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Sexually transmitted infections (STIs) are a global health problem. Even though there are several effective STI prevention strategies, many people do not use them, and more than one million STIs are acquired every day worldwide (World Health Organization, 2022). Experimental studies show that support of psychological need satisfaction (i.e., autonomy, relatedness, and competence), as defined in the Self-Determination Theory, leads to long-term maintenance of different health behaviors, probably by promoting more autonomous regulation (Silva et al., 2011; Williams et al., 2006). Hence, the three basic psychological needs could also play a critical role in whether an individual decides to use (at least) one STI prevention strategy and ultimately engages in maintained use. However, research examining the relationship between basic psychological needs and STI prevention decision-making behavior is limited as valid measurement instruments for basic psychological needs satisfaction and frustration in the context of STI prevention decision making are lacking. With this study, we will explore and improve the cognitive validity of a scale measuring the basic psychological needs in the context of STI prevention decision-making, which was developed by Rexwinkel & Gültzow (2022) [ERCPN reference number: 188_10_2_2018_S102] and which needs more evidence or alterations for it to be valid because the exploratory factor analysis revealed a factor structure that does not align with the Self Determination Theory (SDT). Based on the SDT which constitutes the base of the BPNSFS, one would have expected that the items would load on either six different factors (autonomy satisfaction, autonomy frustration, relatedness satisfaction, relatedness frustration, competence satisfaction, and competence satisfaction) or two different factors (satisfaction and frustration). However, the factor analysis revealed a factor structure that does not align with the SDT: autonomy satisfaction loaded on one factor, autonomy frustration loaded on another factor, and competence satisfaction, competence frustration, relatedness satisfaction, and relatedness frustration surprisingly landed on one factor. Therefore, the unclear factor structure indicates lacking validity for this adaption of the BPNSFS. One source of evidence for validity, and the one this study aims to explore and improve for the mentioned BPNSFS, is cognitive validity, i.e., whether the respondent interprets and responds to survey items in a way that is consistent with the intention of test designers. Testing cognitive validity with a qualitative approach can add to the chain of validity evidence. For example, a quantitative method could prove that participants respond to items consistently but cannot detect if they consistently misinterpret the questions so that they do not reflect the constructs the test designer intended. Hence, measurement error can be reduced, and the questionnaire can be adapted to improve cognitive validity and construct validity. One qualitative method used to improve validity during instrument development, which we will also use for that purpose here is the “think-aloud-method”. We will conduct interviews where participants share their cognitive processes and understanding of the items by thinking aloud while taking the survey. Furthermore, we will use probes if the participants spontaneous elaborations are not sufficient to determine the cognitive validity of the items. The information collected during the interviews will help us to estimate and improve the cognitive validity of the Basic Psychological Need Satisfaction Frustration Scale Adapted to STI Prevention Decision Making.

In an earlier project we have developed the Health Communication Orientations Scale (HCOS). In this project, we will test in an experimental study whether tailoring messages based on the HCOS will lead to better message evaluations.

For the adequate minimization of HIV transmission risk, multiple effective strategies are available. Facilitated by the ongoing development of biomedical HIV prevention strategies such as pre-exposure prohphylaxis (PrEP) and Undetectable=Untransmittable (U=U), sexual decision-making has nowadays become more complex than ever and may rely on informed decision-making processes that require the individual to navigate between objectifiable risks and (dis-)advantages on the one hand and personal values and preferences on the other. Thus, traditional health promotion strategies that solely focus on the rigid prescription of a single "golden standard" may be too inflexible to stand up to the personalized, preference-sensitive nature of modern sexual decision-making. However, the extent to which HIV prevention decisions are indeed guided by informed decision-making processes has yet to be demonstrated. To investigate the role of informed decision-making processes in the context of sexual decision-making, it is crucial to account for the extensive within-person variance of sexual decisions across different sexual experiences. For instance, someone may use condoms for anal sex on day one, while engaging in PrEP-covered condomless anal sex on day two. In line with that notion, Zimmermann et al. (2020) demonstrated the within-person variability regarding the usage of condoms, daily PrEP (dPrEP) and event-driven PrEP (edPrEP) in relation to different types of partners. Therefore, to account for the within-person variance regarding sexual decisions and to investigate the role of informed decision-making, we plan to conduct an experience sampling study of men and transgender women who have sex with men. This study will combine a baseline survey that measures the perceived safety of multiple different sexual scenarios that are presented to the participants with six follow-up surveys that assess the sexual decisions that were implemented by the participants. By matching the baseline surveys with the follow-up surveys, we will be able to deduce an individual subjective safety rating for every single sexual experience that our participants make. By generating subjective safety ratings for every single sexual experience, we will be able to analyze how different decision-making factors determine the ultimate choice. These factors include the momentary perceived need for protection, momentary impulsivity and the level of informed decision-making.

This study involves a qualitative evaluation study investigating the impact of a Dutch sexual health education website, https://www.yoursex.nl, on informed decision making related to sexually transmittable infections (STI) in men who have sex with men (MSM) in the Netherlands. It is conducted as part of a Master Thesis Project by a student at the Faculty of Psychology and Neuroscience of Maastricht University.

An intuitive style in eating decision-making, for example, basing decisions on one's gut feeling, has been related to a less healthy diet, whereas deliberately deciding what to eat, such as making plans about eating behavior, has been related to a healthier diet. The present study investigated whether nutrition knowledge, food preferences, and habit strength for healthy and unhealthy eating moderate these relationships. In total, 1245 participants took part in a preregistered cross-sectional online survey. Results revealed that neither nutrition knowledge, nor liking of healthy or unhealthy foods, nor habit strength for healthy or unhealthy eating interacted with the preference for intuition or deliberation in eating decision-making in affecting dietary intake (βs ≤ |.06|; ts ≤ |2.11|; ps ≥ .035). Instead, including the potential moderating variables in analyses rendered the effect of a preference for intuition largely non-significant. In contrast, the positive effect of a preference for deliberation was largely stable even when including the potential moderating variables. Thus, the present study confirms the general health-promoting effect of a preference for deliberation in eating decision-making. In contrast, results speak in favor of a generally minor role of a preference for intuition for healthy or unhealthy eating.

An inclusive university strives to provide support for all students and staff, including people with mental health issues. Mental health issues refer to different mental health conditions which can impact mood, thinking and behavior, and influence daily life (World Health Organization, 2022). In the Netherlands, more than 4 out of 10 people experience mental health issues in their lives (Ministry of General Affairs, n.d.). Preliminary data from the Dutch Caring Universities consortium shows that this problem also extends to Dutch universities, especially in times of the Coronavirus Disease 2019 (COVID-19) pandemic (Caring Universities, 2020). Next to other challenges imposed by mental health issues, people with said issues have to decide whether they want to disclose them in their social environment. Applied to universities, this means whether they want to disclose their mental health issues in university, e.g., for students to a teacher, and for an employee to their manager. This decision can be very complex, as people must weigh the benefits of disclosure against the drawbacks of choosing not to disclose (van Beukering et al., 2022). The study of van Beukering et al. (2022) has shown that a substantial group of people do not know what to expect in terms of disclosure outcomes, which makes deciding even more difficult. Decision aids could support both university students and staff with this decision as they are known to help users with complex decisions, especially those that involve benefits and drawbacks at the same time (Stacey et al., 2017). Such a decision aid will be developed within a project that is currently being carried out within Maastricht University. International standards indicate that within decision aid development processes needs assessments should take place (Witteman et al., 2021). Therefore, the aim of this research is to explore the motives, considerations and needs of students and staff of Maastricht University regarding the decision to disclose their mental health issues. These results will be used to develop a decision aid. This preregistration specifically applies to this needs assessment as sub project within the bigger decision aid development project.

A content analysis of Instagram posts concerning HIV and AIDS will be performed to investigate how Instagram users communicate about HIV and AIDS prevention, testing, and treatment. Instagram is popular around the globe (1.478 mln. monthly active users; (Statista, 2022)) and is extensively used to communicate about HIV and AIDS, for example to share experiences, but also to motivate HIV testing and other preventative behaviors (Nobles et al., 2020). For these posts to be effective in motivating people to take a decision around HIV and AIDS prevention but also regarding testing and treatment, we believe they should adhere to certain standards. That is why we aim to explore how communication takes place in the context of three themes: Informed Decision Making (IDM), misconceptions about HIV and AIDS, and key psychological needs for motivation according to self-determination theory. Additionally, we will analyze whether communication in line with these themes has an influence on engagement with posts in terms of number of comments. Hereafter, we will shortly address all the themes. In the past, several decision aids have been created to help people make informed choices in the context of their own health. Minimum standards for the qualification of such decision aids have been developed (Durand et al., 2015). It is our goal to assess to what extent posts about HIV and AIDS adhere to these minimum standards, thereby aiming to draw conclusions on the potential impact of such Instagram posts on autonomous and informed decision making. It is our expectation that posts qualifying as decision aid will differ in engagement in terms of number of comments as compared to posts not qualifying as decision aid. Second, our analysis will shed light on the degree to which misconceptions about HIV and AIDS prevention, testing, and treatment are prevalent on Instagram. Misconceptions are associated with more stigma towards people living with HIV and AIDS (Qian et al., 2007) and being stigmatized can in turn interfere with initiation and/or maintenance of HIV and AIDS prevention, HIV testing and HIV treatment (Ekstrand et al., 2012). We aim to gain insight into which misconceptions would deserve the most attention in public campaigns or interventions to debunk such misconceptions. It is our expectation that posts endorsing misconceptions will differ in engagement in terms of number of comments as compared to posts not dealing with misconceptions. Additionally, we expect that posts refuting misconceptions will differ in engagement in terms of number of comments as compared to posts not dealing with misconceptions. Third, following self-determination theory, we intend to investigate to what degree the three key psychological needs are being supported or thwarted in Instagram postings, thereby assessing to what extent Instagram posts are currently helpful in autonomously motivating people to initiate and maintain HIV and AIDS prevention, testing, and treatment behaviors. It is our expectation that posts supporting either one or more key psychological needs will differ in engagement in terms of number of comments as compared to posts not supporting these needs. We will compare results for the above mentioned three concepts across continents as they seem to be relevant across regions around the globe, however communication may differ between regions. Misconceptions seem to be common and show similarities across continents: for example, Be In The Know (formerly known as Avert), a website focusing on East and Southern Africa (https://www.beintheknow.org/hiv-and-stis/hiv-prevention/how-do-you-get-hiv) and the Dutch organization Soa Aids Nederland (https://www.soaaids.nl/nl/alle-soas/hiv/wat-is-aids-wat-is-hiv), largely focus on debunking the same misconceptions in their communication. Also, the three key needs in SDT – autonomy, competence, and relatedness – have been found to be present across cultures (Chen et al., 2014). Since the community on Instagram is a global one, we are interested to see whether there are indications for cultural differences in communication about HIV and AIDS prevention, testing, and treatment, specifically with respect to IDM, misconceptions, and SDT. We realize that there can be vast differences within continents and that this is only a first step in discovering potential patterns. Finally, other factors such as characteristics of the posters will also be explored.

The human papillomavirus (HPV) is the name of a common group of viruses. They usually do not cause problems in the short term, but some types can cause genital warts or even cancer later in life. The incidence of this type of cancer is increasing worldwide (Stanley, 2014), and prevention programmes have been offered in several countries as they showed to be effective to prevent the spread of HPV and mortality for serious consequences of the infections (Plummer & Franceschi, 2002). For example, two types of vaccines were developed to prevent HPV infections: (a) Gardasil®, which prevents cervical cancer and genital warts; (b) Cervarix® which prevents cervical cancer caused by type18 (McLemore, 2006; Paavonen, 2007). As with other types of health(care) options, the decision whether to vaccinate your child and/or yourself against HPV should often be made using a 'Shared Decision Making'–paradigm, i.e., the decision for or against vaccination is not made by a healthcare provider alone, but together with the child and/or their caretaker. In the Netherlands, youth health care agencies are responsible for the HPV vaccine and therefore the consultations in which the decision is made should also take place there. However, we do not know much about how healthcare providers within these agencies view shared decision making and which factors play a role in this behaviour (i.e., whether to adopt shared decision making). Within this project we will therefore map both by means of semi-structured interviews. For this research, we will conduct semi-structured interviews with healthcare providers employed at youth health care agencies responsible for the administration of the HPV vaccine. Consent will be provided written before the interview, and we do not foresee any negative consequences for the participants. Participants will not receive any monetary compensation for participating in this project.

The current study is about the relationship between decisional conflict, the psychological needs as described in the self-determination theory, and the prevention of sexually transmitted infections. The current study will ask participants about the kind of experiences that they have in their life with decisions about strategies to prevent sexually transmitted infections.

Acknowledgement: For this pre-registration, we adapted our proposal to the guidelines from guidelines available on OSF: "Pre-Registration in Social Psychology (van 't Veer & Giner-Sorolla, 2016)". Environmental considerations are becoming increasingly important and there are multiple behavioural options (e.g., different behaviours that relate to recycling, re-using, energy usage etc.) that individuals can choose from to improve their environmental impact. These behaviours differ in the extent they impact the environment, and are not equally affordable, nor equally easy to execute. As a result, people might experience uncertainty in pursue few, or many, of these behaviours. Despite the intention to behave in favour of the environment, one might assume that it is difficult for people to make decisions about the environment on an everyday basis. It is currently unknown if individuals do in fact experience this process as being difficult, and how this influences their environmental behaviours. Similarly, considerable heterogeneity is expected to exist regarding the extent to which people redirect their thoughts, and consequently their behaviours, towards the environment. Specifically, individuals may find themselves in different stages of decision making. For example, one person might just start to think about how to behave more environmentally friendly, while another person may already perform certain pro-environmental behaviours yet wants to become even more environmentally friendly. This may influence the perceived difficulty of the choice to be made. Moreover, we do not know whether experiencing decisional conflict could be related to underlying decisional processes like having a preference for intuitive and/or deliberative decision making. In order to explore these considerations, an online survey is being distributed to adults (i.e., 18 years and older) to investigate to what extent individuals perceive decisional conflict when deciding about engaging in pro-environmental behaviours (RQ 1). Moreover, we will look at whether decisional conflict regarding the decision to engage in pro-environmental behaviours is associated with (not) engaging in pro-environmental behaviours (RQ 2) and whether having a preference for intuitive and/or deliberative decision making moderates the effect of decisional conflict on pro-environmental behaviours (RQ 3). Next, we will examine in which decisional stage individuals find themselves around environmental decision making (RQ 4) and whether the stage people find themselves in is related to decisional conflict (RQ 5). For this research, we use an anonymous questionnaire that is being distributed among a convenience sample of English-, Dutch- and Italian-speaking adults. Consent is provided online, and we do not foresee any negative consequences for the participants. Participants do not receive any monetary compensation for filling in the survey.

The monkeypox (MPX) virus is not a novel occurrence, but cases were only reported a few times a year until May 2022 when transmission of MPX spread globally and was declared a global public health emergency by the WHO shortly after [1,2]. In the WHO European Region, the outbreak of MPX cases is largely targeted towards men among whom men who have sex with men (MSM) who represent the vast majority of the cases [3]. Most likely transmission routes were sexual contact in the majority of cases [3]. Also in the Netherlands, MSM are being considered as the population at risk of MPX, with PrEP users and MSM living with HIV labelled at highest risk due to their sexual risk behaviors [4,5]. Monkeypox could therefore become labelled as a MSM-specific infection which might elicit stigmatization towards this population, similar to the beginning of the HIV epidemic [6]. The current scientific MPX literature focuses predominantly on the epidemiology and clinical outcomes of MPX, but psychosocial aspects such as stigma are under-investigated. However, as exemplified in the HIV stigma literature, stigma can have consequences that are not only highly detrimental for the individual but also for the public health response, resulting, for example, in poor use of HIV prevention strategies and treatment adherence [7]. Therefore, we aim to report on psychosocial aspects of MPX among MSM in the Netherlands that may underlie MPX stigma using data of an online cross-sectional survey that was distributed among MSM on dating apps in a previously established cohort. Goffman conceptualized stigma as an “attribute that is deeply discrediting” imposed by society that reduces someone “from a whole and usual person to a tainted, discounted one”. When the attribute becomes linked to “discrediting dispositions” (e.g., negative evaluations or stereotypes), these may come to be widely believed in the community. We set out to investigate several beliefs that are known to underlie HIV stigma [8] and are likely similar for MPX, such as perceived societal beliefs about the severity of MPX, perceptions that people who acquire MPX are blameworthy (perceived responsibility), associations between these infections and behaviors that violate some individuals’ norms such as sex between men (norm violation), as well as other variables that relate to stigma such as disclosure intentions and expected stereotypes. Given the novel nature of MPX, in this study, we aim to describe each of these variables to explore aspects of MPX stigma, and compare where possible to other infections that are also seen as MSM-specific such as common STIS, including HIV, syphilis, gonorrhea, and chlamydia. From the HIV stigma literature it is clear that aspects of stigma may also be associated with other variables relating to other forms of stigma such as sexuality-related stigma, we will also examine the associations between perceived responsibility (i.e., perceptions that people who acquire MPX are blameworthy) and other variables relating to sexuality-related stigma such as internalized homonegativity (IH) and outness about one’s sexual orientation, as well as social interactions with individuals with MPX (knowing others with MPX), as all have been shown to be significantly associated with internalized stigma in an HIV context. We hypothesize that IH, not being out and not knowing others with MPX are all indicative of internalized stigma relating to their sexuality and increased fear of being perceived as gay or as having sex with men [9,10], and therefore more likely to perceive MPX as one’s own responsibility. References: [1] Bunge, E.M., Hoet, B., Chen, L., Lienert, F., Weidenthaler, H., Baer, L.R., et al. (2022). The changing epidemiology of human monkeypox—A potential threat? A systematic review. PLOS Neglected Tropical Diseases, 16(2):e0010141. [2] World Health Organization. (2022). Responding to the monkeypox outbreak: perspectives of clinicians treating patients with the disease. Accessed online 21-9-22: https://www.who.int/europe/news/item/24-07-2022-responding-to-the-monkeypox-outbreak--perspectives-of-clinicians-treating-patients-with-the-disease. [3] Vaughan, A.M., Cenciarelli, O., Colombe, S., Alves de Sousa, L., Fischer, N., Gossner, C.M., et al. (2022). A large multi-country outbreak of monkeypox across 41 countries in the WHO European Region, 7 March to 23 August 2022. Eurosurveillance, 27(36). [4] Rijksintituut voor Volksgezondheid en Milieu. Monkeypox vaccination. Accessed online 21-9-22: https://www.rivm.nl/en/monkeypox/vaccination. [5] Rijksintituut voor Volksgezonheid en Milieu. Monkeypox (apenpokken). Accessed online 21-9-22: https://lci.rivm.nl/richtlijnen/monkeypox-apenpokken. [6] Gonsalves, G.S., Mayer, K., Beyrer, C. (2022). Déjà vu All Over Again? Emergent Monkeypox, Delayed Responses, and Stigmatized Populations. Journal of Urban Health, 99(4). [7] Sullivan, M. C., Rosen, A. O., Allen, A., Ben-bella, D., Camacho, G., Cortopassi, A. C., et al. (2020). Falling short of the first 90: HIV stigma and HIV testing research in the 90–90–90 era. AIDS and Behavior, 24(2), 357–362. [8] Stutterheim, S.E., Bos, A.E.R., van Kesteren, N.M.C., Shiripinda, I., Pryor, J.B., et al. (2011). Beliefs Contributing to HIV-related Stigma in African and Afro-Carribean Communities in the Netherlands. Journal of Community and Applied Social Psychology, 22(6). [9] Brooks, R.A., Etzel, M.A., Hinojos, E., Henry, C.L. Perez, M. (2005). Preventing HIV among Latino and African American gay and bisexual men in a context of HIV-related stigma, discrimination, and homophobia: perspectives of providers. AIDS Patient Care STD, 19(11). [10] Choi, K.H., Lui, H., Guo, Y., Han, L., Mandel, J.S. (2006). Lack of HIV testing and awareness of HIV infection among men who have sex with men, Beijing, China. AIDS Education and Prevention, 18(1).