Efficacy of Social Norm Interventions on Addictive Behaviours-A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Mental health-related behaviours including addictive behaviours contribute significantly to the global burden of disease. Social norm interventions appear to be a cost-effective means of reducing addictive behaviour. We conducted a systematic review and meta-analysis of the efficacy of social norm interventions for addictive behaviours. We searched the databases Medline and PsycInfo from inception to April 2024 as well as reference lists of eligible studies and related systematic reviews for randomised controlled trials (RCTs) comparing the efficacy of social norm interventions for addictive behaviours to control conditions. Out of the 11,515 potentially eligible RCTs, 52 trials with a total of 31,764 adult participants met inclusion criteria, with 45 trials targeting alcohol consumption, three trials targeting Marijuana use, two trials targeting other substance abuse and two trials targeting gambling. Overall, 37 trials were included in the random-effects meta-analysis. The comparison of social norm interventions to control conditions at posttreatment showed a small but statistically significant effect (g = -0.12; 95% CI = -0.22 to -0.02; p < 0.01). Risk of bias was rated low in 37 RCTs, 14 RCTs were rated as having some risk of bias concerns and one RCT was rated as having high risk of bias. Social norm interventions can be an effective intervention method for reducing substance abuse and gambling. Yet, data is largely derived from studies targeting alcohol consumption and current trials suffer from methodological and practical limitations. The small effect sizes need to be appraised in the context of cost-effectiveness of these interventions.

The origins of moral sensitivities: Probing infants' expectations, evaluations, generalization, and enforcement of moral norms.

Identifying the origins of moral sensitivities, and their elaboration, within infancy and early childhood is a challenging task, given inherent limitations in infants' behavior. Here, I argue for a multi-pronged, multi-method approach that involves cleaving the moral response at its joints. Specifically, I chart the emergence of infants' moral expectations, evaluations, generalization and enforcement, demonstrating that while many moral sensitivities are present in the second year of life, these sensitivities are closely aligned with, and likely driven by, infants' everyday experience. Moreover, qualitative differences exist between the moral responses that are present in infancy and those of later childhood, particularly in terms of enforcement (i.e., a lack of punishment in infancy). These findings set the stage for addressing outstanding critical questions regarding moral development, that include identifying discrete causal inputs to early moral cognition, identifying whether moral cognition is distinct from social cognition early in life, and explaining gaps that exist between moral cognition and moral behavior in development.

Social Determinants Influencing the Non-Adoption of Norms Favorable to the Prevention and Control of Type 2 Diabetes: Qualitative Research.

Diet, physical activity, and body shape play an essential role in the development of type 2 diabetes (T2D) and are the social dimensions most targeted by health professionals in their practices or intervention aimed at preventing and controlling T2D. However, several interventions focus more on individual factors and less on social determinants likely to influence the adoption of dietary, body, and physical activity standards favorable to the prevention and control of T2D. This study aims to explore the social determinants influencing the rejection or adoption of dietary, bodily, and physical activity norms favorable to the prevention and control of T2D among migrants from sub-Saharan Africa. A qualitative exploratory design guided data collection and analysis. Semi-structured qualitative interviews and focus groups were conducted between October 2022 and March 2023 in Montreal and Quebec Cities. The cost of food, the difficulty of accessing certain foods, a reliable level of income, work schedules, the gazes of relatives or communities, migration policies, disappointment and stressful situations linked to migratory status, racial microaggressions, and the lack of food guides adapted to the realities of MASS were the main determinants identified by the participants. These determinants can influence the adoption of public health recommendations on diet for the prevention and control of T2D. People living with T2D obviously have an important role to play, but much of the work lies outside their control. Therefore, Preventive, clinical, or awareness-raising interventions should more consider the life and structural contexts in which these people navigate without ignoring their pre-migratory rules of dietary, body, and physical activity norms.

Exploring the utility of a social norm approach in reducing younger drivers' engagement in hand-held phone use while driving: A qualitative study.

INTRODUCTION: Engagement in hand-held phone use while driving among young drivers is a prevalent concern in society, despite countermeasures to deter the behavior. The social norm approach has been effective in reducing negative behaviors in young adults (e.g., binge drinking, drink driving). However, whether this approach can reduce hand-held phone use while driving in this population has not been thoroughly investigated. METHOD: The qualitative study explored young drivers' attitudes and opinions on social norm messages designed to reduce hand-held phone use while driving. In addition, young drivers' opinions on current campaigns were explored to provide further insight into the effectiveness of these messages. Thirty young drivers were interviewed and shown six social norm messages. RESULTS: The data were analyzed using reflexive thematic analysis, resulting in five themes and one sub-theme: (1) Road safety messages with minimal impact on hand-held phone use while driving; (2) What constitutes an effective road safety message for hand-held phone use while driving; (3) Comparisons between social norm messages and road safety messages; (4) The potential benefits of combined social norms, (4a) Improving and optimizing the message; and (5) "It's kinda just numbers on a screen": Negative views on social norm messages. Results highlight the diverse opinions towards road safety campaigns and the need to increase exposure to these messages. Further, a combined social norm message was perceived as most effective in reducing engagement in hand-held phone use while driving. CONCLUSIONS: The current study provides preliminary evidence that the social norm approach may be effective in reducing hand-held phone use among young drivers. Further, this study highlights the need to maximize exposure to phone use while driving campaigns in this high-risk cohort. PRACTICAL APPLICATIONS: Results support the development of a social norm messaging intervention to reduce young drivers hand-held phone use while driving.

Conformity to masculine norms and its association with drinking behaviors and alcohol-related consequences among adult men: A meta-analysis.

OBJECTIVES: Studies typically show that men are at higher risk for heavy alcohol use than women. Research linking conformity to masculine norms and drinking behaviors among adult males has grown steadily during the past 10 years. We conducted the first meta-analysis that examines (a) the strength of the associations between conformity to masculine norms and alcohol use outcomes, and (b) the extent to which the strength of these associations would be affected by the specific type of drinking behavior or methodological factors. METHODS: We included 35 studies (N=32,412) in this meta-analysis that examined the association between scores on the Conformity to Masculine Norms Inventory (CMNI) and alcohol use outcomes. RESULTS: Across all studies, the average correlation between conformity to masculine norms and alcohol variables was small (r = 0.17). The associations between conformity to masculine norms and specific alcohol variables were also modest: alcohol use composite score of frequency and quantity (r = 0.20), binge drinking frequency (r = 0.14), and alcohol-related consequences (r = 0.16). The mean correlation between each CMNI subscale and alcohol variables was also small (alcohol use composite, rs range from 0.07 to 0.22; alcohol-related consequences, rs range from 0.04 to 0.29; frequency of binge drinking, rs range from -0.06 to 0.22). There was a significant difference in effect size by specific type of drinking behavior (i.e., effect sizes for binge drinking were smaller than effect sizes for other alcohol variables). Methodological factors (i.e., CMNI version; sample type: university vs. adult vs. mixed samples; country where the study was conducted) did not affect the associations between masculine norms and the alcohol-outcome variables. CONCLUSIONS: Conformity to masculine norms is modestly associated with drinking behaviors and alcohol-related consequences. The effect sizes reported in this meta-analysis can assist in power analyses in future studies on conformity to masculine norms and specific drinking behaviors among adult males.

The promoting effect of the absence of second-party's punishment power on third-party punishment in maintaining social fairness norms: An EEG hyper-scanning study.

Third-party punishment (TPP) plays an irreplaceable role in maintaining social fairness. Punishment power is a significant area of study within economic games. However, the impact of whether or not the second-party possesses punishment power on TPP remains unexplored. The present study utilizes the high temporal resolution of EEG and time-frequency analysis, intra-barin functional connectivity analysis, inter-brain synchronization (IBS) analysis, and granger causality analysis(GCA) to comprehensively explore the neural mechanism of TPP from the perspective of third-party individual's decision-making and IBS in the real-time social interaction. Time-frequency results found that, the absence of the punishment power activated more theta-band and alpha-band power compare to when second-party has punishment power. When second-party has no punishment power, functional connection results observed stronger functional connectivity in theta band for medium unfair offers between rTPJ and PFC. Dual-brain analysis revealed that when the second-party has no punishment power, there is a significantly higher IBS in the alpha band between the frontal and frontal-central lobes of the second-party and the parietal and parietal occipital lobes of the third-party. GCA results further showed that the direction of IBS from third-party to second-party was significantly stronger than from second-party to third-party. This study demonstrates that the absence of the second-party's punishment power promote TPP, and similar cognitive process of thinking on how to maintain social fairness enhances IBS. The current study emphasizes the influence of punishment power on TPP, broadens the research perspective and contributes crucial insights into maintain social fairness.

Uncovering the key working mechanisms of a complex community-based obesity prevention programme in the Netherlands using ripple effects mapping.

BACKGROUND: Much remains unknown about how complex community-based programmes can successfully achieve long-term impact. More insight is needed to understand the key mechanisms through which these programmes work. Therefore, we conducted an in-depth study in five communities that implemented the Healthy Youth, Healthy Future (JOGG) approach, a Dutch community-based obesity prevention programme. We aimed to identify perceived outcomes and long-term impacts among local stakeholders and explore potential causal pathways and working mechanisms. METHODS: We used ripple effects mapping (REM), a qualitative participatory method to map outcomes and identify causal pathways, in five communities. We involved 26 stakeholders, professionals and policy-makers affiliated with the local JOGG approach, spread over eight REM sessions and conducted individual interviews with 24 additional stakeholders. To uncover working mechanisms, we compared outcomes and causal pathways across communities. RESULTS: Over 5-9 years of implementation, participants perceived that JOGG had improved ownership of local stakeholders, health policies, intersectoral collaboration and social norms towards promoting healthy lifestyles. Causal pathways comprised small initial outcomes that created the preconditions to enable the achievement of long-term impact. Although exact JOGG actions varied widely between communities, we identified five common working mechanisms through which the JOGG approach contributed to causal pathways: (1) creating a positive connotation with JOGG, (2) mobilizing stakeholders to participate in the JOGG approach, (3) facilitating projects to promote knowledge and awareness among stakeholders while creating successful experiences with promoting healthy lifestyles, (4) connecting stakeholders, thereby stimulating intersectoral collaboration and (5) sharing stakeholder successes that promote healthy lifestyles, which gradually created a social norm of participation. CONCLUSIONS: The JOGG approach seems to work through activating initial stakeholder participation and bolstering the process towards ownership, policy change, and intersectoral collaboration to promote healthy lifestyles. Key working mechanisms can inform further development of JOGG as well as other complex community-based prevention programmes.

Understanding the importance of weight management: a qualitative exploration of lived individual experiences.

PURPOSE: To explore the lived experiences and motivations of individuals engaged in weight management, focusing on psychological, societal, health-related, and personal factors influencing their motivations. METHODS: A descriptive exploratory approach, guided by the Self-Determination Theory (SDT), was followed and semi-structured interviews were conducted with ten adults actively involved in weight management. Thematic analysis identified key themes across four domains: (i) psychological motivation (extrinsic and intrinsic), (ii) societal influence (body image, social norms, media influence), (iii) health consciousness (priority of health, health concerns), and (iv) family support and past weight management experiences (learned habits, supportive environment). RESULTS: The findings revealed a nuanced interplay of intrinsic and extrinsic motivations, societal expectations, health priorities, and the impact of family support on weight management. Aligning with SDT, the study emphasizes the role of autonomy, competence, and relatedness in shaping individual motivations for weight management. CONCLUSIONS: The study provides valuable insights for tailoring interventions aimed at enhancing well-being by addressing the psychological, societal, health-conscious, and familial factors that influence motivations in weight management.

Traditional socio-cultural practices and early pregnancies in Togo: Between social norms and violation of adolescent rights.

This article shows how certain traditional socio-cultural practices that influence the root causes of teenage pregnancy violate the rights of adolescents. The data came from the action-research entitled "Multisectoral and transformative approaches to rites and initiations for adolescent sexual and reproductive health rights", conducted by the Togolese Association for Family Welfare (ATBEF) in May 2022. The option is made for a qualitative approach. The information collected was recorded on dictaphones and then transcribed from the local languages of collection into French. Content analysis was used to write the research report. The results reveal that these practices, which are still prevalent in the localities of the study, and which exert pressure on adolescent girls, are also products of violations of many girls' rights.

Cet article montre en quoi certaines pratiques socio-culturelles traditionnelles qui influencent les causes profondes de la survenue des grossesses chez les adolescentes, constituent une violation des droits de ces dernières. Les données proviennent de la recherche action titrée « Approches multisectorielles et transformatrices des rites et initiations pour les droits en santé sexuelle et de la reproduction des adolescentes ¼, menée par l'Association Togolaise pour le Bien-Etre Familial (ATBEF) en mai 2022. L'option est faite pour une approche qualitative. Les informations collectées ont été enregistrées sur dictaphones puis transcrites des langues locales de collecte vers le français. L'analyse de contenu a été utilisée pour la rédaction du rapport de recherche. Les résultats révèlent que ces pratiques encore prégnantes dans les localités de l'étude et qui exercent des pressions sur les adolescentes, sont aussi des produits des violations de nombreux droits des filles.

A protocol for a cluster randomized controlled trial to assess the impact of Balika Bodhu: A combined empowerment and social norm based sexual and reproductive health and rights intervention for married adolescent girls in rural Bangladesh.

INTRODUCTION: Sexual and reproductive health and rights (SRHR) are vital for both individual well-being and development. Bangladesh has made long strides in improving SRHR over the last few decades. However, the progress has been uneven across various groups of reproductive-aged females, with the married adolescent girls (MAGs) often being more vulnerable to denial of SRHR than other women. This study intends to develop Balika Bodhu, a combined empowerment and social norm intervention for promoting SRHR among the MAGs and assess its impact. METHODS: The evaluation will employ a mixed-method two-arm Cluster Randomized Controlled Trial (CRCT) design, where Arm 1 receives the intervention, and Arm 2 serves as the control. The trial will cover 32 clusters (villages) in Rajbari Sadar sub-district, randomized into two equally distributed study arms. A total of 1,120 MAGs aged 15-19 years will be randomly selected from the clusters (35 per cluster) to form a cohort. The MAGs, their husbands, selected elderly women (26 per village) and influential community members (26 per village) will receive group sessions in the intervention clusters. The MAGs and their husbands will be interviewed at baseline and endline. A randomly selected cross-sectional sample of community members aged 35-59 years at baseline and endline will also be surveyed to measure attitudes and social norm regarding SRHR of MAGs. Qualitative data will be collected using 32 In-depth Interviews, six Key Informant Interviews, and eight Focus Group Discussions from two intervention villages. Intention-to-treat (ITT) analysis will be performed to assess the impact of the intervention. Narrative analysis and the Grounded Theory approach will be used to analyze the qualitative data. CONCLUSION: Rigorous evaluation of Balika Bodhu should contribute to the literature on what works and what does not in addressing denial of SRHR to MAGs using empowerment and social norm intervention and inform policies and programs. TRIAL REGISTRATION: Clinicaltrials.gov: identifier: NCT06126770; Date: Oct 7, 2023. Version 1.

Enactive behaviour settings: situating agency, normativity and transformation.

Behaviour settings are sociocultural places defined by three main ecological aspects: the affordances of material structures, typical patterns of skilful action and socially situated norms. These aspects explain the observed regularities of human behaviour associated with the material characteristics of places. However, the focus of ecological theories on how individual agents attune their actions to the pre-established order of behaviour settings neglects the agents' active role in sustaining or motivating transformations in this order. We therefore propose an alternative enactive approach to behaviour settings that accounts for the role of agents as active supporters and transformers of behaviour settings. Based on the enactive concepts of agency, normativity and dialectics, we argue that agents, as participants of behaviour settings, simultaneously respond to multiple normative dimensions (e.g. biological, sensorimotor and interactive). To sustain the order of behaviour settings, agents sometimes need to inhibit other normative responses of their bodies, which sometimes is detrimental to one or many aspects of their lives. Nonetheless, agents can collectively trigger the transformation of behaviour settings. This transformation can occur dialectically as tensions between two or more norms to which human bodies respond are resolved, even if new tensions arise and the process of changing behaviour setting continues. This article is part of the theme issue 'People, places, things and communities: expanding behaviour settings theory in the twenty-first century'.

Social sanctions in response to injunctive norm violations.

Injunctive social norms are societal standards for how people are expected to behave. When individuals transgress these norms, they face social sanctions for their behavior. These sanctions can take many forms ranging from verbal or non-verbal reactions and from disapproval to ostracism. We review the stable characteristics and situational variables that affect a bystander's tendency to enact social sanctions against someone who violates an injunctive social norm. Stable characteristics include the bystander's extraversion, altruism, the belief that others can change their behavior, and their cultural background. Situational factors include the extent to which the violated norm implicates the bystander, the social hierarchies among the bystander and transgressor, the presence of additional bystanders, and (when applicable) the bystander's relationship to the victim of the norm violation. We also discuss the costs that a bystander can incur by attempting to enact social sanctions. We conclude with a discussion of the application of social sanctions to enforce pro-social social norms.

Persuasive communication, financial incentives, and social norms: Interactions and effects on behaviors.

Social norms and financial incentives are both known to shape the decisions people make about prosocial actions. This paper reviews the financial incentives in normative systems (FINS) model, which integrates theories of social norms from communication, social psychology, and behavioral economics to predict relationships among incentives, norms, and behaviors. It addresses how incentives can affect norms and how they change the effects of norms on behaviors. The model shows how strategic communication (framing) of social norms and incentives can shape the way people respond to incentives, minimizing unwanted outcomes and even enhancing the effectiveness of behavioral incentive payments. These insights can guide hypothesis testing and application to real-world use of incentives for behavior change.

The dynamics of intercultural clinical encounters in times of pandemic crisis. Swedish healthcare providers' reflections on social norms in relation to sexual and reproductive healthcare.

BACKGROUND: Experiences from the COVID-19 pandemic may help to better understand resilience, competences and skills for healthcare providers and the healthcare system. Within sexual and reproductive health inequalities for migrants exist and it is an area where promoting both cultural competency and healthcare equity in the clinical encounter is expected of healthcare providers yet can create tension. The aim is to explore healthcare providers experiences of encounters with migrants in the context of the pandemic and the subsequent changes in routines and norms. METHODS: A qualitative study based on semi-structured interviews with 31 healthcare providers working in sexual and reproductive healthcare in southern Sweden. Interviews were conducted during the COVID-19 pandemic influencing how healthcare providers reflected on their experiences. Analysis was done using reflexive thematic data analysis. FINDINGS: Healthcare providers reflected on how changes in routines increased the understanding of challenges and enablers in the intercultural encounter including the impact on communication and role of relatives and male partners. They emphasized the dynamics of culture in the clinical encounter and healthcare system through highlighting the importance of structural awareness, self-reflection and the flexibility of conducts and norms, often given a cultural connotation. CONCLUSION: The COVID-19 pandemic resulted in changes of previously established routines directly affecting clinical encounters, which provided a unique opportunity for healthcare providers to reflect, with communication and self-reflection being discussed as central in complex encounters. It highlighted the dynamics of presumed deeply rooted cultural norms and the interplay with social factors affecting healthcare providers and patients alike.

If They'd Said You Should Only Drink Five Units I'd Have Listened: A Mixed Methods Study of Alcohol Consumption Following a Diagnosis of Breast Cancer.

OBJECTIVES: As part of a wider study describing the impact of a breast cancer diagnosis on lifestyle behaviours, this paper describes the impact of a breast cancer diagnosis on alcohol consumption and factors influencing consumption. METHODS: Cross-sectional online survey of 140 people (138 women) and interviews with 21 women diagnosed with breast cancer in the last 10 years. RESULTS: Of the 100 survey participants who drank alcohol 25% were drinking at increasing or higher risk levels and 17% strongly wanted to change their drinking behaviour. The habitual aspects of alcohol consumption were the strongest predictor of current alcohol consumption behaviours. Social norms and perceptions about conflicting information were substantial barriers to change. CONCLUSIONS: Breast cancer survivors need accurate information about the risks of alcohol consumption and guidelines in order to make informed decisions about making changes to their behaviour. Interventions to support breast cancer survivors to reduce alcohol consumption need to focus on the development of healthy habits and may benefit from a focus which includes partners and friends.

Computational evolution of social norms in well-mixed and group-structured populations.

Models of indirect reciprocity study how social norms promote cooperation. In these models, cooperative individuals build up a positive reputation, which in turn helps them in their future interactions. The exact reputational benefits of cooperation depend on the norm in place, which may change over time. Previous research focused on the stability of social norms. Much less is known about how social norms initially evolve when competing with many others. A comprehensive evolutionary analysis, however, has been difficult. Even among the comparably simple space of so-called third-order norms, there are thousands of possibilities, each one inducing its own reputation dynamics. To address this challenge, we use large-scale computer simulations. We study the reputation dynamics of each third-order norm and all evolutionary transitions between them. In contrast to established work with only a handful of norms, we find that cooperation is hard to maintain in well-mixed populations. However, within group-structured populations, cooperation can emerge. The most successful norm in our simulations is particularly simple. It regards cooperation as universally positive, and defection as usually negative-unless defection takes the form of justified punishment. This research sheds light on the complex interplay of social norms, their induced reputation dynamics, and population structure.

"We help people change harmful norms": Working with key opinion leaders to influence MNCH+N behaviors in Nigeria.

BACKGROUND: Nigeria's Maternal, newborn, and child health and nutrition (MNCH+N) outcomes rank among the world's poorest. Engaging traditional and religious leaders shows promise in promoting related behaviors. The Breakthrough ACTION/Nigeria project worked with leaders in northern Nigeria to implement the Advocacy Core Group (ACG) model, a social and behavior change (SBC) approach aimed at influencing community norms and promoting uptake of MNCH+N behaviors. Qualitative assessment of the model contributes to evidence on SBC approaches for enhancing integrated health behaviors. METHODOLOGY: This qualitative study was conducted in Nigeria's Bauchi and Sokoto states in May 2021. It involved 51 in-depth interviews and 24 focus group discussions. The study was grounded in the social norms exploration (SNE) technique to examine normative factors influencing behavior change within the ACG model context. Data analysis used a reflexive thematic analysis approach. Ethical approvals were received from all involved institutions and informed consent was obtained from participants. RESULTS: The ACG model was vital in the uptake of MNCH+N behaviors. The influence of ACG members varied geographically with greater impact observed in Sokoto State. Normative barriers to improving MNCH+N outcomes included perceived religious conflicts with family planning, preference for traditional care in pregnancy, misinformation on exclusive breastfeeding (EBF), and gender-based violence resulting from women's decision-making. The study demonstrated positive progress in norm shifting, but EBF and GBV norms showed slower changes. Broader challenges within the health system, such as inadequate services, negative attitudes of healthcare providers, and workforce shortages, hindered access to care. CONCLUSION: The ACG model increased awareness of health issues and contributed to potential normative shifts. However, slower changes were observed for EBF and GBV norms and broad health system challenges were reported. The model appears to be a promising strategy to further drive SBC for better health outcomes, especially where it is combined with supply-side interventions.

Navigating the normativity of behaviour settings: an observational case study.

Traditionally, sensitivity to situational norms is understood as deriving from internal cognitive states that represent the rules for appropriate conduct. On an alternative view, norms are 'out there', in the practices and situations themselves, without being duplicated in the head. However, what does normativity look like when it is performed by people engaging with a concrete situation? A 'behaviour setting' offers a window onto these dynamics. This article presents an observational case study of normative coordination within a behaviour setting. Immersed in a scientific laboratory setting, the observations show how the normative demands of the overall behaviour setting can give shape to various places of action, or 'synomorphs', which invite the participants' activities. Responding to the different needs of each synomorph, in turn, maintains the behaviour setting. What connects these two reciprocal timescales of activity are the situationally sensitive activities of the participants. We end with several examples that bring such sensitivity to the interdependence of the norms of a behaviour setting to the fore. This article is part of the theme issue 'People, places, things, and communities: expanding behaviour settings theory in the twenty-first century'.

Social norm dynamics and cooperation in changing groups.

Social norms promote cooperation in human groups. How are these norms and cooperation affected when groups change due to new members arriving and old members leaving? In this review we highlight the scant literature that researches the effects of group changes on social norms and cooperation. Thus far evidence suggests that newcomers cooperate less than incumbents but adjust their cooperation levels over time. However, this adjustment is not necessarily accompanied by adjustments in terms of group identification and norms. We also point to the data limitations that ensue when researching phenomena at the group level and outline future research directions.

Factors associated with intention of HIV testing among Asian American men: a path analysis.

Research has pointed to myriad cultural and socio-psychological factors associated with HIV testing, such as acculturation, social norms about HIV testing, masculinity, homonegativity, and constructs from the Theory of Planned Behavior. However, the interrelationships of these factors on the intentions of HIV testing among the population of Asian American men remains unknown. A dataset of 425 Asian American men in the U.S., collected online with convenience sampling method during 2020-2021, was analyzed to test a conceptual framework that aimed to fill this gap. Results from a path model with two endogenous variables (homonegativity and HIV testing intention) indicated that perceived social norms about HIV testing, attitude about HIV testing, and perceived HIV risk had directandindirect relationships with the intentions of HIV testing in the study population. However, social norms about HIV testing and perceived HIV risk showed stronger direct effects (standardized estimates = 0.37 and 0.34, respectively, p-value < 0.001). Additionally, we found that the relationships of these factors with HIV testing intention were also mediated by homonegativity. Findings from this study advance our understanding of pathways of associations between a host of cultural and socio-psychological factors with HIV testing intention among an understudied population - Asian American men. Our results will help inform the development of future intervention programs to increase HIV testing in this population.