an action planning message may increase their likelihood of creating a physical activity action plan.

Preliminary investigation of a videogame prototype for cigarette and marijuana prevention in adolescents.

BACKGROUND: Videogames are becoming increasingly popular to deliver health interventions; however, their role in the primary prevention of cigarette and marijuana use has not yet been evaluated. The purpose of this study was to conduct a preliminary test of the efficacy of a role-playing videogame prototype, smokeSCREEN, aimed at developing knowledge and behavioral skills associated with primary prevention of cigarette and marijuana use. The authors also explored participants' gameplay experience. METHODS: This study employed a 1-group pretest-posttest design with 25 adolescent boys and girls aged 11 to 14 years (Mage = 11.56, SD = 0.77) who had never tried cigarettes or marijuana. Participants played four 1-hour gameplay sessions over a 2-week period. Assessments of knowledge, self-efficacy, attitudes, perceived norms, and intentions related to cigarette and marijuana prevention were collected at baseline and 2-week and 12-week follow-ups. Ratings of gameplay experience were collected after the 2 weeks of gameplay. One-way repeated-measures analyses of variance (ANOVAs) were conducted. RESULTS: Findings are (1) improvements in knowledge for both cigarette (Wilks' λ = 0.62, F(2, 23) = 7.21, P = .004) and marijuana (Wilks' λ = 0.67, F(2, 23) = 5.75, P = .009) use from pre- to post-gameplay that were characterized by large effects; and (2) nonsignificant trends in the expected direction emerged for changes in self-efficacy and perceived norms related to both cigarettes and marijuana that were characterized by medium-large effects. Overall, the players provided positive reports of their experience with the smokeSCREEN videogame prototype. CONCLUSIONS: These findings provide preliminary evidence that a videogame has the potential to influence key cognitive and motivational variables and can be an engaging means to deliver a cigarette and marijuana prevention intervention.

A Qualitative Exploration of LGBTQ+ and Intersecting Identities Within Physical Activity Contexts.

LGBTQ+ (lesbian, gay, bisexual, transgender, queer, etc.) individuals face an array of challenges to physical activity participation, such as discrimination and exclusion. The purpose of this study was to gain an understanding of LGBTQ+ experiences in physical activity. Eight focus groups of LGBTQ+ individuals (N = 42) were conducted using a semistructured interview guide, and broad discussions about personal physical activity experiences were encouraged. All focus groups were audio-recorded, transcribed verbatim, and subject to thematic analysis. Three main themes emerged with the following considerations: (a) intersectionality-an intersectional approach is required to explore the complexity of LGBTQ+ experiences within physical activity; (b) the contested concept of "athlete"-LGBTQ+ communities have unique conceptions associated with "athlete" that can render sport, and by extension physical activity contexts, elitist and inaccessible; and (c) "a safe space for us"-LGBTQ+-friendly physical activity practices should be explored to provide practical suggestions for inclusive practices.

Video Game Intervention for Sexual Risk Reduction in Minority Adolescents: Randomized Controlled Trial.

BACKGROUND: Human immunodeficiency virus (HIV) disproportionately impacts minority youth. Interventions to decrease HIV sexual risk are needed. OBJECTIVE: We hypothesized that an engaging theory-based digital health intervention in the form of an interactive video game would improve sexual health outcomes in adolescents. METHODS: Participants aged 11 to 14 years from 12 community afterschool, school, and summer programs were randomized 1:1 to play up to 16 hours of an experimental video game or control video games over 6 weeks. Assessments were conducted at 6 weeks and at 3, 6, and 12 months. Primary outcome was delay of initiation of vaginal/anal intercourse. Secondary outcomes included sexual health attitudes, knowledge, and intentions. We examined outcomes by gender and age. RESULTS: A total of 333 participants were randomized to play the intervention (n=166) or control games (n=167): 295 (88.6%) were racial/ethnic minorities, 177 (53.2%) were boys, and the mean age was 12.9 (1.1) years. At 12 months, for the 258 (84.6%) participants with available data, 94.6% (122/129) in the intervention group versus 95.4% (123/129) in the control group delayed initiation of intercourse (relative risk=0.99, 95% CI 0.94-1.05, P=.77). Over 12 months, the intervention group demonstrated improved sexual health attitudes overall compared to the control group (least squares means [LS means] difference 0.37, 95% CI 0.01-0.72, P=.04). This improvement was observed in boys (LS means difference 0.67, P=.008), but not girls (LS means difference 0.06, P=.81), and in younger (LS means difference 0.71, P=.005), but not older participants (LS means difference 0.03, P=.92). The intervention group also demonstrated increased sexual health knowledge overall (LS means difference 1.13, 95% CI 0.64-1.61, P<.001), in girls (LS means difference 1.16, P=.001), boys (LS means difference 1.10, P=.001), younger (LS means difference 1.18, P=.001), and older (LS means difference=1.08, P=.002) participants. There were no differences in intentions to delay the initiation of intercourse between the two groups (LS means difference 0.10, P=.56). CONCLUSIONS: An interactive video game intervention improves sexual health attitudes and knowledge in minority adolescents for at least 12 months. TRIAL REGISTRATION: Clinicaltrials.gov NCT01666496; https://clinicaltrials.gov/ct2/show/NCT01666496 (Archived by WebCite at http://www.webcitation.org/6syumc9C0).

A Descriptive Systematic Review of Physical Activity Interventions for Caregivers: Effects on Caregivers' and Care Recipients' Psychosocial Outcomes, Physical Activity Levels, and Physical Health.

BACKGROUND: Caregiving can adversely impact individuals' psychosocial and physical well-being. An important task in health research is to find effective ways to enhance caregivers' health and functioning. PURPOSE: To provide a systematic review of the efficacy of physical activity (PA) interventions for caregivers on their and the care recipients' psychosocial outcomes, PA levels, and physical health. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, a descriptive systematic review of studies examining the effects of PA interventions for caregivers on their outcomes and those of the care recipients was conducted. Studies were primarily identified through searching electronic databases. RESULTS: Fourteen studies were reviewed. PA interventions significantly decreased caregivers' distress and increased their well-being, quality of life, sleep quality, PA levels, self-efficacy for caregiving or exercise, and readiness for exercise. Most PA interventions targeted the caregiver alone. Two studies examined the impact of the intervention on the care recipient and found no significant effect. CONCLUSIONS: PA interventions hold promise in improving caregivers' outcomes. However, more high quality trials are needed before definitive conclusions can be drawn.

The design and implementation of a randomized controlled trial of a risk reduction and human immunodeficiency virus prevention videogame intervention in minority adolescents: PlayForward: Elm City Stories.

BACKGROUND: To address the need for risk behavior reduction and human immunodeficiency virus prevention interventions that capture adolescents "where they live," we created a tablet-based videogame to teach skills and knowledge and influence psychosocial antecedents for decreasing risk and preventing human immunodeficiency virus infection in minority youth in schools, after-school programs, and summer camps. METHODS: We developed PlayForward: Elm City Stories over a 2-year period, working with researchers, commercial game designers, and staff and teens from community programs. The videogame PlayForward provides an interactive world where players, using an avatar, "travel" through time, facing challenges such as peer pressure to drink alcohol or engage in risky sexual behaviors. Players experience how their choices affect their future and then are able to go back in time and change their choices, creating different outcomes. A randomized controlled trial was designed to evaluate the efficacy of PlayForward. Participants were randomly assigned to play PlayForward or a set of attention/time control games on a tablet at their community-based program. Assessment data were collected during face-to-face study visits and entered into a web-based platform and unique real-time "in-game" PlayForward data were collected as players engaged in the game. The innovative methods of this randomized controlled trial are described. We highlight the logistical issues of conducting a large-scale trial using mobile technology such as the iPad(®), and collecting, transferring, and storing large amounts of in-game data. We outline the methods used to analyze the in-game data alone and in conjunction with standardized assessment data to establish correlations between behaviors during gameplay and those reported in real life. We also describe the use of the in-game data as a measure of fidelity to the intervention. RESULTS: In total, 333 boys and girls, aged 11-14 years, were randomized over a 14-month period: 166 were assigned to play PlayForward and 167 to play the control games. To date (as of 1 March 2016), 18 have withdrawn from the study; the following have completed the protocol-defined assessments: 6 weeks: 271 (83%), 3 months: 269 (84%), 6 months: 254 (79%), 12 months: 259 (82%), and 24 months: is ongoing with 152 having completed out of the 199 participants (76%) who were eligible to date (assessment windows were still open). CONCLUSION: Videogames can be developed to address complex behaviors and can be subject to empiric testing using community-based randomized controlled trials. Although mobile technologies pose challenges in their use as interventions and in the collection and storage of data they produce, they provide unique opportunities as new sources of potentially valid data and novel methods to measure the fidelity of digitally delivered behavioral interventions.

Using Videogame Apps to Assess Gains in Adolescents' Substance Use Knowledge: New Opportunities for Evaluating Intervention Exposure and Content Mastery.

BACKGROUND: Videogame interventions are becoming increasingly popular as a means to engage people in behavioral interventions; however, strategies for examining data from such interventions have not been developed. OBJECTIVE: The objective of this study was to describe how a technology-based intervention can yield meaningful, objective evidence of intervention exposure within a behavioral intervention. This study demonstrates the analysis of automatic log files, created by software from a videogame intervention, that catalog game play and, as proof of concept, the association of these data with changes in substance use knowledge as documented with standardized assessments. METHODS: We analyzed 3- and 6-month follow-up data from 166 participants enrolled in a randomized controlled trial evaluating a videogame intervention, PlayForward: Elm City Stories (PlayForward). PlayForward is a videogame developed as a risk reduction and prevention program targeting HIV risk behaviors (substance use and sex) in young minority adolescents. Log files were analyzed to extract the total amount of time spent playing the videogame intervention and the total number of game levels completed and beaten by each player. RESULTS: Completing and beating more of the game levels, and not total game play time, was related to higher substance use knowledge scores at the 3- (P=.001) and 6-month (P=.001) follow-ups. CONCLUSIONS: Our findings highlight the potential contributions a videogame intervention can make to the study of health behavior change. Specifically, the use of objective data collected during game play can address challenges in traditional human-delivered behavioral interventions. TRIAL REGISTRATION: Clinicaltrials.gov NCT01666496; https://clinicaltrials.gov/ct2/show/NCT01666496 (Archived by WebCite at http://www.webcitation.org/6cV9fxsOg).

The use of message framing to promote sexual risk reduction in young adolescents: a pilot exploratory study.

Few studies have explored the application of message framing to promote health behaviors in adolescents. In this exploratory study, we examined young adolescents' selection of gain- versus loss-framed images and messages when designing an HIV-prevention intervention to promote delayed sexual initiation. Twenty-six adolescents (aged 10-14 years) participated in six focus groups and created and discussed posters to persuade their peers to delay the initiation of sexual activity. Focus groups were audio-recorded and transcribed. A five-person multidisciplinary team analyzed the posters and focus group transcripts using thematic analysis. The majority of the posters (18/26, 69%) contained both gain- and loss-framed content. Of the 93/170 (56%) images and messages with framing, similar proportions were gain- (48/93, 52%) and loss-framed (45/93, 48%). Most gain-framed content (23/48, 48%) focused on academic achievement, whereas loss-framed content focused on pregnancy (20/45, 44%) and HIV/AIDS (14/45, 31%). These preliminary data suggest that young adolescents may prefer a combination of gain- and loss-framing in health materials to promote reduction in sexual risk behaviors.

Novel methods to collect meaningful data from adolescents for the development of health interventions.

Health interventions are increasingly focused on young adolescents, and as a result, discussions with this population have become a popular method in qualitative research. Traditional methods used to engage adults in discussions do not translate well to this population, who may have difficulty conceptualizing abstract thoughts and opinions and communicating them to others. As part of a larger project to develop and evaluate a video game for risk reduction and HIV prevention in young adolescents, we were seeking information and ideas from the priority audience that would help us create authentic story lines and character development in the video game. To accomplish this authenticity, we conducted in-depth interviews and focus groups with young adolescents aged 10 to 15 years and employed three novel methods: Storytelling Using Graphic Illustration, My Life, and Photo Feedback Project. These methods helped provide a thorough understanding of the adolescents' experiences and perspectives regarding their environment and future aspirations, which we translated into active components of the video game intervention. This article describes the processes we used and the valuable data we generated using these three engaging methods. These three activities are effective tools for eliciting meaningful data from young adolescents for the development of health interventions.

A Serious Video Game Targeting HIV Testing and Counseling: A Randomized Controlled Trial.

PURPOSE: Adolescents are the age group that is least likely to know their HIV status and may unknowingly transmit the virus to others. A randomized controlled trial was conducted to evaluate the impact of the original video game intervention, PlayTest!, on behavioral antecedents for HIV testing and counseling (HTC). METHODS: Participants (N = 287 adolescents) were recruited between 2018 and 2020 and were 48% female, aged 14-18 years (mean age = 15.4 years), and 76% racial minorities. Participants were randomized 1:1 and assigned to either play PlayTest! or a set of control games, ∼one session per week for an hour per session over 4-6 weeks (gameplay) after school. The primary outcome measure was participants' attitudes around HTC at 6 months, with intentions, knowledge, self-efficacy, and behaviors assessed as secondary outcomes. RESULTS: Two hundred and ninety-six participants were enrolled/randomized; nine were withdrawn due to incomplete parental consent forms, leaving 287 participants: 145 were randomized to PlayTest! and 142 to the control condition. Mixed between-within subjects ANOVAs assessed the impact of the study conditions on outcomes. Improvements were seen in the PlayTest! group in HTC attitudes (p < .001), intentions (p < .001), knowledge (p < .001), and self-efficacy (p = .002) at all time-points. At 6 months, for those who had access to HTC (N = 134; prior to COVID-19) and for those who did not have access to HTC (N = 261; during COVID-19), there were no differences in self-reported HTC between the two groups (p = .289 and p = .074, respectively). DISCUSSION: PlayTest! impacted important behavioral antecedents related to HTC and has the potential to broadly increase HTC rates in adolescents.

Mapping the protective pathway of emotional intelligence in youth: From social cognition to smoking intentions.

The purpose of this study was to test perceptions of the social consequences of smoking as a mediator of the relationship between emotional intelligence (EI) and intentions to smoke cigarettes among youth. Upper elementary school students (N = 255, Mage = 10.9 years, 49% male) completed measures of EI, verbal intelligence, smoking-related intentions, past behavior, and perceived social consequences. Mediation was tested using the Sobel test. Perceived social consequences was a marginally significant mediator of the impact of total EI on intentions to smoke (Z = 1.91, p = .057). Follow-up analyses showed that perceived social consequences significantly mediated the effect of 2 EI abilities on smoking intentions: using emotions (Z = 2.02, p = .043) and managing emotions (Z = 2.28, p = .023). The results indicate that the role of higher EI in deterring smoking among youth may be related to social processing ability (i.e., greater perceptions of the negative social consequences of smoking). These findings contribute to a growing body of research demonstrating that EI may reduce cigarette smoking among youth by influencing their social perceptions.

Testing messages to encourage discussion of clinical trials among cancer survivors and their physicians: examining monitoring style and message detail.

Encouraging cancer survivors to discuss clinical trials with their physicians may increase enrollment in clinical trials. Health messages offer one method for encouraging such discussions. We hypothesized that matching messages to an individual's preference for detailed or non-detailed information (i.e., monitoring style) would result in more discussions. Participants (N = 538) were cancer survivors, who phoned the National Cancer Institute's Cancer Information Service (CIS). Participants were classified as higher or lower monitors and then randomized to receive detailed or non-detailed messages in the mail 1 and 4 weeks following their baseline CIS call. At 12 weeks, there was a significant interaction between monitoring style and message detail. Follow-up analyses were nonsignificant but suggested a theoretically consistent pattern in which non-detailed messages were more effective among lower monitors. These findings imply that providing extremely detailed information may be excessive, even to individuals engaged in information seeking behavior.

An exploration and comparison of #BodyPositivity and #BodyNeutrality content on TikTok.

TikTok, one of the most popular visual social media platforms, has been criticized for perpetuating and glorifying eating disorders. In response, content focused on body positivity (loving your body) is growing on TikTok. However, body positivity content on other social platforms promotes positive body image but also perpetuates unrealistic beauty ideals. Body neutrality (deemphasizing the focus on the body's appearance) is an alternative concept that could portray less harmful content, but has yet to be explored. Therefore, the purpose of this study was to explore and compare the content under #BodyPositivity and #BodyNeutrality on TikTok. One hundred and fifty TikToks under each hashtag were downloaded. A thematic analysis of the TikToks was conducted. Three themes were generated that captured content across both hashtags, with only minor differences in content between the two: (1) Resisting societal ideologies (with subtheme: Normalizing insecurities), (2) (Re)producing disordered content (with subtheme: Toxic (body) positivity promotes the need for neutrality), and (3) Social critique. Within the themes, there was the promotion of body positivity through self-love and body acceptance, but also content that continued to emphasize standard beauty ideals and the thin-ideal. Certain TikToks provided educational content that explained the roots of the #BodyPositivity movement and what #BodyNeutrality means as a potentially more realistic approach to body acceptance. Findings suggest that #BodyNeutrality may provide a safer space for individuals online, and future research should assess the impact of such TikToks on those viewing them to assess body and eating attitudes and behaviours.