How I See Me-A Meta-Analysis Investigating the Association Between Identities and Pro-environmental Behaviour.

Prolific research suggests identity associates with pro-environmental behaviours (PEBs) that are individual and/or group focused. Individual PEB is personally driven, self-reliant, and are conducted on one's own (e.g., home recycling). Group focused PEB is other people-reliant and completed as part of a group (e.g., attending meetings of an environmental organisation). A wide range of identities have been related to PEBs. For example, a recent systematic qualitative review revealed 99 different types of identities studied in a PEB context. Most studies were correlational, few had an experimental design. However, the relationships between all these identities and PEBs have so far not been tested quantitatively with meta-analytical techniques. As such, a clear overview of this field is currently lacking. Due to the diverse nature of the field, a priori hypotheses were not possible and relatively broad definitions of identity had to be used to encompass all types of identities and the diverse meanings of identity that have been included in PEB research. What prior theory did allow for was to assess the distinction between two main types of identity, namely how people label, describe, and recognise oneself individually (individual identity), or as part of a group (group identity). Our overall goal was thus to assess the current state of knowledge on identities and PEBs. In 104 studies using a meta-regression following the preferred reporting items for systematic reviews and meta-analyses guidelines, our random-effects meta-analysis showed that the overall concept of identity associated with PEB with a medium Pearson's r (Aim 1). Furthermore, we found that individual identities associated more strongly with PEBs than group identities (Aim 2). The associations between individual and group identities were stronger when the identity and PEB were from the same category (e.g., when both were group-focused; Aim 3). Methodologically, the findings revealed that group identities and group PEBs were most strongly associated for self-reported rather than observed PEBs (Aim 4). Overall identity associated most strongly with group PEBs in the field rather than in the lab (Aim 5) and in student- rather than non-student samples (Aim 6). We discuss the theoretical and practical implications.

The Relationship Between Sociodemographics and Environmental Values Across Seven European Countries.

Given the importance of environmental values (altruistic, biospheric, and egoistic) to pro-environmental behavior, it would be useful to segment the population - an approach known as market segmentation - to tailor pro-environmental messages more effectively. Sociodemographic variables are popular targets for segmentation, as such variables are often knowable in the absence of more nuanced information about individuals. However, evidence for the relationship between sociodemographics and environmental values is sparse, and contradictory. We examined the extent to which popular sociodemographic variables (gender, age, income, education, urbanization level, and political orientation) were predictive of environmental values for 11,820 participants across seven European countries. Overall, sociodemographics were hardly related to environmental values. Only gender and political orientation were weakly but significantly related to environmental values, whereby men and right-wingers showed weaker altruistic and biospheric, and stronger egoistic, values than women and left-wingers. We conclude that sociodemographic variables cannot be considered a suitable proxy for environmental values, and thus that behavior-change campaigns might be more impactful when focused on alternative segmentation strategies in relation to environmental aims.

Social Influence, Risk and Benefit Perceptions, and the Acceptability of Risky Energy Technologies: An Explanatory Model of Nuclear Power Versus Shale Gas.

Risky energy technologies are often controversial and debates around them are polarized; in such debates public acceptability is key. Research on public acceptability has emphasized the importance of intrapersonal factors but has largely neglected the influence of interpersonal factors. In an online survey (N = 948) with a representative sample of the United Kingdom, we therefore integrate interpersonal factors (i.e., social influence as measured by social networks) with two risky energy technologies that differ in familiarity (nuclear power vs. shale gas) to examine how these factors explain risk and benefit perceptions and public acceptability. Findings show that benefit perceptions are key in explaining acceptability judgments. However, risk perceptions are more important when people are less familiar with the energy technology. Social network factors affect perceived risks and benefits associated with risky energy technology, hereby indirectly helping to form one's acceptability judgment toward the technology. This effect seems to be present regardless of the perceived familiarity with the energy technology. By integrating interpersonal with intrapersonal factors in an explanatory model, we show how the current "risk-benefit acceptability" model used in risk research can be further developed to advance the current understanding of acceptability formation.

Values, perceived risks and benefits, and acceptability of nuclear energy.

We examined how personal values and perceptions of risks and benefits are associated with the acceptability of nuclear energy (NE). A theoretical model is tested in which beliefs about the risks and benefits of NE mediate the relationship between values and acceptability. The results showed that egoistic values are positively related to the perceived benefits and acceptability of NE. In contrast, altruistic and biospheric values were positively related to the perceived risks of NE. Although it has been argued that NE may help to combat climate change through lower CO(2) emissions, these environmental benefits were not acknowledged by people with strong biospheric values. Furthermore, results confirmed that the more risks respondents perceived, the less they were inclined to accept NE. In contrast, the more a person believed that NE has beneficial consequences, the more acceptable NE was. Finally, as expected, perceived risks and benefits were found to partly mediate the relationship between personal values and acceptability. We discuss the theoretical and practical implications of these findings.

Morality and nuclear energy: perceptions of risks and benefits, personal norms, and willingness to take action related to nuclear energy.

We examined factors underlying people's willingness to take action in favor of or against nuclear energy from a moral perspective. We conducted a questionnaire study among a sample of the Dutch population (N = 123). As expected, perceptions of risks and benefits were related to personal norms (PN), that is, feelings of moral obligation toward taking action in favor of or against nuclear energy. In turn, PN predicted willingness to take action. Furthermore, PN mediated the relationships between perceptions of risk and benefits and willingness to take action. In line with our hypothesis, beliefs about the risks and benefits of nuclear energy were less powerful in explaining PN for supporters compared to PN of opponents. Also, beliefs on risks and benefits and PN explained significantly more variance in willingness to take action of opponents than of supporters. Our results suggest that a moral framework is useful to explain willingness to take action in favor of and against nuclear energy, and that people are more likely to protest in favor of or against nuclear energy when PN are strong.

Diagnoses and visit length in complementary and mainstream medicine.

BACKGROUND: The demand for complementary medicine (CM) is growing worldwide and so is the supply. So far, there is not much insight in the activities in Dutch CM practices nor in how these activities differ from mainstream general practice. Comparisons on diagnoses and visit length can offer an impression of how Dutch CM practices operate. METHODS: Three groups of regularly trained physicians specialized in CM participated in this study: 16 homeopathic physicians, 13 physician acupuncturists and 11 naturopathy physicians. Every CM physician was asked to include a maximum of 75 new patients within a period of six months. For each patient an inclusion registration form had to be completed and the activities during a maximum of five repeat visits were subsequently registered. Registrations included patient characteristics, diagnoses and visit length. These data could be compared with similar data from general practitioners (GPs) participating in the second Dutch national study in general practice (DNSGP-2). Differences between CM practices and between CM and mainstream GP data were tested using multilevel regression analysis. RESULTS: The CM physicians registered activities in a total of 5919 visits in 1839 patients. In all types of CM practices general problems (as coded in the ICPC) were diagnosed more often than in mainstream general practice, especially fatigue, allergic reactions and infections. Psychological problems and problems with the nervous system were also diagnosed more frequently. In addition, each type of CM physician encountered specific health problems: in acupuncture problems with the musculoskeletal system prevailed, in homeopathy skin problems and in naturopathy gastrointestinal problems. Comparisons in visit length revealed that CM physicians spent at least twice as much time with patients compared to mainstream GPs. CONCLUSIONS: CM physicians differed from mainstream GPs in diagnoses, partly related to general and partly to specific diagnoses. Between CM practices differences were found on specific domains of complaints. Visit length was much longer in CM practices compared to mainstream GP visits, and such ample time may be one of the attractive features of CM for patients.

Emotional and informational patient cues: the impact of nurses' responses on recall.

OBJECTIVE: To investigate older cancer patients' informational and emotional cues, how nurses respond to these cues and the effect of cues and responses on patients' information recall. METHODS: 105 cancer patients (aged >or=65 years) completed a recall questionnaire after an educational session preceding chemotherapy treatment. Recall was checked against the actual communication in videorecordings of the consultations. Patients' emotional and informational cues and subsequent responses by the nurse were rated using an adaptation of the Medical Interview Aural Rating Scale (MIARS). RESULTS: Patients gave more informational than emotional cues. The most frequent response to emotional cues was distancing followed by acknowledgement. Nurses gave appropriate information in response to the majority of informational cues. Patients' expression of emotional or informational cues did not influence recall; neither did nurses' responses to informational cues. Responses to emotional cues did affect recall. The more nurses responded by giving 'minimal' encouragements (e.g. 'Hmmm'), the more patients recalled, while distancing responses (e.g. switching focus) were associated with lower recall scores. CONCLUSION: Responding to patients' emotions is likely to impact information recall. PRACTICE IMPLICATIONS: These results highlight the importance of addressing patients' expressions of emotions in the context of patient education, as it enhances information recall.

Explaining prosocial intentions: testing causal relationships in the norm activation model.

This paper examines factors influencing prosocial intentions. On the basis of the norm activation model (NAM), we propose that four variables influence prosocial intentions or behaviours: (1) personal norms (PN), reflecting feelings of moral obligation to engage in prosocial behaviour, (2) awareness of adverse consequences of not acting prosocially, (3) ascription of responsibility for the negative consequences of not acting prosocially, and (4) perceived control over the problems. We conducted a series of experimental studies to examine how the NAM variables are causally related. As hypothesized, problem awareness, responsibility, and outcome efficacy played an important role in the development of PN and various types of prosocial intentions in the social as well as environmental domain.

Morality and prosocial behavior: the role of awareness, responsibility, and norms in the norm activation model.

The authors examined the relationships between variables included in the Norm Activation Model (NAM; S. H. Schwartz, 1977) of prosocial behavior. Specifically, they evaluated the strength of 2 commonly used interpretations of this model: the NAM as a mediator model and the NAM as a moderator model. For the most part, 5 studies focusing on a variety of prosocial intentions and behavior support the NAM as a mediator model. Furthermore, these studies validate past research by showing that variables included in the NAM are powerful in explaining a diversity of prosocial intentions and behavior in the social and environmental contexts.

Lifestyle counseling in hypertension-related visits--analysis of video-taped general practice visits.

BACKGROUND: The general practitioner (GP) can play an important role in promoting a healthy lifestyle, which is especially relevant in people with an elevated risk of cardiovascular diseases due to hypertension. Therefore, the aim of this study was to determine the frequency and content of lifestyle counseling about weight loss, nutrition, physical activity, and smoking by GPs in hypertension-related visits. A distinction was made between the assessment of lifestyle (gathering information or measuring weight or waist circumference) and giving lifestyle advice (giving a specific advice to change the patient's behavior or referring the patient to other sources of information or other health professionals). METHODS: For this study, we observed 212 video recordings of hypertension-related visits collected within the Second Dutch National Survey of General Practice in 2000/2001. RESULTS: The mean duration of visits was 9.8 minutes (range 2.5 to 30 minutes). In 40% of the visits lifestyle was discussed (n = 84), but in 81% of these visits this discussion lasted shorter than a quarter of the visit. An assessment of lifestyle was made in 77 visits (36%), most commonly regarding body weight and nutrition. In most cases the patient initiated the discussion about nutrition and physical activity, whereas the assessment of weight and smoking status was mostly initiated by the GP. In 35 visits (17%) the GP gave lifestyle advice, but in only one fifth of these visits the patient's motivation or perceived barriers for changing behavior were assessed. Supporting factors were not discussed at all. CONCLUSION: In 40% of the hypertension-related visits lifestyle topics were discussed. However, both the frequency and quality of lifestyle advice can be improved.