INTRODUCTION:People who smoke often develop a smoking identity, making it challenging to quit. The current study aimed to test whether reflecting on one's most feared and aspirational future selves impacted peoples' smoking identity, smoking intentions, and willingness to make a quitting plan. METHODS:Adults who smoke (N = 300) completed an online experiment where they were randomized to a future possible self or control condition. The future-self intervention involved envisioning an aspirational future self as a nonsmoker and future feared self as a smoker. Participants wrote descriptions about and uploaded images representing these possible selves. Those in the control condition wrote about and uploaded images of activities unrelated to smoking. Post-intervention, smoker and nonsmoker identity, intention to quit, and willingness to create a quitting plan were measured as primary outcomes. RESULTS:In comparison to the control condition (M = 5.53), those in the future self intervention (M = 6.20) had stronger nonsmoker identity (p = 0.004), but no differences in smoker identity. Intervention effects were stronger for precontemplators compared to contemplators/preparers. For precontemplators, those who reflected on their future self had greater intentions to quit compared to control participants (b = 0.87, p = 0.002), and these quit intentions were associated with a greater willingness to draft a quitting plan (OR = 1.03, 95% CI [1.00, 1.07]). CONCLUSION:Results suggest that future identity conflict tasks can help people shift from unhealthy to healthy identities, particularly for precontemplators who may not have considered the benefits of quitting. IMPLICATIONS:Our findings suggest that identity-based interventions may be most effective for people who smoke who do not yet intend to quit compared to those already contemplating change.

Abstract Background Compensatory health beliefs (CHBs), the belief that a healthy behavior can offset the effects of a health-compromising one, have been theorized to both justify unhealthy behaviors and motivate health-promoting ones. However, findings in the literature are inconsistent. Methods These meta-analyses synthesized 252 effect sizes from 59 independent samples using robust variance estimation to examine the relationships between CHBs and four outcomes: intentions and engagement in compensatory health behaviors and intentions and engagement in health-compromising behaviors. Results Approximately 13,760 individuals were represented across these analyses (ages 12-79; women ∼66.1%; college-based = 69.8%). CHBs were significantly associated with greater intentions to engage in compensatory health behaviors (r = 0.21) and with greater engagement in health-compromising behaviors (r = 0.18), but were not reliably associated with compensatory health behaviors or intentions to engage in health-compromising behaviors. Heterogeneity was substantial across all models, but only one significant moderator emerged: CHBs were more strongly associated with compensatory intentions in studies examining diet compared to physical activity. Funnel plot symmetry and stability across values of ρ supported the robustness of findings. Conclusions These results highlight the potential for CHBs to undermine health behavior change efforts, particularly when intentions to engage in healthy behaviors are not carried out. Future work should explore state-level CHBs and real-time decision-making to clarify how and when these beliefs influence behavior.

Purpose: It is unclear why parents avoid discussing alcohol use with their emerging adult (EA) children. Understanding parents' reasons for not communicating could inform parent-based interventions (PBIs) aimed at encouraging constructive discussions. The current study adds to the literature by examining common reasons parents avoid discussing alcohol use with their EA children. Methods: Parents of EAs completed a web-based survey that included items assessing reasons for not communicating about alcohol, as well as measures of alcohol communication intentions, parenting self-efficacy, relationship quality, and interest in participating in an alcohol PBI. Results: Results from the Exploratory Factor Analysis revealed five core reasons why parents do not communicate about alcohol: (1) they lack the skills or resources to communicate; (2) they believe their child is a nondrinker; (3) they believe their child is an independent, trustworthy decision maker; (4) they can teach their child how to drink through modeling; (5) they believe communication is futile. Believing that an EA could and should make their own alcohol decisions was the most common reason for not communicating. In multivariate analyses, this reason for not communicating was associated with greater levels of parental self-efficacy and perceiving a child to drink less alcohol. Further, this reason for not communicating was associated with lower intentions to communicate about drinking and less interest in taking part in a PBI. Discussion: Most parents reported barriers to communication. Understanding why parents are reluctant to discuss alcohol use could inform PBI efforts. (c) 2023 Society for Adolescent Health and Medicine. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Preliminary data from a prospective micro-longitudinal study (30 days) that examined the co-evolution of return to use risk among people diagnosed with an alcohol use disorder (AUD) in residential substance treatment is presented. Data assessed the feasibility of using the open dynamic interaction network (ODIN) responsive ecological momentary assessment (rEMA). rEMA collected daily estimates on affect, urges, sober-support engagement, and use. The ODIN app administered twelve daily questions at established EMA times. GPSidentified sober support engagement and alcohol access exposure prompted additional questions. Of the eight hundred questions, most people answered 500 questions. Five-day estimates showed that 80 % of the participants answered between 80 and 100 questions (10-30 questions/day). The ODIN app acquired 95 % of GPS readings across 30 days (similar to 288 GPS readings/day). Most were satisfied with the stability (84 %), look/feel (82 %), and ease of use (92 %) of the ODIN app. Participants also reported interest in longer assessments that prompted them to call a sponsor (85 %) or to use prevention skills (72 %). Preliminary findings show that the ODIN platform accurately and efficiently collects data amongst this population.

BackgroundMany young adults who are enrolled in a university play drinking games (DG), a risky drinking practice that is known to facilitate heavy alcohol consumption. DG participation is associated with increased risk for harm and as such, identifying university students at risk for experiencing DG harms is key. Standardized instruments designed to assess DG behavior and related outcomes are limited by having no established cutoffs to identify those individuals who play DG who are at risk for hazardous alcohol use. In the present study, we developed a short form of the Brief Young Adult Alcohol Consequences Questionnaire-Drinking Games (B-YAACQ-DG) for use among university student samples based on differential item functioning (DIF)-free items across gender, and established cutoffs indicating hazardous use using receiver-operating characteristic curves with AUDIT scores of 6+ as the reference standard.MethodStudents (N = 1,299; ages 18-25; 67.7% women; 71.0% White) from four large public universities in the United States completed a confidential online survey.ResultsAlthough gender-based DIF on several items on the B-YAACQ-DG emerged, there were 16-items that were DIF-free across men and women. An optimal cutoff score for detection of hazardous use for the full version (23-items) of the B-YAACQ-DG was experiencing 4+ DG consequences in the past month, and 3+ consequences for the 16-item DIF-free version.ConclusionsHealth practitioners and alcohol researchers can use the B-YAACQ-DG alongside the AUDIT, to identify university students who play DGs that are in need of intervention. The B-YAACQ-DG can also be used to assess specific DG harms experienced among students who play DGs.

Men's negative attitudes toward women is a known risk factor for sexual aggression perpetration. Sexual aggression is a widespread public health concern, especially among emerging adults, and is associated with a multitude of negative consequences. The current study evaluated whether pornography-related perceived peer norms, own approval, and self-reported use are associated with negative attitudes towards women in a sample of college men. Types of pornography examined included: pornography (in general), pornography that included portrayals of bondage, whipping, and spanking but without explicit dissent (i.e., pornography that depicted bondage/physical aggression), as well as pornography consisting of sexually explicit rape depictions in which force is used. Self-report measures assessing the frequency of pornography exposure, self-acceptance of pornography use, and perceived peer norms were collected from 283 college men. A multiple linear regression model revealed that only perceived peer norms for acceptance of pornography that depicted rape was positively associated with negative attitudes toward women. Findings highlight the importance of better understanding and addressing perceived peer norms in sexual assault prevention programs for college men.

Prior research has shown that many individuals exhibit an aversion to algorithms and are resistant to the use of artificial intelligence (AI) in healthcare. In the present research, we show that an intervention that increases the salience of bias in decision making—either in general or specifically with respect to gender or age—makes individuals relatively more receptive to medical AI. This increased receptiveness to AI occurs because bias is perceived to be a fundamentally human shortcoming. As such, when the prospect of bias is made salient, perceptions of AI integrity—defined as the perceived fairness and trustworthiness of an AI agent relative to a human counterpart—are enhanced.

OBJECTIVE:Previous work has investigated parents' reports of motives for communicating with their young adults about alcohol. Although parents' self-reported motives may predict intentions to communicate, young adults' perceptions of their parents' motives may be important for understanding young adults' responses to parental alcohol communication. The present study was conducted to explore college students' perceptions of their parents' motives for alcohol communication and to investigate whether perceptions of these motives predict changes in alcohol consumption and related consequences during the transition to college. METHOD:First-year college students (n = 306) participated in a longitudinal survey study. Baseline measures at pre-matriculation (Time 1) included assessments of student perceptions of their parents' motives for alcohol communication and covariates (e.g., perceived peer descriptive drinking norms, parental modeling and alcohol communication, and drinking and consequences). At a 1-month follow-up (Time 2), students reported on their alcohol use and consequences. RESULTS:When we controlled for other predictors of college student drinking, results indicated that for each one-unit increase in perceived parental reactive communication motives, the incidence rate of typical weekly drinking increased by 9%, and heavy episodic drinking (HED) increased by 21%. Conversely, the incidence rate of HED decreased by 27% for each one-unit increase in perceived maternal family history communication motives. CONCLUSIONS:These findings suggest that college students' perceptions of their parents' motives for alcohol communication can significantly influence their drinking behavior during the transition to college.

Background: Sexual assault and heavy alcohol use are prevalent and interrelated public health concerns on university campuses. Surprisingly, however, few alcohol harm reduction interventions address this intersection to help students reduce both personal and community risks for sexual assault in college drinking contexts. Objectives: In the current study, students (ages 18-24) shared strategies they use to protect themselves and others from sexual assault in college drinking contexts, as well as challenges to implementing these strategies. A series of six focus groups were conducted across two universities in the U.S. (N = 35). Participants responded to open-ended questions focused on drinking and sexual assault (e.g., What are some of the things students might do to avoid or address situations where they feel pressured of coerced to hook up or have sex when they do not want to?). Results: Thematic analyses demonstrated students' awareness of protective behavioral and bystander intervention strategies that could help reduce vulnerability to experience sexual assault for themselves or others in drinking contexts. Perceived barriers to using bystander intervention strategies included student's own and friends' heavy drinking (decreased inhibitions, loss of autonomy), ambiguity in deciphering risk (lack of familiarity, minimization, diffusion of responsibility), and gender (gender norms, power imbalances). Conclusions: This study informs the development of interventions that help students identify strategies and overcome barriers to reduce risks for sexual assault in college drinking contexts.

OBJECTIVE:Prevention programs that address the intersecting health problems of risky alcohol use, unsafe sexual behaviors, and sexual violence are needed. This pilot project assessed the feasibility, acceptability, and preliminary efficacy of a two-session group-based intervention, Sex Positive Lifestyles: Addressing Alcohol & Sexual Health (SPLASH), targeting these highly interconnected risks for college students across genders. METHOD:A total of 217 participants (51.6% male, ages 18-24) took part in the SPLASH intervention or a nutrition/exercise control condition. SPLASH included three approaches aimed at reducing the incidence of alcohol problems, unsafe sex, and sexual victimization: normative feedback to modify misperceptions around peers' drinking, sexual behaviors, and support of bystander intervention; drinking and sexual-related protective behavioral strategy training to enhance safer drinking and sex-risk behaviors; and bystander intervention skills training to promote bystander efficacy and engagement. Participants completed baseline and follow-up (1-month and 6-month) online assessments. RESULTS:SPLASH demonstrated high acceptability and feasibility, as well as preliminary efficacy. SPLASH participants reported strong acceptability of the intervention, particularly its integrated content and interactive, in-person group format. Successful enrollment (70% randomized) and retainment point to the feasibility of recruiting students to this two-session in-person intervention. Results showed sustained trends toward more accurate perceived sex-related norms and indications of increasing bystander norms among intervention but not control participants. CONCLUSIONS:Results demonstrate the potential for SPLASH to effectively address the interrelated health risks of risky alcohol use, unsafe sex, and sexual violence on college campuses and point to the need for larger-scale studies.

Objective: During young adulthood, drinking and sexual behaviors are both normative and inextricably linked. While this association is well documented, little is known about how students define positive and negative drinking-related sexual experiences. Methods: Thirty-five undergraduates participated in a focus group about sexual experiences in the context of drinking. Thematic analysis was utilized to identify themes in the data. Results: Students' descriptions of positive drinking-related sexual encounters included having a good time, feeling safe, maintaining control over alcohol, as well as feeling safe in drinking contexts where sexual partners are located. Students' perceptions of negative experiences included specific consequences such as a damaged reputation, loss of control due to alcohol, and concern of engagement in sex when they or a partner was too intoxicated to consent. Conclusion: Gaining a better understanding of how college students view positive and negative drinking-related sexual experiences could inform interventions aimed at promoting student well-being.

Vaccination is a crucial form of primary prevention, and it is important to understand the factors that influence parents' decisions to vaccinate their children. The current study examines the utility of the Theory of Planned Behaviour (TPB) and anticipated affect for explaining parents' intentions to vaccinate their children against COVID-19. Parents (N = 843) living in the United States completed an online survey. The TPB variables explained 65% of the variability in parents' intentions. In addition to all three of the TPB antecedents predicting vaccine intentions, both anticipated regret of not vaccinating and anticipated positive emotions of vaccinating were associated with parent intentions. Contrary to predictions, subjective norms were a stronger predictor of intentions when perceived behavioural control was lower compared to higher. These findings help further our understanding of parent-for-child vaccine decisions in the context of novel health threats and inform intervention efforts aimed at encouraging this behaviour.

Scientific evidence regularly guides policy decisions 1 , with behavioural science increasingly part of this process 2 . In April 2020, an influential paper 3 proposed 19 policy recommendations (‘claims’) detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms ‘physical distancing’ and ‘social distancing’. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.

Past research has highlighted a range of factors that impact college students’ sense of belonging. It is less clear how the COVID-19 pandemic has shaped college students’ experience of belonging. The current study used a reflective photography approach to examine US college students’ experience of belonging to their institution during the COVID-19 pandemic. Student responses included themes of Physical Space, Community, Adaptation/Continuity, Identity, and Negative Affect. Physical space emerged as the most common theme. Regardless of whether students were studying on campus or remotely, students described the role of the natural and built environment in finding a sense of connection and belonging. In comparisons based on students’ class year, first-year students talked more about the role of structured groups and other cohorts highlighted the role of past shared experiences. The findings have implications for interventions aimed at promoting student belonging.

Objective The current study examines college students' perceptions of same-gender and opposite gender peer norms for bystander behaviors in drinking contexts, as well as the association between perceived norms and participants' willingness to intervene and actual behavior. Method Participants completed an online survey assessing bystander-related perceived norms, willingness, and behavior. A subset of participants also completed a measure of bystander behavior 4-months later. Results The results indicated a divergent pattern of normative misperceptions for descriptive and injunctive norms, in which participants overestimated descriptive norms and underestimated injunctive norms. Further, participants who perceived greater perceived injunctive norms reported greater willingness to intervene in the future. While those who perceived that their peers intervened more frequently were more likely to have engaged in bystander behavior at baseline and the four-month follow-up. Conclusions Results also suggest that the role of gender-specific norms is complex and dependent on participants' own gender. The results indicate the potential value of developing norms-based interventions addressing bystander behaviors and implications for the types of normative misperceptions to target.

College students have shown elevated mental distress during the coronavirus disease of 2019 (COVID-19). The extent and persistence of mental distress as COVID-19 restrictions have continued is unclear. This study used latent profile analysis to identify student mental health risk subgroups and to evaluate subgroups in relation with substance use. A four-profile solution was supported with a sample of 930 college students (69.6% female, 58.1% White) from 11 US-based institutions. Students were characterized by slight mental health symptoms, mild mental health symptoms, moderate-to-severe mental health symptoms with mild psychosis/substance use, and severe mental health symptoms. The severe profile comprised more ethnoracial or sexual minorities and students impacted from COVID-19. Whereas the severe profile had more alcohol-related consequences, the slight profile had fewer cannabis-related consequences. COVID-19 has exacerbated college student risks for psychiatric disorders. Students of diverse backgrounds and more impacted by COVID-19 show disproportionately more mental distress and related substance use.

Research on access to health services during the COVID-19 pandemic is limited, and the conceptualization of access has not typically included access to community resources. We developed and tested an access-to-health-services measure and examined disparities in access among individuals in the U.S. during the pandemic. Data are from a U.S. sample of 1491 respondents who completed an online survey in August 2021. Linear regression models assessed the relationships between the access-to-health-services-measure components, including impact on access to medicine and medical equipment, impact on access to healthcare visits, and confidence in accessing community resources, and predictor variables, including sociodemographic- and health-related factors. Disparities in access to healthcare during the pandemic were associated with sociodemographic characteristics (i.e., race, gender, and age) and health-related characteristics (i.e., chronic illness, mental health condition, and disability). Factors such as race, gender, income, and age were associated with individuals' degree of confidence in accessing community services. Our study presents a new access-to-health-services measure, sheds light on which populations may be most vulnerable to experiencing reduced access to health services, and informs the development of programmatic interventions to address the salient needs of these populations.

Parents of young adults may approve of their child drinking in lower risk drinking situations (LRDS) because they believe it will prevent their child from drinking in more risky ways. However, when young adults believe their parents approve of drinking in LRDS they experience more negative alcohol consequences, not less. A plausible explanation for the effects of LRDS on risky drinking is that approval toward LRDS implicitly suggests approval toward other drinking situations that most parents would not permit (i.e., higher risk drinking situations [HRDS]). The current study addresses a gap in the literature by investigating perceived parental approval of drinking in HRDS as a mediator of perceived LRDS approval on underage emerging adults’ (UEAs’) drinking and consequences. UEAs (18–20 years of age) were recruited from all 50 states via MTurk to complete a two-part web-based survey study (N=315). Measures included in the mediation model were perceived parental approval of drinking (both LRDS and HRDS related), peak drinking occasion consumption, alcohol-related consequences, and baseline covariates (birth sex and perceived peer drinking norms). Results from the mediation model revealed that perceived LRDS approval was associated with increases in perceived HRDS approval, which, in turn, predicted consequences (controlling for baseline peak drinking, consequences, and covariates). Findings from this study provide the first evidence to support perceived HRDS approval as a mechanism through which LRDS approval influences alcohol-related consequences. These results suggest that PBIs may benefit from targeting parent approval toward both LRDS and HRDS.