Negative Outcome Expectancies Research Articles

Assessing teachers' intervention-related expectations and self-efficacy: An examination of the factor structure of the implementation beliefs assessment.

Individual-level determinants are hypothesized to enable or prevent successful implementation of evidence-based practices, yet there are limited options for measuring theory-informed, individual-level determinants that influence teachers' and other implementers' delivery of school-based interventions. The goal of this study was to develop a self-report scale that measures variables that have been associated with initial and sustained behavior change related to school-based intervention implementation according to the health action process approach (HAPA). Participants were a nationally representative sample of kindergarten through Grade 12 public school teachers, stratified by grade level and geographical region. Item generation was based on a systematic review of the literature on outcome expectations and self-efficacy, the core constructs related to initiating and sustaining behavior change from the HAPA and in consultation with the theory developer. The sample was randomly split; half of the sample was used for exploratory factor analysis (EFA), and the other half was used for confirmatory factor analysis (CFA). The EFA resulted in a final factor structure of three dimensions of the Implementation Beliefs Assessment (IBA): (a) implementation self-efficacy, (b) positive outcome expectations, and (c) negative outcome expectations. This structure was supported in the other half of the sample using CFA. Additional analyses supported the reliability of IBA data. The IBA represents a step forward toward psychometrically sound measurement of factors associated with initial and sustained behavior change. Implications for future research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring mother-daughter communication and social media influence on HPV vaccine refusal for daughters aged 9-17 years in a cross-sectional survey of 11,728 mothers in China

ABSTRACT This study investigated the influences of mother-daughter communication and social media on mothers’ HPV vaccine refusal for their daughters aged 9–17. A cross-sectional online survey among 11,728 mothers of girls aged 9–17 in Shenzhen, China was implemented between July and October 2023. Multi-level logistic regression models were fitted. Among 11,728 participants, 43.2% refused to have their daughters receive an HPV vaccination. In multivariate analysis, more openness in the mother-daughter communication (AOR: 0.99, 95%CI: 0.98, 0.99), perceived more positive outcomes of mother-daughter communication (AOR: 0.77, 95%CI: 0.75, 0.79), higher frequency of exposure to testimonials about daughters’ HPV vaccination (AOR: 0.81, 95%CI: 0.78, 0.85) and information encouraging parents to vaccinate their daughters against HPV on social media (AOR: 0.76, 95%CI: 0.73, 0.79), and thoughtful consideration of the veracity of the information specific to HPV vaccines (AOR: 0.80, 95%CI: 0.77, 0.83) were associated with lower vaccine refusal. Mothers who were not the main decision-makers of daughters’ HPV vaccination (AOR: 1.28 to 1.46), negative outcome expectancies of mother-daughter communication (AOR: 1.06, 95%CI: 1.04, 1.08), and mothers’ HPV vaccine refusal (AOR: 2.81, 95%CI: 2.58, 3.06) were associated with higher vaccine refusal for their daughters. The level of mothers’ HPV vaccine refusal for their daughters was high in China. Openness and outcome expectancies of mother-daughter communication and information exposure on social media were considered key determinants of HPV vaccine refusal for daughters. Future HPV vaccination programs should consider these interpersonal factors.

Low-Fidelity Prototype of a Sensor-Dependent Interaction Platform: Formative Evaluation With Informal Caregivers of Older Adults With Cognitive Impairment.

Unobtrusive sensing technologies developed for monitoring deviant behaviors in older adult care require integration with an interaction platform to facilitate the flow of information between older adults and their caregivers. However, the continuous monitoring capabilities generate a considerable amount of data that must be interpreted, filtered, and personalized before being communicated to the informal caregivers based on their specific care needs and requirements. For the effective implementation of unobtrusive sensing solutions (USSs) in the care of older adults with cognitive impairment, we aimed to explore the expectations and preconditions regarding the implementation of USSs from the perspective of informal caregivers. Subsequently, we designed and evaluated a low-fidelity prototype of an interaction platform for its conceptual workflow and usability, incorporating persuasive system design features based on the needs and requirements of informal caregivers. Overall, 6 informal caregivers of older adults with cognitive impairment living alone participated in this qualitative interview study. We explored the expectation and preconditions regarding implementation through open-ended questions and conducted a formative evaluation (usability study with a think-aloud approach) to evaluate the conceptual workflow and used persuasive system design features in the interaction platform. Overall, a combination of inductive and thematic analyses was used to analyze the interviews. The results of this study present both positive and negative outcome expectations regarding the implementation of USSs, highlighting benefits such as objective decision-making and peace of mind and concerns about information overload and the potential substitution of human contact. Strategic information communication agreements between informal and formal caregivers were deemed crucial for the successful implementation of USSs in care. Overall, informal caregivers had a positive experience with the low-fidelity prototype of the interaction platform, particularly valuing the personalization feature. In conclusion, to achieve successful implementation, a holistic design approach is necessary, and equal consideration should be given to the personalization-privacy paradox to balance users' needs and privacy.

Community flood preparedness in a collectivist cultural context: lessons from Ibadan, Nigeria

ABSTRACT This study explores community flood preparedness in Ibadan, Nigeria. The qualitative method was adopted, and key informant interviews with community leaders in selected flood-prone communities were undertaken. Findings indicate that communities are not adequately prepared for floods, but cooperation associated with collectivism help flood victims cope with floods. Pervasive negative outcome expectancy and trust in flood structural protection measures are significant influences on communities’ poor flood preparedness. While assistance associated with collectivism has been helpful, it will not suffice in the event of mega-floods. These underline the urgency of taking early action to strengthen the Ibadan communities’ resilience to flood risks.

Explaining the personal cognitive factors affecting physical activity and nutritional behaviors in the middle-aged at risk of coronary artery disease: A directed qualitative content analysis.

Coronary artery disease (CAD) is the most common cardiovascular disease worldwide. Nutrition and physical activity are recognized as the major lifestyle-related behaviors to reduce the risk of noncommunicable diseases. It is essential to explain personal cognitive factors to identify potential ways to increase physical activity and improve nutritional behavior. Therefore, the present study aimed to explain the personal cognitive factors affecting physical activity and nutritional behavior in the middle-aged population at risk of a CAD. The present qualitative study was conducted with a directed content analysis approach. A purposive sampling was used with maximum variety of sex, age, education, marital status, job, and risk factors of CAD. The data were collected through semistructured interviews with 20 middle-aged participants at the risk of CAD visiting comprehensive health centers in Bandar Abbas city. The interviews continued until data saturation. The present findings led to the identification of 4 main categories (i.e., self-efficacy, collective efficacy, outcome expectations, knowledge) and 10 subcategories. It seems that to increase the self-efficacy, attention should be paid to individuals' past experiences, self-efficacy of action and maintenance and successful middle-aged peers. Measures should be taken to improve and strengthen it. Peer support, networking, forming online groups (in social networks), and a comprehensive use of social media can help increase collective efficacy. Expectations of positive and negative outcomes and the public knowledge can also be modified through accurate and appropriate information provided in different campaigns for awareness-raising.

The influence of negative urgency and mood inductions on alcohol cognitions.

Negative urgency (NU), the tendency to act rashly during negative emotional states, is a robust risk factor for alcohol misuse that is posited to function in part through alcohol-related cognitions. Nonetheless, relatively little research has examined mood-based fluctuations in such cognitions, which could help to explain how the trait of NU translates to impulsive alcohol-related behaviors. We examined how NU impacted several alcohol cognitions (positive/negative alcohol expectancies, positive/negative alcohol valuations, and alcohol craving for positive/negative emotional reinforcement) before and after negative, neutral, or positive mood inductions. We hypothesized that NU would predict greater and more favorable endorsement of alcohol and its effects following negative (vs. positive or neutral) mood induction. Participants (N = 428) were southern-midwestern college students recruited for an online experiment. Following the provision of consent, participants rated NU and preinduction alcohol cognitions, and were then randomly assigned to one of three (negative, neutral, or positive) mood inductions; subsequently, postinduction alcohol-cognition ratings were immediately obtained. We conducted six robust multilevel linear models (one per DV) examining NU's influence on within-person changes in alcohol cognitions across each mood induction. No three-way interactions were identified and only one two-way interaction involving NU was identified. There were main effects across mood induction conditions and time points for NU predicting greater endorsement of positive and negative alcohol outcome expectancies, and greater alcohol craving for positive and negative emotional reinforcement. Greater NU predicts greater perceived likelihood of alcohol's effects, alongside greater desire for mood improvement from alcohol. The absence of three-way interactive effects indicates NU's influence on mood-dependent fluctuations in alcohol cognitions may manifest over longer timescales (e.g., months and years), involve alternative cognitive processes (e.g., drinking motives and implicit alcohol cognitions), and apply more broadly to desires for mood improvement than purely negative emotional reinforcement.

A Group Randomized Controlled Trial of Relationships Under Construction Sexual Risk Avoidance Education.

We analyzed data from a study to evaluate the effectiveness of the Relationships Under Construction (RUC) sexual risk avoidance education program promoting positive youth development and healthy relationships. Twelve schools in the Midwestern region of the United States randomized to the intervention implemented RUC in health or science classes, while control schools collected study measures and implemented the standard curriculum. Post-randomization analyses revealed significant differences in grade, race/ethnicity, and prior relationship education at baseline between intervention and control students. Subsequent analyses controlled for these differences. We distributed parental notification letters to 641 students, and no parents requested that their adolescent opt out of data collection. We obtained assent and baseline computer-assisted survey interviews or paper-and-pencil instrument forms from 100% of these students. Findings suggest that RUC significantly reduced sexual activity (odds ratio = 0.56, p = .046) at 3-month follow-up, compared to those in the control group. RUC also reduced pornography viewing and improved attitudes about delayed gratification, beliefs, decision making, and negative outcome expectations. Our findings suggest that RUC improves sexual attitudes, beliefs, and behaviors among this population of adolescents. Additional research is needed to assess RUC impacts among diverse populations.

Development and psychometric assessment of Health Action Process Approach (HAPA) in terms of smoking cessation among Chinese smokers

The Health Action Process Approach (HAPA) is a two-stage (pre-intentional and post-intentional) behavioral change model that distinguishes between motivation and volition in behavior change process. This study aims to develop HAPA-based assessments for smoking cessation among current smokers. The HAPA-based measures were developed and the draft measures included nine constructs, namely, risk perception in smoking-induced cancer, risk perception in smoking-induced systemic disease, positive outcome expectancy, negative outcome expectancy, self-efficacy in quitting smoking, self-efficacy in maintaining, self-efficacy in re-initiating, quitting planning and coping planning in smoking cessation, with a total of 26 items. A cross-sectional survey was conducted in China in 2022. Principal Component Analysis was used for Exploratory Factor Analysis (EFA). Cronbach’s α coefficient was calculated to evaluate the internal consistency. Variables such as severity of smoking addiction were selected to evaluate the correlation between the HAPA scale and these variables. Of the 928 participants, 76.4% (709/928) were male and the median age was 35 years. Five factors were extracted by EFA. The factor loadings of each item were all greater than 0.60, and the cumulative variance contribution rate was 90.15%. The Cronbach’s α coefficient of each HAPA-based subscales was 0.929–0.986. The HAPA-based measurements are comprehensive, reliable and valid in the assessment of smokers’ smoking cessation cognition, which can be used to guide the design and implementation of intervention and the development of theory.

Factors Affecting Breast Screening Behavior of First-Degree Relatives of Breast Cancer Patients in China: A Cross-sectional Study.

Breast cancer is the most common cancer in women, and first-degree relatives (FDRs) of breast cancer patients have a significantly higher risk of developing breast cancer. However, the factors affecting breast cancer screening behavior of FDRs in China remain unclear. The aim of this study was to determine the social cognitive theory factors influencing screening behaviors of FDRs. A cross-sectional survey was conducted, and 430 FDRs were recruited. Data were collected using demographic information and self-reported questionnaire based on the social cognitive theory. The structural equation modeling method was used to analyze the influence of social cognitive factors on breast cancer screening behavior. The model showed a good fit (goodness of fit = 0.462). Goal setting and self-regulation (β = 0.631, P < .001) and positive outcome expectation (β = 0.098, P = .042) were positively related to breast cancer screening behavior. Negative outcome expectation was negatively related to breast cancer screening behavior (β = -0.102, P = .024). In addition, positive outcome expectation, negative outcome expectation, and goal setting and self-regulation are mediators of self-efficacy (β = 0.475, P < .001) to breast cancer screening behavior. Goal setting and self-regulation are important influences on breast cancer screening behavior. The social cognitive theory is both applicable to and effective in explaining and predicting breast cancer screening behavior. Health professionals can develop appropriate intervention strategies based on the social cognitive theory among FDRs. It is necessary to focus on the people who influence women, such as spouses, mothers, or daughters.

Emotion Dysregulation and E-Cigarette Expectancies among College Student E-Cigarette Users

Background: E-cigarette outcome expectancies (i.e., beliefs about the expected consequences of e-cigarette use) are a key factor in motivating use. Emotion regulation difficulties have demonstrated significant associations with outcome expectancies; however, there has yet to be an examination of associations between specific emotion regulation difficulties and specific e-cigarette outcome expectancies, which could serve as targets for intervention efforts. Therefore, the current study sought to examine the unique predictive ability of specific emotion regulation difficulties in terms of e-cigarette outcome expectancies. Methods: Participants were 116 college student e-cigarette users (Mage = 19.72, SD = 1.88; 71.6% female) who completed self-report questionnaires for course credit. Results: Greater difficulties engaging in goal-directed behavior when experiencing negative emotions and fewer difficulties accessing effective emotion regulation strategies were associated with positive reinforcement outcome expectancies. Greater emotion regulation difficulties in general were also associated with negative reinforcement outcome expectancies, though there were no significant individual predictors. Conclusion: These results suggest that greater emotion regulation difficulties are associated with mood-related e-cigarette outcome expectancies, and targeting emotion regulation difficulties, particularly difficulty engaging in goal-directed behavior when upset, may be useful to incorporate into intervention efforts.

PILOT RCT TO EXAMINE A MOBILE HEALTHY EATING INTERVENTION FOR PERSONS WITH FRAILTY

Abstract New scalable approaches are needed to promote healthy eating and improve health in persons with frailty. We evaluated a new mobile intervention consisting of a patient-facing app and clinician interface to support Mediterranean-style eating in a pilot RCT. Fourteen females and one male, averaging 71 years of age, were randomized to intervention (n=8) or control (n=7) for three months. In the intervention, participants were encouraged to interact with the app at least once a week, whereas, in control, participants received handouts with information and online resources concerning the Mediterranean Diet. Mann-Whitney and Cohen’s d estimates were used to compare groups and evaluate effects. All participants completed and consistently adhered to the study protocol throughout the study. At the end of the study, there was a significant improvement in the intervention compared to the control in the following outcomes: SPPB (W=45, p=0.049; d=1.14); Mediterranean Diet Knowledge (W=49.5,p=0.013; d=1.26); consumption of vegetables (W=47, p=0.03; d =1.42); consumption of legumes (W=54, P=0.001; d=1.32), and negative outcome expectations (W=9,p=0.03; d=0.56). Albeit insignificant, intervention group participants improved their inflammatory, lipids, and glycemic blood measures. At the exit interviews, most participants expressed satisfaction with the app and acknowledged that the app was useful and easy to operate. They also provided points for improvement concerning control over the frequency of interactions with the app, more personalized choices for meals, and better visualization of their progress. The study demonstrated the preliminary efficacy of the digital intervention and suggested several mechanistic measures involved in behavioral change.

The impact of human-AI collaboration types on consumer evaluation and usage intention: a perspective of responsibility attribution.

Despite the widespread availability of artificial intelligence (AI) products and services, consumer evaluations and adoption intentions have not met expectations. Existing research mainly focuses on AI's instrumental attributes from the consumer perspective, along with negative impacts of AI failures on evaluations and willingness to use. However, research is lacking on AI as a collaborative agent, investigating the impact of human-AI collaboration on AI acceptance under different outcome expectations. This study examines the interactive effects of human-AI collaboration types (AI-dominant vs. AI-assisted) and outcome expectations (positive vs. negative) on AI product evaluations and usage willingness, along with the underlying mechanisms, from a human-AI relationship perspective. It also investigates the moderating role of algorithm transparency in these effects. Using three online experiments with analysis of variance and bootstrap methods, the study validates these interactive mechanisms, revealing the mediating role of attribution and moderating role of algorithm transparency. Experiment 1 confirms the interactive effects of human-AI collaboration types and outcome expectations on consumer evaluations and usage willingness. Under positive outcome expectations, consumers evaluate and express willingness to use AI-dominant intelligent vehicles with autonomous driving capabilities higher than those with emergency evasion capabilities (AI-assisted). However, under negative outcome expectations, consumers rate autonomous driving capabilities lower compared to emergency evasion capabilities. Experiment 2 examines the mediating role of attribution through ChatGPT's dominant or assisting role under different outcome expectations. Experiment 3 uses a clinical decision-making system to study algorithm transparency's moderating role, showing higher transparency improves evaluations and willingness to use AI products and services under negative outcome expectations. Theoretically, this study advances consumer behavior research by exploring the human-AI relationship within artificial intelligence, enhancing understanding of consumer acceptance variations. Practically, it offers insights for better integrating AI products and services into the market.

Factors Influencing Intention on Condom Use During Sexual Intercourse With Regular Female Partners Among Men Who Have Sex With Men in Western China: A Structural Equation Modeling Analysis.

Given the rapid rise in HIV infection among men who have sex with men (MSM) in China, they may be a potential bridge for HIV transmission to the general female population, and increasing condom use is an important protective measure. This study aimed to explore factors that influence the intention of condom use during sexual intercourse with regular female partners among MSM in Western China, based on the Health Action Process Approach model. This study used a baseline sample from a cohort study of the National Science and Technology Major Project. A nonprobability sampling method was adopted to recruit MSM from western China. Information on sociodemographic characteristics, HIV-related characteristics, sexual behavior, and constructs of the Health Action Process Approach model was collected through structured questionnaires, and the data were analyzed using a structural equation model. Among 232 participants, 62.9% (146 of 232) intended to use condoms every time they had sex with their regular female partners during the following 3 months. The results of the structural equation model showed that self-efficacy had the greatest influence on behavioral intention (β = 0.398, P < 0.001), followed by negative outcome expectancy (β = -0.303, P < 0.05). In addition, risk perception (β = 0.206, P < 0.05) and positive outcome expectancy (β = 0.270, P < 0.01) had indirect effects on intention, whereas self-efficacy played a mediating role in these indirect influencing factors. Risk perception, outcome expectancy, and self-efficacy are predictors of condom use intention, with self-efficacy in particular serving as a significant medium for future interventions. These findings could provide a reference for future targeted interventions to reduce the likelihood of HIV transmission from MSM to the female population.

Anxiety-related constructs and smoking outcome expectancies among Latinx smokers.

Hispanic/Latinx (hereafter Latinx) smokers in the United States (US) experience unique smoking cessation-related challenges. Smoking outcome expectancies (i.e., positive and negative beliefs about the consequences of smoking behavior) have been linked to the maintenance of smoking and comorbidity with negative emotional states such as anxiety among Latinx smokers. However, past work has not characterized rates of probable anxiety disorder and elevated levels of anxiety sensitivity among English-speaking daily Latinx smokers from the United States or concurrently evaluated the explanatory relevance of anxiety symptoms and anxiety sensitivity for negative and positive smoking outcome expectancies. The present investigation sought to (a) determine the base rate of probable anxiety disorder and elevated anxiety sensitivity and (b) explore the unique roles of anxiety symptoms and anxiety sensitivity in relation to negative and positive smoking outcome expectancies. Participants included 338 English-speaking Latinx adult daily cigarette smokers from the United States (Mage = 35.53 years; SD = 8.65; age range 18-61; 37.3% female). Findings revealed high rates of probable anxiety disorder (50.9%) and elevated anxiety sensitivity (73.4%) among English-speaking Latinx smokers from the United States. Anxiety sensitivity, but not anxiety symptoms or disorders, was significantly related to negative consequences, negative reinforcement, positive reinforcement, and appetite/weight control smoking outcome expectancies. Overall, anxiety experiences were common among Latinx smokers, and anxiety sensitivity was a relatively more consistent and robust predictor of negative and positive outcome expectancies relative to anxiety symptoms and probable anxiety disorder. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Generating a Moderated Mediation Model of Positive Outcome Expectancy and Aggression.

According to previous theories of aggression, positive outcome expectancy for aggression can predict aggression, while moral disengagement and negative outcome expectancy for aggression may, respectively, serve as mediators and moderators in this prediction process. To test the hypothesis, Study 1 first developed the Aggression Outcome Expectancy Questionnaire and examined its two-factor structure, which consists of positive and negative outcome expectancy for aggression. Next, 677 college students were recruited to participate in Study 2 and were asked to complete the Aggression Outcome Expectancy Questionnaire, Civic Moral Disengagement Questionnaire, and Buss-Perry Aggression Questionnaire. The findings indicated the following: (1) The Aggression Outcome Expectancy Questionnaire for college students demonstrated acceptable reliability and construct validity, confirming the two-factor structure of aggression outcome expectancy. (2) After controlling for sex and age, moral disengagement partially mediated the relationship between positive outcome expectancy and aggression. (3) Negative outcome expectancy for aggression moderated the effect of positive outcome expectancy on aggression, as well as moral disengagement. Specifically, negative outcome expectancy for aggression attenuated the positive predictive effect of positive outcome expectancy on aggression and moral disengagement. In conclusion, the present study extends our understanding of the motivational mechanism of aggression, offering a theoretical reference for preventing and intervening in aggressive behavior among college students.

The Potential Risk Compensation after Receiving HPV Vaccination among Men Who Have Sex with Men in Southwest China: A HAPA-Based Analysis.

Background: men who have sex with men (MSM) are a high-risk group for human papillomavirus (HPV) infection, and the HPV vaccine is effective in preventing it. However, according to risk compensation theory, people may increase sexual risk behaviors after receiving HPV vaccination. Based on the Health Action Process Approach (HAPA), this study investigated the influencing factors to predict intention to reduce condom use (risk compensation intention) among MSM after taking HPV vaccination in southwest China. Methods: we conducted a cross-sectional study among 948 MSM in southwest China using a non-probability sampling method and an electronic questionnaire including sociodemographic characteristics, sexual risk behavior characteristics, HPV-related prevention behavior, and the HAPA scale. Confirmatory factor analysis was performed using a structural equation model. Results: among 948 MSM, the incidence rate of reducing the frequency of condom use was 14.1%. The structural equation model showed that self-efficacy (β = -0.378, p = 0.020) and positive outcome expectancy (β = 0.366, p < 0.05) had greater effects on behavioral intention, followed by negative outcome expectancy (β = -0.296, p < 0.05) and risk perception (β = -0.232, p < 0.05). Conclusions: risk compensation may not be a major barrier to receiving HPV vaccination among MSM. Nevertheless, the recognition of possible risk compensation is necessary to implement appropriate interventions to reduce the occurrence of risk compensation.

The pursuit of intimacy: intimate relationship development for women with physical disabilities.

Understanding the barriers and facilitators to intimate relationship development among women with physical disabilities is crucial for promoting positive rehabilitation outcomes. This study investigates these factors using a Consensual Qualitative Research approach. The research team utilized Consensual Qualitative Research. Consensual Qualitative Research is widely used in various social services to address limitations inherent limitations of other qualitative methods. Women with various physical disabilities (n=6) were identified and interviewed using a utilized a semi-structured interview. Their attitudes towards intimacy, outcome expectancy, and self-concept of women with physical disabilities were examined. The impact of physical disabilities, including disability stigma, on these factors was also assessed. Data was coded utilizing multiple researcher consensus as well as an auditor to consensually agree upon domains and core ideas while taking into account validity and trustworthiness, as per the methodology chosen. The study discovered general themes (100% representation) concerning core values and barriers to intimacy, societal barriers to intimate relationships, and hope for future relationships. Typical themes (50-83% representation) included non-romantic intimacy, physical barriers to intimacy, perceived limitations, and negative outcome expectancies. Across the board, the influence of disability limitations, identity, and societal attitudes became evident. The role of rehabilitation professionals in advocating for social skills development and self-confidence enhancement emerged as crucial. The study illuminated barriers to intimacy among women with physical disabilities, such as societal stigma and self-concept associated with disability. The critical role of rehabilitation professionals in normalizing intimacy discussions and equipping individuals with necessary social skills and self-confidence was underscored. This focus could yield enhanced intimate relationship outcomes and improve the quality of life for women with physical disabilities.

Outcome Expectations in Psychotherapy: Validation of the Therapy Single Category Implicit Association Test (Therapy SC-IAT)

BackgroundFormer studies demonstrated that negative outcome expectations (OE) toward psychotherapy predict unfavorable psychotherapy outcomes. Critically, the measurement of OE is limited to direct measures that could be subject to self-presentational distortions. This study aimed to validate an online single category implicit association test (SC-IAT) to measure OE toward psychotherapy indirectly.MethodsWe conducted three direct measures of OE, the Therapy SC-IAT, and a (control) Flower SC-IAT in a large sample (N = 705).ResultsThe Therapy SC-IAT correlated with most direct measures of OE (convergent validity) but not with measures of flower associations (discriminant validity). In exploratory analyses, we found that direct and indirect measurements of OE were related to prior experiences with psychotherapy.ConclusionWe discuss ways to improve the indirect-direct correlations and suggest that our newly developed indirect measure could complement the assessment of expectations in research and clinical practice.

Rural and urban residents' attitudes and preferences toward COVID-19 prevention behaviors in a midwestern community.

Rural populations are more vulnerable to the impacts of COVID-19 compared to their urban counterparts as they are more likely to be older, uninsured, to have more underlying medical conditions, and live further from medical care facilities. We engaged the Southeastern MN (SEMN) community (N = 7,781, 51% rural) to conduct a survey of motivators and barriers to masking to prevent COVID-19. We also assessed preferences for types of and modalities to receive education/intervention, exploring both individual and environmental factors primarily consistent with Social Cognitive Theory. Our results indicated rural compared to urban residents performed fewer COVID-19 prevention behaviors (e.g. 62% rural vs. 77% urban residents reported wearing a mask all of the time in public, p<0.001), had more negative outcome expectations for wearing a mask (e.g. 50% rural vs. 66% urban residents thought wearing a mask would help businesses stay open, p<0.001), more concerns about wearing a mask (e.g. 23% rural vs. 14% urban were very concerned about being 'too hot', p<0.001) and lower levels of self-efficacy for masking (e.g. 13.9±3.4 vs. 14.9±2.8, p<0.001). It appears that masking has not become a social norm in rural SEMN, with almost 50% (vs. 24% in urban residents) disagreeing with the expectation 'others in my community will wear a mask to stop the spread of Coronavirus'. Except for people (both rural and urban) who reported not being at all willing to wear a mask (7%), all others expressed interest in future education/interventions to help reduce masking barriers that utilized email and social media for delivery. Creative public health messaging consistent with SCT tailored to rural culture and norms is needed, using emails and social media with pictures and videos from role models they trust, and emphasizing education about when masks are necessary.

ABC-training as a new intervention for hazardous alcohol drinking: Two proof-of-principle randomized pilot studies.

ABC-training is a new intervention to encourage health behavior change that targets the automatic activation of adaptive beliefs (i.e. automatic inferences). The aim of this proof-of-principle study was to test the effectiveness of web-based ABC-training to change outcome expectancies of alcohol drinking in a sample of hazardous drinkers. One exploratory and one confirmatory experiment with two between-subject conditions (online ABC- and control-training) and assessments at baseline and 1 week later (after three sessions of training). Participants recruited on Prolific Academic completed the web-based study. Adults with self-reported hazardous alcohol drinking (Experiment 1: 193 adults, United Kingdom, age mean = 46.7 years; Experiment 2: 282 adults, different nationalities, age mean = 38.3 years). ABC-training involved completing an online task that required choosing personally relevant alternative behaviors to drinking alcohol in personally relevant antecedent contexts to attain personally important outcomes. Comparator was control-training, in which participants selected both the alternative behaviors and alcohol drinking an equal number of times. Training was completed at baseline, after 3 days and after 1 week. Primary outcome was change in automatic and self-reported (negative/positive) outcome expectancies of alcohol drinking from baseline to after 1 week. Secondary outcomes were change in weekly alcohol consumption, self-efficacy, craving and motivation (and approach-alcohol associations in Experiment 1). Moderators were baseline outcome scores, motivation, age and alcohol dependency. Findings of this study are as follows: stronger increase in negative outcome expectancies after ABC- than control-training (Experiment 1: self-report, 95% confidence interval of difference scores (CIdiff ) = [0.04, Inf]; automatic, CIdiff = [0.01, Inf]; Experiment 2: self-report, CIdiff = [0.16, Inf]; automatic, CIdiff = [0.002, Inf]). Stronger reduction in self-reported positive outcome expectancies after ABC- than control-training (Experiment 1: CIdiff = [-Inf, -0.01]; Experiment 2: CIdiff = [-Inf, -0.21]) but mixed findings on automatic positive outcome expectancies (Experiment 1: CIdiff = [-Inf, 0.02]; Experiment 2: CIdiff = [-Inf, -0.001]). ABC-training may change outcome expectancies of alcohol consumption, but testing of clinically relevant effects in other samples is warranted.