Health Communication and Behavioral Change During the COVID-19 Pandemic.

The COVID-19 pandemic challenged the public health system to respond to an emerging, difficult-to-understand pathogen through demanding behaviors, including staying at home, masking for long periods, and vaccinating multiple times. We discuss key challenges of the pandemic health communication efforts deployed in the United States from 2020 to 2022 and identify research priorities. One priority is communicating about uncertainty in ways that prepare the public for disagreement and likely changes in recommendations as scientific understanding advances: How can changes in understanding and recommendations foster a sense that "science works as intended" rather than "the experts are clueless" and prevent creating a void to be filled by misinformation? A second priority concerns creating a culturally fluent framework for asking people to engage in difficult and novel actions: How can health messages foster the perception that difficulties of behavior change signal that the change is important rather than that the change "is not for people like me?" A third priority entails a shift from communication strategies that focus on knowledge and attitudes to interventions that focus on norms, policy, communication about policy, and channel factors that impair behavior change: How can we move beyond educating and correcting misinformation to achieving desired actions?

Bypassing as a non-confrontational influence strategy.

Psychological interventions tend to be confrontational in nature. That is, when psychologists seek to bring about change in beliefs, attitudes, or behaviors, they often do so by directly confronting the presumed barrier to change. Confrontational approaches can be effective, but suffer from limitations to their efficacy, such as the possibility of arousing discomfort or defensiveness from the recipient. The current piece seeks to highlight an alternative strategy that we refer to as bypassing, which refers to a general approach for bringing about behavior change without confrontation. Leveraging insights from research on misinformation, stereotypes, and persuasion, we present evidence that non-confrontational approaches can be as effective, if not more so, than the traditional confrontational paradigm.

Social media use and vaccination among Democrats and Republicans: Informational and normative influences.

Our objective was to determine whether social media influences vaccination through informational and normative influences among Democrats and Republicans. We use a probability-based longitudinal study of Americans (N = 1768) collected between December 2022 and September 2023 to examine the prospective associations between social media use and vaccination as well as informational and normative influence as mediating processes. Greater social media use correlates with more frequent vaccination (cross-lagged coefficients: COVID-19 = 0.113, p < 0.001; influenza = 0.123, p < 0.001). The underlying processes, however, vary between Democrats and Republicans. Democrats who use social media more are more likely to vaccinate because they encounter information about new pathogens. In contrast, Republicans who use social media more are more likely to vaccinate because they think that people who are important to them receive the recommended vaccines. Our findings underscore the potential for social media campaigns to promote vaccination, among both Democrats and Republicans by paying attention to the specific processes in each audience.

A systematic review and meta-analysis of strategies to promote vaccination uptake.

Although immunization can dramatically curb the mortality and morbidity associated with vaccine-preventable diseases, vaccination uptake remains suboptimal in many areas of the world. Here, in this meta-analysis, we analysed the results from 88 eligible randomized controlled trials testing interventions to increase vaccination uptake with 1,628,768 participants from 17 countries with variable development levels (for example, Human Development Index ranging from 0.485 to 0.955). We estimated the efficacy of seven intervention strategies including increasing access to vaccination, sending vaccination reminders, providing incentives, supplying information, correcting misinformation, promoting both active and passive motivation and teaching behavioural skills. We showed that the odds of vaccination were 1.5 (95% confidence interval, 1.27 to 1.77) times higher for intervention than control conditions. Among the intervention strategies, using incentives and increasing access were most promising in improving vaccination uptake, with the access strategy being particularly effective in countries with lower incomes and less access to healthcare.

Health-promotion interventions targeting multiple behaviors: A meta-analytic review of general and behavior-specific processes of change.

Although health-promotion interventions that recommend changes across multiple behavioral domains are a newer alternative to single-behavior interventions, their general efficacy and their mechanisms of change have not been fully ascertained. This comprehensive meta-analysis (6,878 effect sizes from 803 independent samples from 364 research reports, N = 186,729 participants) examined the association between the number of behavioral recommendations in multiple-behavior interventions and behavioral and clinical change across eight domains (i.e., diet, smoking, exercise, HIV [Human Immunodeficiency Virus] prevention, HIV testing, HIV treatment, alcohol use, and substance use). Results showed a positive, linear effect of the number of behavioral recommendations associated with behavioral and clinical change across all domains, although approximately 87% of the samples included between 0 and 4 behavioral recommendations. This linear relation was mediated by improvements in the psychological well-being of intervention recipients and, in several domains (i.e., HIV, alcohol use, and drug use), suggested behavioral cuing. However, changes in information, motivation, and behavioral skills did not mediate the impact of the number of recommendations on behavioral and clinical change. The implications of these findings for theory and future intervention design are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Inaugural editorial.

The commencement of a new editorial tenure within the Journal of Personality and Social Psychology: Attitudes and Social Cognition (JPSP: ASC) provides an opportunity for reflection regarding the journal's core mission. The editors recognize that social psychology is at a crossroads due to competing demands that may have led to reduced submissions and posed challenges for previous editors in filling the journal's pages. Now, JPSP: ASC has been allotted more pages to allow for growth during this editorial term. Although this is desirable for the field, it adds to the pressure of identifying articles for publication given the difficulties filling the pages during previous editorial terms. As the premier outlet of social psychology since 1965, JPSP: ASC will retain its centrality if we increase submissions and publish more articles, while continuing to strive to communicate methodologically trustworthy, intellectually stimulating, and socially relevant research, in a responsible fashion. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Who is saying what on Twitter: An analysis of messages with references to HIV and HIV risk behavior / Quién dice qué en Twitter: Mensajes con referencia a VIH y conducta de riesgo de VIH

Abstract: This research aimed to determine the nature of social media discussions about HIV. With the goal of conducting a descriptive analysis, we collected almost 1,000 tweets posted February to September 2015. The sample of tweets included keywords related to HIV or behavioral risk factors (e.g., sex, drug use) and was coded for content (e.g., HIV), behavior change strategies, and message source. Seven percent of tweets concerned HIV/AIDS, which were often referred to as jokes or insults. The majority of tweets coded as behavior change attempts involved attitude change strategies. The majority of the tweets (80%) came from private users (vs. organizations). Different types of sources employed different types of behavior change strategies: For instance, private users, compared to experts or organizations, included more strategies to decrease detrimental attitudes (29% versus 6%, p < .001), and also more strategies to counter myths and misinformation (6% versus 1%, p = .008). In summary, tweets related to HIV/AIDS and associated risk factors frequently use the terms in jokes and insults, come largely from private users, and entail attitudinal and informational strategies. Online health campaigns with clear calls to action and corrections of misinformation may make important contributions to social media conversations about HIV/AIDS.

Resumen: Esta investigación tuvo el objetivo de caracterizar las discusiones sobre VIH en los medios sociales. Con el objetivo de realizar un análisis descriptivo, recogimos alrededor de mil tweets entre febrero y septiembre del 2015. Estos tweets fueron seleccionados si incluían palabras claves relacionadas con el VIH o con factores de riesgo conductual tales como sexo o uso de drogas. Cuatro codificadores clasificaron los tweets en función del contenido (e.g., el VIH como enfermedad, referido a un producto o servicio), la estrategia de cambio conductual (cambio conductual, llamada a la acción, o corrección de mitos), y la fuente del mensaje (e.g., usuarios privados, expertos, empresas comerciales). La mayoría de los tweets (80%) provenía de usuarios privados en lugar de institucionales. El 7% de los tweets se refería estrictamente al VIH u otras infecciones de transmisión sexual, frecuentemente utilizando esos términos como bromas o insultos, tales como escribir que una experiencia displacentera "me dio SIDA". La mayoría de los intentos de cambio conductual incluía estrategias de reducción de actitudes negativas. Fuentes de distintos tipos empleaban estrategias de cambio conductual de distintos tipos. Por ejemplo, usuarios privados (comparados con expertos, organizaciones comerciales, y otras organizaciones, tal como periódicos y ONGs), publicaban más mensajes clasificados como estrategias de promoción de actitudes negativas (29% versus 6%, p < .001), y tenían más correcciones de mitos (6% versus 1%, p = .008). En resumen, los tweets que mencionan el VIH o factores de riesgo de VIH utilizan los términos en bromas e insultos con gran frecuencia, provienen mayormente de usuarios privados, e incluyen estrategias de cambio de actitud. Las campañas de Internet con llamadas claras a la acción y con correcciones de mitos pueden hacer contribuciones importantes a las conversaciones sobre VIH en los medios sociales.

Stigma Cues Increase Self-Conscious Emotions and Decrease Likelihood of Attention to Information about Preventing Stigmatized Health Issues / Señales sobre Estigma Aumentan las Emociones Conscientes y Disminuyen la Probabilidad de Atención a la Información sobre Prevención de Cuestiones Estigmatizadas de Salud

Health communications are only effective if target audiences actually receive the messages. One potential barrier to effective health communication is the potential stigma of attending to health information, particularly for stigmatizing health issues. The purpose of the present paper was to examine when participants report self-conscious emotions (e.g., shame, embarrassment) in response to health communications, as well as likelihood of reading health information associated with these emotions. Across three studies, participants read information about preventing diseases that are either highly stigmatized or non-stigmatized. Increased accessibility of stigma cues by (a) manipulating the perceived absence vs. presence of others, or (b) measuring lower vs. higher rejection sensitivity resulted in increased self-conscious emotions in response to information about stigmatized health issues. In addition, stigma cues decreased the likelihood of reading information about stigmatized (but not non-stigmatized) health information. Implications for health outcomes and intervention design are discussed.

La comunicación en torno a la salud solo es efectiva si la audiencia meta recibe el mensaje. Una barrera potencial que tiene la comunicación efectiva sobre salud es el estigma potencial de hacer caso a la información sobre salud, particularmente en temas estigmatizados. El objetivo del presente estudio fue examinar cuándo reportan los participantes emociones conscientes (p.e. vergüenza, culpa) en respuesta a comunicación sobre salud, así como la probabilidad de leer información asociada con estas emociones. A través de tres estudios, los participantes leyeron información sobre prevención de enfermedades que son altamente estigmatizadas o que no lo son. El aumento de la accesibilidad de las señales sobre estigma mediante (a) la manipulación de la ausencia percibida vs. presencia de otros, o (b) la medición de alta o baja sensibilidad al rechazo, resultó en aumento de emociones conscientes en respuesta a la información sobre temas de salud estigmatizados. Además, las señales sobre estigma disminuyeron la probabilidad de lectura de información sobre información estigmatizada (no así para la no estigmatizada). Se discuten las implicaciones sobre consecuencias de salud y diseño de intervención.

When is Retention in Health Promotion Interventions Intentional? Predicting Return to Health Promotion Interventions as a Function of Busyness / ¿Cuándo es la adherencia en las intervenciones de promoción de salud intencional? Predicción de regreso a las intervenciones de promoción de la salud en función de la ocupación

To test when intentional decisions enhance retention in health-promotion interventions, we analyzed the rate of return of 278 clients of HIV-prevention counseling at a state health department in Florida. Specifically, the role of intentions as a facilitator of returns was analyzed as a function of busyness (more children and work hours), while demographic and health factors that also influenced returns were controlled for. Consistent with the notion that actions depend on ability, intentions predicted the behavior of the less busy participants but failed to facilitate retention when participants were occupied with children and work. These findings suggest the efficacy of different retention strategies -one emphasizing explicit intention formation, and the other either attracting clients to counseling on the spot or using more ubiquitous technologies.

Para poner a prueba cuándo las decisiones intencionales promueven la retención dentro de las intervenciones de promoción de salud, se analizó la proporción en que 278 usuarios de consejería de prevención de VIH regresaban al departamendo de salud estatal de Florida. Específicamente, el rol de las intenciones como facilitador de los retornos fue analizado como una función de trabajo (más hijos y más horas laborales), mientras que los factores demográficos y de salud que también tenían influencia fueron controlados. Consistente con la noción de que las acciones dependen de la habilidad, las intenciones predijeron la conducta de los usuarios menos ocupados y no predijeron en los casos de usuarios con mayor carga de trabajo e hijos. Estos hallazgos sugieren la eficancia de diferentes estrategias de retención -una enfatizando la formación explícita de intenciones, y otra ya sea atrayendo clientes a consejería sobre la marcha, o utilizando tecnología más ubicuas.

Ciberadicción y relación de objeto / Cyberaddiction and object relation

Este trabajo aborda la ciberadicción, considerada como un modo de relación narcisista a un objeto imaginario, frágil substituto del objeto sexual, en el caso de jóvenes que presentan dos tipos de síntomas: la fobia de la sexualidad genital, así como la utilización compulsiva del chat. Engarzada en la lógica imaginaria del fantasma, la dependencia al chat representa un compromiso patológico entre el deseo y la defensa que, lejos de desmontar el síntoma fóbico, lo refuerza.