Explaining citizens' plastic reduction behavior with an extended theory of planned behavior model: An empirical study in Switzerland.

The growing volume of plastic waste resulting from human activities is suffocating our planet. To combat this escalating issue, this study delves into the formation of plastic reduction behavior among Swiss citizens using an extended theory of planned behavior model. Through an online survey, the study obtained 149 valid responses, which were analyzed using partial least squares-based structural equation modeling. The results indicate a significant and strong relationship between plastic risk perception and attitudes towards plastic reduction and environmental protection. Notably, the cognitive dimension (ß = 0.802, p = 0.000) of plastic risk perception exhibits a tighter and stronger association with attitude compared to the emotional dimension (ß = 0.406, p = 0.000). Among the three variables in the theory of planned behavior model, perceived behavioral control (ß = 0.384, p = 0.000) emerges as the strongest determinant of behavioral willingness for plastic reduction. It is followed by attitude (ß = 0.214, p = 0.030). However, no significant relationship is observed between subjective norm and behavioral willingness for plastic reduction (ß = 0.07, p = 0.292). Finally, attitude fully mediates the relationship between plastic risk perception and behavioral willingness for plastic reduction. Theoretical and managerial implications are discussed.

Predicting COVID-19 Vaccination Intentions to Inform Evidence-Based Messaging for Building Vaccine Confidence Among Rural Americans.

PURPOSE: Examine possible message topics to promote rural vaccination using psychosocial antecedents of vaccination. DESIGN: Cross-sectional survey administered by Research America, Inc. SETTING: West Virginia (WV). SAMPLE: 756 WV adults via convenience sample (n = 370; ∼2% response rate from online panel of ∼20 000 WV residents), and random digit dial of landlines (n = 174; ∼1% response rate from 18 432 numbers) and cellphones (n = 212; ∼1% response rate from 20 486 numbers). MEASURES: Outcome measures included self-reported vaccination intention and behavior. Predictor measures, rooted in theories of social and behavioral science that have been found to be predictive of vaccination outcomes (i.e., Reasoned Action Approach, Extended Parallel Process Model), included perceived severity and susceptibility, negative affect, instrumental and affective attitudes, social norms, self-efficacy, response efficacy, and perceived control. ANALYSIS: Multivariate linear regression for intention and logistic regression for behavior. RESULTS: Intention was positively predicted by affective attitude, ß = .30, P < .05, instrumental attitude, ß = .19, P < .05, response efficacy, ß = .19, P < .05, negative affect, ß = .16, P < .05, self-efficacy, ß = .13, P < .05, and subjective norm, ß = .13, P < .05, F(10, 267) = 30.12, Adj. R2 = .53. Vaccination status was predicted by instrumental attitude, exp(B) = 2.09, and subjective norm, exp(B) = 2.00, Pseudo R2 = .29, log likelihood = 125.11, χ2(10) = 38.34, P < .05. Promising message targets were instrumental attitude, M = 3.21, SD = 1.46, and subjective norms, M = 3.76, SD = 1.71. CONCLUSION: COVID-19 vaccine confidence messages should address (1) positive feelings and safety perceptions, (2) vaccination's effectiveness in preventing serious COVID-19, and (3) subjective vaccination norms.

Cultural worldviews and waste sorting among urban Chinese dwellers: the mediating role of environmental risk perception.

Objective: Waste sorting has received considerable attention in recent decades. However, research on the mechanisms underlying the relationships among cultural worldview, environmental risk perception, and waste sorting is rather scarce. This study aims to explore the cultural worldviews, environmental risk perception, and waste sorting among urban Chinese and their mechanisms. Methods: This was a cross-sectional study involving 744 urban Chinese residents (371 men and 373 women). A questionnaire was utilized to measure cultural worldviews, environmental risk perception, and waste sorting. Pearson correlation analysis and structural equation modeling were used to examine the relationship between cultural worldviews, perceptions of environmental risk, and waste sorting. Results: Waste sorting had a relatively insignificant negative relationship with fatalism and individualism. The correlation between environmental risk perception and cultural worldviews was negative except for egalitarianism, and the correlation between hierarchy and environmental risk perception was higher than the others, while individualism was higher than fatalism. Heightened environmental risk perception mediates the relationship between egalitarianism and waste sorting. Reduced environmental risk perception mediates the relationship between hierarchy and waste sorting, and mediates the relationship between individualism and waste sorting. Conclusion: These new findings provide initial support for the mediating role of environmental risk perception in the relationship between cultural worldviews and waste sorting. Both theoretical and practical implications for understanding the psychological mechanisms of waste sorting are discussed.

Making decisions one drink at a time and the "just one drink" effect: A fuzzy-trace theory model of harmful drinking.

BACKGROUND: Understanding the decision factors that drive harmful alcohol use among young adults is of practical and theoretical importance. We apply fuzzy-trace theory (FTT) to investigate a potential danger that may arise from the arguably correct notion that a single drink carries no meaningful risk. Decisions that are mentally represented as one drink at a time could contribute to excessive drinking. METHODS: College students (N = 351) made a series of decisions to take or decline eight hypothetical drinks presented one at a time. Outcome measures included each decision, recent alcohol consumption (weekly drinks, peak blood alcohol content, and binges), and alcohol-related harms (scores on the Brief Young Adult Alcohol Consequences Questionnaire and Alcohol Use Disorders Identification Test). Linear regression models predicted each outcome from sex, perceived risk of a single drink, perceived risk of heavy drinking, perceived consequences of drinking, and general health-related risk sensitivity. RESULTS: Consistent with FTT, decisions to have a first drink and up to four additional drinks in short succession were each associated with lower perceived risk of one drink-a "just-one drink" effect-independent of perceived risks of heavy drinking, perceived consequences of drinking, and general risk sensitivity. Similarly, all measures of recent alcohol consumption and consequent harms were associated with perceived risk of one drink. Participants reporting "zero risk" of a single drink had worse outcomes on all measures than those reporting at least "low risk." CONCLUSIONS: Results are consistent with the theoretically informed premise that consumption decisions are typically made one drink at a time rather than by deciding the total number of drinks to be consumed in a sitting. When decisions about alcohol use proceed one drink at a time, a perception of zero risk in a single drink may contribute to heavy drinking.

Risk perception, well-being, depression and anxiety in children and adolescents with rheumatic diseases during the COVID-19 pandemic - results from the prospective multicenter KICK-COVID study in Germany.

OBJECTIVE: To investigate the psychosocial burden in children and adolescents with juvenile rheumatic diseases during the COVID-19 pandemic. METHODS: As part of the multicentre observational KICK-COVID study linked to the National Pediatric Rheumatology Database, adolescents < 21 years and parents of children < 12 years with rheumatic diseases answered questions on perceptions of health risk (PHR) due to SARS-CoV2, stress, well-being (WHO-5) and symptoms of depression (PHQ-9) and anxiety (GAD-7). Data were collected at routine visits from June to December 2021 and assessed for association with demographic and clinical parameters, treatment and patient-reported outcomes by multivariable regression analyses. RESULTS: Data from 1356 individuals (69% female, 50% adolescents) were included. Median PHR on a numeric rating scale (NRS, 0-10) was 4 (IQR 2-6), median perceived stress was 3 (IQR 1-6). Adolescents reported a worse well-being with a significantly lower median WHO-5-score (60, IQR 40-76) than parents reported for their children < 12 years (80, IQR 68-84). Moderate to severe symptoms of depression and anxiety were reported by 14.3% and 12.3% of the adolescents, respectively. PHR was significantly higher in patients with systemic lupus erythematosus, methotrexate or biologic disease-modifying anti-rheumatic drug therapy than in patients without these characteristics, whereas lower WHO-5 or higher PHQ-9 or GAD-7 scores were only associated with poorer patient-reported health status and physical functioning. CONCLUSION: The perception of health risk due to SARS-CoV2 infection was not paralleled by an impairment of mental health, which were, however, significantly correlated with self-rated health status and functional capacity, highlighting the importance of patient-reported outcome assessment. TRIAL REGISTRATION: German Clinical Trials Register (DRKS), no. DRKS00027974. Registered on 27th of January 2022.

The energy crossroads: Exploring the moderating role of the energy crisis on the acceptance of the development of a uranium mine.

The energy crisis caused by the lack of supply from some countries involved in armed conflicts, coupled with society's continuous demand for energy production, is leading to the proposal of new energy sources, such as the development of uranium mines to increase nuclear energy production. Mine projects (MPs) trigger numerous conflicts in the local societies involved. While for some people, they represent an opportunity for development and benefits, for others these proposals are perceived as a threat and a health risk. However, energy scarcity and price increases create a social dilemma that moderates the established relationships between the perceived risks and benefits and the valuation of energy proposals. This research aims to analyze both the weight of the factors influencing the acceptance of a uranium MP and the moderating role of the energy crisis on these factors. A total of 629 people participated in this study (371 before and 258 after the energy crisis). The participants answered a questionnaire assessing their socio-demographic characteristics, beliefs about the environment, the perceived risks and benefits, and their emotional balance, as well as their level of knowledge and acceptance of the uranium mine proposal. The results show that age, gender, and level of education and knowledge both directly and indirectly influence the acceptance of a mine. In addition, the perception of risks and benefits is associated with the emotional balance generated, explaining the level of final acceptance of the proposal. The moderation-mediated energy crisis hypothesis influences the relationship between the perceived risks and acceptance of the uranium mine. The results are discussed in order to determine factors for intervention to alleviate the social conflicts created by new energy proposals.

Analysis of causal relations between vaccine hesitancy for COVID-19 vaccines and ideological orientations in Brazil.

This article presents a causal inference analysis of vaccine hesitancy for Coronavirus disease 2019 (COVID-19) vaccines based on socio-demographic data obtained via questionnaires applied to a sample of the Brazilian population. This data includes the respondents' political preferences, age group, education, salary range, country region, sex, believing fake news, vaccine confidence, and intention to get the COVID-19 vaccine. The research created a causal graph using these variables, seeking to answer questions about the probability of people getting vaccinated. The results of this research corroborate findings observed in the literature, also presenting unique findings: (i) The perception that the vaccine is safe is positively affected by age group and negatively by religion; (ii) The older the person, the greater the probability of considering the vaccine safe and, consequently, of getting vaccinated; (iii) The religion variable showed great importance in the model since it has a simultaneous causal effect on political preferences and the perception of vaccine safety; (iv) The data reveal that the probability of a person accepting the vaccination against COVID-19 is reduced given the fact that they believe fake news related to the vaccine. The methodology applied in this research can be replicated for populations from other countries so that it is possible to generate customized models. General causal models can be helpful for agencies dealing with vaccine hesitancy to decide which variables should be addressed to reduce this phenomenon.

Governmental Restrictions and Real Estate Investor Risk Perception.

We investigate the impact of governmental restrictions on the short-term risk perception, as proxied by the going-in cap rate, of investors in regional and neighborhood shopping centers. We use the COVID-19 pandemic as a natural experiment and proxy for the length and severity of COVID-19 restrictions with the political affiliation of state governors. Using a sample of 40 metropolitan statistical areas (MSAs) across 27 states over the period of 2018 to 2021, we find that for states with Republican governors, which proxy for shorter and fewer COVID-19 restrictions, investors in regional malls required a lower going-in cap rate in the pandemic period than for states with Democratic governors. This effect does not exist for neighborhood shopping centers, whose tenants were not as affected by COVID-19 restrictions. Robustness checks suggest that our findings can be explained with mask mandates as one type of governmental restrictions, and that COVID-19 related restrictions do not impact the long-term risk perception of retail real estate investors. We furthermore find that the political attitudes of an MSA have an impact on investor risk perception.

Observing heroic behavior and its influencing factors in immersive virtual environments.

Studying heroism in controlled settings presents challenges and ethical controversies due to its association with physical risk. Leveraging virtual reality (VR) technology, we conducted a three-study series with 397 participants from China to investigate heroic actions. Participants unexpectedly witnessed a criminal event in a simulated scenario, allowing observation of their tendency to physically intercept a thief. We examined situational factors (voluntariness, authority, and risk) and personal variables [gender, impulsivity, empathy, and social value orientation (SVO)] that may influence heroism. Also, the potential association between heroism and social conformity was explored. In terms of situational variables, voluntariness modulated participants' tendency to intercept the escaping thief, while perceived risk demonstrated its impact by interacting with gender. That is, in study 3 where the perceived risk was expected to be higher (as supported by an online study 5), males exhibited a greater inclination toward heroic behavior compared to females. Regarding other personal variables, the tendency to engage in heroic behavior decreased as empathy levels rose among males, whereas the opposite trend was observed for females. SVO influenced heroic behavior but without a gender interaction. Finally, an inverse relationship between heroism and social conformity was observed. The robustness of these findings was partly supported by the Chinese sample (but not the international sample) of an online study 4 that provided written descriptions of VR scenarios, indicating cultural variations. These results advance insights into motivational factors influencing heroism in the context of restoring order and highlight the power of VR technology in examining social psychological hypotheses beyond ethical constraints.

Flooding in semi-unformal urban areas in North Africa: Environmental and psychosocial drivers.

Urban flooding is recognized as a nature-driven disaster shaped by inherent factors such as climate, morphology, and hydrology, affecting vulnerability and flood exposure. While these factors play a paramount role, significant psychosocial intricate drivers are acknowledged, though they are challenging for prediction and assessment. This study delves into these drivers in a specific context, aiming to draw conclusions that extend beyond. It undertakes a comprehensive approach, integrating cloud-based Radar flood detection, analysis of flood causation patterns, and geostatistical analysis of a social survey based on cross-synthesis, contingency analysis, and structural equation modeling. In particular, we characterize the case of the coastal city of Tetouan in Morocco, which is representative in its environmental and socioeconomic settings to most cities in North Africa. It unraveled the nuanced interplay of psychosocial, economic, and territorial dynamics influencing flood exposure. The findings reveal how watershed location molds unique environmental exposures, steering nuanced, emotional, and behavioral responses among residents. Gender and education differentials reveal diverse perceptions and awareness of flood risks. Psychosocial intricacies come to the forefront, portraying education, income, and awareness as crucial mediators influencing cognitive and affective responses. Elevated education, increased income, and heightened awareness correlate with heightened perception and coping strategies. Findings reveal that risk perception significantly and differently influences risk acceptance, coping, and aversion through an array of identified key factors influencing coping strategies, mediating elements in flood damage relationships, and underscoring the pivotal role of perception in shaping responses to risk. Moreover, it found that lower risk acceptance leads to higher coping and aversion, and the latter positively affects coping, indicating that acceptance reduces the motivation to avoid the risk and decreases the willingness to adopt coping strategies to reduce the exposure. The outcomes carry critical implications for comprehending individual and collective social behaviors, informing strategies, and mitigating flood risk that apply at a wider context. It accentuates the inadequacy of relying solely on structural engineering for risk management, citing spatial constraints, misinformation, and lapses in prior-risk memory as compounding exposure challenges. This recognition catalyzes action, advocating tailored awareness campaigns, educational initiatives, and capacity-building programs, spotlighting the need for heightened individual profiles to enhance social understanding, engagement, and resilience. We anticipate profound insights, fostering a richer comprehension of urban flooding complexities and informing adaptive strategies on a broader scale.

How the Stringency of the COVID-19 Restrictions Influences Motivation for Adherence and Well-Being: The Critical Role of Proportionality.

BACKGROUND: The stringency of the measures taken by governments to combat the COVID-19 pandemic varied considerably across countries and time. In the present study, we examined how the proportionality to the epidemiological situation is related to citizens'behavior, motivation and mental health. METHODS: Across 421 days between March 2020 and March 2022, 273,722 Belgian participants (Mage = 49.47; 63.9% female; 33% single) completed an online questionnaire. Multiple linear mixed regression modeling was used to examine the interaction between the epidemiological situation, as indicated by the actual hospitalization numbers, and the stringency index to predict day-to-day variation in the variables of interest. RESULTS: Systematic evidence emerged showing that disproportional situations, as opposed to proportional situations, were associated with a clear pattern of maladaptive outcomes. Specifically, when either strict or lenient measures were disproportional in relation to the epidemiological situation, people reported lower autonomous motivation, more controlled motivation and amotivation, less adherence to sanitary rules, higher perceived risk of infection, lower need satisfaction, and higher anxiety and depressive symptoms. Perceived risk severity especially covaried with the stringency of the measures. At the absolute level, citizens reported the highest need satisfaction and mental health during days with proportional lenient measures. CONCLUSION: Stringent measures are not per se demotivating or compromising of people's well-being, nor are lenient measures as such motivating or enhancing well-being. Only proportional measures, that is, measures with a level of stringency that is aligned with the actual epidemiological situation, are associated with the greatest motivational, behavioral, and mental health benefits.

Fear and trust: How risk perceptions of avian influenza affect Chinese consumers' demand for chicken.

This article quantifies the impact of H7N9 bird flu on chicken demand and consumer willingness to pay (WTP) in China. We measure risk perception, fear and trust against actual reduction in consumption and stated change in WTP for safe chicken between 2012 and 2013. Through a survey conducted in each year on the same Chinese urban consumers, we found that the consumption of chicken never increased after the emergence of H7N9 in 2013, and WTP for safe chicken did not necessarily increase relative to generic risks associated with consuming chicken in 2012. Factors such as the fear of H7N9's spreading, the impact of distrust (especially the distrust in government) enhanced the deviation of consumption and WTP; and the sheer mentioning of H7N9 is more important and negative than whether it was associated with a risk-perception reducing or risk-perception elevating message given to consumers.

Factors Associated with Sexually Transmitted Infections among Users of Voluntary HIV Counseling and Testing Centers in Portugal.

Objective: Users of publicly funded voluntary HIV Counseling and Testing Centers (VCT C) in the Portuguese National Service have been found to have higher rates of HIV risk behavior than the general population, but data concerning the relationship between socio-demographic, behavioral, and cognitive variables, and Sexually Transmitted Infections (ST Is) in this specific population are limited. This study tests the impact of socio-demographic, behavioral and cognitive variables on ST Is in a sample of 168 users of VCT C. Methods: A cross-sectional study using structured questionnaires was conducted. Results: Being older, being gay or bisexual, and having more barriers towards safer sex (e.g., negative attitudes toward safer sex behavior) were associated with increased odds of having had a ST I diagnosis. We found significant differences between heterosexual and gay men for number of sexual partners, frequency of anal sex, exchanging sex for money or drugs, history of ST Is, AIDS knowledge, and risk beliefs about the partner, with gay men showing higher rates. Conclusions: ST Is education should target older, gay or bisexual individuals, and focus on information as well as on changing barriers towards safer sex and associated health beliefs.

Influence of Disease-Related Stigma on Patients' Decisions to Upload Medical Reports to the German Electronic Health Record: Randomized Controlled Trial.

BACKGROUND: The rollout of the electronic health record (EHR) represents a central component of the digital transformation of the German health care system. Although the EHR promises more effective, safer, and faster treatment of patients from a systems perspective, the successful implementation of the EHR largely depends on the patient. In a recent survey, 3 out of 4 Germans stated that they intend to use the EHR, whereas other studies show that the intention to use a technology is not a reliable and sufficient predictor of actual use. OBJECTIVE: Controlling for patients' intention to use the EHR, we investigated whether disease-specific risk perceptions related to the time course of the disease and disease-related stigma explain the additional variance in patients' decisions to upload medical reports to the EHR. METHODS: In an online user study, 241 German participants were asked to interact with a randomly assigned medical report that varied systematically in terms of disease-related stigma (high vs low) and disease time course (acute vs chronic) and to decide whether to upload it to the EHR. RESULTS: Disease-related stigma (odds ratio 0.154, P<.001) offset the generally positive relationship between intention to use and the upload decision (odds ratio 2.628, P<.001), whereas the disease time course showed no effect. CONCLUSIONS: Even if patients generally intend to use the EHR, risk perceptions such as those related to diseases associated with social stigma may deter people from uploading related medical reports to the EHR. To ensure the reliable use of this key technology in a digitalized health care system, transparent and easy-to-comprehend information about the safety standards of the EHR are warranted across the board, even for populations that are generally in favor of using the EHR.

Risk perception about communicable and vector borne diseases among international travellers to Pakistan: A cross sectional study.

With the rise in air travel, the risk of diseases travelling from one geographical area to another has also increased. Relatively little is known about how travellers know and perceive the health risks associated with travel and how they adopt preventive measures before and while travelling abroad. The objective of this study is to determine the risk perception about communicable and vector-borne diseases among international travellers arriving from different countries and to find any association between the level of risk perception and independent variables. A cross-sectional study was conducted with 426 participants enrolled through convenient sampling technique. An already validated questionnaire was used to collect information. Chi square test was applied to ascertain any significant association between dependent and independent variables. Out of 426 respondents, only 226 (53%) had a high risk perception, whereas 220 (47%) had a low risk perception. A significant association was noted between the level of risk perception and gender (x2=20.9, p=0.000), level of education (x2=42.9, p=0.000), nationality (x2=7.5, p= 0.006) and region of arrival of the passengers (x2=26.2, p= 0.000). The results of the study revealed that 220 (47%) of the travellers had a low risk perception that may lead to an increase in the burden on healthcare system in Pakistan as well as exporting any new disease from Pakistan to other parts of the world where it does not already exist.

A comparative analysis of distracted driving behavior among drivers of different income levels: A case study in huainan, China.

This research aims to investigate the differences and causes behind distracted driving behavior among drivers with varying income levels. A comparative survey of 1121 drivers in Huainan City, China, was conducted, including 562 drivers from high-end communities representing the high-income group, and 559 drivers from general communities representing the low-income group. Employing social norms, risk perception, and experience as independent variables, the study further examines the role of in-group bias as a mediating variable, with distracted driving behavior serving as the dependent variable, through the construction of two structural equation models for analysis. The study found that among the high-income driver group, in-group bias significantly mediates the impact of social norms, risk perception, and experience on distracted driving behavior; however, this mediating effect is less pronounced in the low-income driver group. This finding is crucial for understanding the potential distracted driving behaviors induced by in-group bias within the high-income driver group and for effectively promoting driving safety. In summary, this research provides new insights into reducing distracted driving behavior among the high-income driver group, thereby enhancing road safety.

Perfiles de consumo de sustancias y percepción de riesgo en jóvenes asistentes a festivales de rock / Patterns of substance use and perceived risk in youth attending rock festivals

Este trabajo examinó la ocurrencia de consumo de diferentes sustancias psicoactivas e identificó clases de consumidores entre asistentes a un festival de rock. Participaron 447 participantes (56.4% mujeres) que completaron una encuesta sobre consumo de sustancias, riesgo percibido con relación al consumo de sustancias, intención de consumo y frecuencia de asistencia a recitales. La mayoría de los participantes exhibió policonsumo. Mediante la técnica de análisis de clases latentes, se identificaron dos clases de consumidores: una caracterizada por el consumo de alcohol, tabaco y marihuana y la otra, caracterizada por el consumo de esas tres sustancias y, además, estimulantes y alucinógenos. La percepción de un menor riesgo se asoció a una mayor frecuencia de consumo de sustancias. Los hallazgos sugieren que la población de jóvenes asistentes a recitales de rock exhibe una alta vulnerabilidad al consumo de riesgo de sustancias y debería ser objeto de intervenciones específicas. (AU)

The present study examined substance use occurrence and identified classes of consumers among those attending a rock festival. A sample of 447 participants (56.4% women) completed a survey measuring substance use, perceived risk associated with substance use, intention to substance use and frequency of attending rock festivals. Most of the participants exhibited consumption of multiple substances. Using latent class analysis, we identified two classes of consumers: one characterized by the consumption of alcohol, tobacco and marijuana and the other, characterized by the consumption of these three substances and, in addition, stimulants and hallucinogens. The perception of a lower risk was associated with a higher frequency of substance use. The findings suggest that the population of young people attending rock festivals exhibits a high vulnerability to risky substance use and should be targeted for specific interventions. (AU)

Discordance Between HIV Risk Perception, Sexual Behavior, and Pre-exposure Prophylaxis Adherence Among Young Sexual and Gender Minorities in the United States.

PURPOSE: In the United States, youth experience suboptimal HIV pre-exposure prophylaxis (PrEP) adherence. One common idea posits that this is due to their developing decision-making skills. However, quantitative evidence of this assumption is limited. We therefore examined whether individual decision-making factors, such as HIV risk perception and sexual behavior, predicted PrEP adherence in a national trial of young sexual and gender minorities (YSGMs). METHODS: In 2019-2021, the Adolescent Medicine Trials Network for HIV Interventions 142 study enrolled 225 PrEP users (ages 16-24) throughout the country. Regression models estimated the associations between HIV risk perception (using a modified Perceived HIV Risk Scale), sexual behavior (condomless anal sex in ≤ 3 months), and self-reported oral PrEP adherence (≥4 pills in the past week) at the same time point (baseline) and longitudinally (3 months). RESULTS: Baseline risk perception (risk ratio [RR]: 0.92, 95% confidence interval [CI]: 0.82, 1.04) and condomless anal sex (RR: 1.10, 95% CI: 0.97, 1.25) were not associated with PrEP adherence at the same time point and did not predict 3-month adherence (RR: 0.97, 95% CI: 0.85, 1.11; RR: 1.05, 95% CI: 0.93, 1.19, respectively). Baseline risk perception was not associated with condomless anal sex at either time point (baseline RR: 1.16, 95% CI: 0.94, 1.43; 3-month RR: 1.07, 95% CI: 0.90, 1.28). DISCUSSION: In this national trial of YSGM, HIV risk perception and condomless anal sex did not predict PrEP adherence. Targeting individual-level perceptions and behaviors will likely insufficiently address youth's suboptimal PrEP use. Future research should identify YSGM-specific adherence drivers and train providers to recognize such motivations.

Fall risk perception in older adults: A concept analysis.

BACKGROUND: Fall prevention is crucial for older adults. Enhanced fall risk perception can encourage older adults to participate in fall prevention programs. However, there is still no unified definition of the concept of fall risk perception. OBJECTIVE: To explore the concept of fall risk perception in older adults. DESIGN: A concept analysis. DATA SOURCES: The literature was searched using online databases including PubMed, Cochrane Library, Embase, CINAHL Complete, PsycINFO, Web of Science, China National Knowledge Infrastructure, WangFang and SinoMed. Searches were also conducted in Chinese and English dictionaries. The literature dates from the establishment of the database to April 2023. METHODS: The methods of Walker and Avant were used to identify antecedents, attributes and consequences of the concept of "fall risk perception" in older adults. RESULTS: Eighteen publications were included eventually. The attributes were identified as: (1) dynamic change, with features of continuum and stage; (2) whether falls are taken seriously; (3) a self-assessment of the fall probability, which is driven by individual independence; and (4) involves multiple complex emotional responses. The antecedents were identified as: (1) demographic and disease factors; (2) psychological factors and (3) environmental factors. The consequences were identified as: (1) risk-taking behaviour; (2) risk compensation behaviour; (3) risk transfer behaviour; and (4) emotions. CONCLUSION: A theoretical definition of fall risk perception was identified. A conceptual model was developed to demonstrate the theoretical relationships between antecedents, attributes and consequences. This is helpful for the development of relevant theories and the formulation of fall prevention measures based on fall risk perception as the intervention target.

Response of Unvaccinated US Adults to Official Information About the Pause in Use of the Johnson & Johnson-Janssen COVID-19 Vaccine: Cross-Sectional Survey Study.

Using a rapid response web-based survey, we identified gaps in public understanding of the Centers for Disease Control and Prevention's messaging about the pause in use of the Johnson & Johnson-Janssen COVID-19 vaccine and estimated changes in vaccine hesitancy using counterfactual questions.