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Alcohol and sexual arousal are contextual determinants of condomless sex. Dual-process theory postulates that two types of cognitive processing contribute to the regulation of behavior: one that is fast, intuitive and automatic, and another that is slower and deliberative. This study applied a dual-process model to investigate condomless sexual behavior, highlighting the potential importance of implicit attitudes in condomless sex. We investigated whether the impact of alcohol and sexual arousal on condom use-related attitudes and intentions was explained by diminished working memory capacity, as dual-process models suggest. We also investigated whether this effect could be explained by implicit and explicit attitudes toward condom use. Male participants (N = 30) were randomized using a 2 × 2 within-subjects design that manipulated alcohol intoxication (placebo vs. alcohol beverages) and sexual arousal (neutral vs. erotic movie clips). We measured participants’ working memory capacity, intentions to use a condom, and explicit and implicit attitudes toward condom use. Significant main effects of alcohol intoxication and sexual arousal on working memory capacity were found. No significant interaction was found for the combined effect of alcohol intoxication and sexual arousal on intentions to use a condom. There was no significant effect of implicit attitudes on intentions to use a condom, although a trend toward significance (p = 0.06) was found for the effect of implicit attitudes on intentions to use a condom when participants were in a state of alcohol intoxication. Theoretical and practical implications of this study are discussed.

BackgroundIn many countries, HIV pre-exposure prophylaxis (PrEP) users are screened quarterly for STIs. We assessed the consequences of less frequent STI testing. We also assessed determinants of asymptomatic STI and potential for onward transmission.MethodsUsing data from the AMPrEP study, we assessed the proportion of syphilis, and genital, anal, and pharyngeal chlamydia and gonorrhoea diagnoses which would have been delayed with biannual versus quarterly screening. We assessed the potential for onward transmission by examining reported condomless anal sex (CAS) in periods after to-be-omitted visits when screening biannually. We assessed determinants of incident asymptomatic STIs using Poisson regression and calculated individual risk scores on the basis of the coefficients from this model.ResultsWe included 366 participants. Median follow-up was 47 months (IQR 43–50). 1,183STIs were diagnosed, of which 932(79%) asymptomatic. With biannual screening, 483 asymptomatic STIs (52%) diagnoses would have been delayed at 364 study visits. Of these visits, 129 (35%), 240 (66%) and 265 (73%) were followed by periods of CAS with steady, known casual or unknown casual partners, respectively. Older participants had a lower risk of asymptomatic STI (incidence rate ratio (IRR) 0.86/10-year increase, 95% CI 0.80 to 0.92), while CAS with known (IRR 1.36, 95% CI 1.10 to 1.68) and unknown (IRR 1.86, 95% CI 1.48 to 2.34) casual partners and chemsex (IRR 1.51, 95% CI 1.28 to 1.78) increased the risk. The individual risk scores had limited predictive value (sensitivity=0.70 (95% CI 0.66 to 0.74), specificity=0.50 (95% CI 0.48 to 0.51)).ConclusionReducing the STI screening frequency to biannually among PrEP users will likely result in delayed diagnoses, potentially driving onward transmission. Although determinants for asymptomatic STIs were identified, predictive power was low.

COVID-19 and the resulting measures to curb the spread of the virus have significantly changed our lives, including our nutritional choices. In this rapid scoping review an overview is provided of what psychological factors may be associated with peoples' eating behaviour during COVID-19 restrictions. Relevant literature was identified using PubMed, PsycInfo, CINAHL and MEDLINE databases from 2019 onwards. For included studies, information on study characteristics, eating behaviours, and psychological factors were extracted. 118 articles were included, representing 30 countries. Findings indicated that most people consumed more and unhealthy food in times of COVID-19 restrictions, while some consumed less but often for the wrong reasons. Several psychological factors, related to (1) affective reactions, (2) anxiety, fear and worriers, (3) stress and (4) subjective and mental wellbeing were found to be associated with this increase in food consumption. These outcomes may help to be better inform future interventions, and with that, to be better prepared in case of future lockdown scenarios.

Body shaming (BS) is a popular term for a type of negative social interaction, which frequently occurs in social media. However, there is a lack of a clear scientific definition of BS and data on its relation to other concepts in social aggression research. The present study therefore aimed at providing a definition and classification of BS. In an exploratory online-study, 25 participants (60%) provided personal definitions of BS and rated the fit of a suggested definition. In addition, they reported similarities with and differences to related concepts (appearance teasing, cyberbullying, trolling). We conducted qualitative analyses of the verbal definitions guided by the Grounded Theory approach and quantified the fit to existing concepts in the field of social aggression. The results show that BS is perceived as an unrepeated act in which a person expresses unsolicited, mostly negative opinions/comments about a target’s body, without necessarily intending to harm him/her. Still, the target perceives the comments as negative. BS can range from well-meant advice to malevolent insults and it can occur online and offline. Participants saw similarities between BS and appearance teasing. BS can be a tool for trolling and can evolve to cyberbullying with repetition over time. Altogether, BS is a form of social aggression that has a negative impact on individuals. The definition and classification help to investigate BS and its effects on body image and mental health in future research.

INTRODUCTION: Alcohol abstinence remains common among adults globally, although low and middle-income countries are experiencing declines in abstention. The effect of alcohol policies on lifetime abstinence is poorly understood. The International Alcohol Control (IAC) policy index was developed to benchmark and monitor the uptake of effective alcohol policies and has shown strong associations with alcohol per capita consumption and drinking patterns. Uniquely, the index incorporates both policy 'stringency' and 'impact', reflecting policy implementation and enforcement, across effective policies. Here we assessed the association of the IAC policy index with lifetime abstinence in a diverse sample of jurisdictions.METHODS: We conducted a cross-sectional analysis of the relationship between the IAC policy index score, and its components, and lifetime abstinence among adults (15+ years) in 13 high and middle-income jurisdictions. We examined the correlations for each component of the index and stringency and impact separately.RESULTS: Overall, the total IAC policy index scores were positively correlated with lifetime abstinence (r = 0.76), as were both the stringency (r = 0.62) and impact (r = 0.82) scores. Marketing restrictions showed higher correlations with lifetime abstinence than other policy domains (r = 0.80), including restrictions on physical availability, pricing policies and drink-driving prevention.DISCUSSION AND CONCLUSION: Our findings suggest that restricting alcohol marketing could be an important policy for the protection of alcohol abstention. The IAC policy index may be a useful tool to benchmark the performance of alcohol policy in supporting alcohol abstention in high and middle-income countries.

Background: The diet of toddlers is often not in accordance with dietary recommendations, putting them at risk of poor health outcomes later in life. Parents can struggle to provide their toddler with a healthy diet and interventions are needed. Helping parents to form healthy feeding habits may facilitate healthy feeding behaviours. Therefore, the aim of this study was to establish the feasibility of a 6-week online intervention to build healthy feeding behaviours in parents of toddlers.Methods: Parents and primary caregivers of children aged 2-3 (N = 75) were recruited to complete a 6-week online intervention consisting of 6 modules targeting habit formation, planning, goal setting, self-efficacy, interpersonal influences and picky eating. Demographics and feeding behaviours were measured with self-report at baseline and follow-up. Intervention acceptability and feasibility ratings were also gathered post-intervention.Results: Most participants were recruited online, highly educated and in a relationship. After 6-weeks, 17 participants completed the follow-up questionnaire, 11 of whom indicated that they had completed the whole intervention. Improvements were found for some feeding behaviours. Generally, participants who completed the programme reported that they found it acceptable.Conclusions: This study provides insights for future intervention development. Firstly, an online healthy feeding intervention seems to be acceptable but may need to focus on fewer change techniques. Further, engagement should be improved by including target group members and compulsory reminders. The target behaviours seem to be relevant. Online recruitment seems to be preferable and reaches parents and primary caregivers nationwide.

In many countries, HIV infections among MSM (MSMHIV) are closely monitored, and updated epidemiological reports are made available annually, yet the true prevalence of MSMHIV can be masked for areas with small population density or lack of data. Therefore, this study aimed to investigate the feasibility of small area estimation with a Bayesian approach to improve HIV surveillance. Data from the European MSM Internet Survey 2017 (EMIS-2017, Dutch subsample, n=3,459) and the Dutch survey ‘Men & Sexuality-2018’ (SMS-2018, n=5,653) were utilized in this study. We first applied a frequentist calculation to compare the observed relative risk of MSMHIV per Public Health Services (GGD) region in the Netherlands. We then applied a Bayesian spatial analysis and ecological regression to account for variance due to space and determinants associated with HIV among MSM to obtain more robust estimates. Results of the prevalence and risk estimations from EMIS-2017 and SMS-2018 converged with minor differences. Both estimations confirmed that the risk of MSMHIV is heterogenous across the Netherlands with some GGD regions, such as GGD Amsterdam [RR=1.21 (95% credible interval 1.05-1.38) by EMIS-2017; RR=1.39 (1.14-1.68) by SMS-2018], having a higher-than-average risk. Results from our ecological regression modelling revealed significant regional determinants which can impact on the risk for MSMHIV. In sum, our Bayesian approach to assess the risk of HIV among MSM was able to close data gaps and provide more robust prevalence and risk estimations. It is feasible and directly applicable for future HIV surveillance as a statistical adjustment tool.

Background Between March 15 and May 31, 2020, the Dutch government imposed lockdown and health measures to curb the coronavirus disease 2019 (COVID-19) pandemic. As part of social distancing, sexual distancing was one of these measures. Sexual distancing implied refraining from sex with partners outside of one's household. We aimed to elucidate barriers and motives for complying with sexual distancing and related factors that could have led to (non)compliance among men who have sex with men. Methods In this exploratory qualitative study, we interviewed men who have sex with men who visited the center for sexual health in Amsterdam during the first COVID-19 lockdown using a semistructured interview guide from March to May 2020. We interviewed both men who complied and did not comply with sexual distancing. The interviews were transcribed verbatim and analyzed using an open-coding process in MAXQDA. Results We included 18 noncompliers and 4 compliers to COVID-19 sexual distancing. Barriers to compliance were the following: lack of information on, or understanding of, the need for sexual distancing; being single; having had an active sex life before COVID-19; a high perceived importance of the social aspect of sex; a strong urge for sex; using sex to cope with the negative impact of the pandemic; being under the influence of alcohol or drugs; and not perceiving COVID-19 as a serious health threat. Motives for compliance were the following: perceiving COVID-19 as a serious health threat, direct confrontation with critically ill COVID-19 patients, protecting someone dear from COVID-19, and being convinced of the importance of social and/or sexual distancing measures. Conclusions Information on sexual distancing needs to be made more explicit, accessible, understandable, inclusive, customized to individual barriers, and relatable to the key populations. This may improve the effectiveness of measures and health recommendations in both the current COVID-19 pandemic and future respiratory outbreaks.

BACKGROUND: The Kilimanjaro Diabetic Programme used the Intervention Mapping framework to develop a theory- and evidence-based diabetic retinopathy screening programme. A Working Committee of health care workers and stakeholders ensured community engagement and empowerment of the target audience.OBJECTIVES: To deliver a culturally appropriate, sustainable, community supported health intervention, promoting eye health behaviour change, to prevent avoidable blindness.METHODS: The six steps of the Intervention Mapping protocol incorporated eight components: (1) a needs assessment of people with diabetes and health care workers (2) a clinical trial of diabetic retinopathy screening modes, (3) comic strips as a motivational strategy for diabetic retinopathy screening uptake, (4) health care worker education (5) an electronic database of people with diabetes (6) a self-carry diary (7) implementation of mobile diabetic retinopathy retinal screening (8) process and outcome programme evaluation.RESULTS: The programme eliminated barriers to diabetic retinopathy screening in Kilimanjaro Christian Medical Centre eye and diabetic clinics, placing a digital retinal screening camera in the diabetic clinic and a fast-track screening system in the eye clinic. Two comic strips and a diary provided information about self-management and record of medications, treatment, blood sugar and blood pressure at clinic visits. An annual rural health care worker education programme met requests for knowledge on treatment and care of diabetes, targeting prevention of diabetic retinopathy. Rural digital retinal screening was implemented. Rural diabetes clinics were initiated.CONCLUSIONS: Intervention Mapping provided a systematic, iterative model to formulate and deliver an urban and rural diabetic retinopathy screening programme.TRIAL REGISTRATION NUMBER: ISRCTN31439939. Details available at https://www.isrctn.com/.

In the present study, we reason that the ability to keep unwanted thoughts and intrusions at bay – thought control ability – might explain part of the relationship between trait self-control and positive psychological outcomes. We predict that the ability to keep unwanted thoughts at bay causes people high in trait self-control to report higher subjective well-being (Study 1), and makes them to be more likely to cope with stressful life events in an adaptive rather than maladaptive manner (Study 2). Two cross-sectional studies among healthy individuals were conducted (Study 1 n = 284; 70% female; Mage = 22.15 years; Study 2 n = 210, 65.7% female, Mage = 28.07) in which trait self-control, thought control ability, subjective well-being (study 1), and coping styles (study 2) were measured. Additionally, we investigated the mediating role of thought control ability and the conditional effect of gender on this mediation. The results of Study 1 indicate that trait self-control is positively related to subjective well-being. Moreover, thought control ability fully mediated the relationship between trait self-control and subjective well-being, and this effect was particularly strong for women. In Study 2, trait self-control was positively associated with adaptive forms of coping, but negatively with maladaptive coping. Moreover, thought control ability partially mediated the relationship between trait self-control and both types of coping, with stronger results for women than for men. These results suggest that trait self-control affects positive life outcomes in part through an ability to keep unwanted thoughts at bay, thereby facilitating a focus on goal pursuit.

In South Africa, lay HIV counsellors are at the forefront of many HIV-related behavioural interventions. However, they have limited formal counselling training and little ongoing in-service support, leading to considerable variability in approaches to counselling. We describe the use of Intervention Mapping to develop a motivational interviewing counselling training and support program, titled “Thusa-Thuso - helping you help”, for lay HIV counsellors practising in primary health care clinics in South Africa. The program is contextually relevant, locally-produced, scalable, and is designed to impart sustained motivational interviewing counselling skills in lay HIV counsellors for improved antiretroviral therapy (ART) uptake in the universal-test-and-treat era.

The development of diverse and inclusive workforces is increasingly being prioritized by organizations. However, organizations often struggle to adequately address the unique issues faced by transgender and nonbinary (TNB) people, and this can result in workplace discrimination, with deleterious consequences on employees' job attitudes and behavior, and their well-being. Co-worker and organizational support may play an important role for TNB employees' job attitudes and behavior. In an online survey with 225 TNB employees, we investigated how perceived co-worker support relates to job attitudes and work behavior, specifically job satisfaction, affective commitment, turnover intentions, job anxiety, and counterproductive work behavior. We also investigated whether these relationships were mediated by perceived organizational support. We found significant associations between perceived co-worker support and all job attitudes and work behavior. We also found that all of these relationships were mediated by the extent to which the organization was considered supportive. The findings thus suggest that companies should focus on supporting TNB employees at both the organizational and interpersonal level.Public Significance Statement Perceived organizational and co-worker support interact and jointly promote positive job attitudes and work behavior in TNB employees, namely more job satisfaction and affective commitment, and less turnover intentions, job anxiety, and counterproductive work behavior. Companies should thus focus on supporting TNB employees at both the organizational and interpersonal level.

Nowadays the prediction and change of waste-related behaviors represent a key topic for scholars and policy makers. The theoretical mainstays applied to waste separation behavior, such as the Theory of Planned Behavior (TPB), the Norm Activation Model and the Value Belief Norm, do not include the construct of goal in their formulation. Other goal-focused theories, such as the Goal Systems Theory (GST), lack applications on separation behavior. Recently, Ajzen and Kruglanski (2019) have proposed the Theory of Reasoned Goal Pursuit (TRGP) which combines TPB and GST. Considering TRGP has the potential to offer further insights on human behavior and, to our knowledge, there is no application of TRGP to recycling behavior yet, this paper analyses waste separation behavior of households in Maastricht and Zwolle (The Netherlands) under the lens of TRGP. Although waste separation behavior represents a kind of habitual behavior, this paper highlights the influence of goals and motivation on intention to separate waste. Furthermore, it offers some indications to promote behavior change and some suggestions for future research directions.

Background The present study is the first step of a 3-year European project in which a tailored smartphone application will be developed and tested as a potential tool in the personalized treatment of children and adolescents with overweight. Methods In this study, 10 focus groups (n = 48 participants) were conducted in Belgium, The Netherlands and France with adolescents with overweight (12–16 years; n = 30) and parents of adolescents with overweight (n = 18) to investigate their perceptions on (un)healthy behavior, the drivers of these behaviors, and the needs of an eHealth application for weight loss. A thorough thematic analysis was performed using Nvivo12. Results Results show that adolescents with overweight have a well-articulated perspective on (un)healthy behavior and their needs. Parents underestimate their own influence on the (un)healthy behavior of their children and report difficulties in healthy lifestyle parenting, which makes their role as a coach rather ambiguous. Concerning the needs of an eHealth application, both parents and adolescents formulated some challenging expectations regarding the content and the format including information, a monitoring feature and features that increase participants’ motivation to behave healthy. The results of this analysis will form the basis for designing a personalized eHealth application, which will be tested in a next phase. Conclusion We can conclude that adolescents have a well-articulated perspective on healthy and unhealthy behavior and their needs, whereby a new app could be of great help. It could function as a day-by-day diary and as a supportive coach.

Background Women who are susceptible to rubella are advised to vaccinate against rubella to prevent infection in future pregnancies, and thus avert the risk of congenital rubella syndrome in their unborn child. Rubella outbreaks periodically occur in the under-vaccinated orthodox Protestant community in the Netherlands. The objective of this mixed-methods study was to determine and understand personal experience with rubella, perceived rubella susceptibility, and intention to accept rubella screening and vaccination among unvaccinated orthodox Protestant women. The ultimate aim of this study was to inform policy and practice and contribute to the prevention of cases of congenital rubella syndrome. Methods A mixed-methods study was conducted combining an online survey and semi-structured interviews among unvaccinated Dutch orthodox Protestant women aged 18–40 years. Descriptive analysis was used for quantitative data. Qualitative data was analysed using codes and categories. Results Results of the survey (167 participants) showed that most participants had personal experience with rubella (74%, 123/167) and 101 women (61%, 101/167) indicated they had had rubella themselves. More than half of the women were undecided whether to accept rubella susceptibility screening (56%; 87/156) or rubella vaccination (55%; 80/146). Qualitative findings (10 participants) showed that most women thought they were not susceptible to rubella. Indecisiveness and negative attitudes to accept rubella vaccination were related with religious arguments to object vaccination and with women’s perception of absence of imminent threat of rubella. Furthermore, results showed presence of misconceptions among women in the interpretation of their susceptibility and high confidence in their parents’ memory that they had experienced rubella as a child although no laboratory screening had been conducted. Conclusions In light of an imminent rubella outbreak in the Netherlands, a tailored education campaign should be prepared aimed at and established in cooperation with the under-vaccinated orthodox Protestant community. Health care providers should provide adequate information on rubella and support decision-making in order to stimulate women to make a deliberate and informed decision on rubella screening and, if necessary, subsequent vaccination.

Permissive beliefs are considered the most proximal predictor of actual behavior. Whereas they have frequently been researched in substance-use disorders, the field of social networking sites (SNS) use is missing the investigation as to how relevant permissive beliefs might be in this context, what might be causal precursors of permissive beliefs (i.e., desire thinking), and which processes might influence the effect that permissive beliefs have on actual behavior (i.e., self-control). To answer these questions, 116 people who use SNS participated in an online survey that contained an experimental manipulation of desire thinking and questionnaires measuring permissive beliefs, self-control, and severity of problematic SNS use. In a one-week follow-up, 85 participants reported their SNS usage times. Results showed that the association between permissive beliefs and tendencies to use SNS problematically was not significant. The experimental manipulation led to a decrease in permissive beliefs in the control condition, but did not increase permissive beliefs in the desire thinking condition. Permissive beliefs predicted SNS use in the follow-up assessment, which was not moderated by self-control. The results suggest that permissive beliefs seem to be unrelated to addictive tendencies of SNS use, but are nevertheless associated with daily use. Desire thinking does not appear to activate permissive beliefs in this study, possibly because the use of social networks is less often experienced as conflicting. Due to its ubiquitous availability, the use of social networks itself might quickly resolve the conflict between desires and possible regulatory attempts, making good reasons for use unnecessary.

Background Adolescents should have access to high quality and responsive sexual and reproductive health, however, it is unclear to what extent the national policy on health and development of adolescent is implemented by health care workers in Plateau State. This study assessed the general availability of sexual and reproductive health services, the delivery of responsive adolescent sexual and reproductive health services and health care worker?s understanding of what constitutes adolescent responsive sexual and reproductive health services. Methods Using a cross sectional design, we interviewed 409 health care workers selected through a multistage sampling technique, across six Local Government Areas of Plateau State, Nigeria using an interviewer-administered survey questionnaire. Results The most available sexual and reproductive health services was antenatal and delivery care (69.2%), contraception 25.9% and 14.9% reported post abortion care. Only 1.2% indicated the availability of the four recommended essential sexual and reproductive health services (counselling/information provision, provision of contraceptives, testing/treatment for sexually transmitted infection (STI) /HIV and post abortion care) in their facilities. Little over half (58.4%) felt their facilities were adequate in meeting the sexual and reproductive health needs of adolescent and this was associated with delivery of post abortion care (AOR=3.612; CI=1.886-6.917; p = .001) and providing sexual and reproductive health services to adolescents without parental consent (AOR=3.612; CI=1.886-6.917; p = .001). Most health care workers had poor understanding of adolescent responsiveness of sexual and reproductive health services, understanding better among health workers who provided services without parental consent and in a separate room for privacy and confidentiality. Conclusion We conclude that adolescent sexual and reproductive health services is not yet as stipulated in the national policy in Plateau State, Nigeria and in general, health workers have poor understanding of what it means to provide adolescent-responsive services.

Do social networking sites (SNSs) influence well-being? According to the active-passive model of SNS use, the impact of SNSs on well-being depends on how they are used: Using SNSs actively to interact with other users positively affects well-being, whereas passive consumption of SNS content negatively affects well-being. However, emerging evidence suggests that the active-passive distinction is too coarse to fully capture the relationship between SNS use and well-being. Here we describe the extended active-passive model of SNS use, which refines the original model in three ways: It decomposes active use, decomposes passive use, and crosses usage types with user characteristics. We describe recent empirical evidence illustrating the benefits of these three extensions and highlight important future research directions. The extended active-passive model of SNS use provides a nuanced understanding of the relationship between SNS use and well-being by highlighting that active use of SNSs is not always beneficial and passive use is not always detrimental.

Experimental tests of interventions need to have sufficient sample size to constitute a robust test of the intervention's effectiveness with reasonable precision and power. To estimate the required sample size adequately, researchers are required to specify an effect size. But what effect size should be used to plan the required sample size? Various inroads into selecting the a priori effect size have been suggested in the literature-including using conventions, prior research, and theoretical or practical importance. In this paper, we first discuss problems with some of the proposed methods of selecting the effect size for study planning. We then lay out a method for intervention researchers that provides a way out of many of these problems. The proposed method requires setting a meaningful change definition, it is specifically suited for applied researchers interested in planning tests of intervention effectiveness. We provide a hands-on walk through of the method and provide easy-to-use R functions to implement it.

In this conceptual analysis, we theorise breastfeeding as an embodied ‘dirty’ performance of femininity and draw on Hoskin’s (2019a) work on femme theory to propose that women who breastfeed in public, who do so for an ‘extended’ time, and who enjoy it are subject to femmephobic attacks. We integrate three streams of literature to unsettle the ‘taint’ of breastfeeding. We first theorise breastfeeding as an act of femininity where women perform gender trouble in line with Butler's work. We also draw on Douglas’ work on ‘dirt’ and Rivera’s work on emotional ‘dirty’ work to theorise that ‘taint’ is one way in which society stigmatises the phenomenon of breastfeeding. Specifically, we propose that embodied breastfeeding evokes ‘tainted’ emotions. We then draw on Schippers’ work on ‘containing’ pariah forms of femininity (lest they ‘contaminate’ patriarchy) by showing how femmephobic stigmatisation limits breastfeeding women’s corporeality and presence in shared spaces.

A publicized series of police (and other) violence against unarmed Black people over the last decade has fueled unprecedented mass protest as well as political and policy debate in the United States, and beyond. Given this ethical dispute over whether democratic society upholds its cardinal values of freedom and equality for all, sentiment toward Black Lives Matter is suggestive of what people believe police killings, and protest against them, say about the state of democracy itself. In this review, we use the latest empirical evidence in psychology and related sociobehavioral sciences to document sentiment regarding Black Lives Matter. Because continuing racial inequity is a foundational assumption of Black Lives Matter, we will also review the most relevant studies of attention to, knowledge of, and beliefs and feelings about police violence and related acts and issues that may be viewed as indicating racial inequity. Much of this work shows a dramatic divergence of sentiment across racial and political lines, as increased social and political polarization and insulation evidences in divergent attention, cognition, affect, emotion, motivation, and action regarding relevant events and social issues. In this way, examinations of the psychology of such sentiment reveal just how deep the social and political rifts run in society.

Adherence to antiretroviral therapy (ART) remains an important factor in HIV prevention and treatment efforts. We explored the individual and environmental factors influencing antiretroviral adherence among PLWH in Ghana. This study used 20 semi-structured in-depth interviews and three focus group discussions (FGD) involving 29 PLWH attending one of three antiretroviral clinics. Thematic analysis covered experiences of PLWH clinic visits, knowledge, attitudes, self-efficacy related to ART adherence, psychological wellbeing and stigma. The findings suggest that both individual and environmental factors including treatment outcome, coping skills, disclosure, self-regulation, healthcare-provider interaction, family and partner support, organization of ART clinics, stigma, and transportation cost influenced treatment adherence. Interventions that empower PLWH and reduce HIV-related stigma in the community will most likely support antiretroviral adherence. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Objective: To examine how White Americans’ in-group identification and belief in systemic racial injustice affects reactions to (peaceful vs. destructive) Black Lives Matter (BLM) protest. Method: In the aftermath of the killing of George Floyd in summer 2020, White Americans (N = 399) were randomly assigned to view pictures of either peaceful (marches, sit-ins) or destructive (of property) BLM protests. Ethnic in-group identification and belief in systemic racial injustice were examined as important individual differences that should moderate views of protest (controlling for political orientation). Results: Among Whites lower in belief in systemic racial injustice, there was little support for BLM protest or racial redress, regardless of other factors. In contrast, support among those with greater belief in systemic racial injustice varied as a function of in-group identification and the form of protest. Lower identified Whites endorsed peaceful and destructive Black protest about equally, whereas higher identified Whites supported peaceful Black protest more than destructive protest. This pattern of results did not extend to support for systemic efforts at racial redress. Conclusions: Findings suggest (a) that belief in systemic racial injustice is a prerequisite for White support of BLM protest; (b) but that such support is undermined among highly identified Whites if the Black protest is destructive; (c) and that reactions to protest do not necessarily extend beyond views of protest to views regarding systemic efforts at racial redress, including reform of the police.

To improve sexual health among people living with HIV, sexual health should be addressed during consultations in routine HIV care. The aim of the present study was to investigate to what extent Sexual Health Counselling (SHC) is incorporated into routine Dutch HIV care and to explore differences between physicians and nurses in their practices and views regarding SHC. A cross-sectional survey was conducted among all HIV physicians (N=110) and HIV nurses (N=82) in the Netherlands. A questionnaire assessed socio-demographic characteristics, current SHC practice, topics addressed, and factors associated with engaging in SHC. The response rate was 53.6% (N=59) among physicians and 60.0% (N=40) among nurses. SHC was performed by 26.1% of physicians and 83.9% of nurses (Χ² (1) = 27.68, p

BACKGROUND: Behavior change interventions have a vital role in enhancing human health and well-being. Nevertheless, concerns have been raised about suboptimal reporting of behavior change interventions, making analyses, replications, and intervention re-use hard or impossible to conduct.OBJECTIVE: This paper introduces acyclic behavior change diagrams (ABCDs) to achieve more transparent development, evaluation, and reporting of behavior change interventions. ABCDs are a visual representation of the assumptions regarding causal-structural chains that underlie putative active ingredients of behavior change interventions. These causal-structural chains link the behavior change principles that are applied in an intervention to the (determinants of) behavior targeted in that intervention.CONCLUSIONS: ABCDs are helpful in making implicit assumptions explicit and help communicate assumptions with team members and other stakeholders. Moreover, we believe they make evaluation easier, and their machine-readability allows for ABCDs to be imported directly into (systematic review) databases with negligible costs while disclosing complete and accurate data. Finally, the ABCD approach fits well with other initiatives to gain a deeper understanding and synthesis of the literature on active intervention elements.

Research supports the hypothesis that people with a positive body image engage in a cognitive process of protective filtering, whereby positive information is "filtered in" and negative information is "filtered out" to promote and maintain positive body image (Wood-Barcalow et al., 2010). To provide more insight into this process, this study qualitatively explored the experiences of young women self-identifying as having a positive body image (N = 20, Mage = 21.00) when they were exposed to beauty-ideal imagery. Participants wrote down their thoughts during beauty-ideal exposure on Instagram, and were interviewed. Via reflexive thematic analysis, we identified four themes concerning the protective filtering strategies the participants described using: (a) critiquing the beauty ideal/imagery; (b) appreciating their own/other's bodies; (c) focusing on the values and personality of the women in beauty-ideal imagery; (d) linking beauty-ideal imagery with its past negative consequences. Participants described factors contributing to the effectiveness of their protective filtering, and advice for others to foster positive body image. Overall, many of the protective filtering strategies overlapped with key characteristics of positive body image. Future research may examine whether deliberately "activating" these characteristics in the face of body image-threats could protect and promote positive body image among other women as well.

We examine whether information about a female candidate’s relationship history, obtained from social media profiles, affects evaluations of her suitability for a student union board position. Moreover, we investigate whether it is possible to mitigate any bias against women with multiple partners by providing information about the origins of prejudice. We utilized a 2 (relationship history: multiple vs. one partner(s)) X 2 (mitigating information: explaining prejudice against promiscuous women vs. explaining prejudice against outgroups) experimental design across two studies. Participants were female students (Study 1: n = 209 American students; Study 2; n = 119 European students), who indicated whether they would hire the applicant for a job, and evaluated this applicant. Results show that generally, participants tended to evaluate the candidate with multiple partners less positively than the candidate with only one partner: They were less likely to hire her (Study 1), evaluated her less positively (Study 1), and considered her less of a fit with the organization (Study 1 and 2). The results regarding providing additional information were not consistent. Our findings suggest that private social media information can influence applicant evaluations and hiring decisions, and therefore organizations should be careful when utilizing social information in recruitment processes.

HIV treatment adherence in Indonesia is a major challenge. Although previous studies have demonstrated several barriers and facilitators to adherence, studies providing a comprehensive analysis from both PLHIV and HIV service providers’ perspectives are limited, especially in Indonesia. In this qualitative study with 30 people living with HIV on treatment (PLHIV-OT) and 20 HIV service providers (HSPs), we explored, via online interviews, the barriers and facilitators to antiretroviral therapy (ART) adherence using a socioecological approach. Both PLHIV-OT and HSPs reported stigma as a major barrier at each socioecological level, including public stigma at the societal level, stigma in healthcare settings, and self-stigma at the intrapersonal level. Stigma reduction must therefore be prioritized. PLHIV-OT and HSPs also reported support from significant others and HSPs as the foremost facilitators to ART adherence. The enablement of support networks is thus an important key to improved ART adherence. Overall, the societal level and health system barriers to ART adherence should be addressed in order to remove barriers and enhance the facilitators at the subordinate socioecological levels.

IntroductionUnderstanding the individuals' willingness to pay (WTP) for the COVID-19 vaccine could help design policy interventions to control the COVID-19 pandemic. This study aimed to estimate the individuals' willingness to pay (WTP) for a COVID-19 vaccine and to identify its associated determinants.MethodsA cross-sectional survey was conducted on 526 Iranian adults using a web-based questionnaire. A double-bounded contingent valuation approach was used to estimate WTP for the COVID-19 vaccine. The parameters of the model were estimated based on the maximum likelihood method.ResultsA considerable proportion of participants (90.87%) were willing to pay for a COVID-19 vaccine. Based on our discrete choice model, the estimated mean WTP for a COVID-19 vaccine was US$ 60.13 (CI: 56.80–63.46; p < 0.01). Having a higher perceived risk of being contaminated with COVID-19, higher average monthly income, higher education level, pre-existence of chronic diseases, previous experience of vaccination, and belonging to higher age groups were significant determinants associated with WTP for COVID-19 vaccination.ConclusionThe present study indicates a relatively high WTP and acceptance of a COVID-19 vaccine among the Iranian population. Average monthly income, risk perception, education level, the preexistence of chronic disease, and previous vaccination experience increased the likelihood of WTP for a vaccine. Subsidizing the COVID-19 vaccine for the low-income population and raising risk perception among the population should be considered in formulating vaccine-related interventions.

OBJECTIVE: To assess whether cognitive reappraisal and acceptance are effective emotion regulation strategies to decrease the influence of negative affect on intention to accept maternal pertussis vaccination (MPV) among pregnant women in the Netherlands.METHODS: An experimental study with baseline and two follow-up measurements was conducted. Participants selected after baseline (N = 382) were randomized into two experimental groups (cognitive reappraisal, acceptance) and a control group. The effect of the experimental manipulations on negative affect was examined with multilevel analyses. A moderation analysis was performed to examine whether the manipulations moderated the association between negative affect and intention.RESULTS: All groups showed a decrease in negative affect (all p's < 0.001), with no differences between groups. A small decrease in the influence of negative affect on intention was found among those who used acceptance.CONCLUSION: No additional value of the emotion regulation strategies was found compared to the control group. However, exploratory analyses showed that acceptance seemed a promising strategy to decrease the influence of negative affect on intention to accept MPV.PRACTICE IMPLICATIONS: This study stressed the relevance for communication strategies to consider the emotions pregnant women experience during the decision-making process about the MPV.

Driving simulator data can be sampled in function of distance (equally spaced) or time (with constant frequency). Consequently, the sampling data might have problems in the envisaged type of analysis (i.e. point location based analysis vs. zonal-based analysis). These issues are illustrated by means of five driving simulator datasets. The nearest sampled parameter value in the direct vicinity of the specific point is a very good proxy for the driving parameter value at the point of interest along the road. The analysis of driving parameters in zones requires a different approach. In summary, the interpolation technique is preferred over using raw sampled data to calculate mean parameter values. We introduce an equivalent time integral formula to compute the mean value of a driving parameter with respect to distance. Based on this paper, we demonstrate that it is very important to mention the data processing approach in driving simulator methodology.

Background In the earlier developed and evaluated 12-week UPcomplish intervention, the aim was to reduce sedentary behaviour (SB) among office workers and increase their quality of life (QoL). In the current study, we explored moderators of effectiveness. Method We applied a stepped wedge design with five intervention groups starting with time lags of seven weeks (n = 142, 96 females). Participants wore the VitaBit to continuously measure SB and received surveys about QoL and psychosocial determinants at the beginning, middle, and end of the intervention. We regressed baseline participant characteristics and behaviours onto intra-individual improvements (centred around calendar week means) in determinants, SB, performance objectives, and QoL. Results Those scoring high in baseline intention, task performance, stress, vitality, and emotional well-being improved less in these variables. Baseline stress (β = − 0.05 [SE = 0.01; 95% CI = − 0.08, − 0.02; pcorrected = .02]) and emotional well-being (β = 0.02 [SE = 0.01; 95% CI = 0.01, 0.03; pcorrected = .02]) were associated with improvement in contextual performance. Baseline attitude (β = − 12.92 [SE = 3.93; 95% CI = − 20.80, − 5.04; pcorrected = .02]) and perceived behavioural control (PBC; β = − 9.27 [SE = 3.04; 95% CI = − 15.37, − 3.16; pcorrected = .03]) were negatively associated with improvements in emotional well-being. Post hoc analyses with a sub-group scoring lower in determinants revealed that improvement in PBC was positively associated with SB registration. Conclusion Participants scoring low in baseline determinants might profit from UPcomplish via an increase in PBC. In combination with changes within organizations (e.g. the implementation of standing desks), UPcomplish might potentially reduce SB. Trial Registration NL7503 — registered 1 February 2019.

Background: Epistemic Network Analysis (ENA) is a unified, quantitative - qualitative method aiming to draw from both methodological worlds by leveraging a data set containing raw and quantified qualitative data, as well as metadata about data providers or the data itself. ENA generates network models depicting the relative frequencies of co-occurrences for each unique pair of codes in designated segments of qualitative data.Methods: This step-by-step tutorial demonstrates how to model qualitative data with ENA through its quantification via coding and segmentation. Data was curated with the Reproducible Open Coding Kit (ROCK), a human- and machine-readable standard for representing coded qualitative data, enabling researchers to document their workflow, as well as organize their data in a format that is agnostic to software of any kind.Results: ENA allows researchers to obtain insights otherwise unavailable by depicting relative code frequencies and cooccurrence patterns, facilitating a comparison of those patterns between groups and individual data providers.Conclusions: ENA aids reflexivity, moves beyond code frequencies to depict their interactions, allows researchers to easily create posthoc groupings of data providers for various comparisons, and enables conveying complex results in a visualization that caters to both qualitative and quantitative sensibilities.

Social media are popular among adolescents worldwide, including the global South. The way adolescents use social media is influenced by their own perception of social media but also by how their parents use and perceive social media. This study aims to understand how Indonesian young adolescents (12–15 years old) and parents of adolescents use and perceive social media. For this purpose, we conducted eight focus group discussions and eight semi-structured interviews with 30 Indonesian adolescents and 15 Indonesian parents. Thematic analysis of the qualitative data reveals that both adolescents and parents use social media for social, practical, and pleasure activities. Most adolescents mention that they consider themselves skilled in using social media, while parents consider themselves less skilled. Both adolescents and parents mention that social media offer benefits for adolescents, including emotional, social, and practical benefits. However, adolescents and parents also mention the risks of social media use for adolescents, including social, emotional, and informational risks, as well as the displacement of more meaningful activities. As such, both adolescents and parents do not perceive social media as inherently good or bad but rather as a novel medium that offers benefits for adolescents but also involves several risks to be considered by parents and other relevant stakeholders. This study adds to our understanding of social media use in the global South and offers a theoretical basis for future studies on the impact of adolescents’ social media usage on wellbeing in an Indonesian context. However, future research is necessary to depict possible differences in social media use between Indonesia and other countries in the global South.

Road traffic crashes have emerged as the new public health threat in India and many other developing countries. With a population of nearly 1.37 billion people, India now faces the worst-ever road congestion in most cities and towns, and Indian roads have become more vulnerable to road crashes. Young MTW (motorized two-wheelers) riders are more vulnerable to road crashes due to a lack of experience in comprehending, assessing and responding to hazards. Young riders in the age range of 18-25 years contribute to more than half of total fatal crashes. The current research was based on the Indian university town of Manipal with a sizeable young student population in this age range. Manipal is home to the Manipal Academy of Higher Education (MAHE), and it hosts approximately 30,000 young students from all across India and 60 countries all over the world. The overall aim of this dissertation is to understand the risky riding behaviour among young, motorized two-wheelers in Manipal, Karnataka, India. A comprehensive understanding of these factors is necessary, given that little is known about risky riding behaviour and its psychological implications in India. Furthermore, the resulting information can inform interventions to promote less risky or safer riding among young motorized two-wheelers in Manipal and similar settings.

Background HIV testing among patients with malignant lymphoma (PWML) is variably implemented. We evaluated HIV testing among PWML, and mapped factors influencing hematologists’ testing behavior. Materials We conducted a mixed-methods study assessing HIV testing among PWML, factors influencing HIV testing and opportunities for improvement in five hospitals in the region of Amsterdam, the Netherlands. The proportion of PWML tested for HIV within 3 months before or after lymphoma diagnosis and percentage positive were assessed from January 2015 through June 2020. Questionnaires on intention, behavior and psychosocial determinants for HIV testing were conducted among hematologists. Through twelve semi-structured interviews among hematologists and authors of hematology guidelines, we further explored influencing factors and opportunities for improvement. Findings Overall, 1,612 PWML were included for analysis, including 976 patients newly diagnosed and 636 patients who were referred or with progressive/relapsed lymphoma. Seventy percent (678/976) of patients newly diagnosed and 54% (343/636) of patients with known lymphoma were tested for HIV. Overall, 7/1,021 (0.7%) PWML tested HIV positive, exceeding the 0.1% cost-effectiveness threshold. Questionnaires were completed by 40/77 invited hematologists, and 85% reported intention to test PWML for HIV. In the interviews, hematologists reported varying HIV testing strategies, including testing all PWML or only when lymphoma treatment is required. Recommendations for improved HIV testing included guideline adaptations, providing electronic reminders and monitoring and increasing awareness. Conclusions Missed opportunities for HIV testing among PWML occurred and HIV test strategies varied among hematologists. Efforts to improve HIV testing among PWML should include a combination of approaches.

Väitekirja elektrooniline versioon ei sisalda publikatsioone, Doktoritöö kaitsmine toimub Maastrichti Ülikoolis, Nutitelefonide ja sotsiaalmeedia suhtlusvõrgustike (SM) levikuga on nii akadeemilistes ringkondades kui ka väljaspool kaasnenud mure, et need digitaalsed kommunikatsioonitehnoloogiad võivad negatiivselt mõjutada kasutajate vaimset tervist. Sel põhjusel on viimase kahe aastakümne jooksul tehtud palju uuringuid mõistmaks kuidas need digitaalsed kommunikatsioonitehnoloogiad mõjutavad kasutajate vaimset tervist. Varasemad uuringud on keskendunud peamiselt üldisele ajale, mille inimesed veedavad nutitelefone ja SM-e kasutades. Need uuringud on andnud erinevaid tulemusi ja meta-analüüsid on näidanud, et keskmiselt on nutitelefoni ja SM-i kasutamise mõju vaimsele tervisele negatiivne, kuid väike. Kuid üldisele kasutusajale keskendumine ei võta arvesse (1) kasutustüüpe, (2) kasutaja omadusi ja (3) erinevust digitaalsete kommunikatsioonitehnoloogiate mitte-probleemse ja probleemse kasutamise vahel ega ka seda kuidas need kolm aspekti koos toimivad kasutajate vaimsele tervisele. Käesolev väitekiri käsitleb neid kolme peamist piirangut ja suurendab meie arusaamist sellest olulisest küsimusest. Esiteks näitab doktoritöö, et erinevad SM-i (nt aktiivne versus passiivne) ja nutitelefonide (nt sotsiaalne versus mittesotsiaalne) kasutustüübid on vaimse tervisega erinevalt seotud. Teiseks näitab töö, et need seosed erinevad kasutajate lõikes süstemaatiliselt ja tuvastab samuti nende seoste juures olulist rolli mängivad ohutegurid (nt neurootilisus). Kolmandaks selgitab doktoritöö ka otsesed ja kaudsed seosed nende ohutegurite, digitaalsete kommunikatsioonitehnoloogiate probleemse kasutamise ja vaimse tervise näitajate vahel. Kokkuvõttes näitab käesolev doktoritöö, et digitaalsete kommunikatsioonitehnoloogiate mõju vaimsele tervisele on keeruline ja sõltub digitaalsete kommunikatsioonitehnoloogiate kasutusviiside ja kasutajate omaduste vastastikusest interaktsioonist., The rise of smartphones and social networking sites (SNS) has been accompanied by concerns inside and outside academia that these digital communication technologies negatively influence mental health. For this reason, much work has been done in the past two decades to understand how these digital communication technologies impact mental health. Past research predominantly focused on the amount of time people spend using smartphones and SNS. This yielded mixed findings and meta-analyses revealed that, on average, the effect of smartphone and SNS usage on mental health is negative but small. However, focusing on overall usage time does not take into account (1) usage types, (2) user characteristics, and (3) the distinction between non-problematic and problematic usage of digital communication techno¬logies, and how the interplay between these three aspects impacts mental health. The present dissertation addresses these three key limitations and enhances our understanding of this pressing matter. First, this dissertation shows that different usage types of SNS (e.g., active versus passive) and smartphones (e.g., social versus non-social) are differentially related to mental health. Second, it demonstrates that these relationships differ systematically across users and identifies vulner¬ability factors in these relationships (e.g., neuroticism). Third, this dissertation also clarifies the complex direct and indirect relationships between these vulnerability factors, problematic usage of digital communication technologies, and mental health outcomes. Overall, this dissertation demonstrates that the impact of digital communication technologies on mental health is complex and depends on an interaction between usage types and user characteristics., https://www.ester.ee/record=b5543436

This PhD project, initiated in September 2020, aimed to support the Maastricht University Board in addressing the COVID-19 pandemic. The project can be divided into three periods. From September to December 2020, studies were conducted with students to understand their adherence to COVID-19 guidelines and the factors influencing their compliance. The goal was to develop an intervention to support students in adhering to the university's guidelines. Between January and July 2021, a study focused on students' vaccination intentions, leading to the development of an intervention to support them in their vaccination decisions. From May to September 2021, a study explored the safety feelings of university employees regarding their return to campus in September, resulting in an intervention addressing their concerns and providing information for the upcoming academic year. Overall, the project aimed to tackle the challenges posed by the pandemic within the university community.

Background Partner notification (PN) after a sexually transmitted infection (STI) diagnosis is being promoted as a means to interrupt transmission chains. We investigated whether Internalised Homonegativity (IH) is associated with PN among men having sex with men (MSM). Methods PN, defined as notifying at least one partner after diagnosis of syphilis and gonorrhoea, was queried in two internet-based self-completion surveys conducted between Oct 2017 and May 2018 in 68 countries in Europe, Latin America, Canada, and the Philippines. IH is defined by a man’s level of agreement or disagreement with negative social beliefs about male homosexuality. Covariates included in a multivariate regression model with a random intercept at country level were age, HIV diagnosis, partnership status, sexual self-efficacy, HIV serostatus communication during last sex with a non-steady partner, place where this partner was met, and PN-related socio-historical background of the country of residence. We grouped countries in three areas: North- and Central-Western European countries plus Canada, former socialist countries, and Latin-American/Mediterranean countries plus the Philippines. In each of the three areas individuals were assigned to 4 subgroups based on IH quartiles and PN rates were determined for each subgroup. Results PN rates were calculated for 49 countries (excluding countries with less than 10 diagnoses). Mean proportions of MSM notifying their partners were 68.1% and 72.9% after syphilis and gonorrhoea diagnoses, respectively. PN rates were lower in Latin American countries and the Philippines compared to European countries. Within Europe, a North–South divide with lower PN rates in Mediterranean countries was observed. In each of the three regions we mostly observed a stepwise increase of PN rates with decreasing IH. Regression analysis showed lower IH scores associated with higher PN rates. Higher perceived self-efficacy, living in a partnership, and HIV status communication were positively associated with PN. Men who had met their last partner in a gay social venue were more likely to have notified their partners of a syphilis diagnosis compared to men who had met this partner online. Men with diagnosed HIV were less likely to report PN. Conclusions We could demonstrate that IH was associated with PN among MSM across all countries included in our analysis. Reducing cultural homophobia and ensuring inclusive policies may contribute to STI prevention and control.

Background. Older adults are a high-risk group when it comes to fire in their homes. In this study we aimed to identify the most important predictors of fire safe behaviours among older adults. Methods. A questionnaire, consisting of 42 questions, was used to measure social cognitive determinants of fire safe behaviours. Findings. The findings showed that most respondents reported performing fire safe behaviours in their homes, in particular not connecting powerstrips to each other and cleaning the dryer lint filter. However, older adults do not feel very susceptible to the risk of residential fires as indicated by low scores on risk perception and susceptibility. Perceived behavioural control, attitude and response efficacy were found to be determinants that have unique contributions to the explanation of fire safe behaviours. In addition, this research showed that older adults perceive the emergency services, people who have experienced a house fire themselves, the municipality, and housing companies as reliable sources of communications about home fire prevention. Conclusion. The findings suggest that perceived behavioural control, attitude and response efficacy are important target variables for future interventions promoting fire safe behaviour among older adults. background.

The majority of adolescents communicate via text-based messaging, particularly through WhatsApp, a widely used free communication application. Written content on WhatsApp has the methodological potential to provide rich qualitative interview data. This study compares data collected using text-based WhatsApp versus face-to-face interview techniques. Semi-structured interviews were conducted with a sample of early school leavers in South Africa, using WhatsApp ( n = 9) and face-to-face ( n = 27) followed by a focus group discussion with interviewers. Mann–Whitney U and chi-squared were used to assess associations. WhatsApp text-based interviews took significantly longer to complete but were comparable to face-to-face on the number of themes generated. Rapport, measured as the number of statements from the interviewer aimed at creating a sense of affinity, comfort, and distress reduction, differed between interview conditions. It may be methodologically appropriate for researchers to offer participants a choice of a preferred method of interviewing or consider pragmatic blended approaches of face-to-face and WhatsApp.

Aberrant DMN connectivity and activity have been robustly linked to Major Depressive Disorder (MDD) and risk for depression. This link has mostly been explained in terms of rumination, a form of negative, repetitive cognitive processing. Yet, accumulating findings are indicating altered DMN dynamics during emotional processing in MDD, pointing at a potential emotion-related DMN pathology in depression linked to inflexibly sustained emotional responses. Such a link might be especially important in understanding risk of depression. However, whether inflexible emotional processing (i.e. emotional inertia) is connecting aberrant DMN organization to risk of depression as well as how this might relate to rumination remains unclear. Addressing this gap, 34 participants underwent a resting-state fMRI and a 7-day Experience Sampling phase. Using regression and multiple mediation analysis we investigated the relations between negative emotional inertia, rumination, DMN organization and risk of depression as indicated by high subclinical depressive symptoms. The findings indicated that DMN efficiency at rest was positively associated with depressive symptoms and risk of depression. Both negative emotional inertia in daily life and rumination were independently mediating this relationship. While negative emotional inertia was connected to a broad increase in the coupling of DMN regions, rumination was only related to an increase in node strength of the dorsomedial Prefrontal Cortex. These findings are pointing towards an emotional-related DMN pathology contributing to risk of depression. Furthermore the findings are indicating that this relationship is independent from the rumination-related link between the DMN and depression - representing different aspects of DMN organization. ispartof: Journal Of Affective Disorders vol:293 pages:347-354 ispartof: location:Netherlands status: published

Background Research on the relationship between Facebook use intensity and depressive symptoms has resulted in mixed findings. In contrast, problematic Facebook use has been found to be a robust predictor of depressive symptoms. This suggests that when intense Facebook use results in a problematic usage pattern, it may indirectly predict depressive symptoms. However, this mediation pathway has never been examined. Moreover, it remains unclear whether the possible indirect relationship between Facebook use intensity and depressive symptoms through problematic Facebook use is moderated by demographic (age), and personality (neuroticism and extraversion) characteristics. Methods To address these gaps, we conducted an online cross-sectional study (n = 210, 55% female, age range: 18–70 years old, Mage = 30.26, SD = 12.25). We measured Facebook use intensity (Facebook Intensity Scale), problematic Facebook use (Bergen Facebook Addiction Scale), depressive symptoms (Center for Epidemiologic Studies Depression Scale Revised), and neuroticism and extraversion (Ten Item Personality Inventory). Results A mediation analysis revealed that problematic Facebook use fully mediates the relationship between Facebook use intensity and depressive symptoms. Moreover, a moderated mediation analysis demonstrated that this indirect relationship is especially strong among young users and users scoring high on neuroticism. Conclusions These findings expand our understanding of the mechanisms underlying the relationship between Facebook use intensity and depressive symptoms and describe user characteristics that act as vulnerability factors in this relationship.

Problematic use of social networking sites (SNS) has a negative impact on mental health. It has been found that people who score high on neuroticism are especially vulnerable towards engaging with SNS in a problematic way but it is not clear which psychological mechanisms explain this relationship. We addressed this issue by examining the mediating role of fear of missing out and self-control in the relationship between neuroticism and problematic SNS use. For this purpose, we conducted a cross-sectional study ( n = 151, 69.5% female, Mage = 26.23, SD = 7.52) and tested for parallel mediation using structural equation modelling. Neuroticism was found to be predictive of increased levels of problematic SNS use. Moreover, neuroticism was associated with both increased levels of fear of missing out and decreased levels of self-control. However, only fear of missing out was found to robustly mediate the relationship between neuroticism and problematic use of SNS. These findings suggest that fear of missing out could be an intervention target to prevent people scoring high on neuroticism from engaging in problematic SNS use.

BackgroundTo design a comprehensive approach to promote children's sleep health in Amsterdam, the Netherlands, we combined Intervention Mapping (IM) with the Health in All Policies (HiAP) perspective. We aimed to create an approach that fits local infrastructures and policy domains across sectors.MethodsFirst, a needs assessment was conducted, including a systematic review, two concept mapping studies, and one cross-sectional sleep diary study (IM step 1). Subsequently, semi-structured interviews with stakeholders from policy, practice and science provided information on potential assets from all relevant social policy sectors to take into account in the program design (HiAP and IM step 1). Next, program outcomes and objectives were specified (IM step 2), with specific objectives for policy stakeholders (HiAP). This was followed by the program design (IM step 3), where potential program actions were adapted to local policy sectors and stakeholders (HiAP). Lastly, program production (IM step 4) focused on creating a multi-sector program (HiAP). An advisory panel guided the research team by providing tailored advice during all steps throughout the project.ResultsA blueprint was created for program development to promote children's sleep health, including a logic model of the problem, a logic model of change, an overview of the existing organizational structure of local policy and practice assets, and an overview of policy sectors, and related objectives and opportunities for promoting children's sleep health across these policy sectors. Furthermore, the program production resulted in a policy brief for the local government.ConclusionsCombining IM and HiAP proved valuable for designing a blueprint for the development of an integrated multi-sector program to promote children's sleep health. Health promotion professionals focusing on other (health) behaviors can use the blueprint to develop health promotion programs that fit the local public service infrastructures, culture, and incorporate relevant policy sectors outside the public health domain.