Predicting smoking cessation, reduction and relapse six months after using the Stop-Tabac app for smartphones: a machine learning analysis.

BACKGROUND: An analysis of predictors of smoking behaviour among users of smoking cessation apps can provide useful information beyond what is already known about predictors in other contexts. Therefore, the aim of the present study was to identify the best predictors of smoking cessation, smoking reduction and relapse six months after starting to use the smartphone app Stop-Tabac. METHOD: Secondary analysis of 5293 daily smokers from Switzerland and France who participated in a randomised trial testing the effectiveness of this app in 2020, with follow-up at one and six months. Machine learning algorithms were used to analyse the data. The analyses for smoking cessation included only the 1407 participants who responded after six months; the analysis for smoking reduction included only the 673 smokers at 6-month follow-up; and the analysis for relapse at 6 months included only the 502 individuals who had quit smoking after one month. RESULTS: Smoking cessation after 6 months was predicted by the following factors (in this order): tobacco dependence, motivation to quit smoking, frequency of app use and its perceived usefulness, and nicotine medication use. Among those who were still smoking at follow-up, reduction in cigarettes/day was predicted by tobacco dependence, nicotine medication use, frequency of app use and its perceived usefulness, and e-cigarette use. Among those who had quit smoking after one month, relapse after six months was predicted by intention to quit, frequency of app use, perceived usefulness of the app, level of dependence and nicotine medication use. CONCLUSION: Using machine learning algorithms, we identified independent predictors of smoking cessation, smoking reduction and relapse. Studies on the predictors of smoking behavior among users of smoking cessation apps may provide useful insights for the future development of these apps and future experimental studies. CLINICAL TRIAL REGISTRATION: ISRCTN Registry: ISRCTN11318024, 17 May 2018. http://www.isrctn.com/ISRCTN11318024 .

Predicting the Users' Level of Engagement with a Smartphone Application for Smoking Cessation: Randomized Trial and Machine Learning Analysis.

INTRODUCTION: Studies of the users' engagement with smoking cessation application (apps) can help understand how these apps are used by smokers, in order to improve their reach and efficacy. OBJECTIVE: The present study aimed at identifying the best predictors of the users' level of engagement with a smartphone app for smoking cessation and at examining the relationships between predictors and outcomes related to the users' level of engagement with the app. METHODS: A secondary analysis of data from a randomized trial testing the efficacy of the Stop-Tabac smartphone app was used. The experimental group used the "full" app and the control group used a "dressed down" app. The study included a baseline and 1-month and 6-month follow-up questionnaires. A total of 5,293 participants answered at least the baseline questionnaires; however, in the current study, only the 1,861 participants who answered at least the baseline and the 1-month follow-up questionnaire were included. Predictors were measured at baseline and after 1 month and outcomes after 6 months. Data were analyzed using machine learning algorithms. RESULTS: The best predictors of the outcomes were, in decreasing order of importance, intention to stop smoking, dependence level, perceived helpfulness of the app, having quit smoking after 1 month, self-reported usage of the app after 1 month, belonging to the experimental group (vs. control group), age, and years of smoking. Most of these predictors were also significantly associated with the participants' level of engagement with the app. CONCLUSIONS: This information can be used to further target the app to specific groups of users, to develop strategies to enroll more smokers, and to better adapt the app's content to the users' needs.

Machine learning reveals the most important psychological and social variables predicting the differential diagnosis of rheumatic and musculoskeletal diseases.

There is an ongoing debate about the importance and the extent to which psychological and psychopathological factors, adverse childhood experiences, and socio-demographic characteristics are associated with the development of certain types of rheumatic disease. With the aim of contributing to knowledge on the subject, the present study uses machine learning modeling to determine the importance of 20 psychological and social variables in predicting two classes of rheumatic disease: inflammatory rheumatic and musculoskeletal diseases (RMD) (rheumatoid arthritis = RA, spondyloarthritis = SA, and Sjögren's syndrome = SS) versus non-inflammatory RMD, namely fibromyalgia = FM). A total of 165 French women with FM, RA, SA, and SS completed an inventory of personality traits, a psychopathology diagnosis questionnaire, and a fatigue/pain questionnaire. They also answered questions about adverse childhood experiences and socio-demographic characteristics. Random forest and logistic regression machine learning algorithms were used for data analysis. The main findings suggest that mistreatment during childhood ((MDA = 10.22), the agreeableness personality trait (MDA = 3.39), and somatic disorder (MDA = 3.25) are the main psychological and social predictors of the type of rheumatic disease diagnosed. The first two predictors (OR = 18.92 and OR = 6.11) are also more strongly associated with FM than with RA-SA-SS. Overall, adverse childhood experiences seem relatively more important than personality traits, psychopathological or demographic variables. The results of this study suggest that traumatic childhood experiences may lead to psychopathological disorders in adulthood, which in turn might underlie, at least in part, the development of FM. Since there are no imaging or biological markers of FM, the present findings contribute to the scientific literature offering information to help patients with FM understand their pathology. They may also provide physicians with more diagnostic information.

Assessment of the Popularity and Perceived Effectiveness of Smartphone Tools That Track and Limit Smartphone Use: Survey Study and Machine Learning Analysis.

BACKGROUND: Problematic smartphone use, like problematic internet use, is a condition for which treatment is being sought on the web. In the absence of established treatments, smartphone-provided tools that monitor or control smartphone use have become increasingly popular, and their dissemination has largely occurred without oversight from the mental health field. OBJECTIVE: We aimed to assess the popularity and perceived effectiveness of smartphone tools that track and limit smartphone use. We also aimed to explore how a set of variables related to mental health, smartphone use, and smartphone addiction may influence the use of these tools. METHODS: First, we conducted a web-based survey in a representative sample of 1989 US-based adults using the crowdsourcing platform Prolific. Second, we used machine learning and other statistical tools to identify latent user classes; the association between latent class membership and demographic variables; and any predictors of latent class membership from covariates such as daily average smartphone use, social problems from smartphone use, smartphone addiction, and other psychiatric conditions. RESULTS: Smartphone tools that monitor and control smartphone use were popular among participants, including parents targeting their children; for example, over two-thirds of the participants used sleep-related tools. Among those who tried a tool, the highest rate of perceived effectiveness was 33.1% (58/175). Participants who experienced problematic smartphone use were more likely to be younger and more likely to be female. Finally, 3 latent user classes were uncovered: nonusers, effective users, and ineffective users. Android operating system users were more likely to be nonusers, whereas younger adults and females were more likely to be effective users. The presence of psychiatric symptoms did not discourage smartphone tool use. CONCLUSIONS: If proven effective, tools that monitor and control smartphone use are likely to be broadly embraced. Our results portend well for the acceptability of mobile interventions in the treatment of smartphone-related psychopathologies and, potentially, non-smartphone-related psychopathologies. Better tools, targeted marketing, and inclusive design, as well as formal efficacy trials, are required to realize their potential.

Assessing Spaniard men's willingness and determinants to use a male contraceptive pill.

OBJECTIVE: As the clinical trials to develop male contraceptive pills are underway, understanding men's attitudes towards this contraceptive method is transcendental. This research was conducted to identify the degree of willingness and the determinants to use male contraceptive pill among Spaniard men. METHODS: A sample of 402 Spaniards men was presented with 36 scenarios comprising four within-subject factors (cost of pills, pill efficacy, side effects and context). In each scenario, a man is asked by his partner to use the contraceptive pill. Participants indicated their own willingness to use the pill in each circumstance. RESULTS: Cluster analysis revealed that participants took one of seven different positions regarding their willingness to use a contraceptive pill: never agree (10%); mainly depends on pill efficacy (6%); mainly depends on side effects (10%); depends on side effects and efficacy (12%); depends on context and side effects (12%); quite always (25%); always agree (25%). Participants' willingness to use contraceptive pills was more pronounced in the case of mild side effects and higher pill efficacy. CONCLUSION: Fifty percent of participants would use the male pill regardless of the circumstances. Access to this contraceptive method, when available, can contribute to greater equity in reproductive rights of the population.

People's willingness and determinants to use selected tele-consultation public health services in Mozambique.

BACKGROUND: To achieve universal health coverage by 2030, sub-Saharan African countries are planning to develop large scale tele-consultation public health services. However, there is a lack of knowledge regarding the level of peoples' willingness to use this kind of tele-health services. To address this gap and inform policymakers, the present study aims at accessing the Mozambican people's willingness to use tele-consultation public health services and the determinants associate to their willingness. METHODS: A total of 403 adults participated in the study. The material consisted of 32 vignettes (scenarios) describing realistic health problem situations in which an individual was proposed to use a tele-consultation public health service, varying as a function of five factors: consultation category, health problem category, health problem severity, physician category, and the consultation price. For each health problem situation presented in the vignettes, the participants were asked to rate their willingness to use the proposed tele-consultation service on an 11-point scale. A cluster analysis using the K-means procedure was applied to the quantitative raw data to capture the participants' different perspectives. ANOVA, x2 and t-test analyses were also conducted to examine the effects of the different health problem situations and the sociodemographic characteristics on the participant ratings. RESULTS: Five different perspectives (clusters) were found: never-willing (15% of the sample), severity (26%), consultation-category (22%), undecided (16%), and price-severity (21%). These perspectives were associated with participants' sociodemographic characteristics. CONCLUSION: According to the main results, it seems that the majority of the participants (69%) were highly willing to use tele-consultation public health services in the case of mild illness, cheaper prices and follow-up consultation. In addition, the participants' willingness was significantly affected by some of the participants' sociodemographic characteristics.

Identifying determinants of Mozambican men's willingness to use a male contraceptive pill.

Objective: Given the possibility of a male contraceptive pill in the near future, understanding men's attitudes towards this contraceptive method is crucial, especially in high-risk populations with limited access to education. This research was conducted to identify the determinants of Mozambican men's willingness to use a contraceptive pill when it is made available. Methods: A sample of 412 Mozambican men was presented with 36 vignettes comprising four within-subject factors (cost of pills, pill efficacy, side effects and context). Each vignette presented a scenario in which a man is asked by his partner to use the contraceptive pill, and participants indicated their own willingness to use the pill under each circumstance. Results: Cluster analysis revealed that participants took one of four different positions regarding their willingness to use a contraceptive pill: never (11%); depends on side effects alone (25%); depends on side effects and costs (11%); depends on side effects and context (46%). These positions were associated with participants' sociodemographic characteristics. Conclusion: Among the Mozambican men in this study, a minority appeared to believe that the responsibility for contraception should be shared between sexual partners. Men's willingness to use a contraceptive pill was, however, more pronounced in the case of serious medical risk to their partner. Overall, only about one-fifth of participants were either reluctant or unwilling to consider using a male contraceptive pill.

HIV prevention: mapping Mozambican people's views on the acceptability of the widow's sexual cleansing ritual called pita-kufa.

BACKGROUND: In Mozambique, the widow is traditionally required to undergo a cleansing ritual called pita-kufa, which generally involves several sessions of unprotected sexual intercourse with the brother of her deceased husband. This ritual may play a role in the spread of HIV and reveals, to some degree, the subordinate position to which women are subjected in Mozambican society. Thus, this study's aim was to map Mozambicans' views on the acceptability of this ritual, given the gender and public health concerns linked to it. METHODS: A total of 359 Mozambicans participated in the study. The data collection instrument consisted of 18 vignettes describing realistic pita-kufa situations, varying as a function of three factors: a widow's willingness or not to perform the ritual, the perceived effectiveness of the ritual, and the risk level of HIV infection linked to the practice. For each pita-kufa situation presented in the vignettes, the participants were asked to rate its acceptability on an 11-point scale. In addition, the participants wrote comments giving their general views on the ritual. A cluster analysis using the K-means procedure was applied to the quantitative raw data to capture different perspectives, and the participants' written comments were subjected to thematic and frequency content analysis. RESULTS: From the data gathered though the vignettes, three different perspectives were found: total unacceptability (55% of the participants), conditional acceptability (29% of the participants) and unconditional acceptability (16% of the participants). From the data gathered though the participants' written comments, it emerged that they thought that the practice of this ritual should evolve (61%), stop (27%) and be kept as it is (12%). CONCLUSION: According to the main results, it seems that a large majority of study participants think that this ritual is outdated and needs to evolve in order to minimize the risk of HIV transmission and respect women's rights.

Predictors of compulsive cyberporn use: A machine learning analysis.

Introduction: Compulsive cyberporn use (CCU) has previously been reported among people who use cyberporn. However, most of the previous studies included convenience samples of students or samples of the general adult population. Research examining the factors that predict or are associated with CCU are still scarce.In this study, we aimed to (a) assess compulsive cyberporn consumption in a broad sample of people who had used cyberporn and (b) determine, among a diverse range of predictor variables, which are most important in CCU scores, as assessed with the eight-item Compulsive Internet Use Scale adapted for cyberporn. Materials and Methods: Overall, 1584 adult English speakers (age: 18-75 years, M = 33.18; sex: 63.1 % male, 35.2 % female, 1.7 % nonbinary) who used cyberporn during the last 6 months responded to an online questionnaire that assessed sociodemographic, sexual, psychological, and psychosocial variables. Their responses were subjected to correlation analysis, analysis of variance, and machine learning analysis. Results: Among the participants, 21.96% (in the higher quartile) presented CCU symptoms in accordance with their CCU scores. The five most important predictors of CCU scores were related to the users' strength of craving for pornography experiences, suppression of negative emotions porn use motive, frequency of cyberporn use over the past year, acceptance of rape myths, and anxious attachment style. Conclusions: From a large and diverse pool of variables, we determined the most important predictors of CCU scores. The findings contribute to a better understanding of problematic pornography use and could enrich compulsive cyberporn treatment and prevention.

Online dating: predictors of problematic tinder use.

BACKGROUND: Geolocation apps have radically transformed dating practices around the world, with profound sociocultural implications. Few studies, however, have explored their addictive potential or factors that are associated with their misuse. OBJECTIVE: The present study aimed to assess the level of problematic Tinder use (PTU) in an adult sample, using a machine learning algorithm to determine, among 29 relevant variables, the most important predictors of PTU. METHODS: 1,387 users of Tinder (18-74 years-old; male = 50.3%; female = 49.1%) completed an online questionnaire, and a machine learning tool was used to analyze their responses. RESULTS: On 5-point scale, participants' mean PTU score was 1.91 (SD = 0.70), indicating a relatively low overall level of problematic app use. Among the most important predictors of Problematic use were the use of Tinder for enhancement (reduce boredom and increase positive emotions), coping with psychological problems, and increasing social connectedness. The number of "matches" (when two users show mutual interest), the number of online contacts on Tinder, and the number of resulting offline dates were also among the top predictors of PTU. Depressive mood and loneliness were among the middle-ranked predictors of PTU. CONCLUSION: In accordance with the Interaction of Person-Affect-Cognition-Execution model of problematic internet use, the results suggest that PTU relates to how individual experience on the app interacts with dispositional and situational characteristics. However, variables that seemed to relate to PTU, including lack of self-esteem, negative mood states and loneliness, are not problems that online dating services as currently designed can be expected to resolve. This argues for increased digital services to identify and address potential problems helping drive the popularity of dating apps.

Validation of the english version of the Multidimensional Mentalizing Questionnaire (MMQ).

BACKGROUND: Mentalizing refers to the ability to understand one's own and others' mental states. Mentalizing is considered a key component of social cognition and healthy personality development. A multinational assessment tools able to appraise the multidimensional and multifaceted aspects of this complex construct are needed. OBJECTIVE: The present study had two aims: (a) validate an English version of the Multidimensional Mentalizing Questionnaire (MMQ, 33 items) which was designed to assess mentalizing based on an integrated and multilevel model of mentalizing; (b) explore the correlational relationships between the six dimensions of the MMQ and a set of sociodemographic, psycho-cognitive, mental health, and socio-functional variables. METHODS: Overall, 1823 individuals (age: 19-76 years old [M = 45; SD = 16]; sex: male = 48.51%, female = 50.57%, non-binary = 0.9%) participated in an online survey. While the participants came from 77 different countries, most of them were residents in UK and USA (95%). Data analytics include confirmatory factorial analysis and Pearson correlations. RESULTS: The CFA results validated the factorial structure of a 28-items MMQ-English version, with acceptable goodness of fit indices. Regarding the psychometric properties, the MMQ-English version showed good internal reliability and significant positive correlation with another scale designed to assess an analogue construct showing a fair convergent validity. The findings indicated that males, individuals with lower levels of education, lower socio-economic status, depressed, and with a higher score of loneliness are significantly more likely to report poor mentalizing compared with females, individuals with higher education level, greater SES, happier, and with lower scores of loneliness. CONCLUSION: The present study validated the English version of the MMQ.

How much online pornography is too much? A comparison of two theoretically distinct assessment scales.

BACKGROUND: Online pornography use, an ever more common activity, has raised myriad psychosocial and clinical concerns. While there is a need to screen for and measure its problematic dimension, there is a debate about the adequacy of existing assessment tools. OBJECTIVE: The study compares two instruments for measuring pathological online pornography use (POPU) that are based on different theoretical frameworks-one in line with DSM-5 criteria and the six-component addiction model and one in line with ICD-11 criteria. METHODS: An international sample of 1,823 adults (Mean age = 31.66, SD = 6.74) answered an online questionnaire that included the Short Version of the Problematic Pornography Consumption Scale (PPCS-6) and the Assessment of Criteria for Specific Internet-Use Disorders (ACSID-11). Factorial, correlational, and network analyses were conducted on the data. RESULTS: Both tools adequately screened for online "addictive" behavior, but the ACSID-11 was superior in assessing the degree of clinical risk. CONCLUSION: Depending on the specific aim of the assessment (screening vs. clinical diagnostics), both online pornography measurement tools may be useful.

Using artificial intelligence to identify the top 50 independent predictors of subjective well-being in a multinational sample of 37,991 older European & Israeli adults.

Subjective well-being (SWB) is widely recognized as an important health outcome, but its complexity, myriad predictors, and analytic requirements pose significant challenges to identifying the relative order and impact of SWB determinants. This study involved a representative sample of 37,991 older adults from 17 European countries and Israel. An aggregate index of SWB was developed and compared across countries, and machine-learning algorithms were used to rank-order the strongest 50 (of an initial 94) SWB predictors from 15 categories. General Additive Modeling (GAM) and low-degree polynomials (i.e., splines) were used to determine the independent effect sizes and significance levels for each of these top-50 SWB predictors. Of the 18 countries included in this study, Denmark had the highest mean SWB, while Greece had the lowest. The two top-ranked SWB predictors (loneliness, social activity satisfaction) were social factors, which also had the highest overall group ranking, followed by physical health, demographics, financial status and personality. Self-reported health was the strongest health-related predictor, neuroticism was the strongest personality predictor, and women reported higher SWB than men. SWB decreased with age, and increased with income up to 350,000 euros/year, after which it declined. Social factors were of primary importance for subjective well-being in this research, while childhood experiences and healthcare status exerted the smallest effects. The vast majority of the top 50 SWB predictors were statistically significant, with the notable exceptions of body mass index and most health behaviors, which may impact SWB indirectly through their effects on physical health. Future multivariate modeling is recommended to clarify the mechanisms for these and other observed relationships.

Relationship between gamer profiles, gaming behavior, sociodemographic characteristics, and big five personality traits among French law students.

BACKGROUND: Over the past 10 years, gamer profiles have been developed to understand the reason underlying players' intrinsic motivation. While the research undertaken has led to the creation of distinct models (e.g., BrainHex and Hexad typologies), there is a lack of studies on the prevalence of these profiles among a specific population and the association between the target population's profiles and their personality traits, gaming behavior, and sociodemographic characteristics. METHODS: Thus, the present study aimed to (a) establish the gamer profiles of French undergraduate law students, (b) examine the relationships between the participants' profiles and their personality traits, gaming behavior, and sociodemographic characteristics, with a view to the development of serious games specifically intended for this population. In total, 753 French undergraduate students participated in the study, completing an online questionnaire. Data were analyzed using Latent Profile Analysis (LPA), chi-square, and ANOVA. RESULTS: The main findings show that among participants, the two most prevalent gamers' profiles are Mastermind (45%) and Seeker (22.7%); followed by three less represented archetypes: Conqueror (12.9%), Daredevil (9.7%), and Achiever (9.7%). These archetypes are associated with the participants' Big Five personality traits. Specifically, Daredevils, Masterminds, and Seekers have high mean scores on Extraversion (p < .001); Achievers and Seekers have high mean scores on Agreeableness (p < .001); Seekers and Achievers have high mean scores on Neuroticism (p < .001); and Seekers, Masterminds, and Achievers have high mean scores on Openness (p < .001). The unveiled profiles are also significantly associated with the participants' gaming behavior including their playing frequency (p < .001), game types (p = .031), and sociodemographic characteristics (p < .001). For example, Masterminds are more likely to be female than the other four profiles (p < .001), while Conquerors and Daredevils are more likely to have a low socio-economic status compared to those with intermediate and high socio-economic status (p = .49). CONCLUSION: These findings can be used to design serious/educational games tailored to the studied population.

Finding Intimacy Online: A Machine Learning Analysis of Predictors of Success.

While an extensive scientific literature now exists on the use of online dating services, there are very few studies on user satisfaction with dating apps and with the resulting offline dates. This study aimed to assess the level of satisfaction with Tinder use (STU) and the level of satisfaction with Tinder offline dates (STOD) in a sample of adult users of the app. The study also aimed to examine, among 28 variables, those that are the most important in predicting STU and STOD. Overall, 1,387 Tinder users completed an online questionnaire. A machine learning model was used to rank order predictors from most to least important. On a 4-point scale, participants' mean STU score was 2.39, and, on a 5-point scale, mean STOD score was 3.05. The results indicate that satisfaction with dating apps and with resulting offline dates is strongly predicted by participants' age and by their motives for using Tinder (enhancement, emotional coping, socialization, finding "true love," or casual sexual partners), whereas the variables negatively associated with satisfaction were those related to psychopathology. Interestingly, 65.3 percent of app users were married or "in a relationship," and only 50.3 percent of app users were using it to meet someone offline. Generally, participants who engage with the app to cope with personal difficulties seem more likely to report higher levels of dissatisfaction, suggesting that dating apps are a poor coping mechanism and highlighting the need to address underlying problems or pathologies that may be driving their use.

Smartphone apps for mental health and wellbeing: A usage survey and machine learning analysis of psychological and behavioral predictors.

Objective: Despite the availability of thousands of mental health applications, the extent to which they are used and the factors associated with their use remain largely unknown. The present study aims to (a) assess in a representative US-based population sample the use of smartphone apps for mental health and wellbeing (SAMHW), (b) determine the variables predicting the use of SAMHW, and (c) explore how a set of variables related to mental health, smartphone use, and smartphone "addiction" may be associated with the use of SAMHW. Methods: Data was collected via online questionnaire from 1989 adults. The data gathered included information on smartphone use behavior, mental health, and the use of SAMHW. Latent class analysis was used to categorize participants. Machine learning and logistic regression analyses were used to determine the most important predictors of SAMHW use and associations between predictors and outcome variables. Results: While two-thirds of participants had a statistically high probability for using SAMHW, nearly twice more had high probability for using them to improve wellbeing compared to using them to address mental health problems (43% vs. 18%). In both groups, these participants were more likely to be female and in the younger adult age bracket than male and in the adult or older adult age bracket. According to the machine learning model, the most important predictors for using the relevant smartphone apps were variables associated with smartphone problematic use, COVID-19 impact, and mental health problems. Conclusion: Findings from the present study confirm that the use of SAMHW is growing, particularly among younger adult and female individuals who are negatively impacted by problematic smartphone use, COVID-19, and mental health problems. These individuals tend to bypass traditional care via psychotherapy or psychopharmacology, relying instead on smartphones to address mental health conditions or improve wellbeing. Advising users of these apps to also seek professional help and promoting efforts to prove the efficacy and safety of SAMHW would seem necessary.

Willingness to Use Male Contraceptive Pill: Spain-Mozambique Comparison.

Previous studies have suggested that social and cultural factors significantly influence people's willingness to use the male contraceptive pill, which is in relatively advanced development. The present study aims at comparing Spanish and Mozambican participants level of willingness to take a male contraceptive pill. Factorial designed scenarios were used to collect data on the two population samples (Spain = 402 participants; Mozambique = 412 participants). One-way analysis of variance (ANOVAs) were performed comparing the average scores of Mozambique and Spain at the levels of each modelled factor: The cost of the pills (30 €/USD 20 for 3 months vs. free); Efficacy (99% vs. 95%); Side effects (none, mild and severe); Context (disease, condom abandonment and diversification of contraceptive methods). The two groups found significant differences in the scores for each of the four factors, in light of the socio-cultural differences between the two countries. In the Spanish sample, the main factor affected the willingness to use male contraceptive pill (MCP) were the side effects, while for Mozambican men it was the context. Along with technological change, an ideological-social change in gender roles is required to ensure equity in contraceptive responsibilities and the participation of men at all socio-demographic levels in reproductive health.

A global grounded theory exploration of investigators' perspectives on male hormonal contraceptive development and acceptability.

While best practices have been proposed on how to engage men in family planning (FP), the limited options of male hormonal contraceptives (MHC) are a barrier to reaching men as clients of FP programs. The lack of alternative MHC is preventing the global health community from providing holistic reproductive healthcare. A qualitative grounded theory study was conducted in 2020 to explore MHC experts' perceptions around the development and theoretical acceptability of MHCs. Individual in-depth interviews were conducted with 15 key informants. The informants cited evidence that there is a demand for MHC. The inability to access this data by the pharmaceutical industry was acknowledged. Many informants expressed concern of the possibility for MHC to increase male power in a predominantly patriarchal world. To most informants, at least for the initial introduction of MHC, fertility sharing is something that will largely happen among couples alone rather than individually. There is proven demand among women and men for MHC, however industries may still be reluctant to invest. Effort is needed by the sexual and reproductive health and rights community to include male engagement in FP and to advocate for the development and use of MHC as a tool for women's empowerment.

Infant vaccination against malaria in Mozambique and in Togo: mapping parents' willingness to get their children vaccinated.

Background: Malaria is one of the most widespread and deadly diseases worldwide and large majority of malaria cases and deaths occurs in Africa. Efforts to develop an effective vaccine against malaria are underway and several vaccine prototypes are on different clinical trial phases.Objective: As many sub-Saharan African countries have shown interest in introducing large-scale infant vaccination against malaria when a definitively approved vaccine will be available, the present study aimed at mapping Mozambican parents' willingness to get their children vaccinated and comparing the results with findings from a similar study we conducted in Togo (209 participants).Methods: In Mozambique, 227 parents indicated their willingness to get their children vaccinated (using an 11-point scale) against malaria under different conditions varying as a function of the main constructs of health-protective theories: perceived risk of getting malaria, perceived severity of malaria, effectiveness of the vaccine, cost of the vaccine, and neighbors' attitude toward vaccination. The participant responses were subjected to cluster analysis, ANOVA and Ch2 test.Results: Six qualitatively different positions were found, which were labeled Cost (12%); Neighbors, Risk, and Cost (28%); Treatment, Risk, and Cost (10%); Always Vaccinate (7%); Risk and Cost (13%); and Risk, Treatment, Effectiveness, and Cost (22%). These positions were associated with participants' socio-demographic characteristics.Conclusion: A similar variety of parental positions on malaria vaccination was found in Mozambique and in Togo, which suggests that malaria vaccination campaigns in sub-Saharan African countries must be tailored in design and implementation to match the diversity of parents' needs and views.

Assessing Mozambicans' willingness and determinants to use pre-exposure prophylactic HIV medication.

In anticipation of the introduction of the pre-exposure prophylaxis drugs as an additional HIV prevention tool, we mapped the different positions of Mozambicans' willingness to use it. Overall, 507 adults indicated willingness to use under different conditions varying as a function of perceived susceptibility to and severity of infection, side effects, administration protocol, and cost. Three qualitatively different positions were found: Unwillingness irrespective of conditions (4%), depend on circumstances (76%), and unconditional willingness (8%). A large majority of participants were willing to use pre-exposure prophylaxis drugs, provided that the administration is not too constraining, and the adverse side effects can be minimized.