Boosts for walking: how humorous messages increase brisk walking among cognitively fatigued individuals.

BACKGROUND: A well-studied internal barrier to regular physical activity, and more specifically brisk walking, is cognitive fatigue. However, thus far little research examined how cognitively fatigued individuals can be motivated to exercise, more specifically to engage in brisk walking. This study investigates whether humorous intervention messages might be an effective strategy to motivate cognitively fatigued individuals to brisk walk, and through which underlying processes. METHODS: An online experiment was performed in which variation in cognitive fatigue was induced through mental arithmetic questions. Afterwards, participants (n = 250) recruited through Prolific, randomly received either humorous or non-humorous intervention messages related to brisk walking. Potential mediators of the relations between physical activity, humour and cognitive fatigue were measured, were self-efficacy, self-control, and motivation. RESULTS: First, regression analyses confirmed that cognitive fatigue negatively influences brisk walking intentions and that the perceived humour of the intervention messages moderated this relationship. Second, results showed that self-control and self-efficacy are mediators explaining the relationship between cognitive fatigue and brisk walking intentions. Lastly, this study found that perceived humour of the intervention messages moderated the relationship between cognitive fatigue and self-control, indicating that perceptions of self-control were positively changed after receiving messages that were perceived as humorous compared to messages that were not perceived as humorous, subsequently increasing brisk walking intentions. CONCLUSIONS: This study is the first to unravel the underlying relationship between humorous intervention messages and brisk walking intentions through positive changes in perceptions of self-control within a cognitively fatigued sample. Results of this study suggest that existing smartphone applications monitoring and promoting brisk walking should integrate tailored message strategies within their cues to brisk walk by implementing humour as a strategy to motivate users when they are cognitively fatigued.

The Facts or the Story? It Takes Both to Sensitize People About Unknown Health Hazards.

Communicating about new or unknown health risks is challenging because it requires audiences to engage with and process novel and often complex health information. This study examines how texts can convey awareness and increase knowledge about health risks people are unaware of. The focus is on how text genre (narrative, expository, and mixed-genre) affects relevant emotional (arousal, transportation) and cognitive outcomes (knowledge and risk severity), measured using both online (electrodermal activity) and offline self-report measures. Mixed-effects model analyses revealed that narrative texts exhibit the highest self-reported arousal, transportation, and risk severity. Additionally, transportation mediates the relationship between text genre and risk severity. Ultimately, mixed-genre texts produced significantly higher arousal peaks and confidence ratings on knowledge posttests compared to expository texts. Taken together, the findings suggest that narrative texts perform better at raising awareness, whereas mixed-genre texts seem more effective in learning. The implications for health risk communication are discussed.

Insight in the Conspiracist's Mind.

ACADEMIC ABSTRACT: The motto of the conspiracist, "Do your own research," may seem ludicrous to scientists. Indeed, it is often dismissed as a mere rhetorical device that conspiracists use to give themselves the semblance of science. In this perspective paper, we explore the information-seeking activities ("research") that conspiracists do engage in. Drawing on the experimental psychology of aha experiences, we explain how these activities, as well as the epistemic experiences that precede (curiosity) or follow (insight or "aha" experiences) them, may play a crucial role in the appeal and development of conspiracy beliefs. Aha moments have properties that can be exploited by conspiracy theories, such as the potential for false but seemingly grounded conclusions. Finally, we hypothesize that the need for autonomous epistemic agency and discovery is universal but increases as people experience more uncertainty and/or feel epistemically excluded in society, hence linking it to existing literature on explaining conspiracy theories. PUBLIC ABSTRACT: Recent events have made it painfully clear that conspiracy beliefs can tear deep rifts in society and that we still have not found an adequate, de-escalating response to this. To understand the appeal of conspiracy theories and find new, humanizing ways to talk about them, we propose in this perspective paper to start from the universal human need to autonomously make discoveries through personal knowledge-generating actions. Indeed, psychological research shows that the aha experiences that accompany subjective discoveries create confidence in and perceived ownership of ideas that may be exploited by conspiracy theories. We hypothesize that people experiencing more uncertainty and/or epistemic exclusion in society will especially feel the need to re-establish autonomous epistemic agency and discovery. While this explanation starts from shared human experiences and practices, it also illustrates the potential of those processes to lead to a narrowed world and ossified cognition.

Health-seeking behaviour regarding schistosomiasis treatment in the absence of a mass drug administration (MDA) program: the case of endemic communities along Lake Albert in Western Uganda.

INTRODUCTION: Schistosomiasis poses a serious public health problem and a social challenge affecting over 240 million people, the majority of whom live in sub-Saharan Africa. The World Health Organization (WHO) recommends praziquantel (PZQ) drug treatment through regular mass drug administration (MDA) accompanied by social mobilisation and health education and sensitisation. With social mobilisation and health education and sensitisation, there is bound to be increased demand for the PZQ, especially in the case of endemic communities. However, it is not clear where communities go for PZQ treatment in the absence of PZQ MDA. We explored the health-seeking behaviours regarding schistosomiasis treatment among communities along Lake Albert in Western Uganda when MDA had delayed, to inform a review of the implementation policy for the achievement of the WHO's 2030 target of 75% coverage and uptake. METHODS AND MATERIALS: We conducted a community-based qualitative study in Kagadi and Ntoroko, an endemic community in January and February 2020. We interviewed 12 individuals: local leaders, village health teams, and health workers, and conducted 28 focus group discussion sessions with 251 purposively selected community members. The audio recordings of the data were transcribed and analyzed using a thematic analysis model. RESULTS: Generally, participants seldom seek medication for schistosomiasis-related signs and symptoms from government hospitals and health centres II, III and IV. Instead, they rely on community volunteers such as VHTs, private facilities, such as clinics and drug shops nearby, or traditional sources (e.g. witch doctors and herbalists). Results show that factors influencing people to seek treatment from sources other than the government are: the absence of PZQ drugs in the government health facility; health workers' negative attitude towards patients; long distances to the government hospitals and health facilities; poor and inaccessible roads; medication-related costs; and negative perceptions of the PZQ drug. CONCLUSIONS: Availability and accessibility of PZQ seem to be a big challenge. PZQ uptake is further hampered by health systems and community-related and socio-cultural factors. Thus there is a need to bring schistosomiasis drug treatment and services closer to endemic communities, stock nearby facilities with PZQ and encourage endemic communities to take the drug. Contextualised awareness-raising campaigns are needed to debunk myths and misconceptions surrounding the drug.

Around the same table: Uniting stakeholders of food-related communication.

There is an abundance of messages on food and health communicated nowadays by diverse stakeholders, including nutrition and health experts, food industries, celebrity chefs, and food influencers, among others. If each of these stakeholders has different interests and uses other communication strategies, confusion and polarization about food and nutrition is likely to arise. Especially when these messages not only represent facts, but many are emotionally loaded, focusing on "beliefs". Yet even when stakeholders contradict each other in their communication about food related to health, they influence each other. This conceptual paper aims to identify and position the different stakeholders participating in discourse about food and health. Taking a stakeholder marketing perspective in which understanding the whole requires a holistic view, we position the stakeholders as interrelated networks and discuss how their communication strategies influence each other. Stakeholder multiplicity in food communication is often looked at from a negative perspective in terms of conflicting and polarizing voices, however we suggest that this may also take the form of positive, complimentary, and cooperative partnerships. We argue for stakeholders to build complementarities and embrace each one's unique expertise in order to foster objective messages about food and health. Communication about food and health would be ideally shaped by using the guidelines of nutrition experts, the preparation techniques of (celebrity) chefs, and the successful communication strategies of knowledgeable food influencers. Where many individual players nowadays aim to fulfill all of these expert roles, we urge for more cooperation among different stakeholders' unique expertise, without entirely having to forego each individual interest. Strengthening cooperation and improving communication requires an approach that brings the diverse stakeholders in a meaningful way together around the same table.

"Everywhere You Look, You'll Find Food": Emerging Adult Perspectives Toward the Food Media Landscape.

This study explores what emerging adults value in food media, i.e. food-focused content and personae in media. Emerging adults (18-25) are an important target group for food media as they transition toward nutritional independence and consume media substantially. Seven semi-structured focus groups were conducted with thirty-seven Belgian participants. Thematic analysis revealed three themes (hedonism, ability, information) grouping nine subthemes (entertainment, sensory appeal, convenience, familiarity, cost, autonomy, education, health and fitness, and innovation) characterizing emerging adults' food media experiences. Incidental exposure and interpersonal influences also mark their food media consumption. This demonstrates food media's interwovenness in emerging adults' media habits. Further research should consider these themes and complexities, including their potential impact toward food-related habits and media use.

"Our" food versus "my" food. Investigating the relation between childhood shared food practices and adult prosocial behavior in Belgium.

This study focuses on the connection between prosocial behavior, defined as acting in ways that benefit others, and shared meals, defined as meals that consist of food(s) shared with others. In contrast to individual meals, where consumers eat their own food and perhaps take a sample of someone else's dish as a taste, shared meals are essentially about sharing all the food with all individuals. Consequently, these meals create situations where consumers are confronted with issues of fairness and respect. One should not be greedy and consume most of a dish; instead, rules of polite food sharing need to be obeyed. It is therefore proposed that those who have often engaged in shared meals during childhood will have a more prosocial personality, as compared to those who less often took part in shared meals during childhood. To test this hypothesis, data about frequency of shared meals during childhood and altruistic personality in early adulthood were collected using a cross-sectional survey in Belgium (n = 487). Results confirm that higher levels of shared meal consumption correspond to higher scores on the self-report altruism scale among students.

A meta-analysis of serious digital games for healthy lifestyle promotion.

Several systematic reviews have described health-promoting effects of serious games but so far no meta-analysis has been reported. This paper presents a meta-analysis of 54 serious digital game studies for healthy lifestyle promotion, in which we investigated the overall effectiveness of serious digital games on healthy lifestyle promotion outcomes and the role of theoretically and clinically important moderators. Findings showed that serious games have small positive effects on healthy lifestyles (g=0.260, 95% CI 0.148; 0.373) and their determinants (g=0.334, 95% CI 0.260; 0.407), especially for knowledge. Effects on clinical outcomes were significant, but much smaller (g=0.079, 95% CI 0.038; 0.120). Long-term effects were maintained for all outcomes except for behavior. Serious games are best individually tailored to both socio-demographic and change need information, and benefit from a strong focus on game theories or a dual theoretical foundation in both behavioral prediction and game theories. They can be effective either as a stand-alone or multi-component programs, and appeal to populations regardless of age and gender. Given that effects of games remain heterogeneous, further explorations of which game features create larger effects are needed.

Assessing the Effectiveness of an mHealth Intervention to Support Men Who Have Sex With Men Engaging in Chemsex (Budd): Single-Case and Pre-Post Experimental Design Study.

BACKGROUND: This study focuses on the Budd app, a mobile health intervention designed for gay, bisexual, and other men who have sex with men who participate in chemsex. Chemsex, the use of psychoactive drugs in a sexual context, presents substantial health risks including increased HIV transmission and mental health issues. Addressing these risks requires innovative interventions tailored to the unique needs of this population. OBJECTIVE: This study aims to evaluate the effectiveness of the Budd app in promoting drug harm reduction practices among its users, focusing on knowledge, behavioral intention, risk behavior awareness, and self-efficacy. METHODS: The study used a mixed methods approach, combining a single-case experimental design and a pre-post study. A total of 10 participants from an outpatient clinic were recruited, and each attended the clinic 3 times. During the first visit, participants installed a restricted version of the Budd app, which allowed them to report daily mood and risk behavior after chemsex sessions. Phase A (baseline) lasted at least 2 weeks depending on chemsex participation. In the second visit, participants gained full access to the Budd app, initiating phase B (intervention). Phase B lasted at least 6 weeks, depending on chemsex participation, with identical data input as phase A. Participants completed pre- and postintervention surveys assessing behavioral determinants during the first and third visit. RESULTS: The study observed an increased knowledge about chemsex substances postintervention, with a mean percentage improvement in knowledge scores of 20.59% (SD 13.3%) among participants. Behavioral intention and self-efficacy showed mixed results, with some participants improving while others experienced a decrease. There was also a variable impact on awareness of risk behavior, with half of the participants reporting a decrease postintervention. Despite these mixed results, the app was generally well-received, with participants engaging with the app's features an average of 50 times during the study. CONCLUSIONS: The Budd app showed effectiveness in enhancing knowledge about chemsex substances among gay, bisexual, and other men who have sex with men. However, its impact on safe dosing behavior, behavioral intention, self-efficacy, and risk behavior awareness was inconsistent. These findings suggest that while educational interventions can increase knowledge, translating this into behavioral change is more complex and may require more participants, a longer follow-up period, and additional strategies and support mechanisms.

Pathways to informed choices: The impact of freedom of choice and two-sided messages on psychological reactance and vaccination intentions among individuals who express concerns.

BACKGROUND: Reducing the spread of infectious diseases through vaccination faces the challenge of vaccine hesitancy: referring to questions, concerns and doubts arising when making a vaccine-related decision. A motivational state often arising within people exposed to health messages supporting informed decision making is psychological reactance, functioning as a driver to behavior opposed to the one recommended through the health message. Hence, there is a pressing need for communication strategies effective in counteracting reactance to health messages. METHODS: This study tested two communication strategies that can potentially reduce psychological reactance and ameliorate evaluations of the message and subsequent behavioral vaccination intentions in the context of COVID-19. These were: (1) explicitly reminding individuals of their freedom of choice (to either accept or refuse the vaccine) and (2) providing a two-sided message, including, apart from evidence-based information on the necessity of vaccines, a set of concerns, and questions (about the vaccines) which are refuted immediately. A total of 234 participants who indicated having concerns about the COVID-19 vaccine participated in a 2 (freedom of choice: no choice vs. choice) × 2 (message sidedness: one-sided vs. two-sided) between-subjects online experiment where they received an informational brochure about COVID-19 vaccination. RESULTS: The results show that emphasizing freedom of choice significantly increased perceived credibility of the message, perceived information utility, and ultimately, vaccination intentions. A decrease in psychological reactance mediated these effects. Message sidedness did only show a significant direct effect on perceived information utility. No interaction effect was found. CONCLUSION: These findings indicate the importance of freedom of choice in reducing psychological reactance, which in its turn can lead to an increase of positive message evaluations and vaccination intentions among individuals who express concerns. The opportunities of message sidedness as an efficacious vaccination communication strategy should be further investigated.

Features for Hate? Using the Delphi Method to Explore Digital Determinants for Online Hate Perpetration and Possibilities for Intervention.

Online hate speech on social media platforms causes harm to those who are victimized as well as society at large. The prevalence of hateful content has, thus, prompted numerous calls for improved countermeasures and prevention. For such interventions to be effective, it is necessary to gain a nuanced understanding of influences that facilitate the spread of hate speech. This study does so by investigating what are relevant digital determinants for online hate perpetration. Moreover, the study explores possibilities of different technology-driven interventions for prevention. Thereby, the study specifically considers the digital environments in which online hate speech is most often produced and disseminated, namely social media platforms. We apply frameworks related to the concept of digital affordances to focus on the role that technological features of these platforms play in the context of online hate speech. Data were collected using the Delphi method in which a selected sample of experts from both research and practice answered multiple rounds of surveys with the goal of reaching a group consensus. The study encompassed an open-ended collection of initial ideas, followed by a multiple-choice questionnaire to identify, and rate the most relevant determinants. Usefulness of the suggested intervention ideas was assessed through the three lenses of human-centered design. The results of both thematic analysis and non-parametric statistics yield insights on how features of social media platforms can be both determinants that facilitate online hate perpetration as well as crucial mechanisms of preventive interventions. Implications of these findings for future intervention development are discussed.

Neuroendocrine and psychophysiological investigation of the evolutionary roots of gossip.

This study investigates an evolutionary hypothesis of gossip postulating that in humans it serves a similar function as social grooming in other primates. It examines whether gossip decreases physiological markers of stress and increases markers of positive emotionality and sociability. Dyads of friends (N = 66) recruited at the university, participated in an experiment where they experienced a stressor followed by social interaction (gossip or control task). Individual levels of salivary cortisol and [Formula: see text]-endorphins were assessed at before and after social interactions. Sympathetic activity and parasympathetic activity were monitored throughout the experiment. Individual differences in Tendency and Attitude towards Gossip were investigated as potential covariates. Gossip condition was characterized with increased sympathetic and parasympathetic activity, but did not differ in cortisol or [Formula: see text]-endorphins levels. However, high Tendency to Gossip was associated with decreases in cortisol. Gossip was shown to be more emotionally salient than non-social talk, but the evidence with regard to lowering stress was not sufficient to support an analogy to social grooming.

Influence of the COVID-19 pandemic and social media on the behaviour of pregnant and lactating women towards vaccination: a scoping review.

BACKGROUND: Pregnant women, foetuses and infants are at risk of infectious disease-related complications. Maternal vaccination is a strategy developed to better protect pregnant women and their offspring against infectious disease-related morbidity and mortality. Vaccines against influenza, pertussis and recently also COVID-19 are widely recommended for pregnant women. Yet, there is still a significant amount of hesitation towards maternal vaccination policies. Furthermore, contradictory messages circulating social media impact vaccine confidence. OBJECTIVES: This scoping review aims to reveal how COVID-19 and COVID-19 vaccination impacted vaccine confidence in pregnant and lactating women. Additionally, this review studied the role social media plays in creating opinions towards vaccination in these target groups. ELIGIBILITY CRITERIA: Articles published between 23 November 2018 and 18 July 2022 that are linked to the objectives of this review were included. Reviews, articles not focusing on the target group, abstracts, articles describing outcomes of COVID-19 infection/COVID-19 vaccination were excluded. SOURCES OF EVIDENCE: The PubMed database was searched to select articles. Search terms used were linked to pregnancy, lactation, vaccination, vaccine hesitancy, COVID-19 and social media. CHARTING METHODS: Included articles were abstracted and synthesised by one reviewer. Verification was done by a second reviewer. Disagreements were addressed through discussion between reviewers and other researchers. RESULTS: Pregnant and lactating women are generally less likely to accept a COVID-19 vaccine compared with non-pregnant and non-nursing women. The main reason to refuse maternal vaccination is safety concerns. A positive link was detected between COVID-19 vaccine willingness and acceptance of other vaccines during pregnancy. The internet and social media are identified as important information sources for maternal vaccination. DISCUSSION AND CONCLUSION: Vaccine hesitancy in pregnant and lactating women remains an important issue, expressing the need for effective interventions to increase vaccine confidence and coverage. The role social media plays in vaccine uptake remains unclear.

Drug behaviors, sexually transmitted infection prevention, and sexual consent during chemsex: insights generated in the Budd app after each chemsex session.

Chemsex refers to the intentional use of drugs before or during sex in a specific context, typically involving prolonged sex sessions with multiple partners. Engaging in chemsex is associated with a wide range of health risks and related risk behaviors. We developed a mobile phone application ('Budd-app') to support and inform chemsex participants, reduce potential negative impacts associated with chemsex (e.g., physical, psychological and social health harms), and encourage more reasoned participation. During Budd's development process, 11 participants completed a survey after each chemsex session they attended. This data collection approach provided precise experiences on drug related behavior, prevention measures for sexually transmitted infection and sexual consent on 63 chemsex sessions. The mean duration of chemsex sessions was 17.5 h. Polydrug use was reported during 95% of chemsex sessions with an average of 3.5 agents per session. Unsafe dosing occurred at 49% of chemsex sessions, and 9/11 participants dosed unsafely at least once. Seven participants did not consistently take measures to prevent STI transmission. Nine had experienced peer pressure, both regarding drug use and sexual health. The same number reported sex without consent, not respecting others' boundaries as well as their own boundaries not being respected. Many participants experienced negative impact of their chemsex behavior during (7/9) and after (8/9) chemsex. Through participants' behavior assessment during multiple chemsex sessions, 'within-person' variability can be clarified. This clarification provides valuable insights in personal, emotional and contextual vulnerabilities. These insights can direct an individualized care and support trajectory aimed at addressing those vulnerabilities.

"Meating halfway": Exploring the attitudes of meat eaters, veg*ns, and occasional meat eaters toward those who eat meat and those who do not eat meat.

Empirical studies have persistently reported negative attitudes of meat eaters toward vegetarians and vegans (veg*ns), but scant attention has been paid to veg*ns' attitudes toward meat eaters. We aimed to investigate the attitudes of meat eaters and veg*ns from both perspectives. In addition, we explored the attitudes of occasional meat eaters. We performed a cross-sectional study (Study 1) among meat eaters, veg*ns, and occasional meat eaters, as well as a content analysis of publicly available tweets (Study 2). Study 1 (N = 477, Mage = 23.45, SD = 5.91) showed that the attitudes of veg*ns toward meat eaters are significantly more negative compared to the attitudes of meat eaters toward veg*ns, but both were lower than the midpoint on scales measuring negative attitudes toward the other. Study 2 showed that only a small portion (<1%) of tweets (N = 1,328) on meat eating or veg*nism contained signs of negative attitudes. The two studies provide little evidence of the existence of strong negative attitudes.

The Effects of Expressing Empathy/Autonomy Support Using a COVID-19 Vaccination Chatbot: Experimental Study in a Sample of Belgian Adults.

BACKGROUND: Chatbots are increasingly used to support COVID-19 vaccination programs. Their persuasiveness may depend on the conversation-related context. OBJECTIVE: This study aims to investigate the moderating role of the conversation quality and chatbot expertise cues in the effects of expressing empathy/autonomy support using COVID-19 vaccination chatbots. METHODS: This experiment with 196 Dutch-speaking adults living in Belgium, who engaged in a conversation with a chatbot providing vaccination information, used a 2 (empathy/autonomy support expression: present vs absent) × 2 (chatbot expertise cues: expert endorser vs layperson endorser) between-subject design. Chatbot conversation quality was assessed through actual conversation logs. Perceived user autonomy (PUA), chatbot patronage intention (CPI), and vaccination intention shift (VIS) were measured after the conversation, coded from 1 to 5 (PUA, CPI) and from -5 to 5 (VIS). RESULTS: There was a negative interaction effect of chatbot empathy/autonomy support expression and conversation fallback (CF; the percentage of chatbot answers "I do not understand" in a conversation) on PUA (PROCESS macro, model 1, B=-3.358, SE 1.235, t186=2.718, P=.007). Specifically, empathy/autonomy support expression had a more negative effect on PUA when the CF was higher (conditional effect of empathy/autonomy support expression at the CF level of +1SD: B=-.405, SE 0.158, t186=2.564, P=.011; conditional effects nonsignificant for the mean level: B=-0.103, SE 0.113, t186=0.914, P=.36; conditional effects nonsignificant for the -1SD level: B=0.031, SE=0.123, t186=0.252, P=.80). Moreover, an indirect effect of empathy/autonomy support expression on CPI via PUA was more negative when CF was higher (PROCESS macro, model 7, 5000 bootstrap samples, moderated mediation index=-3.676, BootSE 1.614, 95% CI -6.697 to -0.102; conditional indirect effect at the CF level of +1SD: B=-0.443, BootSE 0.202, 95% CI -0.809 to -0.005; conditional indirect effects nonsignificant for the mean level: B=-0.113, BootSE 0.124, 95% CI -0.346 to 0.137; conditional indirect effects nonsignificant for the -1SD level: B=0.034, BootSE 0.132, 95% CI -0.224 to 0.305). Indirect effects of empathy/autonomy support expression on VIS via PUA were marginally more negative when CF was higher. No effects of chatbot expertise cues were found. CONCLUSIONS: The findings suggest that expressing empathy/autonomy support using a chatbot may harm its evaluation and persuasiveness when the chatbot fails to answer its users' questions. The paper adds to the literature on vaccination chatbots by exploring the conditional effects of chatbot empathy/autonomy support expression. The results will guide policy makers and chatbot developers dealing with vaccination promotion in designing the way chatbots express their empathy and support for user autonomy.

Mobilizing bystanders of cyberbullying: an exploratory study into behavioural determinants of defending the victim.

This study explores behavioural determinants of defending behaviour in cyberbullying incidents. Three focus groups were conducted with youngsters aged 12-16 y. Major themes that were found as important behavioural determinants to defend the victim were a low moral disengagement, that the victim is an in-group member and that the bystander is popular. Bystanders preferred to handle cyberbullying offline and in person, and comforting the victim was considered more feasible than facing the bully. With a high peer acceptance of passive bystanding and lack of parental support for defending behaviour, youngsters do not receive much encouragement from their environment to exhibit defending behaviour towards victims. These preliminary results suggest befriending and peer support interventions hold promise, as well as environmental interventions with parents and teachers. These first results will need to be confirmed in more in-depth analyses and in quantitative research.

Using Intervention Mapping to Develop an mHealth Intervention to Support Men Who Have Sex With Men Engaging in Chemsex (Budd): Development and Usability Study.

BACKGROUND: Chemsex refers to the intentional use of drugs before or during sex among men who have sex with men (MSM). Engaging in chemsex has been linked to significant negative impacts on physical, psychological, and social well-being. However, no evidence-based support tools have addressed either these harms or the care needs of MSM who engage in chemsex. OBJECTIVE: The purpose of this paper was to describe the development of a mobile health intervention (named Budd) using the intervention mapping protocol (IMP). Budd aims to support and inform MSM who participate in chemsex, reduce the negative impacts associated with chemsex, and encourage more reasoned participation. METHODS: The IMP consists of 6 steps to develop, implement, and evaluate evidence-based health interventions. A needs assessment was carried out between September 2, 2019, and March 31, 2020, by conducting a literature study and in-depth interviews. Change objectives were selected based on these findings, after which theory-based intervention methods were selected. The first version of the intervention was developed in December 2020 and pilot-tested between February 1, 2021, and April 30, 2021. Adjustments were made based on the findings from this study. A separate article will be dedicated to the effectiveness study, conducted between October 15, 2021, and February 24, 2022, and implementation of the intervention. The Budd app went live in April 2022. RESULTS: Budd aims to address individual factors and support chemsex participants in applying harm reduction measures when taking drugs (drug information, drug combination tool, and notebook), preparing for participation in a chemsex session (articles on chemsex, preparation tool, and event-specific checklist), planning sufficient time after a chemsex session to recover (planning tool), seeking support for their chemsex participation (overview of existing local health care and peer support services, reflection, personal statistics, and user testimonials), taking HIV medication or pre-exposure prophylaxis in a timely manner during a chemsex session (preparation tool), and contacting emergency services in case of an emergency and giving first aid to others (emergency information and personal buddy). CONCLUSIONS: The IMP proved to be a valuable tool in the planning and development of the Budd app. This study provides researchers and practitioners with valuable information that may help them to set up their own health interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/39678.

Knowledge, attitudes, and practices regarding schistosomiasis infection and prevention: A mixed-methods study among endemic communities of western Uganda.

INTRODUCTION: In Uganda, schistosomiasis (re)infections have continued to remain high despite the implementation of mass drug administration and sensitization campaigns aimed at controlling the disease. This could imply that there are some barriers to the implemented preventive measures. We conducted a mixed-methods study in Kagadi and Ntoroko districts around Lake Albert to assess knowledge, attitudes, and practices regarding schistosomiasis and to explore and understand perspectives regarding the disease. MATERIALS AND METHODS: Semi-structured survey questionnaires were administered to 337 household adults selected through systematic random sampling. We also interviewed 12 participants and held 28 focus-group discussion sessions with 251 individuals respectively. Quantitative data was analysed using frequencies, percentages, and chi-square tests for associations, while themes and sub-themes were used to analyse qualitative data respectively. FINDINGS: A total of 98.5%, 81.3%, and 78.5% had heard about schistosomiasis, and knew the main transmission modes and symptoms, respectively. The majority (75.8%) said avoiding contact with water was a preventative way, while 67.5% said observing signs and symptoms was a form of diagnosis. Furthermore, 98.4% and 73.4% said it was important to defecate in latrines and to avoid contact with contaminated water respectively. However, it is difficult to avoid contact with lake water because it is the only source of livelihood, especially for fisher communities. Open defecation is commonly practiced along the lake due to insufficient space and difficulties in the construction of latrines. Myths and misconceptions reported include; lake water is safe, gassing in water causes transmission, fetching water early in the morning and from deep water is safe, and feces in the lake water act as a bait for catching fish. CONCLUSIONS AND RECOMMENDATIONS: Despite adequate knowledge of schistosomiasis and a positive attitude towards its prevention, existing myths and misconceptions, coupled with persistent risky water, sanitation, and hygiene practices still pose a challenge. A more robust community-based awareness intervention using bottom-up participatory approaches, accompanied by the provision of clean and safe water sources and increasing latrine coverage, could provide lasting solutions to these barriers.

Physical Activity during the First Lockdown of the COVID-19 Pandemic: Investigating the Reliance on Digital Technologies, Perceived Benefits, Barriers and the Impact of Affect.

The measures to fight the spread of the COVID-19 pandemic have been concentrated on inviting people to stay at home. This has reduced opportunities to exercise while also shedding some light on the importance of physical health. Based on an online survey, this paper investigated physical activity behaviours of a Belgians sample (n = 427) during the lockdown period between the end of May 2020 and the beginning of June 2020 and found that, during this period, the gap between sufficiently and insufficiently active individuals widened even more. This paper analysed important moderators of physical activity behaviours, such as barriers and benefits to exercise, digital support used to exercise, and individuals' emotional well-being. Descriptive analysis and analyses of variance indicated that, generally, individuals significantly increased their engagement in exercise, especially light- and moderate-intensity activities, mostly accepted the listed benefits but refused the listed barriers, increased their engagement in digital support and did not score high on any affective measures. A comparison between sufficiently active and insufficiently active individuals during the lockdown showed that the former engaged even more in physical activity, whereas the latter exercised equally (i.e., not enough) or even less compared to before the lockdown. By means of a logistic regression, five key factors of belonging to the sufficiently active group were revealed and discussed. Practical implications for government and policies are reviewed.