Understanding family-level decision-making when seeking access to acute surgical care for children: Protocol for a cross-sectional mixed methods study.

BACKGROUND: There is limited understanding of how social determinants of health (SDOH) impact family decision-making when seeking surgical care for children. Our objectives of this study are to identify key family experiences that contribute to decision-making when accessing surgical care for children, to confirm if family experiences impact delays in care, and to describe differences in family experiences across populations (race, ethnicity, socioeconomic status, rurality). METHODS: We will use a prospective, cross-sectional, mixed methods design to examine family experiences during access to care for children with appendicitis. Participants will include 242 parents of consecutive children (0-17 years) with acute appendicitis over a 15-month period at two academic health systems in North Carolina and Virginia. We will collect demographic and clinical data. Parents will be administered the Adult Responses to Children's Symptoms survey (ARCS), the child and parental forms of the Adverse Childhood Experiences (ACE) survey, the Accountable Health Communities Health-Related Social Needs Screening Tool, and Single Item Literacy Screener. Parallel ARCS data will be collected from child participants (8-17 years). We will use nested concurrent, purposive sampling to select a subset of families for semi-structured interviews. Qualitative data will be analyzed using thematic analysis and integrated with quantitative data to identify emerging themes that inform a conceptual model of family-level decision-making during access to surgical care. Multivariate linear regression will be used to determine association between the appendicitis perforation rate and ARCS responses (primary outcome). Secondary outcomes include comparison of health literacy, ACEs, and SDOH, clinical outcomes, and family experiences across populations. DISCUSSION: We expect to identify key family experiences when accessing care for appendicitis which may impact outcomes and differ across populations. Increased understanding of how SDOH and family experiences influence family decision-making may inform novel strategies to mitigate surgical disparities in children.

Toward a Comprehensive, Data-Driven Model of American Political Goals: Recognizing the "Values" and "Vices" Within Both Liberalism and Conservativism.

When a person indicates they are "liberal" or "conservative," an important part of what they are communicating is their goals for how they would like society to be structured. However, past theories have described these goals in dramatically different fashions, suggesting that either conservativism or liberalism reflects a divisive or unifying goal. To help overcome this impasse, we systematically compared a broad, representative sample of all possible higher-order goals (drawn a previous lexical investigation of more than 1,000 goals) to the political ideology of American adults (total n = 1,588). The results of five studies suggested that proposals from competing theories are all partially correct. Conservativism simultaneously reflects the unifying "value" of Tradition, as well as the divisive "vice" of Elitism; while Liberalism simultaneously reflects the unifying "value" of Inclusiveness, and the divisive "vice" of Rebellion. These results help to integrate proposals from previous competing theories into a single framework.

Getting COVID-19: Anticipated negative emotions are worse than experienced negative emotions.

OBJECTIVE: When people think about negative events that may occur in the future, they tend to overestimate their emotional reactions, and these "affective forecasts" can influence their present behavior (Wilson and Gilbert, 2003). The present research examined affective forecasting for COVID-19 infection including the associations between emotions and preventive intentions and behavior. METHODS: In two studies, we compared individuals' anticipated emotions and recalled emotions for COVID-19 infection. Study 1 asked college students (N = 219) and Study 2 asked general adults (N = 401) to either predict their emotions in response to a future COVID-19 infection or to recall their emotions associated with a previous infection. RESULTS: In both studies, reliable differences in negative emotions emerged. Those who were predicting their feelings associated with a future infection anticipated more negative emotion than those who were recalling their feelings associated with a past infection reported. Greater negative emotion in both studies was significantly associated with being more likely to have been vaccinated as well as higher intentions to get the booster vaccine. CONCLUSIONS: These findings suggest that compared to those who have had a COVID-19 infection, those who have not yet experienced infection anticipate they will experience greater negative emotion, and this may have implications for preventive behaviors. In general, these findings suggest that people may have an impact bias for COVID-19 infection.

The Naturalness Bias Influences Drug and Vaccine Decisions across Cultures.

HIGHLIGHTS: The naturalness bias - preferring natural to synthetic drugs or vaccines - occurred across cultures (Americans, Canadians, and Chinese).Chinese participants showed a stronger naturalness bias than Americans did when the medical context was focused on vaccination, and safety concerns mediated this effect.The naturalness bias may influence medical decision making across cultures, but Chinese participants may be more sensitive to naturalness in a vaccine context.

Development and Validation of the Single-Item Mindfulness Scale (SIMS).

Mindfulness is a focused attention to and acceptance of present experiences. Although several reliable and valid multi-item measures of trait mindfulness exist, researchers may sometimes want a short and quick measure of mindfulness. In this project, we developed and validated the Single-Item Mindfulness Scale (SIMS) to assess trait mindfulness. We conducted eight studies involving 3,125 adult and adolescent participants. The studies consisted of cross-sectional, short longitudinal, and daily diary designs. We first developed the wording of the SIMS in Studies 1 and 2 and then examined the validity and reliability in Studies 3-8. The SIMS was found to be reliable and valid. It correlated with several multi-item measures of mindfulness at effect sizes in the medium to large range. It also correlated in expected ways with variables known to be related to existing multi-item measures of mindfulness such as self-compassion, anxiety, negative affect, positive affect, depression, neuroticism, empathy, prosocial behavior, and self-consciousness. Furthermore, it correlated positively with daily reports of mindfulness in a two-week diary study. Although existing multi-item trait mindfulness scales should be used, when possible, the SIMS is recommended in situations when time, question quantity, or researcher focus is constrained.

Religiosity and the Naturalness Bias in Drug and Vaccine Choices.

Research reveals a bias for natural versus synthetic drugs. We sought to determine if this bias is associated with religiosity. Three cross-sectional studies (N = 1399 U.S. participants) were conducted to examine the impact of religiosity on the naturalness bias in the drug and vaccine domains. We assessed measures of religiosity, preferences for natural versus synthetic drugs and vaccines in hypothetical scenarios, and a health-related behavior (COVID-19 vaccination status). The results revealed that participants high versus low in religiosity had stronger preferences for natural versus synthetic drugs and vaccines. Furthermore, participants high versus low in religiosity were less likely to have taken the COVID-19 vaccine, and the natural drug bias was a mediator of this effect. Overall, participants higher in religiosity had a stronger preference for natural versus synthetic drugs and vaccines, and this preference had implications for health behavior.

Predictors of the intention to receive a SARS-CoV-2 vaccine.

BACKGROUND: It is imperative to understand the predictors of vaccine hesitancy for current and future pandemics. METHODS: A representative sample (age, race & gender) of 1054 US adults was collected in October 2020 to examine the predictors of vaccine hesitancy. Participants were asked several questions including their intention to receive a vaccine for the novel coronavirus. RESULTS: Predictors significantly associated with a greater intention to receive a COVID-19 vaccine included greater perceived feelings of vulnerability to COVID-19, having received a flu vaccination at the time the question was asked, more liberal political orientation, non-Black race, male gender, and a lower naturalness bias. CONCLUSIONS: Vaccines are essential for mitigating current and future pandemics. Multiple strategies are important in encouraging people to be vaccinated and the predictors highlighted here and elsewhere are likely to be useful targets.

What is the "opposite" of a value? A lexical investigation into the structure of generally undesirable goal content.

OBJECTIVES: Past taxonomies of goal-content have focused (either exclusively or predominantly) on generally-desirable values, and they suggest that some values oppose other values. However, many goals are generally-undesirable (i.e., the average person is committed to avoiding them), and these "vices" have been under-studied. This is an important gap because other models suggest that the "opposite" of a value is actually a vice. METHODS: To fill this gap, we conducted a lexical investigation. Two large samples (involving 504 undergraduates & 257 online participants) first rated their commitment to approaching or avoiding a large number of goals from the English lexicon. RESULTS: Analyses indicated that vices can be summarized in terms of Elitism, Rebellion, and Disrepute, which appear opposite from Inclusiveness, Tradition, and Prominence values (respectively) in MDS models. In Study 3 (involving 280 undergraduates) and Study 4 (involving 261 online participants), we found that Schwartz values of Universalism, Tradition, and Self-Enhancement actually appeared opposite from Elitism, Rebellion, and Disrepute (respectively) in MDS models, rather than from other values. CONCLUSIONS: This investigation develops an instrument which can distinguish between different vices at a holistic level, and it suggests that they are actually the opposite of select values.

Evaluation of the moderated-expression and differential configuration hypotheses in the context of "successful" or "noncriminal" psychopathy.

The concept of "successful" psychopathy has intrigued the field, yet relatively little actual science exists to understand what makes those high in psychopathic traits more or less successful, or even what constitutes "success." In the current study, we examined the validity of the moderated expression hypothesis, including an elaborated version that considers differential configuration of psychopathy traits, as accounting for differences in criminal and noncriminal (the most common operationalization of "success") expressions of psychopathy. The latter was conceptualized from the perspective of the triarchic psychopathy model. We recruited a community sample (n = 212) that had been overweighted toward psychopathic personality traits. The triarchic psychopathy domains of boldness, meanness, and disinhibition were modeled as latent constructs based on scores from multiple psychopathy measures. We examined affective processing dysfunction, various executive cognitive deficits, substance misuse, and socioeconomic indicators (income, education) as potential moderators of associations between psychopathy and criminality. We estimated a series of latent regression models in which we tested interaction effects between hypothesized moderators and a latent criminality variable. We found that affective processing dysfunction, substance misuse, and the triarchic psychopathy domain of disinhibition all moderated the association between meanness and criminality, in that the latter association was stronger as these moderators increased in severity. Disinhibition was also moderated by substance misuse and boldness by both personal income and commission errors from a go/no-go task, though in the case of the latter domain, these moderators served as protective factors against criminality. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Be Responsible?

The bystander effect reveals that people are less likely to help a person in need when others are present. We examined the impact of priming the concept of responsibility on the bystander effect in a field study. Lone pedestrians (N = 259) were randomly assigned to a two (Bystanders: none and three nonresponsive bystanders) by two (Shirt: blank shirt and shirt with "Be Responsible" written on the front) design. A researcher dropped eight pens approximately 15 ft from a lone pedestrian, while wearing one of the two shirts in the presence/absence of bystanders (confederates). The bystander effect was found: Pedestrians helped pick up pens more frequently in the no bystanders condition (59.05% helped) compared to the nonresponsive bystanders condition (41.67% helped). The responsibility prime tended to boost helping rates, but it did not significantly increase helping rates either as a main effect or as part of an interaction term. The bystander effect was replicated in a field setting, but priming the concept of responsibility did not appear to reduce it.

What shall we call God? An exploration of metaphors coded from descriptions of God from a large U.S. undergraduate sample.

People use numerous metaphors to describe God. God is seen as a bearded man, light, and love. Based on metaphor theories, the metaphors people use to refer to God reflect how people think about God and could, in turn, reflect their worldview. However, little work has explored the common metaphors for God. This was the purpose of the current investigation. Four trained raters coded open-ended responses from predominantly Christian U.S. undergraduates (N = 2,923) describing God for the presence or absence of numerous metaphoric categories. We then assessed the frequency of each of the metaphor categories. We identified 16 metaphor categories that were present in more than 1% of the responses. The top categories were "GOD IS POWER," "GOD IS HUMAN," and "GOD IS MALE." These findings were similar across religious affiliations. We attempted to support our coding analysis using top-down and bottom-up automated language analysis. Results from these analyses provided added confidence to our conclusions. We discuss the implications of our findings and the potential for future studies investigating important psychological and behavioral outcomes of using different metaphors for God.

Social psychology and COVID-19: What the field can tell us about behavior in a pandemic.

The COVID-19 pandemic has wreaked havoc in the lives of people around the world. Pandemics are powerful situations that can be examined from a social psychological lens. In this special section, four articles present data collected before and during the pandemic, providing a type of quasi-experimental design that helped examine the impact of the pandemic on social behavior. A number of findings emerged: the pandemic potentially increased instances of cyberbullying; the pandemic may have increased reports that Black-White intergroup interactions are more competitive and discriminatory; the pandemic may have reduced negative attitudes and bias in domestic versus international students in the U.S; and the pandemic may have allowed feelings of helplessness to provide a fear-reducing mechanism. We expand upon these findings by discussing how social psychology can help us understand and modify behaviors related to health and social relations during major threats like a pandemic.

Trait mindfulness is negatively associated with distress related to COVID-19.

Research suggests that mindfulness is associated with psychological health including a healthier response to stressors. OBJECTIVE: This research tested associations between trait mindfulness and mental health factors related to the novel coronavirus (COVID-19). METHODS: Two studies (Study 1 N = 248 college students; Study 2 N = 300 U.S adults) assessed trait mindfulness, perceived stress and anxiety, worry about the coronavirus, and anticipated negative affect of a coronavirus diagnosis. Additionally, Study 2 assessed depressive symptoms and coping with the coronavirus. RESULTS: In both studies, findings indicated that individuals higher in trait mindfulness reported less stress and anxiety. Higher mindfulness in both studies was also associated with less worry about the virus and anticipating less negative affect if one gets the virus. In Study 2, trait mindfulness was negatively related to depression, and numerous associations between mindfulness and coping emerged, showing higher trait mindfulness was associated with healthier strategies in coping with coronavirus. CONCLUSIONS: These data are consistent with research that has revealed that those who think and act more mindfully are less stressed and anxious. By revealing these associations with mindfulness in the context of a real-world, novel stressor, this research makes an important contribution to the literature.

Leveraging individual differences to understand grounded procedures.

We applaud the goals and execution of the target article, but note that individual differences do not receive much attention. This is a shortcoming because individual differences can play a vital role in theory testing. In our commentary, we describe programs of research of this type and also apply similar thinking to the mechanisms proposed in the target article.

Injury patients' perceptions of drink-driving: A qualitative assessment of drink-driving behavior in Moshi, Tanzania.

BACKGROUND: Globally, about 2.3 billion people are current alcohol drinkers, and 283 million have an alcohol use disorder. Alcohol use while driving is a major contributor to road traffic injuries (RTI). We need to understand the culture and perception of drink-driving in this setting to understand why people continue to drink drive and allow policymakers to develop more effective ways to address drink-driving behavior. This study aims to qualitatively determine what injury patients, their families, and community advisory board members in Tanzania believe about drink-driving to help inform policies to address this problem. METHODS: The semi-structured focus group was designed based on the grounded theory and assessed using thematic analysis. Focus groups participants were a convenience sample of injury patients, their families, and community advisory board (CAB) members. Analysis was iterative throughout the study. All transcripts were coded using a thematic narrative approach. Representative quotes for each theme were then selected based on comparative analysis of coding with input from research team members. RESULTS: A total of ten focus groups were conducted (4 patient, 4 family, and 2 CAB) with a total of 104 participants (37 females and 67 males). The normalization of drinking among drivers has allowed this behavior to become ingrained in the culture. Participants expressed notions that passengers are responsible for their own safety, rather than drivers being responsible for their passengers. Most participants believe it is a citizen's duty to inform the police of suspected drink-driving, however there were differing opinions about how effective informed police officers can be in practice. Focus group discussions between all three population types highlighted major themes of 'drinking is ingrained in boda boda driver culture', 'individuals have a personal responsibility to address drink-driving', and a 'police enforcement on drink-driving is necessary'. CONCLUSIONS: Normalization of drink-driving in commercial driver culture creates a dangerous environment for passengers which can be mitigated by education and health promotion. As most passengers already take personal responsibility for their own road traffic safety, they may be likely to make use of safe ride options, if available. While legislation is in place against drink-driving, police officers need to be empowered with appropriate training and funding to enforce them.

Alcohol stigma as it relates to drinking behaviors and perceptions of drink drivers: A mixed method study in Moshi, Tanzania.

BACKGROUND: Alcohol is a leading risk factor for road traffic injury in low- and middle-income countries, such as Tanzania. This research seeks to explore the drinking patterns, perceptions, and stigma of drink driving behavior of injury patients at Kilimanjaro Christian Medical Center in Moshi, Tanzania. METHODS: This mixed methods study incorporated the Perceived Alcohol Stigma (PAS), an additive Likert scale, and the Alcohol Use Disorders Identification Test (AUDIT). Results are reported as medians with IQRs. Additionally, focus groups with injury patients, their families, and community members (n = 104) were conducted and analyzed in pairs using an inductive thematic content analysis approach. RESULTS: Those who self-reported driving after ingesting 3 or more alcoholic drinks had a median AUDIT score (median = 11.0) significantly higher than those who denied drink driving (median = 5.5, p < 0.01). The PAS showed a high overall stigma against those who use alcohol but differed for drink drivers, drinkers, and abstainers (median = 20.8, 23.9, 34.9, p < 0.01). Thematic content analysis highlighted a 'disapproving of drink drivers', that 'problematic drinking is a drinking behavior which negatively affects others', and a 'passiveness toward drinking and drink driving'. CONCLUSIONS: Stigma against those who use alcohol is present in Tanzania. Perceived stigma is significantly lower among those who drink drive than those who do not. Overall, there appears to be a community-wide disapproval of drinking and driving, which is coupled with feeling unable to change this risky behavior.

Road traffic crash experience among commercial motorcyclists in Kigali, Rwanda.

Objective: Road traffic injuries (RTI) cause ∼1.2 million deaths and 50 million injuries annually, disproportionately occurring in low- and middle-income countries. Although policy changes and infrastructural developments have continued to contribute to the decrease in RTI-related deaths, limited studies have investigated the relationship between motorcycle taxi driver behaviors and RTIs in Rwanda. This study aims to describe the safety behaviors of commercial motorcyclists in Kigali, Rwanda.Methods: We surveyed 609 commercial motorcyclists in January 2014 then conducted a cross-sectional analysis of the results, including descriptive and bivariate logistic regression analyses.Results: We found that 38.7% of surveyed motorcycle drivers experienced a crash during their lifetime, of which, more than half (n = 134, 56.8%) suffered injuries. Of all injuries, 38.8% (n = 52) resulted in hospitalization, and 14.2% (n = 19) in disability. Among motorcyclists, 100% reported always wearing a helmet, 99% reported always wearing a chin strap, and 98.8% reported always having a passenger helmet. There was an association between sustaining a crash and believing that helmets (p = 0.08) and chin straps (p = 0.05) reduced crash risk.Conclusions: Rwandan commercial motorcyclists demonstrate generally proper safety behaviors, but remain a high-risk occupational group. Road safety policy initiatives have been effective in changing driver behavior regardless of driver safety beliefs.

Perceptions of alcohol use among injury patients and their family members in Tanzanian society.

Alcohol is one of the leading causes of death and disability worldwide. Rates of alcohol abuse in Moshi, Tanzania, are about 2.5 times higher than the Tanzanian average. We sought to qualitatively assess the perceptions of alcohol use among injury patients in Moshi, including availability, consumption patterns, abuse, and treatments. Participants were Emergency Department injury patients, their families, and community advisory board members. Participants were included if they were ≥18 years of age, a patient or patient's family member seeking care at the Kilimanjaro Christian Medical Center Emergency Department, Moshi, Tanzania, for an acute injury, clinically sober at the time of enrollment, medically stable, able to communicate in Swahili and consented to participate. Focus group discussions were audiotaped, transcribed, translated, and analyzed in parallel using an inductive thematic content analysis approach. Resultant themes were then reanalyzed to ensure internal homogeneity and external heterogeneity. Fourteen focus group discussions, with a total of 104 participants (40 patients, 50 family members, 14 community advisory board members), were conducted. Major themes resulting from the analysis included: 1) Early/repeated exposure; 2) Moderate use as a social norm with positive attributes; 3) Complications of abuse are widely stigmatized; and 4) Limited knowledge of availability of treatment. Our findings suggest that, among our unique injury population and their families, despite the normalization of alcohol-related behaviors, there is strong stigma toward complications stemming from excess alcohol use. Overall, resources for alcohol treatment and cessation, although broadly desired, are unknown to the injury population.

Lexical derivation of the PINT taxonomy of goals: Prominence, inclusiveness, negativity prevention, and tradition.

What do people want? Few questions are more fundamental to psychological science than this. Yet, existing taxonomies disagree on both the number and content of goals. Thus, we adopted a lexical approach and investigated the structure of goal-relevant words from the natural English lexicon. Through an intensive rating process, 1,060 goal-relevant English words were first located. In Studies 1-2, two relatively large and diverse samples (total n = 1,026) rated their commitment to approaching or avoiding these goals. Principal component analyses yielded 4 replicable components: Prominence, Inclusiveness, Negativity Prevention, and Tradition (the PINT Taxonomy). Studies 3-7 (total n = 1,396) supported the 4-factor structure of an abbreviated scale and found systematic differences in their relationships with past goal-content measures, the Big 5 traits, affect, and need satisfaction. This investigation provides a data-driven taxonomy of higher-order goal-content and opens up a wide variety of fascinating lines for future research. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A Behavioral Confirmation and Reduction of the Natural versus Synthetic Drug Bias.

Research reveals a biased preference for natural v. synthetic drugs; however, this research is based on self-report and has not examined ways to reduce the bias. We examined these issues in 5 studies involving 1125 participants. In a pilot study (N = 110), participants rated the term natural to be more positive than the term synthetic, which reveals a default natural-is-better belief. In studies 1 (N = 109) and 2 (N = 100), after a supposed personality study, participants were offered a thank you "gift" of a natural or synthetic pain reliever. Approximately 86% (study 1) and 93% (study 2) of participants chose the natural v. synthetic pain reliever, which provides a behavioral choice confirmation of the natural drug bias. In studies 3 (N = 350) and 4 (N = 356), participants were randomly assigned to a control or experimental condition and were asked to consider a scenario in which they had a medical issue requiring a natural v. synthetic drug. The experimental condition included a stronger (study 3) or weaker (study 4) rational appeal about the natural drug bias and a statement suggesting that natural and synthetic drugs can be good or bad depending on the context. In both studies, the natural bias was reduced in the experimental condition, and perceived safety and effectiveness mediated this effect. Overall, these data indicate a bias for natural over synthetic drugs in preferences and behavioral choices, which might be reduced with a rational appeal.