To Örebro University

Introduction: Chronic pain and sleep disturbance bidirectionally influence each other in a negative spiral. Although this academic knowledge is known by researchers, it is imperative to bridge it over to the general public because of its applied implications. However, it is unclear how academia and the general public reciprocally shape each other in terms of knowledge of the sleep–pain relationship. The purpose of this study was (1) to assess the longitudinal trajectories of research on the sleep–pain relationship and the general public’s interest in this topic and (2) to examine whether the academic interest leads to the general public’s interest, or vice versa.

Methods: We used a Big Data approach to gather data from scientific databases and a public search engine. We then transformed these data into time trends, representing the quantity of published research on, and the general public’s interest in, the sleep–pain relationship. The time trends were visually presented and analyzed via dynamic structural equation modeling.

Results: The frequency of both published articles and searches soared after 2004. Published research leads to an increased interest in the sleep–pain relationship among the general public but does not predict more published articles. Furthermore, the general public’s interest reinforces itself over time but does not predict published research.

Conclusion: These results are encouraging because it is essential for research on the sleep–pain relationship to reach a broader audience, beyond the walls of academia. However, to prevent a potential alienation between academic and practical knowledge, we encourage openness among researchers to being inspired by the general public’s knowledge of the sleep–pain relationship

Public feeding of free-roaming cats subsidizes their population growth, and has consequences in highly interconnected ecosystems including predation of native wildlife and alteration of their behavior and populations. Research is needed to explain, predict, and possibly curb public feeding. We conducted a theoretically informed analysis of key beliefs underlying intentions to feed free-roaming cats in Malaysia, offering new insights as well as management suggestions. Normative beliefs had the strongest associations with behavioral intentions. Management strategies should consider social influences from families and friends of those who feed free-roaming cats, especially cat owners and their significant others. Our results also suggest key behavioral beliefs regarding disadvantages of feeding free-roaming cats could be strengthened through education and other initiatives. The findings are particularly important for Malaysia, which is biodiversity-rich but has a large free-roaming cat population and a high incidence of public feeding.

Previous studies have associated youth's exposure to filmic images of smoking with real-life smoking acquisition; initial research in low- and middle-income countries confirms this relationship. The present study in Yunnan, southwest China sought answers to the following questions: How do young people in China make sense of smoking imagery they have seen in film? How are these perceptions shaped by the cultural and social context of images? How do these understandings relate to real-life tobacco use? A study with focus groups and grounded theory was conducted in 2010 and 2011 (Sept–Jan) with middle-school students ages 12 and 13 (n = 68, focus groups = 12, schools = 6). Films and media literacy were important means through which knowledge about smoking was constructed and communicated. Film representations of smoking concurred with Chinese social behaviour (Confucian social networks, face-making, and the notion of society as a harmonious social unit), and were interpreted as congruent with real-life smoking. This pattern, in turn, was intertwined with perceived gender identities of smokers, gender-specific social behaviour, and willingness of girls to explore issues of gender equity. These findings lend new insights into interaction between smoking imagery in film and Chinese youth's smoking beliefs. Tobacco control programs in China should consider young people's interpretations of smoking and the ways they are nested in cultural and social milieu.

The article discusses the status of therapy and counselling in China in the midst of economic, social and cultural change. Topics covered include the increasing prevalence of emotional problems in the country such as anxiety, depression, and suicide, the similarity between counselling theories and approaches in China and Great Britain such as behaviourism, cognitive behavioural therapy (CBT) and psychoanalysis, and the need to modify Western counselling approaches for Chinese clients.

Objective: Adolescence is an important time period in smoking experimentation and initiation. This study examined heterogeneity in key beliefs about smoking intention among Chinese adolescents.

Methods: Survey data came from 951 students (18 and 19 years) in two high schools in Kunming, Yunnan Province, China. The survey questions assessed smoking beliefs and perceptions based on the Theory of Planned Behavior. Regression and latent class analysis were utilized to identify key beliefs (i.e., beliefs that are most influential in smoking intention) and their heterogeneity.

Results: Emotion-related beliefs were reported by both genders, highlighting the role of anxiety and stress in smoking intention. Female and male adolescents had different sets of key beliefs. There were distinct subgroups of beliefs in the sample (two among female adolescents, and three among male adolescents) characterized by disparate patterns of behavioral beliefs, normative beliefs, and control beliefs and smoking status.

Conclusions: Considerable heterogeneity in belief profiles, which differs based on gender and smoking status, furnishes a more complete understanding of smoking intention among Chinese adolescents. Gender-specific anti-smoking interventions can be targeted to the beliefs of specific subgroups of adolescents. Stress management for students could also be a useful tool to prevent smoking uptake.

The article focuses on counselling in China. The Chinese society is in transition; however many people are finding it hard to adjust to this change and new ways of living. These people need help to overcome their anxieties, therefore, several counselling centers have been set up, Chinese counsellors have adopted behaviourism, cognitive behavioural therapy, and psychoanalysis approaches; the Chinese counsellors have also developed indigenous therapies which are in line with the Chinese culture.

Free-roaming cats negatively affect wildlife, human health, and society, and anthropogenic food sources partly maintain their populations. There is a dearth of theory-informed interventions to change people’s beliefs about feeding animals. Here, we outline a behavioural change intervention protocol to modify Malaysians’ key beliefs (i.e. the most influential beliefs) about feeding free-roaming cats. Our protocol serves as a novel, timely, and potentially valuable tool for addressing a significant conservation and societal issue. The Theory of Planned Behaviour is the theoretical framework of the intervention, underpinning its targets (i.e. behavioural beliefs, normative beliefs), content, delivery, and evaluation. The prescriptive intervention consists of one full-day workshop (duration = 5 h) with three sessions each attempting to alter one key belief using behavioural change strategies. A two-armed parallel-group prospective-cluster randomised controlled trial will be used to evaluate the efficacy of the intervention. The protocol can be easily delivered for the public and adapted for other types of locations, human–animal interactions, and contexts. It also complements animal management and policy change approaches.

Little information has been reported about the welfare and management of free-roaming animals in Middle Eastern countries. Here we describe a case study of free-roaming cat (Felis catus) management policies in two universities in Beirut, Lebanon whereby cats are immensely valued for their presence and the benefits they bring to students and employees. Guided by concern for animal welfare, the innovative, humane approaches by the universities include arranging adoptions, discouraging pet abandonment, food provision, health monitoring, nurturing a social responsibility consciousness among young people, formal endorsement of animal rights and humane treatment in student conduct expectations, sterilization, and veterinary care. The policies serve as blueprint for universities and other institutions across the globe to adopt proactive approaches to free-roaming cat management as well take responsibility for the welfare of all animals on campus (rather than only for ethical conduct in use of animals in scientific research). They also inspire students, as the next generation, to safeguard animals and the environment.

This study analyses lay understandings of health among Dai Lue, an ethnic minority in China, and how they are played out in help-seeking practices. Interviews and focus groups with sixty-three rural villagers in Xishuangbanna, southwest China revealed that health was largely interpreted as a social experience embedded in Dai Lue culture and ethnicity. Salient to this interpretation was family, community connectedness and Dai Lue ceremonies and festivals, as well as connections with a socio-political context. Ethnicity and ‘othering’ was an important thread running through their lay health beliefs, especially distinctions between Dai and Han. The health research, policy and practice implications of the findings are also discussed, and are likely to be applicable to other ethnic minorities in China.

We narrate our travel in a city with a prominent tobacco company to contribute to the literature on smoking and place. We show that in Yuxi, the location of the Hongta Group, China’s largest tobacco manufacturer, a smoker’s sense of self and of place is affectively, cognitively and socially tied to the tobacco industry. Tobacco-related symbolism in the city is highly visible and abundant. Smoking and tobacco are enmeshed in the fabric of the city and of people’s lives, an integrated and totalising phenomenon we characterise as ‘rhizomatic smoking’. Hence, we call for ‘rhizomatic tobacco control’ as a new direction for conceptualising the entirety of tobacco in society and for subjecting tobacco control in China to critical scrutiny.

In this article, we report our research on Dai Lue in a rural area of Xishuangbanna, revealing how their tattoos have become an emblem of the self or an interiority cultivated through outer appearance, acted out and contested on people’s bodies as parchments for society’s discourses. China’s version of modernisation and nation-state building has underpinned shifting tattoo designs and subjectivities. Tattooing among younger people was different to their elders, as they were less inclined to practise it for a sense of belonging and conformity to Dai Lue and, instead, did so to stand out from and within their ethnic group, expressing a more individual and volitional self—a profound cultural change which also pervades many other aspects of their lives. We also show how popular discourses in China concerning the nation and ethnic minorities are being embodied and visually performed by Dai Lue through their tattoos, albeit creatively and not homogeneously. Our findings call for a more inclusive national story line in China which moves beyond simple stereotypes of ethnic categories currently popular in society to appreciate the complexity of peoples’ lives. Our study also updates the literature on tattooing among Dai Lue which, hitherto, was limited to descriptions in Chinese texts of old tattoo designs and rituals in isolation from society and politics.

In this study, we analyzed identity construction among young smokers in China, with three interconnected objectives: to theorize the turning points and career trajectory of smoking initiation; to account for their characteristics with interactionist processes; and to critically evaluate the applicability of classic typologies of identity change by Becker and Strauss. In-depth interviews with 24 late adolescents (ages 18–19) revealed a smoking initiation career path of four interconnected turning points, each characterized by interactionist processes. Smoker peers played a key role in facilitating overall career progression, and shame avoidance was crucial to their social dynamics. We also conclude that classic studies of turning points in general, and substance use specifically, are sufficiently broad and flexible to elucidate tobacco smoker identity construction in China, and facilitate a comparison of commonality and divergence among different “becoming” identities. The implications of these findings for tobacco control in China are discussed.

People’s beliefs about feeding stray cats require investigation. Previous studies were based on assumptions about sample homogeneity, potentially obscuring within-group and background differences in beliefs. A latent class analysis was conducted on critical beliefs identified from 167 Malaysian nationals (Kuala Lumpur residents, aged 18-64), based on the Theory of Planned Behavior (TPB). Two distinct subgroups were discerned, revealing heterogeneity in critical beliefs about feeding stray cats. Subgroup membership was associated with multiple background factors (i.e., ethnicity, past feeding experience, pet cat ownership, and religion). Therefore, interventions to reduce the feeding of stray cats (or to change other behaviors) should accommodate subgroup variations in beliefs and background factors. This study provides a novel methodology for investigating the complexity of human variables in human-animal interaction and other behaviors.

BACKGROUND: Sexual communication is a common target in psychological treatments for vulvodynia, and associations with sexual function and distress, as well as pain intensity, have been demonstrated. However, structured observations of the communication patterns of couples with vulvodynia are lacking, as these are needed to guide treatment efforts.

AIM: To explore (1) the sexual communication patterns in couples with vulvodynia in terms of observed communication quality (operationalized as validating and invalidating responses), self-reported sexual assertiveness, and self-disclosure and (2) associations between sexual communication quality and pain intensity.

METHODS: In a case-control design with within- and between-group comparisons, 62 couples engaged in videotaped discussions about their sexual relationship. Trained coders assessed the discussions by rating sexual communication (validation and invalidation) according to a structured behavioral coding scheme. Group differences in sexual communication quality were examined with parametric and nonparametric tests. Dyadic associations among observed communication quality, self-rated sexual assertiveness, and self-disclosure were examined within the actor-partner interdependence model. Multiple regression was used to test the predictive value of partners' validation/invalidation on the pain intensity of the women with vulvodynia.

OUTCOMES: Observed communication quality (ie, validation and invalidation), self-reported sexual assertiveness, self-disclosure, and pain intensity.

RESULTS: Partners of women with vulvodynia were more invalidating toward their partners than those of women without pain. There were no significant differences in validating/invalidating communication between women in the 2 groups or in validation between partners. Partners' validating communication were significantly associated with women's lower pain intensity. The sexual communication patterns differed between couples with and without vulvodynia, and the associations between validating/invalidating responses and sexual assertiveness were stronger in the vulvodynia group than in the group without pain. Results on validation/invalidation and self-disclosure were inconclusive.

CLINICAL IMPLICATIONS: The results indicate a need to direct treatment interventions toward couples' sexual communication quality (ie, levels of validation and invalidation).

STRENGTHS AND LIMITATIONS: Strengths include systematic behavioral coding and dyadic analyses. Limitations include the cross-sectional design and self-selection of participants.

CONCLUSION: This study demonstrated sexual communication patterns specific to couples with vulvodynia, and we conclude that validation and invalidation are important components of the sexual communication of couples with vulvodynia as they relate to sexual assertiveness, women's self-disclosure, and pain intensity.

Research on forgiveness is limited in Ecuador. This study validated the Enright Forgiveness Inventory–30 (EFI-30) among 960 participants in Ecuador, resulting in robust reliability and validity values. Our findings provide avenues for future research and practices.

Research on forgiveness has received growing academic interest. The Enright Forgiveness Inventory (EFI) is one of the most widely used interpersonal forgiveness measures in the world. However, its validation study had not been conducted in Latin America. This study aimed to investigate the structural validity of the EFI 30-item version (EFI-30) in Argentina. An online survey was administrated including the EFI-30 and a social desirability scale, as well as demographic questions. A convenience sample (N = 472) was recruited. All participants were originally from Argentina, and 47.2% were married or cohabiting in a relationship. Factor analysis was used to evaluate structural validity. Part of the EFI-30 is a single-item forgiveness question that was used to examine the inventory’s convergent validity. Other conventional psychometric tests were also performed to validate the previous analyses. The results confirmed the six-factor structure of the EFI-30, namely, positive affect, negative affect, positive behaviour, negative behaviour, positive cognition, and negative cognition. Findings are consistent with previous validation studies across countries. The strong scalability of the Argentine EFI-30 provides multiple avenues for future research. The study might be replicated among other demographic groups (e.g., adolescents) in Argentina.

The primary aim of the current study was to explore the extent to which videogame helping behaviour could be explained by need satisfaction and passion. The study extends previous research by looking specifically at in-game helping behaviour which has relevance for a range of wellbeing outcomes as well as reducing in-game toxicity. Survey data were collected from 389 participants assessing need satisfaction, passion, empathy and in-game helping behaviour during the past four weeks. Path analysis revealed that helping behaviour is associated with empathy which is more likely in the context of harmonious passion and less likely in context of obsessive passion. Competence and Relatedness were also found to increase the likelihood of helping behaviour.

Objective: This study examined the nature and prevalence of polydrug use in 12–14 year old Australians.

Method: Three Australian school surveys (2006, n=4091; 2009, n=5635; 2017, n=1539; age 12–14 years) spanning 11 years were used. Substances included alcohol, tobacco, cannabis, inhalant, and other illicit substances. Risk factors included depressed mood, low emotional control, poor family management and conflict, and academic performance. Latent class analysis was used to discern classes. Regression analyses were used to test the association of risk factors with classes.

Results: Consistent across surveys, there was a class of adolescents who engaged in wide-ranging polydrug use, with prevalences ranging from 0.44% (2006) to 1.78% (2017). Emotional control problems, low academic performance, and poor family management were elevated in the polydrug class.

Conclusion: A small proportion of 12–14-year-old adolescents engage in polydrug use. Interventions focusing on family risks and emotional control problems may be beneficial.

Free-roaming cats are common in residential and public areas in Malaysia and approach people for food. However, the psychological determinants of public feeding are unknown. This study investigated public perceptions of feeding free-roaming cats, based on an extended theory of planned behavior (TPB). It consisted of qualitative belief-elicitation interviews with 25 participants, followed by a quantitative survey of 167 participants, representative of the country’s population. The majority (87.2%) of the sample had fed free-roaming cats. The mean intention score (4.88 out of 7) indicated the public was likely, and would make an effort, to feed free-roaming cats in the future. The public’s benevolence toward animals largely explained the findings, based on generally positive attitudes and perceptions of moderate social credence and capability and confidence, underpinned by affective and cognitive beliefs. An important finding was the role of anticipated regret in predicting and explaining intentions, which contributed variance over and above that explained by the TPB constructs. The extended framework is explained by the influence of anticipated regret on the perceived evaluation of potential TPB outcomes, which in turn leads to the behavior becoming less volitional. Therefore, future TPB studies of people’s interactions with animals, such as free-roaming cats, should take account of affective and emotional antecedents of behavior, such as anticipated regret, to improve explanatory power. The study also has implications for managing public feeding of free-roaming cats, such as drawing on and strengthening the Malaysian public’s positive attitudes and emotional concern to redirect current feeding practices toward more constructive animal welfare initiatives. Such humane approaches align with the public’s sensitivity toward animal welfare and the historical development of cat population control from lethal methods to humane non-lethal methods to ensure adequate care.

As a preventable disease, skin cancer is a public health issue in Austria. Most sun-safety studies focus on people’s activities in summer, but little is known about sun-protective behavior in winter. Based on the Theory of Planned Behavior (TPB), this study examines psychological perceptions among people who engage in winter sports in Austria. Following a TPB-based belief elicitation study, a consequent survey was conducted among 114 participants (51.8% female; Mage = 29.54 years) in South Austria. Intention, attitude, subjective norm, perceived behavioral control, and risk perception showed strong and significant associations with sun-safe behavior among people who engage in winter sports. The TPB framework explained a large portion of variance in sun-safe behavior (75%) and intention (73%). Gender differences have been identified in TPB-variables as well as several beliefs. Based on the utility of the TPB, our findings suggest guidelines for sun-safety in winter sports settings. Gender differences are in line with previous research, highlighting the vulnerability of men to sun damage during winter sports.

Conspiracy theories flourish during the coronavirus disease 2019 (COVID-19) pandemic especially regarding vaccinations. As the vaccination reluctancy in Austria is high, it is important to understand the antecedents of vaccination intention at the preapproval stage of the vaccination process. An online survey was conducted in August 2020 in Austria with 217 primarily younger, female, educated participants. A two-step cluster analysis resulted in a sceptics cluster with a clear antivaccination tendency along with a right-wing political position, lower trust in general vaccines and lower education levels and the reference cluster. A considerable percentage of participants reported their reluctancy to have a COVID-19 vaccine. Although vaccination intention can be explained by attitude and subjective norm, this decision-making process is undermined by underlying factors such as conspiracy ideation and political position. Policy makers and health interventionists should take political background into consideration in efforts to increase vaccine compliance.

OBJECTIVE: This study aimed to investigate the interrelations between emotion regulation strategies and different types of anger using network analysis.

METHOD: Data were drawn from a cross-sectional sample of 538 adults (55% females; mean age = 39.8 years, SD = 12.3) seeking treatment for anger. Data were collected between March and November 2019 in Sweden. Participants completed measures of anger problems (anger expression, anger suppression, angry reactions, anger rumination, trait anger, hostility, physical aggression, and verbal aggression) and emotion regulation (cognitive reappraisal, expressive suppression, anger relaxation, and five mindfulness strategies). To determine whether distinct clusters of anger nodes would emerge, exploratory graph analysis was employed. Based on clustering of nodes, we estimated separate networks including all measures of emotion regulation.

RESULTS: Two clusters emerged: one consisting primarily of cognitive components of anger, and another of behavioral. Across networks, anger nodes were strongly interconnected, and anger rumination and anger suppression were especially influential. Several direct links were found between specific emotion regulation strategies and cognitive components of anger, whereas most strategies were only indirectly related to angry behavior. Cognitive reappraisal showed no direct link with any of the anger nodes.

CONCLUSIONS: Our findings reveal potential pathways by which different emotion regulation strategies may influence different types of anger, which could serve as therapeutic targets.

Non-suicidal self-injury (NSSI) has been tied to several forms of emotional and behavioral dysregulation in adolescence, with less attention paid to regulation of anger. Most assume that anger dysregulation leads to engagement in NSSI, rather than the reverse. However, it is plausible that NSSI compromises adolescents’ abilities to regulate their emotions, including anger, because it may reduce the development of alternative regulatory strategies and intensify negative emotions by reducing tolerance of distress. Using three waves of data from a sample of adolescents in 17 Swedish schools (n = 1,304 M age = 13.68, SD age = .67; 89% of Swedish origin; 58% girls), we examined the directionality of ties between NSSI and three forms of anger dysregulation: dysregulated expressions of anger, anger suppression, and low anger reflection. We also looked for differences in magnitude of paths and gender differences. Random-intercept cross-lagged panel models showed that NSSI predicted changes in all forms of anger dysregulation but found no support for the opposite direction. Gender differences were not evident. Results challenge directionality assumptions and support suggestions that adolescents’ anger regulation degrades when they self-injure.

Information and communication technologies (ICT) provide digital tools to support and facilitate social engagement. However, the extent to which new ICTs, such as instant messaging, and training on its use, enhance intergenerational family interactions and reduce social isolation and loneliness needs further exploration. In the present study, we developed a brief psychoeducational intervention to promote older adults and their family members (N = 64) to use new technologies to increase communication with each other. With a randomized controlled trial design, we evaluated the effectiveness of the intervention in changing primarily participants’ intergenerational interactions, perceived social isolation, and loneliness. Through repeated-measures analysis of variance, an overall condition by time effect was found in younger family members such that contact frequency improved in the intervention condition compared with the waitlist control condition. Using a dyadic framework, we further investigated the role of the intervention in fostering interactions among family members. Dyadic analyses showed a partner effect with contact frequency in younger adults at pre-assessment predicting contact frequency of older adults at post-assessment. This suggests that support and encouragement from younger family members could increase intergenerational interactions and technology adoption among older adults. Moreover, online phone calls served as a promising tool to enhance intergenerational communication; higher user satisfaction was associated with increased ICT use, perceived usefulness, and fewer barriers to technology. This study provides preliminary findings on the effectiveness of ICT-based interventions for engaging older adults and their family members in the use of newer technologies to promote intergenerational interactions and reduce social isolation.

Previous studies have found that playing massively multiplayer online games (MMOGs) such as World of Warcraft (WoW) can lead to socializing and enhanced connectedness as well as negative well-being outcomes. Motivations for achievement and socializing play central roles in playing MMOGs. Using data from a survey of 181 WoW players, this study examined the relationship among game identities, motivations for playing WoW, and psychological outcomes. Results from analyses of path models suggested that motivations for achievement and socializing were influenced by game identities. Although these motivations substantially explained the variance in players' sense of WoW community, these factors only explained a small portion of negative psychological well-being. This study attests to the possibility of utilizing identity-based motivations in online game studies to understand psychological outcomes for players.

Given the predominance of the theory of planned behaviour (TPB) to represent the psychological determinants underlying people's charitable decisions, the present study synthesised the model's key relationships, using meta-analysis, and tested the predictive utility of the model for charitable giving encompassing donations of blood, organs, time, and money. Given its relevance to altruistic decisions, the impact of moral norm was assessed also. A systematic literature review identified 117 samples (from 104 studies) examining donation intentions and/or prospective behaviour using TPB measures. The sample-weighted average effects for all associations were moderate-to-strong with perceived behavioural control (PBC) most strongly associated with intention (r+ = 0.562), followed by moral norm (r+ = 0.537), attitude (r+ = 0.507), and subjective norm (r+ = 0.472). Intention (r+ = 0.424) showed stronger associations with prospective behaviour than PBC (r+ = 0.301). The standard TPB predictors explained 44% of variance in intention (52% including moral norm). Intention and PBC explained 19% of variance in behaviour. A number of TPB associations showed differences when analysed for moderator variables such as length of follow-up for prospective behaviour and type of target behaviour. Stronger associations were found for the (subjective and moral) norm-intention associations among some of the different types of giving behaviours, especially for donating organs and time. Overall, the large proportion of variance explained by the TPB predictors especially for intention highlights those cognitions associated with people's plans to give, informative for charities reliant on people's propensity to give.

In Queensland, Australia drowning deaths of children under the age of 5 have increased over the last 3 years, with home swimming pools being the most common site of this tragedy. Restriction of access to pools and supervision of children using the pool are two behaviours that can prevent drowning. Pool owners who were parents or guardians of children aged under 5 years (N = 242) completed a survey regarding these behaviours. We examined the impact of owners’ risk perceptions and feelings of anticipated regret on the pool safety intention and behaviours of (1) restriction of child access and (2) supervision of children, after taking into account established psychosocial determinants of decision making conceptualised by the theory of planned behaviour (attitude, subjective norm, perceived behavioural control). In addition, underlying beliefs (attitudinal, normative, control) were examined. While anticipated regret significantly predicted intentions for both behaviours, risk perception was not a significant predictor of intention to perform either behaviour. The established decision-making constructs of attitudes, norms, and control factors influenced intention, with intention and control factors predicting behaviour. Furthermore, the critical beliefs identified in this study, in particular the approval from close others and experts in the swimming domain, provides for a better understanding of pool safety behaviour. The findings based on psychological variables and critical beliefs can be applied to future intervention strategies aimed at decreasing the incidence of childhood drowning.

OBJECTIVE: Sun safety is crucial for preventing skin cancer. This study evaluated a school-based intervention based on the theory of planned behaviour (TPB), which aimed to encourage sun-protective behaviour among adolescents.

METHODS: Secondary school students (N = 382; 61.1% female; M_age  = 13.73 y) in Queensland, Australia, participated in the study. Schools were randomly allocated to an intervention or control group. The intervention focussed on fostering positive attitudes, increasing perceptions of normative support, and strengthening control perceptions. Participants completed questionnaires assessing the TPB variables and sun-protective behaviour (weekday and weekend) 1 week before intervention (time 1), 1 week after intervention (time 2), and 4 weeks after intervention (time 3).

RESULTS: With baseline between-group differences in TPB variables matched, repeated-measures multivariate analysis of variance was used to evaluate the Time × Condition effects across time. Multigroup comparisons using path models traced the intervariable changes. From times 1 to 3, a significant improvement in weekend sun-protective behaviour was identified in the intervention group (but not the control group), whereas cognitions showed no significant changes across time for either conditions. Multigroup comparisons on path coefficients between the intervention and control group participants indicated that the intervention group members formed stronger positive associations between perceived behavioural control and intention at time 2 and between perceived control and behaviour at time 3.

CONCLUSION: The significant behavioural change on weekends highlights the value of targeting control perceptions, which may encourage adolescents' sun-protective behaviour. Further studies are needed to understand the absence of significant changes in weekday sun-safe behaviour among this at-risk cohort.

ISSUE ADDRESSED: The prevalence of skin cancer remains at a high level in Australia. Young female Australian beachgoers are an at-risk population of skin cancer. Research on sun-protective beliefs held by this at-risk group is limited.

METHODS: Based on the Theory of Planned Behaviour (TPB), we conducted a formative study to understand key sun safe messages among young female beachgoers in Queensland, including an elicitation study (Phase 1; N = 21, M_age  = 24.30 years) and a two-wave questionnaire survey (Phase 2; N = 140, M_age  = 23.96 years).

RESULTS: Following content analysis and regression analyses, three key beliefs were identified: "be uncomfortable and/or unstylish" (behavioural belief), "friends and peers" (normative belief) and "lack of motivation to reapply sunscreen" (control belief).

CONCLUSIONS: The results highlight the influences of friends and peers on beachgoers' sun-protective behaviour for this young female adult cohort. Compared to previous findings among the general population, discrepancies in beliefs suggest interventions targeting this cohort should specifically focus on fashionable sun safe images and motivation to reapply sunscreen. SO WHAT?: Future health promotion and public education should utilise various strategies according to specific groups given the discrepancies identified in beliefs. For female beachgoers, sun safe images and motivations should be the primary foci.

Purpose: There is a wide range of individual and work environment factors that influence work ability among workers withpain and stress-related ill-health. The multiple interactions and overlap between these factors are insufficiently understood,and a network approach could mitigate limitations of previous research. This pilot study aimed to explore interactions betweenindividual characteristics and psychosocial work environment and potential links to long-term work ability.

Methods: Prospective data from a prevention project was used. Individuals (N = 147) with pain and/or stress-related ill-health(95% women) at public sector workplaces filled out baseline questionnaires about a collection of individual and work environ-ment factors, which were used for constructing undirected networks. The model was run in three subsamples of workplaces.Finally, a separate model was established with work ability at 6-month follow-up as outcome variable. A shortest pathwayanalysis was calculated to identify mediators of work ability.

Results: Symptom catastrophizing and perceived stress were the most influential factors in all network models. Symptomcatastrophizing and pain-disability risk were found to mediate the relation between perceived stress and long-term workability. Further, demand-control-support factors were interrelated, and patterns of interaction differed between differenttypes of workplaces.

Conclusion: The findings support the importance of individual factors, specifically symptom catastrophizing in an individual’scoping with pain or stress-problems and its influence on long-term work ability. Catastrophizing might play a role in stress-related disorders which should be further investigated. Individual and work environment factors interact and vary acrosscontext, which needs to be taken into consideration to prevent pain and stress-related ill-health at work.

While latent class analysis (LCA) has gained popularity in social sciences, including psychology, the visualization of latent classes has been the subject of limited discussions. This article reviews the elements of LCA figures, covering issues such as graph type, axis labels, and subgroup naming. Bar charts and line graphs have been identified as two major visualization approaches in LCA studies. It is concluded that LCA figures serve as an important visual vehicle to display subgroup characteristics. However, the elements of LCA figures need careful consideration as they could furnish the text with additional information. A checklist is summarized for LCA figure preparation.

This is a narrative reflection about my experience of the ongoing coronavirus (COVID-19) outbreaks across countries between January and early March 2020. My recalled memories showed the shifting and contingent thoughts and emotions. Contextual factors such as my ethnic identity and local anti-coronavirus policies also constructed my perceptions of the pandemic. While my story is unfinished as the coronavirus outbreak is still happening, the narratives provide a novel perspective to understand public health practices in a global context. As the health knowledge construction is infused with identity and personal meanings, this reflection also shows that people from a racial group may face unfair treatment in a pandemic. My narratives suggest the need for a more globally synchronized health communication in pandemics.

When coronavirus disease (COVID-19) news along with protective health recommendations first came to people’s life, such ambiguous information became a public opinion. Performing protective behaviors can be regarded as an approval of the majority opinion as people have to alter their established health positions and practices. So far, the association between public opinion and protective health behaviors is unclear especially in the pandemic context. This study utilized a survey data collected between 1 and 10 April 2020 in Germany (n = 101), Austria (n = 261), Switzerland (n = 26), and China (n = 267). We compared the protective health behaviors between the Chinese and European participants, as well as examined the associations between the protective health behaviors, peer influence, and fear of social isolation. Protective health behaviors were found similar between Chinese and European participants, although being independent from peer influence and fear of social isolation were related to protective health behaviors in the Chinese sample. Our cross-national findings are consistent with previous studies, suggesting that both official and unofficial health communication show stronger influences in Asian populations. Findings from this study provide advice for public communication strategies to promote protective health behaviors during pandemics.

Objective: Psychological constructs related to the fear-avoidance model such as fear of movement, pain catastrophizing, and affective distress have been found to be inter-related among patients with chronic pain. However, relationships of these constructs have mostly been examined using regression-based analyses. This cross-sectional study employs a novel analytical approach, network analysis, to illustrate the complex interplays among these variables as well as pain intensity and pain interference.

Methods: This study utilized the Swedish Quality Registry for Pain Rehabilitation, including data from 10,436 participants (76.0% women; Mage = 45.0 years). Networks were analyzed separately for patients with different pain extents (i.e., numbers of pain locations) as the interplays may differ qualitatively depending on pain extent.

Results: We found that patients with a larger pain extent showed a worse clinical presentation (i.e., more depression and anxiety, increased fear of movement and pain interference), and their network differed from the patients with a smaller number of pain extent in terms of how strongly key variables were interconnected. In all network models, pain interference and catastrophizing showed consistently influential roles.

Conclusion: Our findings highlight the interactive nature of psychological aspects of pain and how interrelated associations differ depending on pain extent. Findings are discussed based on ideas on how both fear and pain become overgeneralized.

The present study combined a supervised machine learning framework with an unsupervised method, finite mixture modeling, to identify prognostically meaningful subgroups of diverse chronic pain patients undergoing interdisciplinary treatment. Questionnaire data collected at pre-treatment and 1-year follow up from 11,995 patients from the Swedish Quality Registry for Pain Rehabilitation were used. Indicators measuring pain characteristics, psychological aspects, and social functioning and general health status were used to form subgroups, and pain interference at follow-up was used for the selection and the performance evaluation of models. A nested cross-validation procedure was used for determining the number of classes (inner cross-validation) and the prediction accuracy of the selected model among unseen cases (outer cross-validation). A four-class solution was identified as the optimal model. Identified subgroups were separable on indicators, predictive of long-term outcomes, and related to background characteristics. Results are discussed in relation to previous clustering attempts of patients with diverse chronic pain conditions. Our analytical approach, as the first to combine mixture modeling with supervised, targeted learning, provides a promising framework that can be further extended and optimized for improving accurate prognosis in pain treatment and identifying clinically meaningful subgroups among chronic pain patients.

Objectives: Most of the world's areca nut users reside in south and southeast Asia, but research is scarce. We examine areca nut use among Dai, a Chinese ethnic minority, and its implications.

Results: The history, common knowledge, traditional medical applications, social functions, and changing epidemiology of areca nut use are reviewed. Importantly, areca nut use is embedded in complex social meanings and practices, and is changing as long-standing customs are being shaped by new fashions. Its declining popularity among Dai has important implications for the management of substance misuse, as changing contextual factors such as customs and social norms have been more important than interventions or policies and laws.

Conclusions/Importance: The findings contribute to future strategies to curb the consumption of areca nut, and also help to explain unsuccessful control in China of other substances such as tobacco which overlooked social context. It is imperative that health professionals and researchers engage with the culture, health beliefs, and society of specific populations to formulate culturally appropriate and innovative oral health strategies.

The majority of research about tobacco use in China focuses on Han Chinese, the main ethnic group comprising over 90 per cent of the population, and a paucity of research exists on ethnic minorities. The present study elucidates tobacco use among the Dai people, an ethnic group in Yunnan Province, Southwest China. The study design consisted of interviews and grounded theory methodology in a symbolic interactionist theoretical framework. The categories of the grounded theory revealed tobacco consumption was weaved in a complex web of meanings: social practices, perceptions of health, and work lives as agriculturalists, situated in Dai cultural and social milieu. An important finding was the stage-managing of tobacco as a symbol of 'tradition' versus 'modernity': Through a process of contested modernity, the older men championed long-standing tobacco customs as representative of Dai heritage and thus their own tobacco use as upholding traditions amid encroaching cultural and societal change in China. These findings are important because little is known about Dai people's tobacco use and how they are responding to social change. There are also implications for the development of culturally-appropriate tobacco control strategies.

Awareness of animal influenza and its prevention and control is important for ensuring livestock health, production and welfare. In China, a country stereotyped as a major source of emerging zoonotic infectious diseases, research on the public understanding of animal influenza is limited to the Han, the main ethnic group. The present qualitative study in Southwest China investigated awareness of animal influenza among the Dai, an ethnic minority. The participants (15 men and 10 women, ages 18-83) were smallholder farmers of pigs and poultry in rural areas of Jinghong, Xishuangbanna, Yunnan Province. A mixture of interviews and group discussions took place in homes and villages. The participants were asked about their knowledge of avian influenza (H7N9), swine influenza (H1N1), precautions taken to protect against influenza, procedures when animals were sick and perceived risk of animal influenza. The data were analysed following coding and thematic analysis. The findings demonstrated a limited understanding of animal health and welfare among participants. Specifically, they were largely unaware of animal influenza (H7N9, H1N1) including its causes, symptoms, prevention and treatment. The farmers were also uninformed of the risks they faced and unknowingly engaged in behaviours which increased direct or indirect exposure to infected animals, a risk factor for human infection. They also reported poor usage of veterinary services. In order to guarantee the health, welfare and production of their livestock, immediate action is needed to enable Dai smallholder farmers to prevent and respond to animal influenza effectively and timely.

Tobacco smoking and depression are important contributors to the burden of disease in China, and their onset typically occurs in adolescence. However, there is no consensus on the nature and underlying mechanisms of their interplay, and related studies on Chinese adolescents and ethnic minorities are limited. This study tested the mediation role of depression in the link between smoking intention and behavior in relation to sex. A secondary analysis was conducted on data from a survey of 1,322 Chinese Dai middle school students aged 15–19 years (M = 17.02 years; 773 female students and 542 male students) in Xishuangbanna, China. We found that the mediation role of depression between smoking intention and smoking behavior was nonsignificant, although smoking intention and depression both had significant associations with smoking behavior. Therefore, depression might be better theorized as an underlying predictor of smoking intention or that other volitional factors may link smoking intention and smoking behavior more closely. Nevertheless, depression was a significant independent variable for smoking behavior even when smoking intention was adjusted. Women perceived more depression than men with similar smoking intention levels, yet the relationship between smoking intention and smoking behavior was stronger in men. Although it seems that men were abler to translate their smoking intention into actual smoking, the high level of depression among young women who reported higher levels of smoking intention is noteworthy. Tobacco control for Chinese adolescents could incorporate sex-specific psychological therapies for negative emotions and for the internalization of problems by children.

This study investigates smoking intention, nicotine dependence, and mindfulness among Dai Lue adolescents (N = 1322, ages = 14–18), an understudied Buddhist ethnic minority in China. Based on the Theory of Planned Behavior (TPB), mindfulness showed a negative association with smoking intention. However, for participants with nicotine dependence, the mindfulness-intention association diminished, while volitional processes remained salient. Results from this study contribute to debates in the literature regarding habit versus planned behavior, and provide empirical support for integrating mindfulness into the TPB. The cognitive pathways identified could be targeted in anti-smoking interventions to curb the high prevalence of smoking among Dai Lue adolescents.

Background: Tobacco smoking and tattooing interact in multiple ways because they are risk factors to health and share social determinants and meanings (e.g. deviance). Existing research is limited and reliant on non-generalizable samples in Europe and the United States. Addiction studies on religious Chinese are scarce. In this study, we investigated the embeddedness of smoking in tattooing and tattoo-associated contextual factors in a representative sample of Chinese Buddhist adolescents.

Method: Latent class analyses based on smoking, tattooing, and tattoo norms were conducted on survey data from 1322 Chinese Dai students (aged 15–19 years, 41.2% females) in seven middle schools in Xishuangbanna, Yunnan Province, China. Subgroup membership was subsequently examined in terms of associations with religiosity, spirituality, and traditionalist tattoo esthetics.

Results: Three subgroups with different patterns of cooccurring smoking and tattooing were detected. Tattoo norms—especially peer norms—were found to be distinguishable indicators between subgroups. Traditionalist tattoo esthetics was associated with the lowest smoking-tattooing comorbidity subgroup. Religiosity and spirituality showed sporadic associations with subgroup memberships.

Conclusions: The results demonstrate the complexity of smoking-tattooing comorbidity and the importance of a culturally contextualized understanding of addiction. Greater smoking-tattooing comorbidity among adolescents with higher levels of religiosity and spirituality highlights the limitations of Eurocentric views of addiction. The role of tattoo esthetics suggests that body-related visual information can contribute to substance use. Further studies are needed on religious Chinese, a population overlooked in the literature.

Two models of intention to have a tattoo are compared using data from a survey of 1322 Chinese Dai adolescents aged 15–19 years in seven middle schools in Yunnan Province, China. Structural equation modeling compared a Theory of Reasoned Action (TRA) model with a Prototype Willingness Model (PWM). The TRA emphasizes reasoned action (deliberative, goal-oriented decision-making), while the PWM adds more impetuous (automatic and less effortful) decision processes to the TRA model. Results showed that both the TRA and PWM offered a good prediction of intention to have a tattoo, but the PWM offered more insight into the formation of intention. Multigroup comparisons revealed important inter-variable differences in the models between genders and people with and without tattoos. The intervention implications of the findings are discussed.

Smoking is a major public health problem in Austria, but relevant research and intervention is limited. Based on the Theory of Planned Behavior (TPB), the present study aimed to test the model utility in an Austrian sample. As future self-continuity is likely to impact on health behavior, we also hypothesized an extended TPB with future self-continuity could further explain the variance in smoking. Using a prospective design, 94 current smokers (74.5% women; Mage = 24.27 years; 61.7% daily smokers) from a university in South Austria completed the baseline and follow-up survey (one month after the baseline). Consistent with the TPB, intention and perceived behavioral control (PBC) significantly predicted smoking behavior; affective attitude and PBC were significantly associated with smoking intention. In contrast, cognitive attitude and subjective norm were unrelated to smoking intention. As hypothesized, the TPB explained 42% variance of smoking behavior and 31% variance of smoking intention. Participants' future self-continuity further explained the variance of smoking behavior. Our study demonstrates the utility of the TPB in understanding Austrian smoking behavior. The role of psychological perception of future self among smokers has been highlighted. Future smoking intervention may target PBC, affective attitude, as well as a life-span perspective.

Sun safety research has mainly been conducted in the West, whereas little is known about sun protection practices in India. Using a survey design with a representative sample, we aimed to understand the frequency of sun protection practices in India. We also examined associations between demographic covariates and sun safe behaviours. We surveyed a representative sample (N = 1560) from the Indian population in November 2022. The study variables included sun safe behaviours, sunburn experience, demographic information, and skin tone. We employed descriptive and regression analyses to examine the prevalence of behaviours and their associations. To mitigate potential sampling biases, we applied poststratification weights in the analyses. More than half of the participants (64.2%) routinely performed at least one sun safe behaviour, with only 4.9% of the sample reporting no engagement with sun safe behaviours in the last 12 months. Physical protection (e.g., long sleeves, shade/umbrella) were more common than sunscreen use. Regression analysis showed that higher subjective social status, being younger, and living in one of the Eastern Indian states were the strongest predictors of sun protection practices. Our findings fill an important knowledge gap in global sun safe research, highlighting the urgent need for public sun safety education. Scalable and targeted interventions are needed to promote sun safety awareness and practices among people.

INTRODUCTION: Preventing adolescent alcohol use is an international public health priority. To further understand adolescent alcohol use, this study tested a model of adolescent intention to consume alcohol that incorporated multiple social systems influences.

METHODS: Participants included 2529 Australian secondary school students (M_age = 14.20; 53.7% female). Participants completed a survey about risk and protective factors for alcohol use at individual, family, school and community levels. Structural Equation Modeling (path analysis) was used to evaluate an extended Theory of Planned Behavior (TPB) that incorporated social system determinants of intention to consume alcohol.

RESULTS: The final model explained 60% of the variance in adolescent alcohol use intention. All TPB constructs correlated with intention and experience of lifetime alcohol use. More exposure to information about alcohol use had a weak but significant influence on adolescents' stronger perceived behavioral control. Having less friends who use alcohol, stricter parental rules for adolescent alcohol use, and unfavorable parent attitudes towards alcohol use, were associated with stronger adolescent anti-alcohol attitudes and subjective norms. Community level pro-abstinence attitudes predicted unfavorable adolescent attitudes to alcohol and intention to consume alcohol. Parental rules showed significantly stronger influences on alcohol use intention amongst younger adolescents.

CONCLUSIONS: Key social systems around adolescents significantly predicted intention to consume alcohol, and the extended TPB model explained the major variance in adolescent alcohol use. The findings emphasize the importance of multi-level approaches to the prevention of alcohol use. Situation-based factors that could trigger impulsive emotional response may be a future intervention focus.

Face mask recommendations are conflicting across the world during the coronavirus disease 2019 (COVID-19) pandemic. While universal face mask wearing is a useful non-pharmaceutical preventive strategy, little is known about the perception of mask wearing during a pandemic. This study aimed to examine people’s face mask use in China and Europe. An online survey was conducted among residents in China, Austria, Germany, and Switzerland from the 1st to 10th of April 2020. With a convenience sampling approach, 655 valid answers were received including 267 Chinese and 388 European residents (261 from Austria, 101 from Germany, 26 from Switzerland). Self-reported face mask wearing status and related perceptions were assessed. Compared with the Europeans, Chinese participants showed a stronger pro-masking tendency. Subjective norm was an important predictor of face mask wearing in public. Wearing of face masks in the Chinese sample was also associated with risk perception as well as obedience to advice from local health authority. Discrepancies in face mask wearing suggest that targeted measures to promote face mask wearing are needed in Europe. Globally coordinated guidelines on pandemics are also warranted to face the next waves of COVID-19 and other infectious respiratory diseases.