Outcome Expectations Research Articles

Testing the theory of normative social behavior in Italy and the USA during COVID-19

The COVID-19 pandemic has underscored the importance of understanding how social norms influence preventative health behaviors across cultures. Based on the theory of normative social behavior (TNSB), this study investigates the direct and moderated effects of social norms on intentions to wear masks and practice social distancing cross-culturally during the peak of COVID-19 in 2020. Representative samples were recruited from the United States (N = 333) and Italy (N = 331), two countries with different cultural tightness-looseness and orientations (individualistic-collectivistic; indulgence-restraint; uncertainty avoidance). Results revealed that perceived descriptive norms directly influenced behavioral intentions in the U.S., while perceived injunctive norms were more influential in Italy. Outcome expectations moderated the relationship between descriptive norms and mask-wearing intentions in both countries. Specifically, as perceived benefits increased, the effect of norms on mask-wearing intentions attenuated in both countries. Group identity strengthened the association between descriptive norms and mask-wearing intentions only in Italy. These findings highlight that cultural differences play an important role in normative influence mechanisms, with the U.S. being more influenced by what others do (descriptive norms) and Italy by what others approve of (injunctive norms). The study contributes to the refinement of the TNSB and emphasizes the importance of considering cultural factors in developing effective norm-based interventions to address global health challenges.

Associations of Alcohol Outcome Expectancies with Alcohol Use in Adolescence and Emerging Adulthood: A Meta-Analysis

Associations of Alcohol Outcome Expectancies with Alcohol Use in Adolescence and Emerging Adulthood: A Meta-Analysis

The role of teachers’ direct and emotional mentoring in shaping undergraduates’ research aspirations: a social cognitive career theory perspective

PurposeThis study investigated the influence of teachers on undergraduate students’ development of research aspirations and the mechanisms behind this process.Design/methodology/approachEmploying social cognitive career theory, the study gathered data from 232 undergraduates, developed a structural equation model via the maximum likelihood method and executed empirical testing.FindingsThe findings reveal that neither direct nor emotional mentoring independently satisfies students’ needs for self-efficacy and aspiration in research nor significantly influences research interest. Specifically, the study demonstrates that (1) research self-efficacy, outcome expectations and research interest significantly shape research aspirations; (2) an overemphasis on direct mentoring might impede research aspiration development and (3) a focus on emotional mentoring, while overlooking direct mentoring, could result in diminished research self-efficacy.Originality/valueThis research pioneers a comprehensive analysis of the role of teachers in shaping undergraduate research aspirations through the lens of social cognitive career theory. It underscores the critical need to both balance mentoring approaches and foster intrinsic research motivation.

Examining Relations Between Sexualizing Media Exposure and Sexting Attitudes and Behaviors among U.S. Adolescents.

Based on social cognitive processes (Bandura, 2009), sexualizing media likely provide adolescents with credible role models for their own sexualized self-presentation in other mediated contexts, such as sexting. A survey of 6,093 US adolescents was conducted (Mage = 15.27 years, SD = 1.37; 69.1% cisgender girls; 26.8% cisgender boys, 4.2% gender-minority participants) to examine relations between three types of sexualizing media exposure (reality television, music videos, pornography) and active sexting behaviors (i.e., requesting and sending). Among cisgender boys, exposure to sexually oriented reality television was positively related to active sexting behaviors, but this link was not found for cisgender girls or gender-minority participants. Music video exposure was related to active sexting behaviors only among cisgender boys and pornography consumption was positively related to active sexting behaviors among all gender groups. A positive outcome expectancy (i.e., sexting is fun) consistently mediated these relations. A negative outcome expectancy (i.e., sexting is risky) only mediated the relations between pornography consumption and active sexting behaviors among cisgender girls. Results are discussed in light of social cognitive theory (Bandura, 2009) and the 3AM Model (Wright, 2011).

How P(H)C is your curriculum?

In South Africa and internationally, the alignment of health professions education programme with primary healthcare (PHC) policies is seen to promote the training of fit-for-purpose graduates who can adequately respond to the demands of patient and community needs. This article seeks to describe the development of a tool to assess the degree of PHC in an undergraduate medical curriculum. In defining what is meant by PHC, four dimensions of PHC were identified for the purpose of designing the tool, namely values underpinning PHC, principles of PHC, a generalist focus of the programme, and the level of care that the programme is delivered at. The tool also sought to assess how the content in these dimensions is covered in the curriculum and to which depth students are required to engage. The perspectives that were considered were: what content was being covered, what pedagogy was used, in which context it was being taught and how it was being assessed. For each of these aspects, the dimensions are assessed using an amended Miller’s pyramid to assess the expectations of outcomes for the curriculum. The tool is presented and the article reflects on the use of the tool in a process of assessing a medical curriculum.

Cataract surgery with corneal endothelial pathology

Abstract: It is not uncommon for Fuch’s endothelial corneal dystrophy (FECD) patients to present with a co-existent cataract. Surgeons are often faced with a choice between simultaneous and staged corneal and cataract surgery. Descemet’s membrane endothelial keratoplasty (DMEK) has been found to have better visual outcomes as compared to Descemet’s stripping endothelial keratoplasty (DSEK) and penetrating keratoplasty and is currently the preferred surgery for FECD. Endothelial cell count and pachymetry cutoffs were earlier used for decision-making. Various other investigations such as Scheimpflug imaging and confocal microscopy are now used to prognosticate the outcome when performing cataract surgery only. Triple DMEK has the advantage of a definite treatment in a single sitting. Whereas, a staged approach with DMEK followed by cataract surgery has a better visual outcome. This is due to variable refractive changes in the cornea post-DMEK or DSEK that can lead to inaccurate intraocular lens (IOL) power calculation. Even though the graft detachment rates and rebubbling rates have been found to be comparable in triple DMEK versus a staged surgery, in view of increasing patient demands and expectations for a spectacle-independent outcome, a staged surgery is now preferable. Conventionally, surgeons favored the use of only monofocal lenses; however, the use of premium IOLs, especially extended depth of focus lenses, is now increasing. In this review, we will discuss the various advantages and disadvantages of a simultaneous and staged approach and pearls on decision-making in FECD with cataracts.

The Assessment of Post-secondary Supports: A New Measure of an Understudied SCCT Construct

We investigated environmental supports, an understudied aspect of Social Cognitive Career Theory (SCCT), with rural Appalachian youth, an understudied population. We developed a new measure of proximal influences that bolster the pursuit of postsecondary education, the Assessment of Postsecondary Supports (APSS). Across 3 studies, we develop and validate the new measure, finding strong internal consistency and construct validity. Moreover, scores on the APSS were positively correlated with college-going self-efficacy (CGSE) and college outcome expectations (COE), explaining more unique variance than a measure of perceived educational barriers.

Changing smiles and minds-a community-based trial on parental knowledge impact on early childhood caries.

This study was carried out in New York City over a period of twelve months for each child. 1207 children from 977 families, with clinically diagnosed ECC, were recruited. Inclusion criteria included children that had at least one filled or decayed primary tooth surface and were aged between 2 years to 6 years. Exclusion criteria included children that may have conditions that would have prevented the provision of oral hygiene habits or moderation of diet, for example children with severe autism. Families were recruited from local specialist residency programmes within the city or by direct referral from local CHWs. Evaluation of the parental education was established through use of electronic surveys at baseline level and follow up following CHWs' intervention. The data was collected between 2015 and 2017 and required follow up appointments that were completed via telephone and other remote methods. Data collection separated caries risk factors into six domains with 26 factions across the pre- and post-intervention period. These addressed both parental knowledge of the aetiology of caries and factors that can contribute to this. Domains included titles such as saliva factors, hygiene, diet, severity/susceptibility, and outcome expectations. Parents were asked to note their agreement with the statements using a four-point scale (Strongly Agree, Agree, Disagree and Strongly Disagree). The survey was made up of statements including themes of caries risk factors, and behavioural science that can contribute to caries development. Examples include 'drinking juice can cause tooth decay' and 'all kids get tooth decay'. Correct answers would be given as part of the targeted advice and education given by the CHWs at subsequent visits. Data was collected from a total of 669 parents of 977 taking part in the study. Analysis focussed on the trend of changing knowledge of parents from baseline to follow up. The analysis also assessed features of the participants including the parents' first language, education level, country of birth, average age of the children and their insurance status - this was then assessed to see if this influenced the parents' beliefs and associations. Results found there was an improvement in the parental knowledge of salivary risks for caries, hygiene input and dietary effect post intervention. The only differing result was the statement that 'tooth decay is very common' - this showed a reduced change. The study concluded that the MySmileBuddy programme did improve parental education on Early Childhood Caries and factors influencing the risk of this, though acknowledges that there should be further exploration in the clinical impact that this education would have on the patients' caries status from the CHW input.

Criminal Court Outcomes and Public Expectations: Is Alignment Necessary and How Can it be Achieved?

Criminal Court Outcomes and Public Expectations: Is Alignment Necessary and How Can it be Achieved?

Implementation of a multimodal home-based rehabilitation intervention after discharge from inpatient geriatric rehabilitation (GeRas): an early qualitative process evaluation

BackgroundGeriatric rehabilitation aims at increasing physical and social activity and maintaining the functional reserve of older people. However, the continuity of geriatric rehabilitation in the outpatient setting is limited due to a lack of structured aftercare programs. In order to overcome this, a three-month multimodal home-based intervention program (GeRas) was implemented. The aim of this early qualitative process evaluation was to assess GeRas in terms of perceived reach, effectiveness/efficacy, adoption/uptake, implementation, and maintenance/sustainability (Domains within the RE-AIM Framework) from the perspective of patients who received the intervention and healthcare providers who were involved in the delivery of the intervention.MethodsIn a qualitative process evaluation, 13 healthcare providers and 10 patients were interviewed throughout the beginning of the implementation period of GeRas to capture early experiences using a semi-structured interview guide. The interview guide and qualitative content analysis was guided by the RE-AIM Framework.ResultsThe GeRas program was perceived to be largely well implemented and beneficial by healthcare providers and patients. According to healthcare providers, GeRas showed more advantages compared to usual care. Additionally, outcome expectations were mainly met (Domain 1: Effectiveness). However, the implementation of the intervention delivered via the eHealth system was perceived as challenging (Domain 2: Adoption). Nevertheless, the outpatient physical exercise, the outpatient counselling, and the continuous care after discharge improved perceived well-being regardless of the intervention type (Domain 3: Implementation). To facilitate the continued use of GeRas, technical requirements should be created to increase user-friendliness and to motivate patients to continue the training in the long term (Domain 4: Maintenance).ConclusionAlthough initial experiences with the implementation and effectiveness of GeRas were positive in general, organisational and technical issues need to be resolved to enhance sustainable and successful implementation of the GeRas program.Trial registrationGerman Clinical Trials Register (DRKS00029559). Registered 5/10/2022.

School students’ aspirations for STEM careers: the influence of self-concept, parental expectations, career outcome expectations, and perceptions of STEM professionals

ABSTRACT This study examined the processes that contributed to students’ aspirations for STEM careers and unpacked the relationships between students’ self-concept in science and mathematics learning, perceived parental expectations, perceptions of STEM professionals, career outcome expectations and STEM career aspirations. Structural equation modelling was used to analyse quantitative survey data of 2,477 primary and secondary school students studying in seven Asian regions (Hong Kong, Malaysia, Mainland China, Indonesia, Korea, Taiwan, and Singapore). The results demonstrated that students’ self-concept, perceptions of STEM professionals, and their career outcome expectations all significantly and positively predicted their aspirations for STEM careers. However, this study failed to establish a direct relationship or positive correlation between perceived parental expectations and STEM career aspirations. Students’ self-concept negatively predicted their career outcome expectations related to seeking parental approval. While no significant positive effects of perceived parental expectations on career aspirations were found, an indirect effect of perceived parental expectations on STEM career aspirations via career outcome expectations was observed. Moreover, career outcome expectations mediated the relationships between students’ STEM career aspirations and their perceptions of STEM professionals more strongly than self-concept. The implications of these results for STEM education are discussed.

Remote monitoring system to support positive airway pressure therapy in patients with obstructive sleep apnea: a multi-center randomized controlled trial.

To develop and evaluate an intervention tailored to patients' needs to increase the rate of positive airway pressure (PAP) adherence in patients afflicted with obstructive sleep apnea (OSA), who undergo PAP therapy. A multi-center, 3 parallel-arm, randomized, controlled trial was conducted. Participants with OSA who undergo a PAP therapy were randomized to one of three groups: control arm (usual care), educational booklet arm, and mobile-based application arm. PAP usage, the percentage of days using the device for more than 4h, change in knowledge, risk perception, outcome expectancy, self-efficacy, and ESS were assessed before and one month after interventions in the three groups. Also, the application usage data were analyzed. The result showed the change in average PAP usage, knowledge, risk perception, and self-efficacy in the application group was significantly higher than the control and booklet groups. Also, the change in use for more than 4h in the application group was significantly higher than the control group. Comparing the actual and patients' self-report PAP use indicated patients' self-report about the use of the device is about 50min (0.8h) more than the actual amount of use. The study results indicated that the improvement of primary and secondary outcomes in adherence to PAP was significantly higher in the application group than in other study groups. Given the increasingly penetrating influence of smartphone-based technologies, it seems that mobile-based applications could potentially be adopted in the population of patients with OSA. IRCT2017092236314N1; https://en.irct.ir/trial/27185.

Embraced: On hands and nerves

AbstractIn 2001, I experienced severe radial neuropathy, leading to permanent dysfunctions in the fingers of my left hand. In this personal account of nerve damage, medical and surgical treatment, and adaptation, I first describe the sequence of neuropathies, then turn to how through serendipity, the brace enabled other connections—nervelines—with individuals and places. The brace is a metonym of a severed nerve with its associated loss of movement and capacity; it is also both a functional orthotic and an affordance. It carries me forward, activating other nervelines and networks to make things happen. I write of literal and metaphoric nerves, evolving connectivities, and fiber lines, thought lines and collaborations. I then extend the idea of nervelines and networks to global connnections; I emphasize how the organization of labor, the distribution of goods and services, and the expectations of workers shape body histories and life outcomes.

Associations of Treatment Outcome Expectations and Pain Sensitivity after Cervical Spine Manipulation in Patients with Chronic Non-Specific Neck Pain: A Cohort Study.

(1) Background: This cohort study aimed to evaluate the effect of patients' treatment expectations on pain perception changes following manual therapy cervical manipulations in individuals with chronic mechanical neck pain. (2) Methods: Demographic data were collected by 56 subjects who were asked to fill out the Neck Disability Index (NDI) and the Expectations for Treatment Scale (ETS). All patients received one single cervical manipulation, and pressure pain thresholds (PPTs) were measured before and immediately after the manipulation with a digital algometer. (3) Results: A total of 56 patients participated. Most subjects (62.5%) had high treatment expectations according to the ETS scale. Statistically significant increases in PPTs were noted both locally and in remote areas (p < 0.05), with 37.5-48.2% of participants showing clinically significant changes in pain perception. However, no statistically significant correlation was found between high treatment expectations and increased PPTs (p > 0.05). (4) Conclusions: Although a significant reduction in pain perception was observed, it did not correlate with patients' treatment expectations. Future research for further investigation of this hypothesis by comparing real versus sham treatment and exploring additional mechanisms affecting changes in PPTs after cervical manipulations in this population will contribute to a better understanding of the research question.

Clinical training and practice of using digital health solutions among healthcare workers in clinical settings during Hajj season.

Digital health solutions are widely used in Saudi Arabia, but training, clinical practice and challenges related to using digital health applications have not been evaluated from the perspective of healthcare workers during the Haj season in Makkah. The current study was planned to explore clinical training, practices and challenges related to the use of digital health among healthcare workers during the Haj season from June to August 2023. Of the 470 subjects, 347(73.8%) were males and 123(26.2%) were females. The overall median age was 40 years (interquartile range: 27-56 years). In the clinical practice of using digital health, 185(39.4%) of the subjects strongly agreed that digital health was useful and beneficial during transportation difficulties, and 167(35.5%) strongly agreed that digital health applications had changed their working routine during the Haj season. Negative outcome expectations were the challenge least reported by 72(15.3%) respondents.

Placebo Effects on the Enjoyment of Physical Activity and Performance among Kindergarten Children: A Randomized Controlled Trial.

Studies with adults and school children have shown that placebos can enhance motivation and performance in physical activities. This study aimed to investigate whether similar effects are present in kindergarten-aged children. A total of 101 children (58 girls, 43 boys) aged 3 to 6 years were randomly assigned to one of two groups that either received a deceptive placebo (DP: "magic potion") or a nondeceptive placebo (NDP: "water") to enhance physical abilities. Each child completed three tasks (sprinting; balancing: standing on a balance board; strength: using a handheld dynamometer) both with and without the placebo. The variables assessed included task performance, enjoyment, and expected and perceived placebo efficacy (measured with nonverbal pictorial rating scales). Results showed that both the DP and NDP increased speed. For strength, balance, and task enjoyment (which was very high), no placebo-induced changes were observed. Expected efficacy was higher for the DP; perceived efficacy did not differ between DP and NDP. In conclusion, reported outcome expectations indicated that kindergarten-aged children were already able to differentiate between the two types of placebos which exhibited positive effects concerning running performance. This encourages further research on using nondeceptive placebos to enhance physical activity, which is crucial for children's overall health.

A moderated mediation analysis of the quality of life, gambling craving, escape expectancies and problem gambling relationships

The easy access to Internet through increased availability and ownership of Internet-enabled facilities such as smart/android phones and communication data by adolescents have increased their vulnerability to problem gambling (PG). There is therefore need to understand the relationship between PG and some psychological and situational factors that have the capacity to influence its development and severity. The present study is a test of a moderated mediation model in which the effect of quality of life (QoL) on PG was mediated by escape, and this mediation effect was further moderated by gambling craving (GAC). Participants (N = 197: 83% male, Mage = 24.05 years, SD age = 7.23 years) online gamblers took part in the survey and responded to the Problem Gambling Severity Index (PGSI), GQoL scale, Gambling Outcome Expectancies Scale-Escape (GOES-E), and the GAC scale. PROCESS macro analysis result reveals a significant moderated mediation effect of the escape-PG path by GAC. The findings provide support for escape as a potential pathway through which the QoL-PG association may thrive, and this support was further influenced by GAC. This is a significant contribution to the QoL-PG literature. However, we emphasize the need for further investigation of GAC as a criterion for PG.

Psychological Risk Factors for Delayed Recovery Among Active Duty Service Members Seeking Treatment for Musculoskeletal Complaints at a Navy Shore-Based Military Medical Treatment Facility.

Musculoskeletal injuries (MSIs) are a leading cause of separation from the U.S. Navy. Data have shown that several psychological responses to MSI are associated with treatment outcomes. Yellow flags are maladaptive psychological responses to injury and predict delayed recovery, whereas pink flags indicate resilience after MSI and are associated with good treatment outcomes. Identifying these factors in patients with MSI would permit early targeted care to address factors that may delay their readiness for deployment and enhance factors that support recovery. Active duty service members with MSI who reported to physical therapy outpatient services at a naval hospital were recruited for the study. Yellow flags were assessed at baseline as part of a larger study. Participants completed the Fear Avoidance Beliefs Questionnaire (with two subscales, physical activity and work), the Pain Catastrophizing Scale, and the Hospital Anxiety and Depression Scale. Clinically relevant cut-off scores were used to indicate risk factors of delayed recovery. Pink flags were assessed with the Pain Self-Efficacy Questionnaire and a measure of positive outcome expectations for recovery. Two hundred and ninety participants responded to some or all of the questionnaires. Of these, 82% exceeded the cut-off scores on the physical activity subscale of the Fear Avoidance Beliefs Questionnaire, and 39% did so on the work subscale. Pain catastrophizing exceeded the cut-off in only 4.9% of the sample. Forty-three percent of these exceeded the cut-off for the anxiety subscale of the Hospital Anxiety and Depression Scale; 27% exceeded the cut-off on the depression subscale of the Hospital Anxiety and Depression Scale. Additionally, 54% endorsed scores greater than 40 on the Pain Self-Efficacy Questionnaire, and 53% endorsed a high score on the positive outcome expectations. A substantial portion of the sample endorsed elevated scores on one or more indicators of delayed recovery from MSI. Most participants showed a fear of physical activity, and approximately half reported pain-related distress (anxiety and depression). In addition, feelings of self-efficacy and positive outcome expectations of treatment were endorsed by only about half of the participants, indicating that the remaining half did not report adaptive responses to MSI. Early identification of these risk factors will allow for targeted treatment approaches that incorporate these yellow flags into treatment and support a psychologically informed approach to physical therapy. This approach is likely to reduce delayed recovery and improve deployment readiness.

Impact of Self-Efficacy, Outcome Expectations, Interest, and Perceived Organisational Support on Career Goals of Employees in Rectangle-Shaped Hierarchy Occupations

Impact of Self-Efficacy, Outcome Expectations, Interest, and Perceived Organisational Support on Career Goals of Employees in Rectangle-Shaped Hierarchy Occupations

E-Cigarette Use Behavior and Expectancies Among Sexual Minority and Heterosexual College Student E-Cigarette Users

Background: College students who identify as a sexual minority (i.e., lesbian, gay, bisexual, or other sexual orientation) are at higher risk for e-cigarette use than their heterosexual or “straight” peers. However, little is known about factors, such as e-cigarette outcome expectancies, that might influence these differences in prevalence rates. Therefore, the current study examined differences between heterosexual and sexual minority college student e-cigarette users in terms of days of past-month e-cigarette use, e-cigarette dependence, and e-cigarette outcome expectancies. A secondary aim of the study was to examine whether outcome expectancies served as an explanatory mechanism in the association between sexual minority status and e-cigarette use frequency and dependence. Methods: Participants were heterosexual (n = 90; Mage = 19.65, SD = 2.70; 76.7% female; 77.8% White) and sexual minority (n = 44; Mage = 20.02, SD = 2.18; 68.2% female; 90.9% White) college student e-cigarette users who completed self-report measures. Results: Students who identified as a sexual minority reported greater e-cigarette dependence, more frequent past 30-day use, and greater negative consequences and positive reinforcement e-cigarette outcome expectancies. Follow-up mediation analyses indicated a significant indirect effect of sexual minority status on both days of past-month e-cigarette use and e-cigarette dependence through expectancies for negative consequences and positive reinforcement. Conclusions: These findings suggest that positive reinforcement and negative consequences outcome expectancies may be contributing to the disparities in e-cigarette use among college students who identify as a sexual minority and could be useful targets for cessation interventions for this population.