US state vaccine mandates did not influence COVID-19 vaccination rates but reduced uptake of COVID-19 boosters and flu vaccines compared to bans on vaccine restrictions.

During the COVID-19 pandemic, some US states mandated vaccination for certain citizens. We used state-level data from the CDC to test whether vaccine mandates predicted changes in COVID-19 vaccine uptake, as well as related voluntary behaviors involving COVID-19 boosters and seasonal influenza vaccines. Results showed that COVID-19 vaccine adoption did not significantly change in the weeks before and after states implemented vaccine mandates, suggesting that mandates did not directly impact COVID-19 vaccination. Compared to states that banned vaccine restrictions, however, states with mandates had lower levels of COVID-19 booster adoption as well as adult and child flu vaccination, especially when residents initially were less likely to vaccinate for COVID-19. This research supports the notion that governmental restrictions in the form of vaccination mandates can have unintended negative consequences, not necessarily by reducing uptake of the mandated vaccine, but by reducing adoption of other voluntary vaccines.

Predicting Satisfaction of Parents of Pediatric Patients: Perceived Quality of Providers' Communication Mitigates Negative Effects of Shorter than Desired Consultations.

This research investigated the predictors of satisfaction for parents of pediatric patients after a clinical consultation. Specifically, we assessed whether perceptions of their provider's communication quality influenced the degree to which their (dis)satisfaction with consultation length associated with their provider rating and intent to recommend the provider's office. Using patient satisfaction survey data collected after initial clinical visits to a pediatric hospital (N = 12,004), we found that communication quality was a stronger predictor for those who were dissatisfied with their consultation length, whereas communication quality made a relatively smaller difference for those who were satisfied with their consultation length. Put another way, parents' dissatisfaction with their child's consultation length mattered little when they perceived their provider to be high in communication quality, but it reduced their ratings and intentions to recommend when they perceived their provider to be low in communication quality. These results suggest that providers' communication behaviors have the capacity to buffer patients' negative evaluations otherwise incurred from shorter than desired consultations.

Reducing Psychological Reactance to Health Promotion Messages: Comparing Preemptive and Postscript Mitigation Strategies.

This study compared the relative efficacy of two strategies designed to mitigate psychological reactance in health campaigns by using reminders of behavioral autonomy: preemptive scripts, which appear before the appeal, and restoration postscripts, which appear after. Employing a mixed-model experiment with a 2 (threat to freedom: low vs. high) × 3 (reactance-mitigation strategy: control vs. preemptive script vs. restoration postscript) × 2 (health campaign topic: exercise vs. nutrition) between-subjects design and a within-subjects factor of time (immediate posttest measurement followed by a one-week delay), this study (N = 394) compared the effects of the two mitigation strategies on reactance, attitude, and behavioral intention at two points in time. Moderated mediation models indicated that the reactance-mitigation strategies equivalently reduced the degree to which reactance was experienced in response to increasingly threatening health appeals (relative to the control). This effect indirectly influenced behavioral intention via attitude change and remained after one week.

African American Parents' Perceived Vaccine Efficacy Moderates the Effect of Message Framing on Psychological Reactance to HPV Vaccine Advocacy.

This experiment assessed how the frame of promotional vaccine messages elicited psychological reactance differently for African American parents according to their level of perceived vaccine efficacy. We found that those with low perceived HPV vaccine efficacy experienced more psychological reactance in response to loss-framed messages compared to gain-framed messages, whereas message framing made little difference for those with high perceived HPV vaccine efficacy. In addition, the interaction between frame and perceived HPV vaccine efficacy indirectly affected parents' intentions to vaccinate their child for HPV via reactance. These results support current theorizing about framing effects under defensive message processing specifically as it applies to psychological reactance.

Red-Hot Reactance: Color Cues Moderate the Freedom Threatening Characteristics of Health PSAs.

This study investigated whether color cues in health PSAs affect people's experience of psychological reactance to health recommendations. By integrating psychological reactance theory and color-in-context theory, we predicted that reactance would be greater after viewing a threatening health PSA conveyed in red compared to other colors. Using a 3 (color: gray, green, red) × 2 (freedom threatening language: low, high) experimental design in the context of oral health, we found that red exacerbated the degree to which freedom threatening language elicited perceived freedom threat and reactance, and this effect further decreased attitude and intention toward using a firm-bristled toothbrush. These findings show the importance of considering visual communication like color cues when developing successful health campaigns.

More on Inoculating Against Reactance to Persuasive Health Messages: The Paradox of Threat.

This research examined the efficacy of inoculation as a strategy to mitigate psychological reactance based on the level of threat communicated in the forewarning and subsequent persuasive health appeal. Two 2 (inoculation) × 2 (freedom-threatening language) experiments were conducted. The first (N = 181) used elaborated inoculation designed to enhance the threat of impending reactance to a message advocating for responsible alcohol consumption. The second (N = 159) used limited inoculation designed to minimize the threat of impending reactance to a message advocating for responsible soft drink consumption. Results showed that elaborated inoculation increased reactance, whereas limited inoculation decreased reactance but only when the subsequent appeal used less freedom-threatening language. These findings suggest that inoculation has the potential to facilitate or buffer reactance depending on the level of threat communicated in inoculation forewarnings and in subsequent persuasive health appeals.

Anger Expression Moderates the Effects of Psychological Reactance to Sexual Health Messages.

This study examined how anger expression tendencies moderate the negative consequences of state reactance. An experiment was conducted whereby participants (N = 226) read a health public service announcement (PSA) that encouraged conversations about sexual health history prior to sexual encounters with new partners and that varied in freedom-threatening language. As hypothesized, the freedom-threatening appeal increased perceived threat to freedom and subsequent reactance. However, the negative relationship between reactance and attitude was mitigated for people who were lower in dispositional anger expression. The results showed that the extent to which state reactance resulted in unhealthy outcomes depended on the degree to which people tend to communicate anger. These findings are discussed in terms of theoretical implications for reactance scholars and practical utility for health message designers.

Inoculating against reactance to persuasive health messages.

This investigation examined the possibility of decreasing psychological reactance to health campaigns through the use of inoculation messages. It was hypothesized that an inoculation message, which forewarned of the potential of subsequent reactance, would decrease participants' likelihood of reacting negatively to a freedom-threatening message aimed to reduce excessive alcohol consumption. Participants (N = 275) who were inoculated against potential reactance felt less threatened and experienced less reactance compared to those who did not read an inoculation message. Structural equation modeling showed that inoculation indirectly predicted lower intention to drink alcohol via the theorized mediated reactance process. This research suggests that it is possible to inoculate against self-generated cognitions that might otherwise lead toward negative health behaviors.

Predicting attitude toward methamphetamine use: the role of antidrug campaign exposure and conversations about meth in Montana.

This investigation utilized the integrative model of behavioral prediction to assess the Montana Meth Project (MMP) campaign by testing theoretical antecedents of attitude toward methamphetamine (meth) use. College students in Montana (N = 403) were surveyed about their exposure to MMP ads and communication about meth in conversation. Structural equation modeling showed that the data fit the specified model well. Significant parameters indicated that only beliefs about the negative relational outcomes of meth use, and not about personal well-being or physical appearance, were related to attitude. Attention, rather than encoded exposure, to MMP ads related to each belief about meth use. Conversation frequency related to engagement with MMP ads, and a conversational partner's conveyed attitude toward meth use related to personal and physical beliefs as well as attitudes. Theoretical and practical implications of the findings are discussed.

Exploring dispositional tendencies to seek online information about direct-to-consumer genetic testing.

Varying perspectives exist regarding the implications of genetic susceptibility testing for common disease, with some anticipating adverse effects and others expecting positive outcomes; however, little is known about the characteristics of people who are most likely to be interested in direct-to-consumer genetic testing. To that end, this study examines the association of individual dispositional differences with health risk perceptions and online information seeking related to a free genetic susceptibility test. Healthy adults enrolled in a large health maintenance organization were surveyed by telephone. Eligible participants (N = 1,959) were given access to a secure website that provided risk and benefit information about a genetic susceptibility test and given the option to be tested. Neuroticism was associated with increased perceptions of disease risk but not with logging on. Those scoring high in conscientiousness were more likely to log on. We found no evidence that neuroticism, a dispositional characteristic commonly linked to adverse emotional response, was predictive of online genetic information seeking in this sample of healthy adults.