Development and Application of an Interdisciplinary Rapid Message Testing Model for COVID-19 in North Carolina.

INTRODUCTION: From the onset of the COVID-19 pandemic, public health officials have sought to develop evidence-based messages to reduce COVID-19 transmission by communicating key information to media outlets and the public. We describe the development of an interdisciplinary rapid message testing model to quickly create, test, and share messages with public health officials for use in health campaigns and policy briefings. METHODS: An interdisciplinary research team from the University of North Carolina at Chapel Hill assembled in March 2020 to assist the state health department in developing evidence-based messages to influence social distancing behaviors in the state. We developed and iteratively executed a rapid message testing model; the components of the 4-step model were message creation, survey development, survey administration, and analysis and presentation to health department officials. The model was executed 4 times, each during a 7-day period in April and May, and each subsequent survey included new phrasing and/or messaging informed by the previous week's survey. A total of 917 adults from North Carolina participated in the 4 surveys. RESULTS: Survey participants rated messages focused on protecting oneself and others higher than messages focused on norms and fear-based approaches. Pairing behaviors with motivations increased participants' desire to social distance across all themes and subgroups. For example, adding "Protect your grandmother, your neighbor with cancer, and your best friend with asthma," to messaging received a 0.9-point higher score than the base message, "Stay 6 feet apart from others when out in public." PRACTICE IMPLICATIONS: Our model to promote social distancing in North Carolina during the COVID-19 pandemic can be used for rapid, iterative message testing during public health emergencies.

Development of a web tool to increase research literacy in underserved populations through public library partnerships.

OBJECTIVE: Inadequate diversity in clinical trials is widely recognized as a significant contributing factor to health disparities experienced by racial/ethnic minorities and other diverse populations in the US. To address this in a scalable way, we sought to develop a web tool that could help enhance underserved minority participation in clinical research. METHODS: We used our research literacy support flashcard tool as the initial prototype for human-centered design and usability testing of the web tool Health for All in public library settings. After forming partnerships with leadership from Chicago Public Libraries (CPL), local medical libraries, and the Chicago Department of Public Health, we conducted seven iterative design sessions with focus groups of library patrons and library staff from six CPL branches serving underserved communities followed by two rounds of usability testing and website modification. RESULTS: Based on the qualitative research findings from Design Sessions 1-7, we enacted the design decision of a website that was a hybrid of fact-filled and vignette (personal stories) paper prototypes divided into 4 modules (trust, diversity, healthy volunteers, pros/cons), each with their own outcome metrics. The website was thus constructed, and navigation issues identified in two rounds of usability testing by library patrons were addressed through further website modification, followed by the launch of a beta version of a hybridized single-scrolling and guided module prototype to allow further development with website analytics. CONCLUSIONS: We report the development of Health for All, a website designed to enhance racial/ethnic minority participation in clinical trials by imparting research literacy, mitigating distrust engendered by longstanding racism and discrimination, and providing connections to clinical trials recruiting participants.

English Word and Pseudoword Spellings and Phonological Awareness: Detailed Comparisons From Three L1 Writing Systems.

Spelling is a fundamental literacy skill facilitating word recognition and thus higher-level reading abilities via its support for efficient text processing (Adams, 1990; Joshi et al., 2008; Perfetti and Stafura, 2014). However, relatively little work examines second language (L2) spelling in adults, and even less work examines learners from different first language (L1) writing systems. This is despite the fact that the influence of L1 writing system on L2 literacy skills is well documented (Hudson, 2007; Koda and Zehler, 2008; Grabe, 2009). To address this shortcoming, this study collected data on real word spelling, pseudoword spelling, and phonological awareness (elision) abilities from 70 participants (23 native speakers; 47 ELLs with alphabetic, abjad, and morphosyllabic L1s). Analyses compared performance on real word and pseudoword spelling between L1 English speakers and ELLs, and additionally among the non-native-speaker L1 groups (categorized into alphabet, abjad, and morphosyllabary groups). Similar comparisons were made across groups for performance on phonological awareness. Further, correlations were calculated between phonological awareness and real word spelling and between phonological awareness and pseudoword spelling, separately for L1 English speakers and the various ESL groups. Spelling accuracy on real words and pseudowords as well as phonological awareness skill differed between native speakers and ESL speakers, and also varied by the ESL speakers' L1 writing system. Theoretically interesting patterns emerged in the spelling data. For example, the morphosyllabic L1 speakers had strong real word spelling (better than the other ESL groups) but greatly decreased pseudoword accuracy (a drop of 59% in accuracy). Although alphabetic L1 speakers had low spelling accuracy in terms of strict scoring, they had lower rates of errors per item, highlighting the importance of scoring approach for shaping the conclusions that are drawn. Error rates also revealed vowels to be more problematic than consonants, particularly in abjad L1 speakers. The results demonstrate that L2 spelling abilities, phonological awareness, and the relationships among them vary by L1 writing system, and that differing approaches to scoring and analysis may lead to varying conclusions.

The Neural Correlates of Similarity- and Rule-based Generalization.

The idea that there are multiple learning systems has become increasingly influential in recent years, with many studies providing evidence that there is both a quick, similarity-based or feature-based system and a more effortful rule-based system. A smaller number of imaging studies have also examined whether neurally dissociable learning systems are detectable. We further investigate this by employing for the first time in an imaging study a combined positive and negative patterning procedure originally developed by Shanks and Darby [Shanks, D. R., & Darby, R. J. Feature- and rule-based generalization in human associative learning. Journal of Experimental Psychology: Animal Behavior Processes, 24, 405-415, 1998]. Unlike previous related studies employing other procedures, rule generalization in the Shanks-Darby task is beyond any simple non-rule-based (e.g., associative) account. We found that rule- and similarity-based generalization evoked common activation in diverse regions including the pFC and the bilateral parietal and occipital lobes indicating that both strategies likely share a range of common processes. No differences between strategies were identified in whole-brain comparisons, but exploratory analyses indicated that rule-based generalization led to greater activation in the right middle frontal cortex than similarity-based generalization. Conversely, the similarity group activated the anterior medial frontal lobe and right inferior parietal lobes more than the rule group did. The implications of these results are discussed.

A Comparison of the neural correlates that underlie rule-based and information-integration category learning.

The influential competition between verbal and implicit systems (COVIS) model proposes that category learning is driven by two competing neural systems-an explicit, verbal, system, and a procedural-based, implicit, system. In the current fMRI study, participants learned either a conjunctive, rule-based (RB), category structure that is believed to engage the explicit system, or an information-integration category structure that is thought to preferentially recruit the implicit system. The RB and information-integration category structures were matched for participant error rate, the number of relevant stimulus dimensions, and category separation. Under these conditions, considerable overlap in brain activation, including the prefrontal cortex, basal ganglia, and the hippocampus, was found between the RB and information-integration category structures. Contrary to the predictions of COVIS, the medial temporal lobes and in particular the hippocampus, key regions for explicit memory, were found to be more active in the information-integration condition than in the RB condition. No regions were more activated in RB than information-integration category learning. The implications of these results for theories of category learning are discussed. Hum Brain Mapp 37:3557-3574, 2016. © 2016 Wiley Periodicals, Inc.