Mechanisms of self-persuasion intervention for HPV vaccination: Testing memory and autonomous motivation.

Objective: Optimizing a self-persuasion intervention app for adolescent HPV vaccination requires investigating its hypothesized mechanisms. Guided by the experimental medicine approach, we tested whether (a) self-persuasion intervention components (verbalize vaccination reasons, choose HPV topics) changed putative mechanisms (memory, autonomous motivation) and (b) measures of the putative mechanisms were associated with HPV vaccination. Method: These are secondary analyses from a randomized 2 (cognitive processing: verbalize reasons vs. listen) × 2 (choice: choose HPV topics vs. assigned) factorial trial (Tiro et al., 2016). Undecided parents (N = 161) with an unvaccinated child (11-17 years old) used the self-persuasion app, recalled reasons for vaccination (memory measure), and completed an autonomous motivation measure. Adolescent vaccination status was extracted from electronic medical records 12 months postintervention. Results: The verbalize component resulted in greater recall accuracy of vaccination reasons (p < .001); however, the choose topics component did not increase autonomous motivation scores (p = .74). For associations with HPV vaccination, recall accuracy was not associated (ps > .51), but autonomous motivation scores significantly predicted vaccination (ps < .03), except when controlling for baseline motivation (p = .22). Conclusion: The intervention app engages parents in reasons for vaccination; however, memory may not be a viable mechanism of vaccination. Although the intervention did not affect autonomous motivation, associations with vaccination status suggest it is a viable intervention target for HPV vaccination but alternative strategies to change it are needed. Future testing of a refined app should examine implementation strategies to optimize delivery in clinical or community settings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Trait mindfulness and health behaviours: a meta-analysis.

Mindfulness is defined as bringing one's attention to present-moment experience with acceptance, and is associated with engagement in various health behaviours. To synthesise and evaluate this literature, we conducted a comprehensive meta-analytic review and examined (a) the associations between trait mindfulness and health behaviours and (b) the extent to which these associations were moderated by study and individual differences. A total of 125 independent samples were included (N = 31,697, median male percentage = 38.8%, median age = 28.3). A multilevel random-effects model was used to estimate summary study-level effect sizes, and multilevel mixed-effects models were used to examine moderator effects. Mindfulness had a positive and small association with aggregated health behaviours (r = .08). Mindfulness was positively associated with physical activity, healthy eating, and sleep (rs = .08-.14), and negatively associated with alcohol use (r = -.06). Effects were larger for health promoting behaviours, the acting with awareness facet of mindfulness, and samples involving psychiatric patients. Although findings indicate that individual differences in trait mindfulness do not reliably translate into a pattern of healthful behaviours in general, trait mindfulness shows a stronger associations with health behaviours under certain conditions.

Evaluating the Validity of the Risk Perception Survey for Developing Diabetes Scale in a Safety-Net Clinic Population of English and Spanish Speakers.

PURPOSE: The purpose of this study is to examine the factor structure of the Risk Perception Survey for Developing Diabetes (RPS-DD) and test for factorial invariance by language (English, Spanish) and gender (males, females) in a clinically engaged, racially diverse, low-education population. METHODS: Adult patients seen in a safety-net health system (N = 641) answered an interviewer-administered survey via telephone in their preferred language (English: 42%, Spanish: 58%). Three constructs in the RPS-DD were assessed-personal control (2 items for internal control and 2 for external control), optimistic bias (2 items), and worry (2 items). Single and multigroup confirmatory factor analyses (CFAs) were performed using maximum-likelihood estimation to determine the factor structure and test for invariance. RESULTS: Contrary to previous psychometric analyses in white, educated populations, CFAs supported a 4-factor measurement model with internal and external control items loading onto separate factors. The 4-factor structure was equivalent between males and females. However, the structure varied by language, with the worry subscale items loading more strongly for English than Spanish speakers. CONCLUSIONS: The RPS-DD can be used to investigate group differences across gender and language and to help understand if interventions have differential effects for subgroups at high risk for diabetes. Given the increasing prevalence of diabetes among Spanish speakers, researchers should continue to examine the psychometric properties of the RPS-DD, particularly the worry subscale, to improve its validity and clinical utility.

Big Five personality and health in adults with and without cancer.

Personality is associated with health, but examinations in patients with illnesses are lacking. We aimed to determine whether personality-physical health associations differed between community and cancer samples. This cross-sectional study involved 168 participants without cancer, 212 men with prostate cancer, and 55 women with breast cancer. We examined whether the Big Five personality dimensions were associated with health behaviors and multiple health indicators. Higher conscientiousness and lower neuroticism were associated with better health behaviors and health (rmax = .31), with few differences between community and cancer samples. Findings call for research on the implications of personality in patients with serious illnesses.

Experiential Avoidance: An Examination of the Construct Validity of the AAQ-II and MEAQ.

Experiential avoidance (also referred to as acceptance or psychological flexibility) is a core construct of third-wave behavior therapies. It is the tendency to avoid uncomfortable thoughts or feelings, even when doing so has negative long-term consequences. In order for developments in experiential avoidance and third-wave behavior therapies to continue, it is imperative to examine the construct validity of the most widely used measures of this construct, the Acceptance and Action Questionnaire-II (AAQ-II) and the Multidimensional Experiential Avoidance Questionnaire (MEAQ). In Amazon's Mechanical Turk (N = 1,052) and college (N = 364) samples, we evaluated the construct validity of these measures. The AAQ-II demonstrated suboptimal patterns of convergent and discriminant validity with measures of neuroticism/negative affect (Big Five Inventory, Big Five Aspects Scale, Positive and Negative Affect Schedule), the MEAQ, and mindfulness (Five Factor Mindfulness Questionnaire). In contrast, the MEAQ demonstrated optimal convergent and discriminant validity. Factor analyses at the scale, subscale, and item levels demonstrated that the AAQ-II loads with indicators of neuroticism/negative affect and not with other constructs at the core of third-wave behavior therapies. In contrast, the MEAQ loads on factors with mindfulness or forms its own factors. These findings suggest the AAQ-II functions as a measure of neuroticism/negative affect, whereas the MEAQ functions as an indicator of experiential avoidance. These findings have substantial implications for research on experiential avoidance and third-wave behavior therapies. Therefore, in order to improve the theory, research, and practice of third-wave behavior therapies, we recommend using the MEAQ to assess experiential avoidance.