Socioeconomic privilege and political ideology are associated with racial disparity in COVID-19 vaccination.

Vaccine uptake is critical for mitigating the impact of COVID-19 in the United States, but structural inequities pose a serious threat to progress. Racial disparities in vaccination persist despite the increased availability of vaccines. We ask what factors are associated with such disparities. We combine data from state, federal, and other sources to estimate the relationship between social determinants of health and racial disparities in COVID-19 vaccinations at the county level. Analyzing vaccination data from 19 April 2021, when nearly half of the US adult population was at least partially vaccinated, we find associations between racial disparities in COVID-19 vaccination and median income (negative), disparity in high school education (positive), and vote share for the Republican party in the 2020 presidential election (negative), while vaccine hesitancy is not related to disparities. We examine differences in associations for COVID-19 vaccine uptake as compared with influenza vaccine. Key differences include an amplified role for socioeconomic privilege factors and political ideology, reflective of the unique societal context in which the pandemic has unfolded.

Market segmentation of South African adolescent girls and young women to inform HIV prevention product marketing strategy: A mixed methods study.

The uptake of and adherence to HIV prevention products in South Africa has not achieved widespread success. This study aimed to develop a holistic understanding of the psychographics of adolescent girls and young women in South Africa, a primary audience for HIV prevention products, in order to inform market segmentation and marketing strategies. Extensive ethnographic analyses were complemented with a survey (n = 1,500) centered on personal care product journeys. Clustering and qualitative methods yielded six segments with measurable differences, and revealed common themes surrounding empowerment and self-determination, patriarchy, and misinformation risk. The findings enable targeted approaches for HIV prevention product campaigns.

The quest for significance model of radicalization: implications for the management of terrorist detainees.

Radicalization and its culmination in terrorism represent a grave threat to the security and stability of the world. A related challenge is effective management of extremists who are detained in prison facilities. The major aim of this article is to review the significance quest model of radicalization and its implications for management of terrorist detainees. First, we review the significance quest model, which elaborates on the roles of motivation, ideology, and social processes in radicalization. Secondly, we explore the implications of the model in relation to the risks of prison radicalization. Finally, we analyze the model's implications for deradicalization strategies and review preliminary evidence for the effectiveness of a rehabilitation program targeting components of the significance quest. Based on this evidence, we argue that the psychology of radicalization provides compelling reason for the inclusion of deradicalization efforts as an essential component of the management of terrorist detainees.

Building social identity-based groups to enhance online peer support for patients with chronic disease: a pilot study using mixed-methods evaluation.

Online peer support is increasingly important to encourage patients with chronic diseases to engage in successful self-management. However, studies mainly focus on individual-level participation and have not fully explored how to maximize the impact of online peer support through group identification. In this study, we aim to build an online social identity-based group to examine the impact of group identity on peer support. Twenty-five participants who completed the first phase of a larger study were randomly assigned either to the treatment group (identity-based group level, n = 15, three subgroups, five members in each subgroup) or to the control group (individual-level, n = 10). All participants in both treatment and control groups received the same tasks and incentives. Peer support behavior (informational support and emotional support), task completion (knowledge learning, self-tracking behavior), and health-related outcomes (self-efficacy [SE] and HbA1c) were collected for qualitative and quantitative analysis. Results from a 3-month pilot experiment showed that the treatment group offered substantial enhancement in peer support compared to the control group. It also significantly promoted improvement in SE. However, there was no significant difference in task completion or changes in HbA1c between the two groups. The results of the content analysis suggest that having a team leader, timely responsiveness, and intergroup competition played important roles in building social identity-based online groups and subsequently generating peer support. We provide some encouraging results that indicate how online groups may be effectively designed to promote peer support.

Engagement and Outcomes Associated with Contextual Annotation Features of a Digital Health Solution.

BACKGROUND: Digital health solutions targeting diabetes self-care are popular and promising, but important questions remain about how these tools can most effectively help patients. Consistent with evidence of the salutary effects of note-taking in education, features that enable annotation of structured data entry might enhance the meaningfulness of the interaction, thereby promoting persistent use and benefits of a digital health solution. METHOD: To examine the potential benefits of note-taking, we explored how patients with type 2 diabetes used annotation features of a digital health solution and assessed the relationship between annotation and persistence in engagement as well as improvements in glycated hemoglobin (A1C). Secondary data from 3142 users of the BlueStar digital health solution collected between December 2013 and June 2017 were analyzed, with a subgroup of 372 reporting A1C lab values. RESULTS: About a third of patients recorded annotations while using the platform. Annotation themes largely reflected self-management behaviors (diet, physical activity, medication adherence) and well-being (mood, health status). Early use of contextual annotations was associated with greater engagement over time and with greater improvements in A1C. CONCLUSIONS: Our research provides preliminary evidence of the benefits of annotation features in a digital health solution. Future research is needed to assess the causal impact of note-taking and the moderating role of thematic content reflected in notes.

Unpacking mHealth interventions: A systematic review of behavior change techniques used in randomized controlled trials assessing mHealth effectiveness.

OBJECTIVE: Mobile health interventions have surged in popularity but their implementation varies widely and evidence of effectiveness is mixed. We sought to advance understanding of the diversity of behavior change techniques in mHealth interventions, especially those that leverage advanced mobile technologies. METHODS: We conducted a systematic review of articles published between 2007 and 2017 in high-impact journals in medicine, medical informatics, and health psychology to identify randomized controlled trials in which the effectiveness of an mobile health intervention was tested. Search terms included a mix of general (e.g. mobile health), hardware (e.g. Android, iPhone), and format (e.g. SMS, application) terms. RESULTS: In a systematic review of 21 studies, we found the techniques of personalization, feedback and monitoring, and associations were most commonly used in mobile health interventions, but there remains considerable opportunity to leverage more sophisticated aspects of ubiquitous computing. We found that prompts and cues were the most common behavior change techniques used in effective trials, but there was notable overlap in behavior change techniques used in ineffective trials. CONCLUSIONS: Our results identify techniques that are commonly used in mobile health interventions and highlight pathways to advance the science of mobile health.

Influence of Personality on mHealth Use in Patients with Diabetes: Prospective Pilot Study.

BACKGROUND: Mobile technology for health (mHealth) interventions are increasingly being used to help improve self-management among patients with diabetes; however, these interventions have not been adopted by a large number of patients and often have high dropout rates. Patient personality characteristics may play a critical role in app adoption and active utilization, but few studies have focused on addressing this question. OBJECTIVE: This study aims to address a gap in understanding of the relationship between personality traits and mHealth treatment for patients with diabetes. We tested the role of the five-factor model of personality traits (openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism) in mHealth adoption preference and active utilization. METHODS: We developed an mHealth app (DiaSocial) aimed to encourage diabetes self-management. We recruited 98 patients with diabetes-each patient freely chose whether to receive the standard care or the mHealth app intervention. Patient demographic information and patient personality characteristics were assessed at baseline. App usage data were collected to measure user utilization of the app. Patient health outcomes were assessed with lab measures of glycated hemoglobin (HbA1c level). Logistic regression models and linear regression were employed to explore factors predicting the relationship between mHealth use (adoption and active utilization) and changes in health outcome. RESULTS: Of 98 study participants, 46 (47%) downloaded and used the app. Relatively younger patients with diabetes were 9% more likely to try and use the app (P=.02, odds ratio [OR] 0.91, 95% CI 0.85-0.98) than older patients with diabetes were. Extraversion was negatively associated with adoption of the mHealth app (P=.04, OR 0.71, 95% CI 0.51-0.98), and openness to experience was positively associated with adoption of the app (P=.03, OR 1.73, 95% CI 1.07-2.80). Gender (P=.43, OR 0.66, 95% CI 0.23-1.88), education (senior: P=.99, OR 1.00, 95% CI 0.32-3.11; higher: P=.21, OR 2.51, 95% CI 0.59-10.66), and baseline HbA1c level (P=.36, OR 0.79, 95% CI 0.47-1.31) were not associated with app adoption. Among those who adopted the app, a low education level (senior versus primary P=.003; higher versus primary P=.03) and a high level of openness to experience (P=.048, OR 2.01, 95% CI 1.01-4.00) were associated with active app utilization. Active users showed a significantly greater decrease in HbA1c level than other users (ΔHbA1c=-0.64, P=.05). CONCLUSIONS: This is one of the first studies to investigate how different personality traits influence the adoption and active utilization of an mHealth app among patients with diabetes. The research findings suggest that personality is a factor that should be considered when trying to identify patients who would benefit the most from apps for diabetes management.

Shared reality as collective closure.

We draw on the theory of lay epistemics to understand how universal processes of knowledge formation drive the emergence, and determine the consequences of shared reality in groups. In particular, we highlight the role in these processes of the need for cognitive closure and credible epistemic authorities. Whereas the former construct explains why people seek a shared reality, the latter clarifies who the reality is shared with. In this connection, we review relevant bodies of empirical evidence that bear on the epistemic underpinnings of shared reality phenomena.

Individual differences in regulatory mode moderate the effectiveness of a pilot mHealth trial for diabetes management among older veterans.

mHealth tools to help people manage chronic illnesses have surged in popularity, but evidence of their effectiveness remains mixed. The aim of this study was to address a gap in the mHealth and health psychology literatures by investigating how individual differences in psychological traits are associated with mHealth effectiveness. Drawing from regulatory mode theory, we tested the role of locomotion and assessment in explaining why mHealth tools are effective for some but not everyone. A 13-week pilot study investigated the effectiveness of an mHealth app in improving health behaviors among older veterans (n = 27) with poorly controlled Type 2 diabetes. We developed a gamified mHealth tool (DiaSocial) aimed at encouraging tracking of glucose control, exercise, nutrition, and medication adherence. Important individual differences in longitudinal trends of adherence, operationalized as points earned for healthy behavior, over the course of the 13-week study period were found. Specifically, low locomotion was associated with unchanging levels of adherence during the course of the study. In contrast, high locomotion was associated with generally stronger adherence although it exhibited a quadratic longitudinal trend. In addition, high assessment was associated with a marginal, positive trend in adherence over time while low assessment was associated with a marginal, negative trend. Next, we examined the relationship between greater adherence and improved clinical outcomes, finding that greater adherence was associated with greater reductions in glycated hemoglobin (HbA1c) levels. Findings from the pilot study suggest that mHealth technologies can help older adults improve their diabetes management, but a "one size fits all" approach may yield suboptimal outcomes.

Counterfinality: On the Increased Perceived Instrumentality of Means to a Goal.

The present research investigates the counterfinality effect, whereby the more a means is perceived as detrimental to an alternative goal, the more it is perceived as instrumental to its focal goal. The results from five studies supported this hypothesis. Study 1 demonstrated the counterfinality effect in an applied context: The more pain people experienced when getting tattooed, the more they perceived getting tattooed as instrumental to attaining their idiosyncratic goals (being unique, showing off, etc.). Study 2 experimentally replicated and extended the results of Study 1: A counterfinal (vs. non-counterfinal) consumer product was perceived as more detrimental, which in turn predicted the perceived effectiveness of the product. In Studies 3 and 5, we showed that increased perceived instrumentality due to counterfinality led to more positive attitudes toward a means. Finally, Studies 4 and 5 indicated that simultaneous commitment to both the focal and the alternative goal moderated the counterfinality effect. We discuss how various psychological phenomena can be subsumed under the general framework of counterfinality, which has broad practical implications extending to consumer behavior, health psychology, and terrorism.

To the fringe and back: Violent extremism and the psychology of deviance.

We outline a general psychological theory of extremism and apply it to the special case of violent extremism (VE). Extremism is defined as motivated deviance from general behavioral norms and is assumed to stem from a shift from a balanced satisfaction of basic human needs afforded by moderation to a motivational imbalance wherein a given need dominates the others. Because motivational imbalance is difficult to sustain, only few individuals do, rendering extreme behavior relatively rare, hence deviant. Thus, individual dynamics translate into social patterns wherein majorities of individuals practice moderation, whereas extremism is the province of the few. Both extremism and moderation require the ability to successfully carry out the activities that these demand. Ability is partially determined by the activities' difficulty, controllable in part by external agents who promote or oppose extremism. Application of this general framework to VE identifies the specific need that animates it and offers broad guidelines for addressing this pernicious phenomenon. (PsycINFO Database Record

The psychology of martyrdom: making the ultimate sacrifice in the name of a cause.

Martyrdom is defined as the psychological readiness to suffer and sacrifice one's life for a cause. An integrative set of 8 studies investigated the concept of martyrdom by creating a new tool to quantitatively assess individuals' propensity toward self-sacrifice. Studies 1A-1C consisted of psychometric work attesting to the scale's unidimensionality, internal consistency, and temporal stability while examining its nomological network. Studies 2A-2B focused on the scale's predictive validity, especially as it relates to extreme behaviors and suicidal terrorism. Studies 3-5 focused on the influence of self-sacrifice on automatic decision making, costly and altruistic behaviors, and morality judgments. Results involving more than 2,900 participants from different populations, including a terrorist sample, supported the proposed conceptualization of martyrdom and demonstrated its importance for a vast repertoire of cognitive, emotional, and behavioral phenomena. Implications and future directions for the psychology of terrorism are discussed.

Implementation planning and progress on physical activity goals: the mediating role of life-management strategies.

This 4-week prospective study examined whether the use of life-management strategies mediates the relationship between implementation planning and short-term progress on physical activity goals. In particular the strategies of elective selection, compensation, and loss-based selection were disentangled to assess their specific mediating effects. Results from a sample of 131undergraduate students showed that, as a composite, life-management strategies fully mediated the relationship between planning and goal progress. More specifically, decomposing the effects demonstrated that only elective selection and compensation mediated the association between planning and greater progress on a personal physical activity goal. Results are discussed in light of their practical implications and contributions to the personal goal literature.