Sharing of misinformation is habitual, not just lazy or biased.

Why do people share misinformation on social media? In this research (N = 2,476), we show that the structure of online sharing built into social platforms is more important than individual deficits in critical reasoning and partisan bias-commonly cited drivers of misinformation. Due to the reward-based learning systems on social media, users form habits of sharing information that attracts others' attention. Once habits form, information sharing is automatically activated by cues on the platform without users considering response outcomes such as spreading misinformation. As a result of user habits, 30 to 40% of the false news shared in our research was due to the 15% most habitual news sharers. Suggesting that sharing of false news is part of a broader response pattern established by social media platforms, habitual users also shared information that challenged their own political beliefs. Finally, we show that sharing of false news is not an inevitable consequence of user habits: Social media sites could be restructured to build habits to share accurate information.

Americans discount the effect of friction on voter turnout.

Whether or not someone turns out to vote depends on their beliefs (such as partisanship or sense of civic duty) and on friction-external barriers such as long travel distance to the polls. In this exploratory study, we tested whether people underestimate the effect of friction on turnout and overestimate the effect of beliefs. We surveyed a representative sample of eligible US voters before and after the 2020 election (n = 1,280). Participants' perceptions consistently underemphasized friction and overemphasized beliefs (mean d = 0.94). In participants' open-text explanations, 91% of participants listed beliefs, compared with just 12% that listed friction. In contrast, turnout was shaped by beliefs only slightly more than friction. The actual belief-friction difference was about one-fourth the size of participants' perceptions (d = 0.24). This bias emerged across a range of survey measures (open- and close-ended; other- and self-judgments) and was implicated in downstream consequences such as support for friction-imposing policies and failing to plan one's vote.

Testing interventions to reduce clinical inertia in the treatment of hypertension: rationale and design of a pragmatic randomized controlled trial.

BACKGROUND: Clinical inertia, or failure to intensify treatment when indicated, leads to suboptimal blood pressure control. Interventions to overcome inertia and increase antihypertensive prescribing have been modestly successful in part because their effectiveness varies based on characteristics of the provider, the patient, or the provider-patient interaction. Understanding for whom each intervention is most effective could help target interventions and thus increase their impact. METHODS: This three-arm, randomized trial tests the effectiveness of 2 interventions to reduce clinical inertia in hypertension prescribing compared to usual care. Forty five primary care providers (PCPs) caring for patients with hypertension in need of treatment intensification completed baseline surveys that assessed behavioral traits and were randomized to one of three arms: 1) Pharmacist e-consult, in which a clinical pharmacist provided patient-specific recommendations for hypertension medication management to PCPs in advance of upcoming visits, 2) Social norming dashboards that displayed PCP's hypertension control rates compared to those of their peers, or 3) Usual care (no intervention). The primary outcome was the rate of intensification of hypertension treatment. We will compare this outcome between study arms and then evaluate the association between characteristics of providers, patients, their clinical interactions, and intervention responsiveness. RESULTS: Forty-five primary care providers were enrolled and randomized: 16 providers and 173 patients in the social norming dashboards arm, 15 providers and 143 patients in the pharmacist e-consult arm, and 14 providers and 150 patients in the usual care arm. On average, the mean patient age was 64 years, 47% were female, and 73% were white. Baseline demographic and clinical characteristics of patients were similar across arms, with the exception of more Hispanic patients in the usual care arm and fewest in the pharmacist e-consult arm. CONCLUSIONS: This study can help identify interventions to reduce inertia in hypertension care and potentially identify the characteristics of patients, providers, or patient-provider interactions to understand for whom each intervention would be most beneficial. TRIAL REGISTRATION: Clinicaltrials.gov (NCT, Registered: NCT04603560).

Development of consensus quality indicators for cancer supportive care: a Delphi study and pilot testing.

BACKGROUND: High quality supportive care is fundamental to achieve optimal health outcomes for people affected by cancer. Use of quality indicators provides comparative information for monitoring, management, and improvement of care within and across healthcare systems. The aim of this Australian study was to develop and test a minimum viable set of cancer supportive care quality indicators that would be feasible to implement and generate usable data for policy and practice. METHODS: A two-round, modified reactive Delphi process was employed firstto develop the proposed indicators. Participants with expertise in cancer control in Australia, the United Kingdom, and Canada rated their level of agreement on a 7-point Likert scale against criteria assessing the importance, feasibility, and usability of proposed indicators. Relative response frequencies were assessed against pre-specified consensus criteria and a ranking exercise, which delivered the list of proposed indicators. Draft indicators were then presented to a purposive sample of clinicial and health management staff via qualitative interviews at two acute care settings in Melbourne, Australia for feedback regarding feasibility. Desktop audits of online published health service policy and practice descriptions were also conducted at participating acute care settings to confirm health service data availability and feasibility of collection to report against proposed indicators. RESULTS: Sixteen quality indicators associated with the delivery of quality cancer supportive care in Australian acute healthcare settings met pre-specified criteria for inclusion. Indicators deemed 'necessary' were mapped and ranked across five key categories: Screening, Referrals, Data Management, Communication and Training, and Culturally Safe and Accessible Care. Testing confirmed indicators were viewed as feasible by clinical and health management staff, and desktop audits could provide a fast and reasonably effective method to assess general adherence and performance. CONCLUSIONS: The development of quality indicators specific to cancer supportive care provides a strong framework for measurement and monitoring, service improvement, and practice change with the potential to improve health outcomes for people affected by cancer. Evaluation of implementation feasibility of these expert consensus generated quality indicators is recommended.

Illusory Feelings, Elusive Habits: People Overlook Habits in Explanations of Behavior.

Habits underlie much of human behavior. However, people may prefer agentic accounts that overlook habits in favor of inner states, such as mood. We tested this misattribution hypothesis in an online experiment of helping behavior (N = 809 adults) as well as in an ecological momentary assessment (EMA) study of U.S. college students' everyday coffee drinking (N = 112). Both studies revealed a substantial gap between perceived and actual drivers of behavior: Habit strength outperformed or matched inner states in predicting behavior, but participants' explanations of their behavior emphasized inner states. Participants continued to misattribute habits to inner states when incentivized for accuracy and when explaining other people's behavior. We discuss how this misperception could adversely influence self-regulation.

Toward Robust Assessments of Student Knowledge of Occupation.

IMPORTANCE: Occupational therapy students must master knowledge of occupation, yet how educators assess such knowledge has not been explored. In this study, we elucidate robust assessment practices that can help students master knowledge of occupation. OBJECTIVE: To examine practices that educators use to assess knowledge of occupation. DESIGN: Basic qualitative research. Using inductive and constant comparative methods, we coded 25 interviews and 82 educational artifacts for assessment practices, categorized practices as direct or indirect, and analyzed their alignments with features of robust assessments. SETTING: Twenty-five randomly selected occupational therapy and occupational therapy assistant academic programs in the United States, stratified by geographic region and institution type. PARTICIPANTS: Twenty-nine educators who represented selected programs. RESULTS: We found occupation at instruction and program levels primarily in relation to practice using indirect more than direct practices. Assignments were often highly creative and experiential, yet varied in their alignments with established criteria of robust assessments. CONCLUSIONS AND RELEVANCE: Knowledge of occupation was often intertwined with practice-oriented learning experiences and skills; hence, it was not assessed as a distinctly indispensable learning outcome. Educators can build on current practices to design robust assessments that require students to demonstrate knowledge of occupation in practice contexts and everyday life. WHAT THIS ARTICLE ADDS: In this study, we elucidate a continuum of prevalent educational practices used to assess knowledge of occupation; we also review best practices for robust assessments of such knowledge not only related to practice but also as a dynamic instrument of individual and societal well-being more broadly.

Parental Perspectives of Occupational Therapy in an Equine Environment for Children with Autism Spectrum Disorder.

This paper reports on the qualitative phase of a mixed methods study of occupational therapy in an equine environment for children with autism spectrum disorder (ASD). The study's quantitative phase found that this intervention improved the occupational performance, social motivation, social communication, and self-regulation of some children with ASD. The study's qualitative phase, reported herein, subsequently aimed to describe parental perspectives on children's experiences of the intervention and its influences on everyday life. Using a qualitative descriptive research approach, five parents participated in two rounds of semi-structured interviews. Interview data were analyzed using theoretical thematic analysis. Although parents expressed some concerns about the intervention, overall they found the intervention to be appropriate and acceptable. Next research steps include creation of a manual for the intervention and assessment of feasibility across a broader range of practice sites, occupational therapists, children with ASD, and their parents.

Experiential or Material Purchases? Social Class Determines Purchase Happiness.

Which should people buy to make themselves happy: experiences or material goods? The answer depends in part on the level of resources already available in their lives. Across multiple studies using a range of methodologies, we found that individuals of higher social class, whose abundant resources make it possible to focus on self-development and self-expression, were made happier by experiential over material purchases. No such experiential advantage emerged for individuals of lower social class, whose lesser resources engender concern with resource management and wise use of limited finances. Instead, lower-class individuals were made happier from material purchases or were equally happy from experiential and material purchases.

Psychology of Habit.

As the proverbial creatures of habit, people tend to repeat the same behaviors in recurring contexts. This review characterizes habits in terms of their cognitive, motivational, and neurobiological properties. In so doing, we identify three ways that habits interface with deliberate goal pursuit: First, habits form as people pursue goals by repeating the same responses in a given context. Second, as outlined in computational models, habits and deliberate goal pursuit guide actions synergistically, although habits are the efficient, default mode of response. Third, people tend to infer from the frequency of habit performance that the behavior must have been intended. We conclude by applying insights from habit research to understand stress and addiction as well as the design of effective interventions to change health and consumer behaviors.

Habit in Personality and Social Psychology.

Habits are largely absent from modern social and personality psychology. This is due to outdated perspectives that placed habits in conflict with goals. In modern theorizing, habits are represented in memory as implicit context-response associations, and they guide responding in conjunction with goals. Habits thus have important implications for our field. Emerging research shows that habits are an important mechanism by which people self-regulate and achieve long-term goals. Also, habits change through specific interventions, such as changes in context cues. I speculate that understanding of habits also holds promise for reducing intergroup discrimination and for understanding lay theories of the causes for action. In short, by recognizing habit, the field gains understanding of a central mechanism by which actions persist in daily life.

Animal-Assisted Therapies and Dementia: A Systematic Mapping Review Using the Lived Environment Life Quality (LELQ) Model.

OBJECTIVE: The authors mapped the literature on animal-assisted therapies (AATs) and institutionalized adults with dementia onto the Lived Environment Life Quality (LELQ) Model as a guide for future services and research. METHOD: Refereed literature addressing AATs and institutionalized people with dementia was comprehensively gathered, described, categorized, and synthesized in this systematic mapping review. RESULTS: From 1,342 screened records, the authors included 10 research articles that incorporated dogs in therapy for institutionalized adults with dementia. These canine-assisted therapies offered occupational opportunities and environmental supports conducive to experiences of relative well-being, occupational engagement, and optimal functioning. CONCLUSION: The findings offer proof of the concept that canine-assisted therapies are feasible and can elicit positive quality-of-life experiences in institutionalized people with dementia. Researchers and practitioners need to elucidate the theoretical foundations of AATs. The LELQ Model may serve as a guide for client-centered, occupation-focused, and ecologically valid approaches to animal-assisted occupational therapy.

Healthy eating habits protect against temptations.

Can healthy food-choice habits protect people against temptations of consuming large portion sizes and unhealthy foods? In two studies, we show that the answer is yes, good habits serve this protective role, at least in contexts in which people are not deliberating and thus fall back on habitual responses. In the first study, participants trained with unhealthy habits to approach eating chocolate, but not those trained with healthy habits, succumbed to temptation and ate more chocolates when their self-control resources were depleted. Study 2 extended and clarified these findings by demonstrating the role of environmental cues in eliciting healthy habits when self-control resources are depleted. Participants who had been trained to choose carrots habitually to a pictorial stimulus (i.e., habit cue) subsequently resisted choosing M&Ms as long as the cue was present. This effect of habit cues on healthy food choices suggests the usefulness of manipulating such cues as a means of meeting self-regulatory goals such as portion control.

A genome-wide association scan of tag SNPs identifies a susceptibility variant for colorectal cancer at 8q24.21.

Much of the variation in inherited risk of colorectal cancer (CRC) is probably due to combinations of common low risk variants. We conducted a genome-wide association study of 550,000 tag SNPs in 930 familial colorectal tumor cases and 960 controls. The most strongly associated SNP (P = 1.72 x 10(-7), allelic test) was rs6983267 at 8q24.21. To validate this finding, we genotyped rs6983267 in three additional CRC case-control series (4,361 affected individuals and 3,752 controls; 1,901 affected individuals and 1,079 controls; 1,072 affected individuals and 415 controls) and replicated the association, providing P = 1.27 x 10(-14) (allelic test) overall, with odds ratios (ORs) of 1.27 (95% confidence interval (c.i.): 1.16-1.39) and 1.47 (95% c.i.: 1.34-1.62) for heterozygotes and rare homozygotes, respectively. Analyses based on 1,477 individuals with colorectal adenoma and 2,136 controls suggest that susceptibility to CRC is mediated through development of adenomas (OR = 1.21, 95% c.i.: 1.10-1.34; P = 6.89 x 10(-5)). These data show that common, low-penetrance susceptibility alleles predispose to colorectal neoplasia.

An international systematic mapping review of fieldwork education in occupational therapy.

BACKGROUND: Owing to its importance in preparing occupational therapists, fieldwork education has generated numerous studies. These have not been collected and reviewed, leaving researchers without a map for growing a science of fieldwork education. PURPOSE: This study aimed to systematically categorize the topics, research designs, methods, levels of impact, and themes that have and have not been addressed in fieldwork education scholarship. METHOD: Guided by a systematic mapping review design, 124 articles, identified through database searches and inclusion coding, were studied. Data were collected using a data extraction instrument and analyzed using Microsoft Access queries. FINDINGS: Papers primarily addressed curriculum (n = 51) and students (n = 32). Conceptual/descriptive inquiry methods (n = 57) were predominant. Qualitative (n = 48) and quantitative methods (n = 49) were used equally. Research outcomes mainly targeted perceived participation in fieldwork. Recurring themes included student perceptions, external influences, and transition to practice. IMPLICATIONS: Three recommendations were identified: strengthen procedures for studying singular fieldwork experiences, broaden rationales for studying fieldwork, and translate educational concepts for occupational therapy.

Measuring context-response associations that drive habits.

People achieve important life outcomes of health, financial security, and productivity by repeating operant behavior. To identify whether such operants reflect goal pursuit or habit, the present research introduces a new paradigm that yields objective measures of learning and controls for the motivations of goal pursuit. In two experiments, participants practiced a sequential task of making sushi and then completed a test of the strength of cue-response (habit) associations in memory. Finally, they repeated the sushi task without instructions while under cognitive load (designed to impede deliberation about goals). As predicted, greater task practice yielded stronger cue-response associations, which in turn promoted task success. Practice did not improve performance by enhancing goal intentions or other task motivations. We conclude that repetition facilitates performance by creating mental associations that automatically activate practiced, habitual responses upon perception of recurring context cues.

Leveraging Habits to Improve Adherence to Gout Medications: A Qualitative Study.

OBJECTIVE: This study investigates patients' medication-taking routines and the feasibility of harnessing habit formation through context cues and rewards to improve medication adherence. METHODS: Semistructured qualitative interviews with patients with gout from an urban health care system were conducted to explore typical medication-taking behavior, experiences using electronic pill bottles, barriers to adherence, existing context cues, and potential cues and rewards for habit-forming behavior. Medication-taking patterns were recorded for six weeks using electronic pill bottles before interviews to inform discussion. Transcribed interviews were analyzed to generate themes using codes developed by the study team, with representative quotations selected as illustrations. RESULTS: We conducted interviews with 15 individuals (mean age 60.6 [SD 20.3] years, three women [20%], and nine White patients [60%]). Pill bottle-recorded adherence to urate-lowering therapy (ULT) was high (mean 0.91 [SD 0.10]), and one patient was experiencing an active gout flare. Five key themes emerged: (1) reasons for nonadherence, (2) internal and external motivations for adherence, (3) structured routines around taking medications, (4) rewards for good medication adherence, and (5) the role of pill cap technology in medication-taking. CONCLUSION: The importance of a predictable, structured routine in which participants could incorporate their medication-taking behavior emerged as a key factor that promoted consistent adherence. Further, identifying context cues and reminders seemed to promote incorporation of medication-taking into routines. Therefore, habit-based interventions that use context cues to establish routines around medication-taking may be a feasible strategy to improve adherence in patients with chronic conditions such as gout.

Habits are not goal-dependent: Commentary on Buabang et al. (2023).

People sometimes commit action slips by absentmindedly repeating unwanted responses, such as entering an old password instead of the current one. Most accounts hold that such slips demonstrate stimulus-response habits in which familiar contexts directly trigger well-practiced but now-incorrect responses. In contrast, Buabang et al. (2023) argue that action slips arise due to the continued influence of old, no longer accurate goal outcomes. In a reanalysis, we show that Buabang et al.'s participants actually provide striking evidence of goal-independent S-R habits: They correctly repeated well-practiced responses despite reporting incorrect goals. We also show that Buabang et al. misinterpreted the results of their mediation analyses by overlooking the direct influence of stimuli on responses. Understanding how habits work is important because habit change interventions are unlikely to succeed with goal-directed strategies that overlook context cues' direct activation of practiced responses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Unintentional Nonconformist: Habits Promote Resistance to Social influence.

This research tests a novel source of resistance to social influence-the automatic repetition of habit. In three experiments, participants with strong habits failed to align their behavior with others. Specifically, participants with strong habits to drink water in a dining hall or snack while working did not mimic others' drinking or eating, whereas those with weak habits conformed. Similarly, participants with strong habits did not shift expectations that they would act in line with descriptive norms, whereas those with weak habits reported more normative behavioral expectations. This habit resistance was not due to a failure to perceive influence: Both strong and weak habit participants' recalled others' behavior accurately, and it was readily accessible. Furthermore, strong habit participants shifted their normative beliefs but not behavior in line with descriptive norms. Thus, habits create behavioral resistance despite people's recognition and acceptance of social influence.

Distance to vaccine sites is tied to decreased COVID-19 vaccine uptake.

COVID-19 remains a leading cause of mortality in the United States, despite the widespread availability of vaccines. Conventional wisdom ties failure to vaccinate primarily to vaccine-skeptic beliefs (e.g. conspiracy theories, partisanship). Yet in this research, we find that vaccination is also hindered by travel distance to vaccine sites (a form of friction, or structural barriers). In study 1, Californians living farther from vaccine sites had lower vaccination rates, and this effect held regardless of partisanship. In study 2, Chicago zip codes saw an uptick in vaccination following vaccine site opening. These results proved robust in multiverse analyses accounting for a wide range of covariates, outcomes, and distance indicators. COVID-19 vaccination is hampered not only by vaccine hesitancy but also by structural barriers like distance. Efforts to boost vaccination could benefit from minimizing friction.

Altered sagittal plane mechanics is associated with Functional Movement Screen deep squat score.

Background: The Functional Movement Screen (FMS) assesses the quality of movements, including the deep squat (DS), which is used in sports settings. The validity of the individual item scores has yet to be established. Objectives: To investigate the validity of the FMS DS by comparing the sagittal plane kinematics of participants who achieve different observer scores. Method: Seventeen injury-free, adolescent male cricket bowlers were assessed. The movement was captured using the Optitrack® motion capture system. Simultaneously, observers scored participants' execution of the DS according to the standard FMS scoring criteria. Participants were grouped into Group 1 (lowest score), Group 2 (altered movement mechanics) or Group 3 (perfect score) according to observer scores. Specific joint angles of each group were compared using the Kruskal-Wallis and Mann-Whitney U tests. Results: There were significant differences in the degree to which the femur passed the horizontal between Group 3 and Group 1 (p = 0.04, r = 0.61) and Group 2 and Group 1 (p = 0.03, r = 0.66) and the difference in the degree to which the torso was kept vertical between Group 3 and Group 1 (p = 0.02, r = 0.66) and Group 2 and Group 1 (p = 0.02; r = 0.72). Conclusion: Kinematic differences exist between participants who achieve different observer scores for the FMS DS. Clinical implications: While differences in sagittal plane kinematics have been observed in participants scoring high on the FMS DS and participants scoring low, further investigation into the validity of the frontal plane kinematics is warranted, as well as the concurrent validity of the individual scoring criteria.