Affective Attitudes Research Articles

Using the Theoretical Framework of Acceptability for qualitative assessment of the "COMBAT" VAW intervention in Ghana.

Violence against women (VAW) is a global health problem, which leads to negative sexual, reproductive, mental and physical health outcomes, as well as death in extreme cases. Globally, over 35% of women are reported to have experienced some form of violence, while in Ghana, 37% of women have ever experienced physical violence. Considering that the sustainability of community-based VAW interventions is largely dependent on ownership, this study used the Theoretical Framework of Acceptability (TFA) to assess the COMBAT (Community Based Action Teams) intervention (for example, ethicality, self-efficacy, and intervention coherence) which was implemented to prevent violence against women in Ghana. This qualitative research study was conducted at baseline and end-line of the intervention, which used COMBAT as a vehicle to change social norms on gender and violence in the Central region, Ghana. Participants comprised of adult (women and men) who reside in the Agona District. We analyzed the transcripts from eight (8) Focus Group Discussions conducted within one of the two intervention recipient sites (4 female community FGDs and 4 male community FGDs). Data was analyzed thematically using the Nvivo software version 12. Through the application of the TFA, the findings show that community members perceive VAW as inappropriate at the individual and community levels (ethicality), have good knowledge of the COMBAT intervention and how it works (intervention coherence). Also, the study shows that participants have a positive attitude towards the intervention and its components (positive affective attitude), and could take up components of the intervention, by reporting and seeking for VAW support (positive self-efficacy). There was a perceived reduction in VAW practices in the various communities, as well as a reduction in the abuse of women, thereby improving their well-being (intervention effectiveness). The COMBAT strategy was accepted by the community members hence could be sustained as a culturally appropriate intervention for preventing VAW.

Relationship between Computer-mediated Communication Competence and Attitude toward Using Frog VLE among Secondary School Teachers

This study aims at examining the relationship between teacher computer-mediated communication (CMC) competence and teacher attitude toward using Frog VLE a virtual learning platform. This is a non-experimental research using a cross-sectional survey technique through the administration of a set of questionnaire that comprised teacher demographic variables, teacher CMC competence and teacher attitude toward using Frog VLE. The participants in this study are 351 secondary school teachers from Klang district, Selangor. The results indicated that teachers showed medium level of attitude and medium level of CMC competence toward using Frog VLE. Results showed that there is statistically significant direct causal relationship between teacher CMC competence and teacher attitude toward using Frog VLE. CMC motivation and CMC knowledge are the two direct factors of teachers’ affective and behavioural attitude toward using Frog VLE and CMC motivation predict teachers’ cognitive attitudes toward using Frog VLE.

영유아 어머니의 부모교육경험이 양육스트레스와 양육태도에미치는 영향

The purpose of this study is to investigate the effects of parent educational experiences by theinfants' mothers on the parenting stress and child-rearing attitude. For research object, this studywas to select the infants' mothers who had experienced offline form of parent educationprogram at least once, which has been actually applied in the educational institutes, not thespecific parent education program. To achieve this, this study was to execute the questionnaireas final research object of 298 infants' mothers had attended in the childcare center, located inDaegu Metropolitan City. From the result of this research above, it may be summed up asfollows. First, the parent educational experiences by the infants' mothers had significant negativecorrelation with the parenting stress. In addition, the parent educational experiences had nosignificant correlation with the affective child-rearing attitude. Whereas, there was significantcorrelation with the rejecting, autonomic, dominant child-rearing attitude. Second, the parenteducational experiences had significant effect on the rejecting, autonomic, and dominantchild-rearing attitude among the whole parenting stress by the infants' mothers and the subfieldsof child-rearing attitudes by the infants' mothers.

How mental health professionals perceive old(er) adults

This multidisciplinary work mainly uses a discourse analytical approach (Fairclough 1995; Sarangi 2010a, 2010b) and fine tools (i.e., corpora and text analysis software, Baker 2010) in order to identify the possible presence of ageism (Butler 1969) from responses provided by psychologists who completed the Fraboni Scale of Ageism (Fraboni et al. 1990) used in the Italian validation (Donizzetti 2010) and further adapted to achieve the objective of this study. In fact, for each item (Tot=19) distributed along this 3-dimensional model (separation and avoidance; stereotypes and antilocution; affective attitudes and discrimination), 177 respondents were asked to express their (dis)agreement, not with numbers, as in the traditional scale, but with a text (D’Amico et al. 2020). With reference to the above-mentioned dimensions, some results unveiled the psychologists’ recurring belief system as follows: 38% of respondents believed that old people complain much more than other people, thus confirming their idea of a separate group from theirs; 35.7% thought that the elderly should be entrusted with the care of infants only when supervised, thus fitting the stereotype of the fixed age-identity category; and 80.6 % declared that they were unwilling to reciprocate if an old person initiated a conversation for external and/or context/personality-dependent reasons, thus justifying their discriminatory attitudes. Limited but not negligible results demonstrate a need for mental health education and training to be monitored in order to better understand the professionals’ belief system that emerges from their discourse on old age, because the reiteration of the same belief system, if cemented in social memory, has the strong effect of conferring an aura of objectivity to prevailing attitudes towards old(er) adults, and of inevitably affecting standard professional inter/actions with them.

Scheler and Zambrano: on a transformation of the heart in Spanish philosophy

ABSTRACT This paper compares the concept of the heart in the works of Max Scheler and María Zambrano. Both authors use the heart as a metaphor for distinct human affective phenomena that have a central anthropological, epistemological, and ontological significance. The comparison between authors’ use of the metaphor is organised around three main topics: the order of the heart; the idea of a primordial feeling and its place in the affective life; and the primacy of love in relation to negative affective attitudes. Our aim is twofold: to investigate the influence of Scheler on Zambrano’s thought and to demonstrate how Scheler’s phenomenology of affectivity transformed in Spanish philosophy and, in particular, in Zambrano’s work. After introducing the topic (section 1), the paper focuses on Scheler’s model of affectivity (section 2), presents an overview of Scheler’s reception in Spain focusing on Zambrano’s knowledge of his works (section 3), and examines Zambrano’s notion of the heart tracing parallelisms in Scheler’s works (section 4). The paper concludes with a discussion on Zambrano’s extension and transformation of the metaphor of the heart in the context of Spanish philosophy.

Acceptability of government measures against COVID-19 pandemic in Senegal: A mixed methods study.

While the first case of COVID-19 was declared on March 2 2020 in Senegal, the government banned the attendance of places of worship on 14 March, as a first measure. On March 23, it introduced a curfew, a ban on movement between regions, and the closure of markets. The objective of this study is to measure and understand the acceptability of these four governmental measures as well as the level of public trust in the state to fight the pandemic. We carried out a mixed-method research. The acceptability variables were defined using the theoretical framework of acceptability (TFA). At the quantitative level, we carried out a telephone survey (June/July 2020) at the national level (n = 813) with a sampling strategy by marginal quotas. We conducted a qualitative survey (August/September 2020) with a nested sample (n = 30). The results show a relatively high acceptability of the measures but a heterogeneity of responses. People considered curfews to be much more important (85.7% [83.2%; 88.0%]) than the closure of places of worship (55.4%; [51.9%; 58.7%]), which is least in line with the values and positive affective attitude. Several positive unintended effects of the curfew were stated (security and social/family cohesion). People over the age of 60 have more confidence in the government to fight the pandemic than people under the age of 25, although not significant (7.72 ± 3.12 vs. 7.07 ± 3.11, p = 0.1); and they are more in favour of the closure of places of worship. The more regions are affected by the pandemic, the less confidence respondents report in the government and the less they perceive the measures as effective. The results confirm the importance of government communication and trust in the state to strengthen the acceptability of pandemic measures. Important differences in acceptability show the need to adapt measures and their explanations, instead of unqualified universal action.

P059 Acceptability of remote consulting during COVID-19 among patients with two common long-term musculoskeletal conditions: findings from three qualitative studies and recommendations for practice

Abstract Background/Aims The COVID-19 pandemic led to the widespread adoption of remote consultations. Whilst remote consultations offer many potential advantages to patients and healthcare services, they are unlikely to be suitable for all. Guidance encourages clinicians to consider patient preferences when choosing face-to-face vs remote consultations. However, little is known about acceptability of, and preferences for remote consultations, particularly amongst patients with musculoskeletal conditions. This study aimed to explore the acceptability of, and preferences for, remote consultations among patients with osteoporosis and rheumatoid arthritis. Methods Data for this study derived from three UK qualitative studies: iFraP (improving fracture prevention study), Blast Off (BO; Bisphosphonate aLternAtive regimenS for the prevenTion of Osteoporotic Fragility Fractures), and ERA (Exploring people with Rheumatoid Arthritis’ experience of the pandemic). Each study explored patient experiences of accessing and receiving healthcare during the pandemic year. Transcripts from each data set relating to remote consulting were extracted. A minimum of two study team members worked independently, following a consistent approach, to conduct a rapid deductive analysis using the Theoretical Framework of Acceptability (TFA). The TFA consists of 7 constructs to understand acceptability of, in this context, remote consultations, including: affective attitudes; intervention coherence; perceived effectiveness; burden; self-efficacy; opportunity-costs; and ethicality. Following coding, the findings of all three studies were pooled. Analysis was facilitated by group meetings to discuss interpretations. Results Findings from 1 focus group and 64 interviews with 35 people, who had mostly experienced telephone consultations, were included the analysis. Participants’ emotional attitudes to remote consultations, views on fairness (ethicality) and sense making (intervention coherence) varied according to their specific needs for the consultation and values, relative to the pandemic context; participants perceived remote consultations as making more sense and being ‘fairer’ earlier in the pandemic. Some participants valued the reduced burden associated with remote consultations, while others highly valued, and did not want to give up, non-verbal communication or physical examination associated with face-to-face consults (opportunity costs); although perceived need for physical examination in participants with RA was associated with strong preference for face-to-face consultations, asymptomatic participants with RA and osteoporosis also expressed similar strong preferences. Some participants described low confidence (self-efficacy) in being able to communicate in remote consultations and others perceived remote consultations as ineffective, in part due to suboptimal communication. Conclusion Acceptability of, and preferences for remote consultation appear to be influenced by a range of societal, healthcare provider and personal factors and in this study, were not fixed, or condition-dependent. Remote care by default has the potential to exacerbate health inequalities and needs nuanced implementation. The findings have supported the development of patient-centred recommendations for practice that should be considered alongside clinician-focused recommendations when deciding whether remote consultations are appropriate. Disclosure Z. Paskins: Grants/research support; NIHR, Clinician Scientist Award (CS-2018-18-ST2-010)/NIHR Academy. L. Bullock: None. F. Manning: Grants/research support; part funded NIHR Clinical Research Network Scholar Programme. S. Bishop: None. P. Campbell: None. E. Cottrell: None. C. Jinks: Grants/research support; part funded by the NIHR Applied Research Collaboration (ARC) West Midlands. M. Narayanasamy: None. I. Scott: Grants/research support; funded by an NIHR Advanced Research Fellowship Award (NIHR300826). O. Sahota: None. S. Ryan: None.

Attitudes toward ambiguous situations resemble the domain-specificity of attitudes toward risk

Individual differences in attitudes toward uncertainty have long been studied as a general propensity in how people respond to uncertain situations. However, there has been increasing evidence that people may react to certain kinds of uncertainty, such as risk, heterogeneously across different life domains. The present research examined people's attitudes toward uncertainty, especially ambiguity that is present in different everyday life situations. Two studies (N = 594) were carried out to examine people's responses to ambiguity across life domains and general trait attitudes toward uncertainty. Using network analysis, we found that affective attitudes toward ambiguous situations demonstrated a domain-specific pattern that corresponded to the domain-specific pattern of risk attitudes. Affective responses toward ambiguous situations also strongly correlated with risk taking tendency in each domain. Furthermore, the associations between general trait attitudes toward uncertainty and affective responses to ambiguous situations varied across domains, and such variation could not be explained by differences in perceived uncertainty across domains. Overall, the results suggest that attitudes toward ambiguity in everyday life situations are domain-specific and such domain-specificity is mainly driven by domain-specific attitudes toward risk.

Affective Attitudes Toward Robots at Work: A Population-Wide Four-Wave Survey Study

Robotization of work is progressing fast globally, and the process has accelerated during the COVID-19 pandemic. Utilizing integrated threat theory as a theoretical framework, this study investigated affective attitudes toward introducing robots at work using a four timepoint data (n = 830) from a Finnish working population longitudinal study. We used hybrid multilevel linear regression modelling to study within and between participant effects over time. Participants were more positive toward introducing robots at work during the COVID-19 pandemic than before it. Increased cynicism toward individuals’ own work, robot-use self-efficacy, and prior user experiences with robots predicted positivity toward introducing robots at work over time. Workers with higher perceived professional efficacy were less and those with higher perceived technology-use productivity, robot-use self-efficacy, and prior user experiences with robots were more positive toward introducing robots at work. In addition, the affective attitudes of men, introverts, critical personalities, workers in science and technology fields, and high-income earners were more positive. Robotization of work life is influenced by workers’ psychological well-being factors and perceived as a welcomed change in the social distancing reality of the pandemic.

Consumers' willingness to share digital footprints on social media: the role of affective trust

PurposeDespite consumers' widespread use of social media platforms, there is scant research on the underlying factors that influence their willingness to share digital footprints on social media. The purpose of this study is to address this research gap by examining consumers' cognitive and affective attitudes simultaneously.Design/methodology/approachThis research used quantitative method by using online survey administered to a sample of 733 social media users.FindingsThe findings indicate both cognitive and affective attitudes jointly influence consumers' behavioural intentions with trust as a key construct mediating the relationship between attitudinal antecedents and consumers' willingness to share digital footprints on social media.Research limitations/implicationsThis study contributes to the information systems (IS) literature by offering a comprehensive framework constituting the joint attitudinal components as antecedents to consumers' behavioural intention for sharing digital footprints while trust works as a mediator.Practical implicationsThis paper has important managerial implications. It helps marketers and IS managers in profiling consumers, understanding consumption patterns, sharing of digital footprints, which are useful for effective market segmentation, product development and future design of social media platforms. It informs social media providers of the importance of not only focussing on functional aspects but also underscores the essence of paying attention to consumers' affect towards social media platforms, especially trust.Originality/valueThe paper presents an original framework that explains the influence of joint attitudinal components on behavioural intention, with trust as a mediator.

How product information and source credibility affect consumer attitudes and intentions towards innovative food products

ABSTRACT Innovative foods often offer consumers an important contribution to their quality of life. Nevertheless, consumers often encounter technology-based food innovations with a certain degree of scepticism. To counteract this scepticism, information about the innovative product is often communicated. However, two elements must be taken into account to ensure that the given information does not reinforce the scepticism: first, the right amount of information and, second, the source of information and its credibility. In order to be able to implement these elements effectively in a communication strategy, this paper uses two online experiments and analyses of variance to investigate the impact of different amounts of information and different sources of information on consumers’ product evaluations (i.e., affective attitude, cognitive attitude, and behavioural intention). Study 1 found that more information does not always lead to better product evaluations. Furthermore, the results of study 2 show that independent or scientific sources of information are perceived as more credible and tend to lead to a higher product evaluation. Moreover, higher credibility measured by attractiveness, trustworthiness and expertise leads to a significantly higher product evaluation. From these results, communication strategies can be designed that gain higher consumer acceptance for technology-based food innovations.

The influence of cause-related marketing campaign structural elements on consumers’ cognitive and affective attitudes and purchase intention

This study explored middle- to high income consumers’ awareness and opinions of cause-related marketing and the influences of selected campaign structural elements on consumers’ responses. The study was conducted using qualitative focus groups and a quantitative 2 × 2 × 2 × 2 factorial experiment. A communications approach was adopted to investigate consumer responses to the cause-related marketing communicated campaign itself with education as the beneficiary. The qualitative research revealed that South African consumers are positively disposed toward cause-related marketing in an educational context and that they prefer positive, prosocial campaign messaging. The experiment confirmed that campaign structural elements exert significant independent and interactive influences on consumer intentions, attitudes, and perceptions. A low-involvement product, a specific donation recipient, and a high magnitude actual amount donation were found to have the most significant impact on consumer responses.

Exploring elderly patients’ perspectives on deprescribing: a qualitative study interim analysis

Abstract Introduction The ageing population has caused an increase in polypharmacy, multimorbidities and complexity of patients (1). Polypharmacy increases the likelihood of Adverse Drug Reactions, particularly in elderly patients due to functional/cognitive changes (1). Current research investigating views on deprescribing has shown that patients are often willing to undertake deprescribing, however qualitative research in elderly populations is sparse (1). Aim This study aimed to explore elderly patients’ perspectives on deprescribing and pharmaceutical input into their care. Methods Semi-structured interviews were undertaken with a purposive sample of elderly (>65 years) inpatients with multiple morbidities and/or frailty and were taking at least one regular medicine, at two English NHS hospital Trusts. The interview guide was developed with public contributions, aligned with the study aim and informed by the Theoretical Framework of Acceptability (TFA)(2). The TFA was used because it was developed for assessing the acceptability of healthcare interventions (2). The interview guide included a distress protocol because the patient cohort was vulnerable. Interviews were conducted face-to-face, audio-recorded, transcribed verbatim and analysed using the Framework Analysis approach, with a priori categories informed by the TFA. Results Interviews were conducted with 8 participants (2 male,6 female), aged 67-89 and taking 3-9 pre-admission medicines. Most participants seemed to understand that deprescribing may become appropriate and trusted their doctor to initiate discussion when deprescribing is appropriate. However, participants reported wanting to know the rationale for deprescribing (TFA domain: affective attitude): “…why was I taking it in the first place if I don’t need it now?”. Most participants wanted deprescribing discussions to start with the rationale and some said medicines should be stopped gradually with regular reviews (TFA domain: affective attitude, ethicality). Most participants referred to pharmacists having a small role in their healthcare and none mentioned pharmacists stopping medicines (TFA domain: affective attitude): “… they sort all the drugs out don’t they, that they’re ordered…”. Access to GPs was commonly reported as a burden (TFA domain: burden). Some participants reported not feeling confident to ask their GP questions and some said they had not established trust due to not seeing a regular doctor (TFA domain: burden and opportunity costs): “I’ve gotta get my confidence in them…”. Several participants reported having taken medicines for years and said that they thought the medicines were beneficial, whilst other participants said that if they could take fewer medicines they would (TFA domain: ethicality and perceived effectiveness). Some participants understood that deprescribing required weighing up risks and benefits (TFA domain: intervention coherence): “…consider the benefits and the possibility of side effects”. Conclusion This study adds insights from qualitative research, but these may not be widely transferrable. Whilst these are interim analysis findings that may be further refined, they suggest that deprescribing is likely to be acceptable to patients when conducted by healthcare professionals they trust and who provides the rationale for deprescribing. Patients’ awareness of who can deprescribe would benefit from being increased, since participants did not cite pharmacists as experts who can deprescribe. Future research could explore how to do so. References (1) Reeve E, Shakib S, Hendrix I, Roberts MS, Wiese MD. Review of deprescribing processes and development of an evidence-based, patient-centred deprescribing process. Br J Clin Pharmacol. 2014 Oct;78(4):738-47. (2) Sekhon M, Cartwright M, Francis J. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res, 2017; 17: 88.

Acceptability of family planning in a changing context in Uganda: a realist evaluation at two time points

ObjectivesThis study sought to understand, during an intervention which integrated family planning (FP) and immunisation, (1) if and how prevailing contextual factors influenced acceptability and use of modern contraceptive methods...

A study on Korean listening class using jigsaw -Based on international undergraduates

The purpose of this study was to investigate the effect of the jigsaw task on the improvement of Korean listening ability and affective attitude in the Korean listening class for foreign students. First, it was confirmed that the listening ability improved as the jigsaw task progressed repeatedly. Second, as a result of a survey on learners affective attitudes and responses, learners showed a very positive response to the jigsaw task when comparing before and after the class. The perception of Korean listening itself changed positively after class, and the confidence in Korean listening, class participation, and preference for listening class such as jigsaw task increased significantly. In addition, more than half of the respondents said that the jigsaw task directly helped improve concentration and listening skills. The preference for the listening class through the jigsaw task as a cooperative learning and speaking integration was also high, suggesting that the jigsaw task is positive in the learner evaluation in the listening class. Thereafter, follow-up studies on the number of jigsaw tasks, input level, and selection of listening materials to apply the jigsaw task to the undergraduate listening class should be continued.

Integration of a menstrual health intervention in a community-based sexual and reproductive health service for young people in Zimbabwe: a qualitative acceptability study

BackgroundDespite being fundamental to the health and well-being of women, menstrual health is often overlooked as a health priority and access to menstrual health education, products, and support is limited. Consequently, many young women are unprepared for menarche and face challenges in accessing menstrual health products and support and in managing menstruation in a healthy and dignified way. In this paper, we examine the acceptability of a comprehensive menstrual health and hygiene (MHH) intervention integrated within a community-based sexual and reproductive health (SRH) service for young people aged 16–24 years in Zimbabwe called CHIEDZA.MethodsWe conducted focus group discussions, that included participatory drawings, with CHIEDZA healthcare service providers (N = 3) and with young women who had attended CHIEDZA (N = 6) between June to August 2020. Translated transcripts were read for familiarisation and thematic analysis was used to explore acceptability. We applied Sekhon’s thematic framework of acceptability that looks at seven key constructs (affective attitudes, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy). Data from FGDs and meeting minutes taken during the study time period were used to triangulate a comprehensive understanding of MHH intervention acceptability.ResultsThe MHH intervention was acceptable to participants as it addressed the severe prevailing lack of access to menstrual health education, products, and support in the communities, and facilitated access to other SRH services on site. In addition to the constructs defined by Sekhon’s thematic framework, acceptability was also informed by external contextual factors such as sociocultural norms and the economic environment. Providers highlighted the increased burden in their workload due to demand for MHH products, and how sociocultural beliefs around insertable menstrual products compromising virginity can negatively affect acceptability among young people and community members.ConclusionsMHH interventions are acceptable to young women in community-based settings in Zimbabwe as there is great unmet need for comprehensive MHH support. The integration of MHH in SRH services can serve as a facilitator to female engagement with SRH services. However, it is important to note that contextual external factors can affect the implementation and acceptability of integrated SRH and MHH services within communities.Trial registrationRegistry: Clinicaltrials.gov, Registration Number: NCT03719521, Registration Date: October 25, 2018.

Measuring Attitude toward Chemistry, Biology, and Math at a Hispanic-Serving Institution.

This work describes the evaluation of the Attitude toward the Subject of Chemistry Inventory (ASCI), as well as two modifications (one for measuring attitude toward math and one for measuring attitude toward biology), for college students at a Hispanic Serving Institution. Instrument reliability was tested via multiple administrations of the instruments, and confirmatory factor analysis supported a two-factor structure similar to an existing model of a revised version of the ASCI for all three instruments. The similar factor structure of the three instruments, coupled with interviews with students, provide validity evidence for the instruments and support an interpretation that one of the subscales aligns with a cognitive aspect of attitude while the other subscale aligns with an affective aspect. The results of these instruments indicate that students have a more positive attitude toward biology than either chemistry or math, and more positive affective attitude than cognitive attitude for all three subjects, although student attitudes show little change with respect to biology, chemistry, or math during a typical semester. However, major perturbations, such as switching to remote instruction midsemester, can lead to small but significant increases and decreases in attitude.

Risk perceptions and COVID-19 protective behaviors: A two-wave longitudinal study of epidemic and post-epidemic periods

We investigated how perceived risk and protective behaviors changed as the coronavirus epidemic progressed. A longitudinal sample of 538 people responded to a COVID-19 risk perception questionnaire during the outbreak and post-epidemic periods. Using Structural Equation Modeling (SEM), we examined the mean level change of selected constructs and differences in their relationships. We tested a risk perception pathway in which affective attitude, informed by experience, shaped risk perceptions and protective behaviors. The model also postulated a social pathway in which cultural worldviews, like individualism and hierarchy, predicted risk perceptions and protective behaviors through social norms. Latent mean difference analyses revealed a decrease in social distancing behaviors and an increase in hygiene-cleanliness, corresponding to a reduction in risk perceptions and social norms and a rise in direct and indirect experience, while affective attitude remained substantially stable. Cross-sectional and longitudinal path analyses showed that affective risk perception, primarily informed by affective attitude, and social norms promoted behavior consistency regardless of epidemic contingencies. Instead, analytic risk perceptions were linked to protective behaviors only during the outbreak. Although risk perceptions dropped over time, analytic risk perceptions dropped more steeply than affective risk perceptions. Our findings supported the distinction between affective and deliberative processes in risk perception, reinforcing the view that affective reactions are needed to deploy analytic processes. Our study also supports the claim that perceived social norms are essential to understanding cultural worldview-related protective behaviors variability.

Randomized Controlled Pilot Trial of a Low-Touch Remotely-Delivered Values Intervention to Promote Adherence to Adjuvant Endocrine Therapy Among Breast Cancer Survivors.

Oral anti-cancer treatments such as adjuvant endocrine therapies (AET) for breast cancer survivors are commonly used but adherence is a challenge. Few low-touch, scalable interventions exist to increase ET adherence. To evaluate the acceptability, feasibility, and initial efficacy of a low-touch, remotely-delivered values plus AET education intervention (REACH) to promote AET adherence. A mixed-methods trial randomized 88 breast cancer survivors 1:1 to REACH or Education alone. Wisepill real-time electronic adherence monitoring tracked monthly AET adherence during a 1-month baseline through 6-month follow-up (FU) (primary outcome). Patient-reported outcomes were evaluated through 3- and 6-month FU (secondary). Multiple indices of intervention feasibility and acceptability were evaluated. Qualitative exit interviews (n = 38) further assessed participants' perceptions of feasibility/acceptability and recommendations for intervention adaptation. The trial showed strong feasibility and acceptability, with an eligible-to-enrolled rate of 85%, 100% completion of the main intervention sessions, and "good" intervention satisfaction ratings on average. For Wisepill-assessed AET adherence, REACH outperformed Education for Month 1 of FU (p = .027) and not thereafter. Participants in REACH maintained high adherence until Month 4 of FU, whereas in Education, adherence declined significantly in Month 1. Conditions did not differ in self-reported adherence, positive affective attitudes, future intentions, or necessity beliefs. REACH trended toward less negative AET attitudes than Education at 3-month FU (p = .057) reflecting improvement in REACH (p = .004) but not Education (p = .809). Exploratory moderator analyses showed that average to highly positive baseline AET affective attitudes and oncologist-patient communication each predicted higher adherence following REACH than Education; low levels did not. Participants identified recommendations to strengthen the interventions. REACH, a low-touch values intervention, showed good feasibility and acceptability, and initial promise in improving objectively-assessed AET adherence among breast cancer survivors (relative to education alone). Future research should target improving REACH's tailoring and endurance.

Exploring the acceptability of a WHO school-based mental health program in Egypt: A qualitative study

Mental health interventions should target critical developmental stages, such as childhood and adolescence; and be embedded into cross-sectoral settings including education. The World Health Organization, Eastern Mediterranean Regional office has developed a school-based mental health program (SMHP), encouraging implementation research to inform its scale-up. We contribute to this by exploring stakeholder acceptability of the SMHP as a key assumption underpinning successful program implementation.This qualitative study, conducted January to July 2019 in Al Obour, Egypt, explores stakeholder views of SMHP acceptability, the roles of teachers and school psychologists in supporting child mental health, and barriers to SMHP implementation and scale-up. Focus group discussions (n ​= ​4) and individual in-depth interviews (n ​= ​7) were conducted with 30 stakeholders (parents, teachers, psychologists, and support centre managers). Data were analysed thematically against the theoretical framework of acceptability.Our results indicate that the SMHP is highly acceptable to teachers, psychologists, parents, and other education professionals. Key findings indicate the SMHP fits with teachers' and school psychologists' values, and highlight the importance of collaboration among these stakeholders for program effectiveness. Program features such as a community-based centre and respect for privacy and confidentiality are recognised to reduce parents’ opportunity costs, and influence their affective attitudes, leading to increased engagement. Factors such as teacher burden require additional exploration and strategies to address them as potential impediments to successful SMHP implementation. This qualitative study yields important insights from multiple stakeholders into the acceptability of a school-based mental health intervention, providing support for scale-up of the SMHP in Egypt and the Region.