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BackgroundThis study focuses on the Budd app, a mobile health intervention designed for gay, bisexual, and other men who have sex with men who participate in chemsex. Chemsex, the use of psychoactive drugs in a sexual context, presents substantial health risks including increased HIV transmission and mental health issues. Addressing these risks requires innovative interventions tailored to the unique needs of this population. ObjectiveThis study aims to evaluate the effectiveness of the Budd app in promoting drug harm reduction practices among its users, focusing on knowledge, behavioral intention, risk behavior awareness, and self-efficacy. MethodsThe study used a mixed methods approach, combining a single-case experimental design and a pre-post study. A total of 10 participants from an outpatient clinic were recruited, and each attended the clinic 3 times. During the first visit, participants installed a restricted version of the Budd app, which allowed them to report daily mood and risk behavior after chemsex sessions. Phase A (baseline) lasted at least 2 weeks depending on chemsex participation. In the second visit, participants gained full access to the Budd app, initiating phase B (intervention). Phase B lasted at least 6 weeks, depending on chemsex participation, with identical data input as phase A. Participants completed pre- and postintervention surveys assessing behavioral determinants during the first and third visit. ResultsThe study observed an increased knowledge about chemsex substances postintervention, with a mean percentage improvement in knowledge scores of 20.59% (SD 13.3%) among participants. Behavioral intention and self-efficacy showed mixed results, with some participants improving while others experienced a decrease. There was also a variable impact on awareness of risk behavior, with half of the participants reporting a decrease postintervention. Despite these mixed results, the app was generally well-received, with participants engaging with the app’s features an average of 50 times during the study. ConclusionsThe Budd app showed effectiveness in enhancing knowledge about chemsex substances among gay, bisexual, and other men who have sex with men. However, its impact on safe dosing behavior, behavioral intention, self-efficacy, and risk behavior awareness was inconsistent. These findings suggest that while educational interventions can increase knowledge, translating this into behavioral change is more complex and may require more participants, a longer follow-up period, and additional strategies and support mechanisms.

Abstract Background A well-studied internal barrier to regular physical activity, and more specifically brisk walking, is cognitive fatigue. However, thus far little research examined how cognitively fatigued individuals can be motivated to exercise, more specifically to engage in brisk walking. This study investigates whether humorous intervention messages might be an effective strategy to motivate cognitively fatigued individuals to brisk walk, and through which underlying processes. Methods An online experiment was performed in which variation in cognitive fatigue was induced through mental arithmetic questions. Afterwards, participants (n = 250) recruited through Prolific, randomly received either humorous or non-humorous intervention messages related to brisk walking. Potential mediators of the relations between physical activity, humour and cognitive fatigue were measured, were self-efficacy, self-control, and motivation. Results First, regression analyses confirmed that cognitive fatigue negatively influences brisk walking intentions and that the perceived humour of the intervention messages moderated this relationship. Second, results showed that self-control and self-efficacy are mediators explaining the relationship between cognitive fatigue and brisk walking intentions. Lastly, this study found that perceived humour of the intervention messages moderated the relationship between cognitive fatigue and self-control, indicating that perceptions of self-control were positively changed after receiving messages that were perceived as humorous compared to messages that were not perceived as humorous, subsequently increasing brisk walking intentions. Conclusions This study is the first to unravel the underlying relationship between humorous intervention messages and brisk walking intentions through positive changes in perceptions of self-control within a cognitively fatigued sample. Results of this study suggest that existing smartphone applications monitoring and promoting brisk walking should integrate tailored message strategies within their cues to brisk walk by implementing humour as a strategy to motivate users when they are cognitively fatigued.

Health has always been, and always will be, one of the most highly ranked priorities of people. Understanding how health and health behaviours are created, promoted, and maintained in the future under the influence of constant and changing media environments requires a younger generation of scholars in the field of health communication who are willing and able to bring their own ideas and methods to this ever-changing field. The special issue “Young Scholar Action” reflects an effort to embrace these young scholars from the European Journal of Health Communication and ECREA Health Communication.

Background: The COVID-19 pandemic has revealed the fragility of the global food system, sending shockwaves across countries' societies and economy. This has presented formidable challenges to sustaining a healthy and resilient lifestyle. The objective of this study is to examine the food consumption patterns and assess diet diversity indicators, primarily focusing on the food consumption score (FCS), among households in 38 countries both before and during the first wave of the COVID-19 pandemic. Methods: A cross-sectional study with 37 207 participants (mean age: 36.70 ± 14.79, with 77 % women) was conducted in 38 countries through an online survey administered between April and June 2020. The study utilized a pre-tested food frequency questionnaire to explore food consumption patterns both before and during the COVID-19 periods. Additionally, the study computed Food Consumption Score (FCS) as a proxy indicator for assessing the dietary diversity of households. Findings: This quantification of global, regional and national dietary diversity across 38 countries showed an increment in the consumption of all food groups but a drop in the intake of vegetables and in the dietary diversity. The household's food consumption scores indicating dietary diversity varied across regions. It decreased in the Middle East and North Africa (MENA) countries, including Lebanon (p

Despite the central role that teachers can have in preventing and reducing bullying, they often feel insecure about how to deal with bullying. This study evaluated a short teacher training – called the Teachers SUPporting POsitive RelaTionships (T-SUPPORT) training – that aims to reduce bullying by supporting teachers in building positive teacher-student relationships and in actively dealing with bullying. The aim of the current study was to investigate whether the T-SUPPORT training resulted in higher quality teacher-student relationships, and more active and less passive responses to bullying incidents, and whether these improvements in turn resulted in lower levels of bullying victimization. In a Randomized Controlled Trial 10 Belgian primary schools were randomly assigned to an intervention or control condition. The Grades 4–6 teachers of the five schools in the intervention condition received the three-session school-based training; control teachers received no intervention. Grade 4–6 students (N = 964; 55 classrooms) in these schools completed questionnaires at pre- and post-test. In contrast to the hypotheses, results of the two-level linear mixed model analyses revealed no significant effect of the training on teacher-student relationship quality, teachers’ responses to bullying and bullying victimization. Yet, higher quality teacher-student relationships and more active teacher responses to bullying were significantly associated with less bullying victimization, whereas more passive responses were linked with more victimization. The latter findings are in line with theorizing and research on the role that teachers can play in reducing bullying.

Online aggression is a form of antisocial online behavior that has been widely studied among adolescents, but adults of all ages are involved as well. The goal of the present study is to broaden the understanding of potential risk factors of online aggression perpetration. Associations between socially aversive personality traits and online aggression are examined. In contrast to previous research and to account for ICT affordances, the present study argues for and tests the mediating role of online moral disengagement, and not traditional moral disengagement, in the relationships between traits and perpetration. To this aim, a cross-sectional dataset, balanced in terms of age, was collected among 2,000 adults aged 19–79. A path model revealed indirect associations for two traits, psychopathy and sadism, with online aggression perpetration via online moral disengagement, while controlling for online aggression victimization. Theoretical and practical implications are discussed.

Social media influencers (SMI) are increasingly becoming the target of online aggression. The first part of this study focuses on how this group of online users deals with online aggression and more specifically which coping strategies they use. In contrast to ordinary social media users, SMI experience online aggression situations on two levels: on a personal level and a human brand level. As a second aim, this study wants to explore whether and how personal emotions on the one hand and brand concerns on the other hand explain SMI's choice of coping strategies based on a combination of Transaction Coping Theory and Conservation of Resources Theory. To meet these aims, we conducted a survey among an international sample of SMI (N = 200; Mage= 36.19; 47% female) about their experiences with online aggression, personal emotions, brand concerns and coping strategies. The results of CFA and hierarchical regressions indicate that SMI coping strategies can be classified into cognitive, behavioral and social strategies, with cognitive strategies being the most commonly used. The use of the three types of strategies can be explained by both personal emotions (e.g., being angry and scared) as well as brand concerns (e.g., being concerned about losing commercial opportunities). The brand concerns seem to overwrite part of the contributions of personal emotions, which might point to emotional labor. Lastly, how often one experiences online aggression turns out to be a very important factor above and beyond personal emotions and brand concerns.

Chemsex refers to the intentional use of drugs before or during sex in a specific context, typically involving prolonged sex sessions with multiple partners. Engaging in chemsex is associated with a wide range of health risks and related risk behaviors. We developed a mobile phone application (‘Budd-app’) to support and inform chemsex participants, reduce potential negative impacts associated with chemsex (e.g., physical, psychological and social health harms), and encourage more reasoned participation. During Budd’s development process, 11 participants completed a survey after each chemsex session they attended. This data collection approach provided precise experiences on drug related behavior, prevention measures for sexually transmitted infection and sexual consent on 63 chemsex sessions. The mean duration of chemsex sessions was 17.5 h. Polydrug use was reported during 95% of chemsex sessions with an average of 3.5 agents per session. Unsafe dosing occurred at 49% of chemsex sessions, and 9/11 participants dosed unsafely at least once. Seven participants did not consistently take measures to prevent STI transmission. Nine had experienced peer pressure, both regarding drug use and sexual health. The same number reported sex without consent, not respecting others’ boundaries as well as their own boundaries not being respected. Many participants experienced negative impact of their chemsex behavior during (7/9) and after (8/9) chemsex. Through participants’ behavior assessment during multiple chemsex sessions, ‘within-person’ variability can be clarified. This clarification provides valuable insights in personal, emotional and contextual vulnerabilities. These insights can direct an individualized care and support trajectory aimed at addressing those vulnerabilities.

BackgroundChemsex refers to the intentional use of drugs before or during sex among men who have sex with men (MSM). Engaging in chemsex has been linked to significant negative impacts on physical, psychological, and social well-being. However, no evidence-based support tools have addressed either these harms or the care needs of MSM who engage in chemsex. ObjectiveThe purpose of this paper was to describe the development of a mobile health intervention (named Budd) using the intervention mapping protocol (IMP). Budd aims to support and inform MSM who participate in chemsex, reduce the negative impacts associated with chemsex, and encourage more reasoned participation. MethodsThe IMP consists of 6 steps to develop, implement, and evaluate evidence-based health interventions. A needs assessment was carried out between September 2, 2019, and March 31, 2020, by conducting a literature study and in-depth interviews. Change objectives were selected based on these findings, after which theory-based intervention methods were selected. The first version of the intervention was developed in December 2020 and pilot-tested between February 1, 2021, and April 30, 2021. Adjustments were made based on the findings from this study. A separate article will be dedicated to the effectiveness study, conducted between October 15, 2021, and February 24, 2022, and implementation of the intervention. The Budd app went live in April 2022. ResultsBudd aims to address individual factors and support chemsex participants in applying harm reduction measures when taking drugs (drug information, drug combination tool, and notebook), preparing for participation in a chemsex session (articles on chemsex, preparation tool, and event-specific checklist), planning sufficient time after a chemsex session to recover (planning tool), seeking support for their chemsex participation (overview of existing local health care and peer support services, reflection, personal statistics, and user testimonials), taking HIV medication or pre-exposure prophylaxis in a timely manner during a chemsex session (preparation tool), and contacting emergency services in case of an emergency and giving first aid to others (emergency information and personal buddy). ConclusionsThe IMP proved to be a valuable tool in the planning and development of the Budd app. This study provides researchers and practitioners with valuable information that may help them to set up their own health interventions. International Registered Report Identifier (IRRID)RR1-10.2196/39678

BackgroundThe COVID-19 pandemic along with its confinement period boosted lifestyle modifications and impacted women and men differently which exacerbated existing gender inequalities. The main objective of this paper is to assess the gender-based differentials in food consumption patterns, dietary diversity and the determinants favoring weight change before and amid the COVID-19 pandemic among Arab men and women from 10 Arab countries.MethodsA cross-sectional study was conducted based on a convenience sample of 12,447 households' family members (mean age: 33.2 ± 12.9; 50.1% females) and information from participants aged 18 years and above was collected about periods before and during the pandemic.ResultsFindings showed that, during the COVID-19 period, the dietary diversity, declined by 1.9% among females compared to males (0.4%) (p < 0.001) and by 1.5% among overweight participants (p < 0.001) compared to their counterparts.ConclusionsTo conclude, gender-sensitive strategies and policies to address weight gain and dietary diversity during emergent shocks and pandemics are urgently needed in the region.

Physical inactivity and sedentary behaviours are leading risk factors for preventable health problems worldwide. Therefore, several smartphone-based interventions have tried to enhance physical activity (PA) through goal reminders based on relatively stable characteristics. However, time-varying factors, such as cognitive fatigue, may act as barriers to engagement in PA. This study aims to unravel what type of goal reminder messages are effective for enhancing PA in situations of cognitive fatigue. First, using a 3 x 3 between-subjects design, we evaluated the effectiveness of goal reminders matched with real-time goals under different levels of cognitive fatigue. This study did not find evidence that the tested goal reminders, intended to be adapted to the real-time goals of the participants, were more effective in promoting PA than goal reminders not adapted to individuals’ real-time goals. Second, to better understand how to design future reminders, two questions explored what format and what content participants considered to be helpful when feeling cognitively fatigued. Results show that GIFs, textual reminders, and pictures are suitable formats in smartphone-based interventions and that humorous content is preferred when feeling cognitively fatigued. These findings contribute to the development of just-in-time adaptive interventions that consider dynamic factors to promote PA.

Combining the transactional model of stress and coping and expressive writing theory, this research studied whether writing on one’s personal experiences with the COVID-19 pandemic may improve young people’s emotional reactions to the situation. A standard expressive writing instruction was compared to a positive writing instruction (writing about the positive aspects) and a coping writing instruction (writing about previous experiences and how these are helpful to cope with the situation). The results showed that participants in the positive writing instruction experienced a significantly higher positive change in feelings in relation to the COVID-19 pandemic in comparison with participants in the other writing instructions. This relationship was not mediated by the relative contents of writing. The results can help in designing online social support interventions for coping with the COVID-19 pandemic and stressful events in general.

The COVID-19 pandemic has revealed the Eastern Mediterranean Region's food system's fragility posing severe challenges to maintaining healthy sustainable lifestyle. The aim of this cross-sectional study (N = 13,527 household's family members, mean age: 30.3 ±11.6, 80% women) is to examine the impact of the COVID-19 pandemic on food consumption patterns and household's dietary diversity in 10 Eastern Mediterranean countries. A food frequency questionnaire was used to investigate the consumption patterns along with the calculation of the Food Consumption Score (FCS), a proxy indicator of dietary diversity. Data collected on cooking attitudes, shopping and food stock explore the community mitigation measures. In the overall population, before and during the pandemic, most food groups were consumed less or equal to 4 times per week. As evident from our findings and considering that the pandemic may be better, but it's not over, small to moderate changes in food consumption patterns in relatively short time periods can become permanent and lead to substantial poor dietary diversity over time. While it is a priority to mitigate the immediate impact, one area of great concern is the long-term effects of this pandemic on dietary patterns and dietary diversity in Eastern Mediterranean households. To conclude, the COVID-19 crisis revealed the region's unpreparedness to deal with a pandemic. While the aggressive containment strategy was essential for most countries to help prevent the spread, it came at a high nutritional cost, driving poor dietary diversity.

Emerging research has suggested that digital games can generate entertainment experiences beyond hedonic enjoyment towards eudaimonic experiences: Being emotionally moved, stimulated to reflect on one’s self or a sense of elevation. Studies in this area have mainly focused on individual game characteristics that elicit singular and static eudaimonic game moments. However, such a focus neglects the interplay of multiple game aspects as well as the dynamic nature of eudaimonic experiences. The current study takes a novel approach to eudaimonic game research by conducting a qualitative game analysis of three games (Assassin’s Creed Odyssey, Detroit: Become Human, and God of War) and taking systematic notes on game experiences shortly after playing. Results reveal that emotionally moving, reflective, and elevating eudaimonic experiences were elicited when gameplay notes suggested a strong involvement with the game’s narrative and characters (i.e., narrative engagement) and, in some cases, narrative-impacting choices. These key aspects, in turn, are enhanced by clean player interfaces, graphically realistic characters, close camera perspectives, tone-appropriate soundtrack scores, and both narrative-enhancing (e.g., God of War’s health mechanic) and choice-enhancing mechanics (e.g., Detroit: Become Human’s flowchart). Eudaimonic experiences were also found to evolve throughout the game, with more powerful experiences occurring near the end of the game and some narrative themes fueling the eudaimonic flow of experiences throughout the overall game narrative. This study adds to academic research studying digital games by suggesting an innovative methodological approach that provides a detailed, integrative, and dynamic perspective on eudaimonic game experiences.

Researchers, in studies of online news-site commenting, have found a huge number of aggressive comments and have indicated that such comments should be interpreted within the discussion context that other bystanders, such as journalists and other readers, have created. In this study, we aimed to offer insights into bystanders’ reactions to negative news articles and other bystanders’ aggressive comments in the specific context of celebrity news. Therefore, we subjected Flemish celebrity-news articles (N = 69) and the Facebook reactions (N = 5,529) to those articles to a content analysis. First, using a quantitative content analysis, we coded each comment as having a negative, neutral, or positive tone. Next, we conducted a qualitative content analysis, which consisted of a vertical coding phase and a horizontal coding phase, so as to investigate the comments’ content in more depth and to determine which elements resulted in some comments’ negative and even aggressive tone. The results indicate that most readers’ reactions stayed on topic, thus merely contributing to the negative atmosphere that the journalist had already created. However, unlike the journalists, who tended to express their emotions rather subtly, the readers reacted using extreme aggressive language. Furthermore, although these aggressive reader reactions generally seemed to set an aggressive tone for future reactions, some readers broke this aggressive cycle and explicitly disapproved of the aggressive expressions.

Abstract Mass media, especially television, appears to be playing an increasingly important role in selecting and giving names. The media are providing a pool of potential names, associating them with particular social characteristics and presenting some names as more desirable than others. The practice of “naming after stars” illustrates how media can stimulate the use of certain positively-associated names. Negative name stereotypes may be created or confirmed by the media, especially by television drama, which may, consciously or unconsciously, lead to the depopularization of some names.

The use of reflective interfaces has been proposed as a useful strategy to reduce cyber harassment amongst adolescents on social networking sites (SNS). By using machine-learning techniques, harassing online messages can be detected before a user submits it online, whereafter a message prompts the user to reconsider the post. This study builds further upon research focusing on the short-term effectiveness of reflective interfaces in preventing harassment. In this context, though, it is not unlikely that adolescents' user experience with SNS is thwarted when it contains reflective interfaces that might steer their online behaviour. Therefore, this study explores how adolescents evaluate a reflective interface design, in terms of both pragmatic (i.e. functionality, clarity and supportiveness) and hedonic qualities (i.e. autonomy, privacy, self-expression, self-reflection, and pleasure). Moreover, experienced emotions were investigated. In a mixed-method experiment, 24 adolescents (aged 14-16) interacted with a mock SNS with reflective design features. Participants' emotions were observed while interacting on the SNS that prompted a cue (either containing a verbal message or implicit) for each textual harassment attempt. We further investigated the participants' experiences retrospectively while watching the screen capture video of their interaction with the reflective interface, and administered a self-report questionnaire. Findings reveal that adolescents' short-term experiences with SNS in which reflective cues are implemented are not disrupted to a high extent and attitudes are rather positive. Nevertheless, results clearly pointed to a potential fatigue effect in the long-term. Methods to overcome this and alternative options for providing reflective interfaces are suggested.