A dual-process view on medication adherence: The role of affect.

Medication non-adherence has been recognised as one of the major problems in health care that leads to preventable costs and hospitalisations. This study aimed to assess the role of affect in medication adherence. We propose a dual-process framework of medication adherence based on the reflective-impulsive model, which includes both cognitive and affective processes. We tested this framework in a cross-sectional study (N = 525). The results supported this framework by illustrating the clear role of both cognitive and affective processes.

'A necessary evil': associations with taking medication and their relationship with medication adherence.

Cognitive factors, like beliefs, have been studied extensively as determinants of medication adherence, while affect associated with taking medicines has been studied much less. In the present study (N = 525), we investigated affect by assessing patients' first associations with taking their medicines. Results showed that these associations were related to self-reported medication adherence: Patients who associated taking medicines with negative affect were the least adherent, while those associating taking medicines with the need to take medicines were the most adherent. Our results support the idea that affect should be considered an important determinant of adherence.

Assessing Technology in the Absence of Proof: Trust Based on the Interplay of Others' Opinions and the Interaction Process.

OBJECTIVE: The present research addresses the question of how trust in systems is formed when unequivocal information about system accuracy and reliability is absent, and focuses on the interaction of indirect information (others' evaluations) and direct (experiential) information stemming from the interaction process. BACKGROUND: Trust in decision-supporting technology, such as route planners, is important for satisfactory user interactions. Little is known, however, about trust formation in the absence of outcome feedback, that is, when users have not yet had opportunity to verify actual outcomes. METHOD: Three experiments manipulated others' evaluations ("endorsement cues") and various forms of experience-based information ("process feedback") in interactions with a route planner and measured resulting trust using rating scales and credits staked on the outcome. Subsequently, an overall analysis was conducted. RESULTS: Study 1 showed that effectiveness of endorsement cues on trust is moderated by mere process feedback. In Study 2, consistent (i.e., nonrandom) process feedback overruled the effect of endorsement cues on trust, whereas inconsistent process feedback did not. Study 3 showed that although the effects of consistent and inconsistent process feedback largely remained regardless of face validity, high face validity in process feedback caused higher trust than those with low face validity. An overall analysis confirmed these findings. CONCLUSION: Experiential information impacts trust even if outcome feedback is not available, and, moreover, overrules indirect trust cues-depending on the nature of the former. APPLICATION: Designing systems so that they allow novice users to make inferences about their inner workings may foster initial trust.

Trusting a Virtual Driver That Looks, Acts, and Thinks Like You.

OBJECTIVE: We examined whether participants would trust an agent that was similar to them more than an agent that was dissimilar to them. BACKGROUND: Trust is an important psychological factor determining the acceptance of smart systems. Because smart systems tend to be treated like humans, and similarity has been shown to increase trust in humans, we expected that similarity would increase trust in a virtual agent. METHODS: In a driving simulator experiment, participants (N = 111) were presented with a virtual agent that was either similar to them or not. This agent functioned as their virtual driver in a driving simulator, and trust in this agent was measured. Furthermore, we measured how trust changed with experience. RESULTS: Prior to experiencing the agent, the similar agent was trusted more than the dissimilar agent. This effect was mediated by perceived similarity. After experiencing the agent, the similar agent was still trusted more than the dissimilar agent. CONCLUSION: Just as similarity between humans increases trust in another human, similarity also increases trust in a virtual agent. When such an agent is presented as a virtual driver in a self-driving car, it could possibly enhance the trust people have in such a car. APPLICATION: Displaying a virtual driver that is similar to the human driver might increase trust in a self-driving car.

The development of the ProMAS: a Probabilistic Medication Adherence Scale.

Current self-report medication adherence measures often provide heavily skewed results with limited variance, suggesting that most participants are highly adherent. This contrasts with findings from objective adherence measures. We argue that one of the main limitations of these self-report measures is the limited range covered by the behaviors assessed. That is, the items do not match the adherence behaviors that people perform, resulting in a ceiling effect. In this paper, we present a new self-reported medication adherence scale based on the Rasch model approach (the ProMAS), which covers a wide range of adherence behaviors. The ProMAS was tested with 370 elderly receiving medication for chronic conditions. The results indicated that the ProMAS provided adherence scores with sufficient fit to the Rasch model. Furthermore, the ProMAS covered a wider range of adherence behaviors compared to the widely used Medication Adherence Report Scale (MARS) instrument, resulting in more variance and less skewness in adherence scores. We conclude that the ProMAS is more capable of discriminating between people with different adherence rates than the MARS.

Brightness differences influence the evaluation of affective pictures.

We explored the possibility of a general brightness bias: brighter pictures are evaluated more positively, while darker pictures are evaluated more negatively. In Study 1 we found that positive pictures are brighter than negative pictures in two affective picture databases (the IAPS and the GAPED). Study 2 revealed that because researchers select affective pictures on the extremity of their affective rating without controlling for brightness differences, pictures used in positive conditions of experiments were on average brighter than those used in negative conditions. Going beyond correlational support for our hypothesis, Studies 3 and 4 showed that brighter versions of neutral pictures were evaluated more positively than darker versions of the same picture. Study 5 revealed that people categorised positive words more quickly than negative words after a bright picture prime, and vice versa for negative pictures. Together, these studies provide strong support for the hypotheses that picture brightness influences evaluations.

Living behind dikes: mimicking flooding experiences.

Delta areas like the Netherlands are threatened by global climate change. Awareness is, however, rather low. Our research objective was to investigate whether coping responses to flooding risks could be enhanced in a virtual environment (VE). A laboratory experiment was conducted in which participants were exposed to a simulated dike breach and consequent flooding of their virtual residence. We tested the hypothesis that an interactive 3D flood simulation facilitates coping responses compared to noninteractive film and slide simulations. Our results showed that information search, the motivation to evacuate, and the motivation to buy flood insurance increased after exposure to the 3D flood simulation compared to the film and slide simulations. Mediation analyses revealed that some of these presentation mode effects were mediated by a greater sense of being present in the VE. Implications to use high-end flood simulations in a VE to communicate real-world flooding risks and coping responses to threatened residents will be discussed.

Trust in smart systems: sharing driving goals and giving information to increase trustworthiness and acceptability of smart systems in cars.

OBJECTIVE: We examine whether trust in smart systems is generated analogously to trust in humans and whether the automation level of smart systems affects trustworthiness and acceptability of those systems. BACKGROUND: Trust is an important factor when considering acceptability of automation technology. As shared goals lead to social trust, and intelligent machines tend to be treated like humans, the authors expected that shared driving goals would also lead to increased trustworthiness and acceptability of adaptive cruise control (ACC) systems. METHOD: In an experiment, participants (N = 57) were presented with descriptions of three ACCs with different automation levels that were described as systems that either shared their driving goals or did not. Trustworthiness and acceptability of all the ACCs were measured. RESULTS: ACCs sharing the driving goals of the user were more trustworthy and acceptable than were ACCs not sharing the driving goals of the user. Furthermore, ACCs that took over driving tasks while providing information were more trustworthy and acceptable than were ACCs that took over driving tasks without providing information. Trustworthiness mediated the effects of both driving goals and automation level on acceptability of ACCs. CONCLUSION: As when trusting other humans, trusting smart systems depends on those systems sharing the user's goals. Furthermore, based on their description, smart systems that take over tasks are judged more trustworthy and acceptable when they also provide information. APPLICATION: For optimal acceptability of smart systems, goals of the user should be shared by the smart systems, and smart systems should provide information to their user.

Bias in the exchange of arguments: the case of scientists' evaluation of lay viewpoints on GM food.

Most perspectives on public participation share the notion that dialogues should be open, allowing participants to articulate and evaluate different views and knowledge claims. We hypothesize that participants' evaluation of claims may be biased because participants have a preference for a particular type or source of a claim. This would hamper an open dialogue. We tested the effect of three variables on scientists' evaluation of claims of the general public about GM food: the claim's favorability towards GM food, the phrasing, and the source of the claim. Results are based on a survey-experiment among 73 biotechnology-scientists. Biased processing occurred when scientists evaluated claims. Claims that were corresponding with the attitude of the scientists and that were phrased in a cognitive way were evaluated more positively than claims that were contrasting the attitude of the scientists and that were phrased in an affective way. Contrary to our expectation, scientists evaluated claims of the public more positively than claims of experts.

Prevention, adaptation, and threat denial: flooding experiences in the Netherlands.

Delta areas such as the Netherlands are more and more at risk of future flooding due to global climate change. Motivating residents living in flood-prone areas to effectively cope with local floods may lead to minimization of material losses and loss of life. The aim of this research was to investigate whether the extent to which residents had been exposed to flooding in the past was a key factor in motivating residents to effectively cope with future flooding. We also focused on the psychological variables that mediated this relationship. We conducted a survey (N = 516) among flood victims and nonvictims. We assessed subjective experiences due to past flooding, affective and cognitive appraisals, and coping responses. Results show that victims reported stronger emotions (negative and positive), and the receipt of more social support due to past flooding than did nonvictims. Moreover, victims worry more about future flooding, perceive themselves as more vulnerable to future flooding, perceive the consequences of future flooding as more severe, and have stronger intentions to take adaptive actions in the future than nonvictims. Structural equation modeling reveals that the latter effect was fully mediated by specific experiences and appraisals. Insights into factors and processes that have the potential to motivate residents to effectively cope with future floods may prove helpful in developing interventions to inform residents how to act effectively in case of an imminent flood.

The role of similarity cues in the development of trust in sources of information about GM food.

In evaluating complex new technologies, people are usually dependent on information provided by others, for example, experts or journalists, and have to determine whether they can trust these information sources. This article focuses on similarity as the basis for trust. The first experiment (N = 261) confirmed that a journalist writing about genetically modified (GM) food was trusted more when his attitude was congruent with that of his readers. In addition, the experiment showed that this effect was mediated by the perceived similarity of the journalist. The second experiment (N = 172) revealed that trust in a journalist writing about the focal domain of GM food was even influenced by him expressing a congruent attitude in an unrelated domain. This result supports a general similarity account of the congruence effect on trust, as opposed to a confirmatory bias account.

The role of trust in the affective evaluation of novel risks: the case of CO2 storage.

There is general recognition that trust and affect are closely connected concepts. Usually, affect is modeled as an antecedent of trust. In the present research, we will argue that, particularly in new situations, trust can also evoke affect toward a risky object. Using structural equation modeling, support was found for the hypothesis that trust influences attitudes through this process. In the present study, we analyzed attitudes toward (carbon dioxide) CO(2) storage. The role of affect appears to be moderated by the level of self-relevance. In the case of high self-relevance (storage nearby), people's attitudes appeared to be merely based on affective reactions and trust. This effect is much weaker under low self-relevance (CO(2) storage in general). In such a case, cognitive factors, more particularly beliefs concerning perceived benefits, were also taken into account in attitude formation.

Attitudes toward biotechnology in the European Union.

Public attitudes toward biotechnology in the European Union have been characterized as negative using Eurobarometer data, but so far little attention has been paid to building a robust metric appropriate for emerging public opinion issues which combine high salience with very limited knowledge by the public. On the basis of the general literature about the formation and structure of attitudes and about public perceptions of science, this article presents a new metric and analysis: first, for estimating the level of awareness and knowledge of biotechnology in Europe; second, for assessing the stability and depth of these evaluative perceptions; and third, for exploring the roles of canonical socio-demographic variables, the knowledge variable and general attitudinal schemas for understanding the perceptions of both benefits and risks of biotech applications. The results show the importance of general value orientations or "worldviews" in shaping positive attitudes, and more of these general cognitive schemas should be measured in future research. The same multivariate model was unable to account for a significant percentage of the total variance in the perception of risks, suggesting that new measures are needed to tap this critical area in the acceptance of biotech in Europe.