Greek Parents Research Articles

Exploring Parental Attitudes and Perceptions Regarding Childhood Vaccinations in Greece: A Study Within the Framework of the National Health Examination Survey (EMENO).

Vaccinations have reduced illnesses and mortality rates globally, yet negative attitudes and uncertainty about them hinder their acceptability and efficacy. The study aims to document Greek parents' immunization perceptions and risk factors. Spanning 2014-2017, 447 parents (68% mothers) who participated in the Greek Health Examination Survey EMENO (National Survey of Morbidity and Risk Factors) completed an interview-delivered questionnaire. Attitudes were categorized into three groups: absolutely positive, positive, and negative. Absolutely positive attitudes included positive responses to all five statements in favor of vaccination and negative responses to the two statements against vaccination. Negative attitudes included positive responses to either one or both statements against vaccination and negative responses to all five statements in favor of vaccination.. All other participants were categorized as having a positive attitude. Skepticism towards vaccinations was classified into skeptical and non-skeptical groups based on responses to five statements implying uncertainty or skepticism. Participants were considered skeptical if they provided positive responses to at least three of these statements, and non-skeptical if they had none or up to two positive responses.The statistical analysis accounted for the study design whereas inverse probability weighting was used to adjust for non-response and multiple imputations were employed to impute missing values. The components of parental attitude and vaccine skepticism were identified using weighted multinomial logistic regression and logistic regression, respectively. In total, 16.6% were classified as having absolutely positive attitudes towards vaccinations whereas 42.1% were skeptical of vaccines. Of all participants, 96.0% agreed that vaccinations are essential for their child's well-being and adhere to scientific recommendations. However, concerns were also mentioned, with 26.2% worrying about potential adverse effects, and 21.6% believing it is better to acquire immunity through illness rather than vaccination. Positive participants, compared to absolutely positive ones, were more likely to be of Greek origin (adjusted relative rate ratio (aRRR): 3.35; 95% CI: 1.53-7.30) and living in semi-urban areas (aRRR: 4.84; 95% CI: 1.77-13.29). Negative participants, in contrast, were more likely to have higher education (aRRR: 2.98; 95% CI: 1.05-8.44) but also to live in semi-urban areas (aRRR: 6.43; 95% CI: 1.69-24.56). Furthermore, parents of Greek origin had significantly higher odds of being skeptical towards vaccination (adjusted Odds Ratio (aOR): 2.86; 95% CI: 1.36-5.98), while married or cohabiting parents had lower odds of being skeptical compared to single parents (aOR: 0.60; 95% CI: 0.35-1.06). While parents in this study recognize the importance of childhood immunizations, there is a widespread presence of negative attitudes and skepticism that can have a detrimental impact on vaccination rates.

Fatigue among Greek Parents of Children with Autistic Spectrum Disorder: The Roles of Spirituality and Social Support.

The high demands of caring for and raising a child with autism spectrum disorder on a daily basis may lead parents to physical and mental fatigue. This study aimed to assess the effect of social support and spirituality on the fatigue of parents with children with autistic spectrum disorder. A cross-sectional study with a convenience sample was conducted in Schools of Special Education in Attica (Greece). The sample consisted of 123 parents who completed The Fatigue Assessment Scale (FAS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale (FACIT Sp-12) to measure the levels of fatigue, social support, and spirituality, respectively. The Pearson correlation coefficient was used to investigate the relationship between the quantitative variables. To study the effect of social support and spirituality on fatigue, multivariable linear regression was applied. The mean age was 47.3 years old, 81.3% were women, and 38.9% stated "Close/Very close faith toward God". Higher levels of total MSPSS and FACIT Sp-12 were associated with lower total FAS (r = -0.50, p < 0.001 and r = -0.49, p < 0.001, respectively). Social support and spirituality were significant predictors of fatigue.

Knowledge and beliefs of Greek parents towards HPV infection and vaccination- are they willing to vaccinate their sons?

Human papillomavirus (HPV) stands as one of the prevalent sexually transmitted infections (STIs) and serves as the primary factor behind nearly all instances of cervical cancer, along with various other non-cancerous conditions like genital warts. Our objective was to explore the knowledge and beliefs of Greek parents regarding HPV infection and the vaccination of boys against HPV. A cross-sectional study took place at a university hospital located in the Peloponnese region of Greece, from January to June 2021. The study employed convenience sampling as its methodology, and data gathering involved the distribution of self-administered questionnaires to parents who had at least one son between the ages of 9 and 18 years. The final sample consisted of 120 individuals. 65.8 % of parents have been informed about HPV vaccination, knew that the HPV vaccine provides immunity against genital warts (50 %), and that minimum of two doses is necessary (46.7 %). 30.8 % intended to vaccinate their boys against HPV if the vaccine were available for males. The most important reasons for vaccination were the perception that both genders share equal responsibility in the prevention of sexually transmitted infections (91.7 %) and the protection against cancer (87.6 %), whereas the fear of adverse reactions and the adequate knowledge about HPV-related diseases were most reported as reasons of the intentions to not vaccinate their sons with 31.7 % and 25.8 % respectively. Although parents participating in the study know about HPV, however, there are significant lack of knowledge regarding HPV infection and the vaccine effects, which can significantly affect the acceptance of vaccination for boys.

The Strange Significance of the Name Carpocrates in Early Christian Polemic

Abstract In this philological study we establish and reckon with the fact that the name Carpocrates was exceedingly rare and strange in antiquity. The rarity, we argue, was due to the name being a variant spelling or (purposeful) misspelling of the Greco-Egyptian deity Harpokrates. We also show how bizarre and even comical the name would have sounded to Hellenephone audiences. Greek parents, so far as the evidence suggests, were not naming their sons Carpocrates. We further explain how both the rarity and strangeness of the name functioned as a polemical weapon in the hands of some early Christian writers.

School – family relations: Greek parents’ perceptions of parental involvement

While the value of the school-family partnership is universally accepted, it is not always easy to promote effective parent-teacher partnership. A central question that emerges is how schools can ensure that they develop their home-school relationship in a way that acknowledges the needs and perspectives of children, parents and teachers and enhances parents’ participation in school activities. Our main assumption is that we can better understand school-family relations, by examining the beliefs held by both teachers and parents about their relationship. This study addressed Greek parents’ perceptions of teachers, as well as their own role and responsibilities, parental involvement activities and areas of cooperation with teachers. Analysis of 581 questionnaires to parents revealed that parents perceived distinctly separate roles between teachers and parents. Teachers were perceived as “experts” in academic domains, while parents were perceived as “guardians” of children’s social and emotional growth. Both teachers and parents’ role was to keep each other informed about children’s achievement in school and home setting respectively. Results of the study are discussed in terms of implications for initiatives to develop school-family relations in teacher training programmes.

The inter-familiar issues of Greek parents facing childhood cancer

Cancer as a whole, but especially childhood cancer, creates a number of psychological, social, and family problems as well as practical and financial issues, which every parent is called upon to solve. This study focuses on childhood cancer and aims at a thorough analysis of the physical/organic, psychological, and social problems associated with the parents and relatives of a child with cancer. The special element in pediatric neoplasms is not only the vulnerable population target group, but also the set of secondary effects it has on the environment of the sick child. The research was conducted on a sample of 133 families of children with cancer, and the results were displayed after statistical processing and data analysis with R statistical software. The results of the study confirm with statistically significant data the effect of childhood cancer on the physical, mental, and social health and behavior of the parent. Thus, 53.8% of the respondents stated 5 and above on the 7-point Likert scale for fatigue issues, 55.6% for sleep disorders, 78.1% for stress, and 82.7% for fear. The key findings are characterized by high specificity as it is a unique study that reveals particular aspects of the Greek parent’s behavior, mind, and body during the period of their child’s illness. Conclusion: The effects of childhood illnesses, particularly when they are severe, such as neoplasms, present a looming threat, ushering in a multitude of adverse alterations in the daily lives of the affected child's family.What is Known – What is New:• We know the effects that a childhood illness brings not only to the sick child, but also to the entire family circle. The new element in the present research is that these data reflect the situation in Greece, for which the research data in this area is quite limited. Our research is one of the few studies that demonstrate with statistical data the change in the psychosomatic health of the parent who has a child with cancer.

Greek parents' profile concerning the use of smart mobile devices and their educational applications by preschool and elementary school children

This study examines Greek parents' attitudes towards using smart mobile devices and their educational applications by children aged 4-7 in an informal learning context. The research sample comprised parents whose children attended Crete's public kindergartens and primary schools during 2020-2021. A 30-item Likert-scale questionnaire assessed parents' attitudes toward smartphones and their educational applications. The factor and cluster analyses were conducted, and three parent profiles emerged: neutral, sceptical, and optimistic. Neutral parents value the use of educational applications by their children. Sceptical parents are the ones who attach great importance to the adverse effects that the use of digital technology can have on their children. Optimistic parents are the ones who consider the use of educational applications essential but also are the ones setting ground rules regarding its use. Parents' views regarding smart mobile devices' use are of immense importance, as well as their general perspective, commitment, and support towards their children, as they greatly influence the latter's learning experiences at home.

Exploring Parenting Styles Patterns and Children's Socio-Emotional Skills.

In this study, we adopted parenting styles as a multidimensional and latent construct that includes different aspects of parenting, rather than solely focusing on a single parenting style. In a Web-based survey with 1203 Greek parents, we identified parenting styles and their SDQ reports on their children. According to our results by Latent Profile Analysis, we must use a more complex approach concerning parenting styles. We identified a "Highly Authoritative style" profile with high levels of authoritative, low levels of authoritarian and middle levels of permissive parenting styles. We additionally identified a profile called "Relaxed Authoritative style", with still high but lower levels of authoritative style, low but slightly heightened levels of authoritarian style, and middle levels of permissive style. A further profile, named "Permissive Focused Authoritative style", had a mix of high levels of authoritative, moderate levels of permissive, and elevated levels of authoritarian parenting styles. Finally, in a profile named "Inconsistent Parenting style", we identified parents with a blend of still high, but the lowest of all four levels of authoritative and highest levels of permissive and authoritarian parenting styles. When combining the four identified parenting patterns with the SDQ results, we identified the "highly authoritative parenting style" profile to be the least connected to internalizing or externalizing problems of the respective children.

Physical activity, sedentary behaviour and quality of life in children with autism: insights from Romania and Greece

Background The COVID-19 pandemic has accentuated sedentarism in children, including those with autism. Given the importance of the topic for long-term health, this study aimed to explore the post-pandemic relationship between physical activity, sedentary behaviours and quality of life (QOL) in children with autism from Romania and Greece. Methods An online questionnaire collected information regarding physical activity levels in children and their parents, children’s sedentary behaviours and QOL from 83 Romanian parents (m1age = 40.1; sd1age = 6.37) and 42 Greek parents (m2age = 39.5; sd2age = 5.45) between March and July 2022. Results Most Greek children (95%) had 2 or 3 weekly hours of physical education at school/kindergarten, while only 64% of Romanian children had the same level of physical education. Romanian parents reported being more active (χ2 weekdays= 33.7, df = 3, p < .001; (χ2 leisure= 41.8, df = 2, p < .001) than the Greek counterparts. Contrary to expectations, the parents’ physical activity did not correlate with the child’s physical activity. Sedentary behaviour time was significantly higher in Greek than Romanian children during working days and the weekends. Sedentary behaviour during weekdays predicted the child’ QOL. Conclusions This exploratory study offers insight into Romanian and Greek children’s patterns of physical and sedentary activities. The results stress the need to increase physical activity and decrease sedentary behaviours in children with autism from Romania and Greece. The practical implications and limits of this exploratory approach were further discussed.

Exploring Greek Parents’ beliefs about Distance Learning for their Pre-school Children during the Covid-19 Pandemic

Exploring Greek Parents’ beliefs about Distance Learning for their Pre-school Children during the Covid-19 Pandemic

Alabama Parenting Questionnaire (Parent Form): Psychometric Properties and Validation in a Population of Greek Parents of Young Children (3–6) with and Without Disabilities

Through this study, we aim to evaluate the psychometric properties, such as factor structure, reliability, and construct validity of the Greek translation of the parent report version of the Alabama Parenting Questionnaire (APQ). Four hundred sixty-six parents were enrolled in the study. Firstly, we extracted four factors with the use of EFA (Principal Components Analysis) in a subsample comprised of n = 294 participants. Afterward, we evaluated the internal four-factor structure (Involvement – Positive Parenting – Inconsistent Discipline – Corporal Punishment), though CFA in the entire sample. All goodness of fit indices generated by CFA were found satisfactory (χ2/df = 1.54 &lt; 2 and p = .213, TLI = 0.976 ≥ 0.95, RMSEA = .027 &lt; 0.08, CFI = 0.95 ≥ 0.90 and SRMR = 0.015 &lt; 0.08). No floor-ceiling effects were observed. Assessment of measurement invariance provided us with strong evidence that the proposed structure is both meaningful and valid in families with a child with a disability, as well. Consequently, the APQ-GR (3–6) is an easily applied and comprehended research tool that allows its use in studies on parental characteristics and practices in both families with and without a child with disabilities rearing.

Coping Strategies in Greek Parents of Children with Cancer.

Childhood cancer is a life-threatening, chronic condition and treatment may extent for several years. The diagnosis of cancer in children could stress intensely their parents. To explore coping strategies utilized by Greek parents who have children with cancer. Eighty-five parents of children with cancer, admitted for treatment at the in-patient unit of a Paediatric Hospital in Athens completed a questionnaire with demographic and their children's disease related characteristics and the Family Crisis Oriented Personal Evaluation Scale. Sixty mothers (70.6%) and 25 fathers (29.4%) completed the questionnaire. A percentage of 29.4% of the parents included in this study considered themselves anxious. Elementary or secondary school graduates scored higher in Seeking Spiritual Support (p=0.013). Stay-at-home or unemployed parents scored lower in the subscale of Passive Appraisal (p=0.012). Parents who were very well informed tended to exhibit more frequently passive appraisal behavior (p=0.004). Parents whose child had Hodgkin's lymphoma scored higher in the subscale of Acquiring Social Support (p=0.034). Statistical significance was found between parent's strategies of Seeking Spiritual Support and the gender (girls) (p=0.036), as well as the treatment problems (p=0.008) of hospitalized children. This study may help health professionals understand Greek families' coping strategies when they have a child with cancer. Appropriate knowledge could significantly help them in the field of planning and implementation of personalized care in order to achieve optimal therapeutic outcomes.

Psychosocial adaptation of families with children newly diagnosed with cancer in the Greek population amidst the socioeconomic crisis

Objective To present the initial assessment of psychosocial adaptation among Greek parents whose children were newly diagnosed with cancer amidst the turmoil of an ongoing financial crisis. Study design This prospective observational study used a quantitative approach. Participants Sixty-one parents of children with cancer treated at a large urban tertiary-care children’s hospital were prospectively recruited to participate in our study during the first week of their child’s diagnosis (2013–2016). Methods The parents were asked to complete the psychosocial assessment tool (PAT 2.0), Zung Depression Scale, State-Trait Anxiety Inventory, Hospital Anxiety and Depression Scale, and World Health Organization Quality of Life–Bref Instrument; Moreover, three female healthcare providers (the physician oncologist, the head nurse and a senior nurse) completed the relevant PAT 2.0 -Staff Perceptions questionnaire the results of which were then compared to those of the child’s parent. Findings The majority of parents had PAT 2.0 scores indicative of increased psychosocial risk :54% were stratified into the “Targeted” (moderate risk) and 15% into the “Clinical” (highest risk) categories, whereas healthcare providers underestimated psychosocial risk in 57%−59% of the cases. The subscales that most contributed to the increased scores were Parental Stress Reaction, Family Structure and Resources, and Family Social Support. The PAT 2.0 had statistically significant correlations with most of the anxiety and depression scales, with Zung having the strongest correlation (r-value: +0.5, p-value <0.01). Our cohort presented more anxiety and depression compared to the general Greek population (14% for depression versus 2,9% for the general population and 46% for anxiety compared to 4,1%) in the years of financial recession in Greece. Conclusions The parents of children newly diagnosed with cancer in Greece are at increased risk for developing anxiety and depression in the years of financial recession in Greece compared to general population. Implications for psychosocial providers Parental stress reaction to diagnosis as well as lack of family resources and social support may contribute to this difference. Screening for psychosocial risk factors is essential for the early identification of these families and for the optimal utilization of the limited available resources in times of economic hardship.

Assessing parents' self-efficacy beliefs before andduringthe COVID-19 pandemic in Greece.

The aim of the present study is to establish the psychometric properties of the Self‐Efficacy for Parenting Tasks Index‐Toddler Scale (SEPTI‐TS) in the Greek educational context and to examine changes in parenting self‐efficacy over time. The Short Form of SEPTI‐TS was used to evaluate parents' self‐efficacy on four different domains: nurturance, discipline, play and routine. A sample of 159 parents of children aged from 3 to 5 years completed an online survey at two time periods before and during the COVID‐19 pandemic. Results supported the proposed SEPTI‐TS dimensionality (comparative fit index = .905, root‐mean‐square error of approximation = .053, standardised root mean square residual = .055). The results showed that the average parenting self‐efficacy scores regarding discipline, play and routine were lower than parenting self‐efficacy scores of those domains before the COVID‐19 pandemic. Results also indicated that parents feel high self‐efficacy for play with their children, whereas they perceive low self‐efficacy for children's discipline. Good practices are discussed to address new challenges to Greek parents.

The boundary within: Are applicants of Southern European descent discriminated against in Northern European job markets?

Abstract In the aftermath of the Euro debt crisis, negative stereotypes about Southern Europeans were (re)activated across Northern European countries. Because these stereotypes make explicit reference to productivity-relevant traits, they have the potential to influence employers’ hiring decisions. We draw on a sub-sample of the Growth, Equal Opportunities, Migration and Markets discrimination study (GEMM) to investigate the responses of over 3500 firms based in Germany, the Netherlands and Norway to identical (fictitious) young applicants born to Greek, Spanish, Italian and native-born parents. Using French descendants as a placebo treatment and sub-Saharan African descendants as a benchmark treatment, we find severe levels of hiring discrimination against Southern European descendants in both Norway and the Netherlands, but not in Germany. Discrimination in Norway seems largely driven by employers’ preferences for applicants of native descent, while in the Netherlands discrimination seems specifically targeted against Greek and Spanish descendants. Dutch employers’ propensity to penalize these two groups seems driven by information deficits.

Lived experiences, perceived positive outcomes, and post-traumatic growth among parents with children with epilepsy: A qualitative study

Childhood-onset epilepsy alters the everyday life of parents who have children or adolescents with epilepsy (CAWE). The aim of this qualitative study was to explore the experiences of Greek parents with CAWE, including perceived positive outcomes in their lives, where research in this area is limited. Fifteen parents took part in semi-structured interviews which were conducted online due to the social distancing measures imposed by the COVID-19 pandemic. Main results showed that parents with CAWE experience stress, somatic symptoms, mood swings, fear along with feelings of anger, and a sense of injustice. Positive outcomes were identified at a personal level, in parenting skills, and in achieving family cohesion. Parents reported that they had achieved increased personal strength, new perspectives, better life appreciation, and changes in their spiritual beliefs. Moreover, they mentioned the acquisition of new parenting skills which helped them become better caregivers as well as feeling more united with other family members. The changes that parents identified are discussed in relation to aspects of the Post-Traumatic Growth construct, and future recommendations and implications for practice are proposed.

The impact of COVID-19 lockdown on children's and adolescents' mental health in Greece.

The aim of the study was to investigate the impact of the COVID‐19 lockdown on children's and adolescents' mental health in Greece during the lockdown of spring 2020. A cross‐sectional survey of 1232 Greek parents was conducted in spring 2020. 35.1% of parents reported that their children's psychological health was significantly affected. Parental unemployment, limited opportunity for tele‐work and deteriorating psychological health, increased family conflicts and children's pre‐existing physical health conditions were all significantly associated with mental health impact. Children and adolescents may experience adverse mental health effects due to the COVID‐19 pandemic.

Parental Hesitancy towards the Established Childhood Vaccination Programmes in the COVID-19 Era: Assessing the Drivers of a Challenging Public Health Concern.

(1) Background: Vaccine hesitancy remains a major public health concern. The reasons behind this attitude are complex and warrant careful consideration, especially in the context of the COVID-19 era. The purpose of this study was to estimate vaccine hesitancy towards the established childhood immunization programmes in a non-random sample of Greek parents and explore possible links with important drivers of this phenomenon. (2) Methods: An online self-administered questionnaire was used from October 2020 to April 2021 to collect socio-demographic, lifestyle, and health status data and evaluate knowledge, views, and attitudes of the Greek population on COVID-19 pandemic-related issues. Parents were further asked to complete the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. (3) Results: A total of 1095 parents participated in the study with a mean age of 50 years (SD 9.5 years). The hesitancy against the established childhood vaccinations was estimated at 8.9% (95% CI, 7.3–10.8%). Married status and higher education and income were negatively correlated with hesitancy, whereas positive correlations were found for stress and depressive symptoms and current smoking. Variables related to proper awareness, sound knowledge, and trust toward authorities regarding the COVID-19 pandemic were strongly associated with being less hesitant against the established childhood vaccination programmes. (4) Conclusion: The estimated parental hesitancy against the established childhood vaccination programmes is worrisome. Variables related to good awareness and knowledge of the COVID-19 pandemic were strongly associated with being less hesitant against childhood vaccinations. Since controversy surrounding COVID-19 vaccinations may decrease parents’ confidence in routine childhood vaccinations, appreciating the complex reasons behind vaccine hesitancy may inform public health policies to overcome barriers and increase vaccine acceptance.

Cross-Cultural Adaptation and Psychometric Properties of the Greek Vineland Adaptive Behavior Scales, Second Edition: Parent/Caregiver Rating Form (VABS II-Gr)

Background: Vineland adaptive behavior scales-parent/caregiver rating form (VABS II) is a questionnaire used to examine adaptive behavior in individuals, whose age ranges from birth to 90 years old. The purpose of this study was to translate and assess the psychometric properties of the Greek version VABS II-parents/caregiver, in children. Method: Three samples of participants within the ages 5 - 10 years were analyzed; including two groups of developmental disorders (N = 116) and control group (N = 90). The questionnaire was translated into Greek by two bilingual translators. The pre-final version was pilot tested in 30 mothers of typical and atypical development children, aged 3 - 10 years. The final version was submitted in 206 subjects, twice, in different ways for reliability testing. A split-half reliability test was employed for the reliability of scores for two halves of the test, to evaluate the reliability and internal consistency, of the VABS II-Gr. The spearman-brown formula was used to determine correlations between the domains. Α known-group method was utilized, to estimate construct validity, exploring the differences between the two groups. Results: Across the age groups, overall, the domain reliability estimates are quite high, with a value of .83 to .95. Equivalence reliability (correlation) was found to be excellent (r = .90). Conclusion: The Greek version of VABS-II is an appropriate scale for assessing adaptive behaviors in a Greek context, as it meets the standard of the original version of VABS. This scale was found to be acceptable, understandable, valid and reliable by Greek parents and may thus be used in cross-cultural clinical practice and research.

Perceptions, Attitudes and Intentions of Greek Parents Toward their Underaged Children Vaccination Against Covid 19.

Background:Vaccination of children along with public health protection measures can limit transmission of SARS-COV-2.Objective:The aim of the study was to identify the attitudes and perceptions of Greek parents that affect their intention to vaccinate their children against COVID-19.Methods:The sample of the study consisted of 230 parents of underaged children who were administered a demographic characteristics questionnaire and the “Parental Acceptability of Free COVID-19 Vaccination for Children Under the Age of 18 Years” scale.Results:The majority of participants were females (70.4%), aged 41-50 years old (43.3%), married (86.5%), with university degree (63.5%). The prevalence of parental acceptability of free covid-19 vaccination was moderate (36.6 %) and a small percentage (23.9%) had already vaccinated their children. According to the univariate logistic regression analysis, female gender (adjusted odds ratio [AOR] 3.05, 95% CI 1.43-6.47, p=0.004), highest educational level ([AOR] 2.66, 95% CI 1.21-5.84, p=0.015), history of seasonal influenza vaccination ([AOR] 2.08, 95% CI 1.09-3.98, p=0.026) and self-reported vaccination ([AOR] 17.38, 95% CI 2.29-131.86, p=0.006) were significantly associated with parental acceptability of vaccination. Increasing positive attitude perceptions was associated with an increased likelihood of parental acceptability of COVID-19 vaccination.Conclusion:The moderate parental acceptability of underaged children vaccination against COVID 19 and its association with perceptions and attitudes of parents found in the present study, indicate that it is important to raise awareness of parents about the vaccination of their children and public health policies need to focus on strengthening positive attitudes, increasing social consensus and facilitating the desired behavior.