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Forensic Science International May 2013Behavioural and social sciences are useful in collecting and analysing intelligence data, understanding terrorism, and developing strategies to combat terrorism. This... (Review)
Review
Behavioural and social sciences are useful in collecting and analysing intelligence data, understanding terrorism, and developing strategies to combat terrorism. This article aims to examine the psychopathological concepts of terrorism and discusses the developing roles for behavioural scientists. A systematic review was conducted of studies investigating behavioural aspects of terrorism. These studies were identified by a systematic search of databases, textbooks, and a supplementary manual search of references. Several fundamental concepts were identified that continue to influence the motives and the majority of the behaviours of those who support or engage in this kind of specific violence. Regardless of the psychological aspects and new roles for psychiatrists, the behavioural sciences will continue to be called upon to assist in developing better methods to gather and analyse intelligence, to understand terrorism, and perhaps to stem the radicalisation process.
Topics: Coercion; Criminology; Forensic Psychiatry; Humans; Leadership; Mental Disorders; Motivation; Persuasive Communication; Politics; Psychology, Social; Terrorism
PubMed: 23597734
DOI: 10.1016/j.forsciint.2013.02.004 -
Journal of Medical Internet Research Nov 2012Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed.... (Review)
Review
BACKGROUND
Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence.
OBJECTIVE
This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention.
METHODS
We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence.
RESULTS
We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p=.004), setup (p<.001), updates (p<.001), frequency of interaction with a counselor (p<.001), the system (p=.003) and peers (p=.017), duration (F=6.068, p=.004), adherence (F=4.833, p=.010) and the number of primary task support elements (F=5.631, p=.005). Our final regression model explained 55% of the variance in adherence. In this model, a RCT study as opposed to an observational study, increased interaction with a counselor, more frequent intended usage, more frequent updates and more extensive employment of dialogue support significantly predicted better adherence.
CONCLUSIONS
Using intervention characteristics and persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are differences between health care areas on intervention characteristics, health care area per se does not predict adherence. Rather, the differences in technology and interaction predict adherence. The results of this study can be used to make an informed decision about how to design a web-based intervention to which patients are more likely to adhere.
Topics: Guideline Adherence; Health Behavior; Humans; Information Storage and Retrieval; Internet; Persuasive Communication
PubMed: 23151820
DOI: 10.2196/jmir.2104 -
Health Psychology : Official Journal of... Jan 2014Health messages can be framed in terms of the benefits of adopting a recommendation (gain frame) or the costs of not adopting a recommendation (loss frame). In recent... (Review)
Review
OBJECTIVE
Health messages can be framed in terms of the benefits of adopting a recommendation (gain frame) or the costs of not adopting a recommendation (loss frame). In recent years, research has demonstrated that the relative persuasiveness of gain and loss frames can depend on a variety of dispositional factors. This article synthesizes this growing literature to develop our understanding of the moderators of framing.
METHOD
A systematic review of published literature on gain and loss framing was conducted. Articles were retrieved that tested the interaction between framing and moderators representing individual differences in how people are predisposed to think, feel, and behave. The significance and direction of framing main effects and interactions were noted and effect size data extracted where available.
RESULTS
Forty-seven reports published between January 1990 and January 2012 were retrieved that reported on 50 unique experiments testing 23 different moderators. Significant interactions with typically small to medium simple main effect sizes were found in 37 of the 50 studies. Consistent interactions were found for factors such as ambivalence, approach-avoidance motivation, regulatory focus, need for cognition, and self-efficacy beliefs. Less consistent effects were found for perceived riskiness of activity, issue involvement, and perceived susceptibility/severity.
CONCLUSION
The relative effectiveness of gain- or loss-framed messages can depend on the disposition of the message recipient. Tailoring the frame to the individual therefore has the potential to maximize message persuasiveness.
Topics: Affect; Health Communication; Health Knowledge, Attitudes, Practice; Humans; Motivation; Persuasive Communication; Risk Assessment; Self Efficacy
PubMed: 22924446
DOI: 10.1037/a0029305 -
Epidemiologia E Prevenzione Jan 2012to synthesize scientific evidences about methods to increase cervical, breast and colorectal cancer screening participation. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
to synthesize scientific evidences about methods to increase cervical, breast and colorectal cancer screening participation.
METHODS
a multidisciplinary working group has been set up to define the scope of the report and to conduct the evaluation. The scope and the final evaluation have been submitted to a stakeholder committee, including the Ministry of Health, the National Screening Observatory, regional screening program coordinators, scientific societies, and Lega Italiana Lotta ai Tumori, for comments and integrations. A systematic review of the principal biomedical and social literature databases was conducted to identify experimental and observational studies, updating the existing review by Jepson and coll. (Health Technol Assess. 2000;4(14):i-vii, 1-133).
RESULTS
5900 have been identified, 900 relevant for the topic.Among those, 148 reported quantitative information on intervention efficacy, other 90 came from the previous review. Organised screening programmes, based on invitation letter or on GP involvement,were consistently effective in increasing participation compared to spontaneous screening. Interventions are classified according to their target: individual, community, test simplification, health operators, health service organization. The report presents meta-analyses on efficacy, analyses of cost-effectiveness, impact on organisation and social inequality, and ethical and legal issues, of all the intervention reported in the literature.
CONCLUSIONS
there are several interventions consistently effective in any context, some of them have minimal impact on costs and health service resources.
Topics: Breast Neoplasms; Colonoscopy; Colorectal Neoplasms; Community Participation; Confidentiality; Cost-Benefit Analysis; Early Detection of Cancer; Europe; Female; Health Promotion; Humans; Italy; Male; Mammography; Mass Screening; Occult Blood; Patient Acceptance of Health Care; Persuasive Communication; Truth Disclosure; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 22418841
DOI: No ID Found -
British Journal of Cancer Mar 2012Although the physician survey has become an important tool for oncology-focused health services research, such surveys often achieve low response rates. This mini-review... (Review)
Review
Although the physician survey has become an important tool for oncology-focused health services research, such surveys often achieve low response rates. This mini-review reports the results of a structured review of the literature relating to increasing response rates for physician surveys, as well as our own experience from a survey of physicians as to their referral practices for suspected haematologic malignancy in the United States. PubMed and PsychINFO databases were used to identify methodological articles assessing factors that influence response rates for physician surveys; the results were tabulated and reviewed for trends. We also analysed the impact of a follow-up telephone call by a physician investigator to initial non-responders in our own mailed physician survey, comparing the characteristics of those who responded before vs after the call. The systematic review suggested that monetary incentives and paper (vs web or email) surveys increase response rates. In our own survey, follow-up telephone calls increased the response rate from 43.7% to 70.5%, with little discernible difference in the characteristics of early vs later responders. We conclude that in addition to monetary incentives and paper surveys, physician-to-physician follow-up telephone calls are an effective method to increase response rates in oncology-focused physician surveys.
Topics: Health Care Surveys; Humans; Massachusetts; Medical Oncology; Persuasive Communication; Physicians; Telephone
PubMed: 22374464
DOI: 10.1038/bjc.2012.28 -
The Cochrane Database of Systematic... Dec 2011The same information about the evidence on health effects can be framed either in positive words or in negative words. Some research suggests that positive versus... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The same information about the evidence on health effects can be framed either in positive words or in negative words. Some research suggests that positive versus negative framing can lead to different decisions, a phenomenon described as the framing effect. Attribute framing is the positive versus negative description of a specific attribute of a single item or a state, for example, "the chance of survival with cancer is 2/3" versus "the chance of mortality with cancer is 1/3". Goal framing is the description of the consequences of performing or not performing an act as a gain versus a loss, for example, "if you undergo a screening test for cancer, your survival will be prolonged" versus "if you don't undergo screening test for cancer, your survival will be shortened".
OBJECTIVES
To evaluate the effects of attribute (positive versus negative) framing and of goal (gain versus loss) framing of the same health information, on understanding, perception of effectiveness, persuasiveness, and behavior of health professionals, policy makers, and consumers.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, issue 3 2007), MEDLINE (Ovid) (1966 to October 2007), EMBASE (Ovid) (1980 to October 2007), PsycINFO (Ovid) (1887 to October 2007). There were no language restrictions. We reviewed the reference lists of related systematic reviews, included studies and of excluded but closely related studies. We also contacted experts in the field.
SELECTION CRITERIA
We included randomized controlled trials, quasi-randomised controlled trials, and cross-over studies with health professionals, policy makers, and consumers evaluating one of the two types of framing.
DATA COLLECTION AND ANALYSIS
Two review authors extracted data in duplicate and independently. We graded the quality of evidence for each outcome using the GRADE approach. We standardized the outcome effects using standardized mean difference (SMD). We stratified the analysis by the type of framing (attribute, goal) and conducted pre-planned subgroup analyses based on the type of message (screening, prevention, and treatment). The primary outcome was behaviour. We did not assess any adverse outcomes.
MAIN RESULTS
We included 35 studies involving 16,342 participants (all health consumers) and reporting 51 comparisons.In the context of attribute framing, participants in one included study understood the message better when it was framed negatively than when it was framed positively (1 study; SMD -0.58 (95% confidence interval (CI) -0.94 to -0.22); moderate effect size; low quality evidence). Although positively-framed messages may have led to more positive perception of effectiveness than negatively-framed messages (2 studies; SMD 0.36 (95% CI -0.13 to 0.85); small effect size; low quality evidence), there was little or no difference in persuasiveness (11 studies; SMD 0.07 (95% CI -0.23 to 0.37); low quality evidence) and behavior (1 study; SMD 0.09 (95% CI -0.14 to 0.31); moderate quality evidence).In the context of goal framing, loss messages led to a more positive perception of effectiveness compared to gain messages for screening messages (5 studies; SMD -0.30 (95% CI -0.49 to -0.10); small effect size; moderate quality evidence) and may have been more persuasive for treatment messages (3 studies; SMD -0.50 (95% CI -1.04 to 0.04); moderate effect size; very low quality evidence). There was little or no difference in behavior (16 studies; SMD -0.06 (95% CI -0.15 to 0.03); low quality evidence). No study assessed the effect on understanding.
AUTHORS' CONCLUSIONS
Contrary to commonly held beliefs, the available low to moderate quality evidence suggests that both attribute and goal framing may have little if any consistent effect on health consumers' behaviour. The unexplained heterogeneity between studies suggests the possibility of a framing effect under specific conditions. Future research needs to investigate these conditions.
Topics: Comprehension; Consumer Health Information; Health Behavior; Health Communication; Humans; Perception; Persuasive Communication; Randomized Controlled Trials as Topic
PubMed: 22161408
DOI: 10.1002/14651858.CD006777.pub2 -
BMC Public Health May 2011Health care providers (HCPs) play an important role in public health emergency preparedness and response (PHEPR) so need to be aware of public health threats and... (Review)
Review
BACKGROUND
Health care providers (HCPs) play an important role in public health emergency preparedness and response (PHEPR) so need to be aware of public health threats and emergencies. To inform HCPs, public health issues PHEPR messages that provide guidelines and updates, and facilitate surveillance so HCPs will recognize and control communicable diseases, prevent excess deaths and mitigate suffering. Public health agencies need to know that the PHEPR messages sent to HCPs reach their target audience and are effective and informative. Public health agencies need to know that the PHEPR messages sent to HCPs reach their target audience and are effective and informative. We conducted a literature review to investigate the systems and tools used by public health to generate PHEPR communications to HCPs, and to identify specific characteristics of message delivery mechanisms and formats that may be associated with effective PHEPR communications.
METHODS
A systematic review of peer- and non-peer-reviewed literature focused on the following questions: 1) What public health systems exist for communicating PHEPR messages from public health agencies to HCPs? 2) Have these systems been evaluated and, if yes, what criteria were used to evaluate these systems? 3) What have these evaluations discovered about characterizations of the most effective ways for public health agencies to communicate PHEPR messages to HCPs?
RESULTS
We identified 25 systems or tools for communicating PHEPR messages from public health agencies to HCPs. Few articles assessed PHEPR communication systems or messaging methods or outcomes. Only one study compared the effectiveness of the delivery format, device or message itself. We also discovered that the potential is high for HCPs to experience "message overload" given redundancy of PHEPR messaging in multiple formats and/or through different delivery systems.
CONCLUSIONS
We found that detailed descriptions of PHEPR messaging from public health to HCPs are scarce in the literature and, even when available are rarely evaluated in any systematic fashion. To meet present-day and future information needs for emergency preparedness, more attention needs to be given to evaluating the effectiveness of these systems in a scientifically rigorous manner.
Topics: Civil Defense; Communicable Diseases; Disaster Planning; Health Personnel; Humans; Persuasive Communication; Public Health
PubMed: 21592390
DOI: 10.1186/1471-2458-11-337 -
Journal of Epidemiology and Community... Oct 2011Anti-illicit-drug public-service announcements (PSAs) have become a cornerstone of drug policy in the USA. However, studies of the effectiveness of these interventions... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Anti-illicit-drug public-service announcements (PSAs) have become a cornerstone of drug policy in the USA. However, studies of the effectiveness of these interventions have not been subjected to a systematic evaluation.
METHODS
The authors searched 10 electronic databases along with major conference abstract databases (from inception until 15 February 2010) for all articles and abstracts that evaluated the effectiveness of anti-illicit-drug PSAs. The authors evaluated all studies that assessed intention to use illicit drugs and/or levels of illicit-drug use after exposure to PSAs, and conducted meta-analyses of these studies.
RESULTS
The authors identified seven randomised trials (n=5428) and four observational trials (n=17 404). Only one randomised trial showed a statistically significant benefit of PSAs on intention to use illicit drugs, and two found evidence that PSAs significantly increased intention to use drugs. A meta-analysis of eligible randomised trials demonstrated no significant effect. Observational studies showed evidence of both harmful and beneficial effects.
CONCLUSION
Existing evidence suggests that the dissemination of anti-illicit-drug PSAs may have a limited impact on the intention to use illicit drugs or the patterns of illicit-drug use among target populations.
Topics: Humans; Illicit Drugs; Mass Media; Persuasive Communication; Program Evaluation; Public Health; Substance-Related Disorders; United States
PubMed: 21558482
DOI: 10.1136/jech.2010.125195 -
The Cochrane Database of Systematic... Mar 2011The success of evidence-based practice depends on the clear and effective communication of statistical information. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The success of evidence-based practice depends on the clear and effective communication of statistical information.
OBJECTIVES
To evaluate the effects of using alternative statistical presentations of the same risks and risk reductions on understanding, perception, persuasiveness and behaviour of health professionals, policy makers, and consumers.
SEARCH STRATEGY
We searched Ovid MEDLINE (1966 to October 2007), EMBASE (1980 to October 2007), PsycLIT (1887 to October 2007), and the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2007, Issue 3). We reviewed the reference lists of relevant articles, and contacted experts in the field.
SELECTION CRITERIA
We included randomized and non-randomized controlled parallel and cross-over studies. We focused on four comparisons: a comparison of statistical presentations of a risk (eg frequencies versus probabilities) and three comparisons of statistical presentation of risk reduction: relative risk reduction (RRR) versus absolute risk reduction (ARR), RRR versus number needed to treat (NNT), and ARR versus NNT.
DATA COLLECTION AND ANALYSIS
Two authors independently selected studies for inclusion, extracted data, and assessed risk of bias. We contacted investigators to obtain missing information. We graded the quality of evidence for each outcome using the GRADE approach. We standardized the outcome effects using adjusted standardized mean difference (SMD).
MAIN RESULTS
We included 35 studies reporting 83 comparisons. None of the studies involved policy makers. Participants (health professionals and consumers) understood natural frequencies better than probabilities (SMD 0.69 (95% confidence interval (CI) 0.45 to 0.93)). Compared with ARR, RRR had little or no difference in understanding (SMD 0.02 (95% CI -0.39 to 0.43)) but was perceived to be larger (SMD 0.41 (95% CI 0.03 to 0.79)) and more persuasive (SMD 0.66 (95% CI 0.51 to 0.81)). Compared with NNT, RRR was better understood (SMD 0.73 (95% CI 0.43 to 1.04)), was perceived to be larger (SMD 1.15 (95% CI 0.80 to 1.50)) and was more persuasive (SMD 0.65 (95% CI 0.51 to 0.80)). Compared with NNT, ARR was better understood (SMD 0.42 (95% CI 0.12 to 0.71)), was perceived to be larger (SMD 0.79 (95% CI 0.43 to 1.15)).There was little or no difference for persuasiveness (SMD 0.05 (95% CI -0.04 to 0.15)). The sensitivity analyses including only high quality comparisons showed consistent results for persuasiveness for all three comparisons. Overall there were no differences between health professionals and consumers. The overall quality of evidence was rated down to moderate because of the use of surrogate outcomes and/or heterogeneity. None of the comparisons assessed behaviourbehaviour.
AUTHORS' CONCLUSIONS
Natural frequencies are probably better understood than probabilities. Relative risk reduction (RRR), compared with absolute risk reduction (ARR) and number needed to treat (NNT), may be perceived to be larger and is more likely to be persuasive. However, it is uncertain whether presenting RRR is likely to help people make decisions most consistent with their own values and, in fact, it could lead to misinterpretation. More research is needed to further explore this question.
Topics: Behavior; Community Participation; Comprehension; Controlled Clinical Trials as Topic; Cross-Over Studies; Data Interpretation, Statistical; Health Personnel; Humans; Perception; Persuasive Communication; Probability; Randomized Controlled Trials as Topic; Risk; Risk Reduction Behavior
PubMed: 21412897
DOI: 10.1002/14651858.CD006776.pub2 -
Journal of Medical Internet Research Feb 2011Researchers and practitioners have developed numerous online interventions that encourage people to reduce their drinking, increase their exercise, and better manage... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Researchers and practitioners have developed numerous online interventions that encourage people to reduce their drinking, increase their exercise, and better manage their weight. Motivations to develop eHealth interventions may be driven by the Internet's reach, interactivity, cost-effectiveness, and studies that show online interventions work. However, when designing online interventions suitable for public campaigns, there are few evidence-based guidelines, taxonomies are difficult to apply, many studies lack impact data, and prior meta-analyses are not applicable to large-scale public campaigns targeting voluntary behavioral change.
OBJECTIVES
This meta-analysis assessed online intervention design features in order to inform the development of online campaigns, such as those employed by social marketers, that seek to encourage voluntary health behavior change. A further objective was to increase understanding of the relationships between intervention adherence, study adherence, and behavioral outcomes.
METHODS
Drawing on systematic review methods, a combination of 84 query terms were used in 5 bibliographic databases with additional gray literature searches. This resulted in 1271 abstracts and papers; 31 met the inclusion criteria. In total, 29 papers describing 30 interventions were included in the primary meta-analysis, with the 2 additional studies qualifying for the adherence analysis. Using a random effects model, the first analysis estimated the overall effect size, including groupings by control conditions and time factors. The second analysis assessed the impacts of psychological design features that were coded with taxonomies from evidence-based behavioral medicine, persuasive technology, and other behavioral influence fields. These separate systems were integrated into a coding framework model called the communication-based influence components model. Finally, the third analysis assessed the relationships between intervention adherence and behavioral outcomes.
RESULTS
The overall impact of online interventions across all studies was small but statistically significant (standardized mean difference effect size d=0.19, 95% confidence interval [CI]=0.11-0.28, P<.001, number of interventions k=30). The largest impact with a moderate level of efficacy was exerted from online interventions when compared with waitlists and placebos (d=0.28, 95% CI=0.17-0.39, P<.001, k=18), followed by comparison with lower-tech online interventions (d=0.16, 95% CI=0.00-0.32, P=.04, k=8); no significant difference was found when compared with sophisticated print interventions (d=-0.11, 95% CI=-0.34 to 0.12, P=.35, k=4), though online interventions offer a small effect with the advantage of lower costs and larger reach. Time proved to be a critical factor, with shorter interventions generally achieving larger impacts and greater adherence. For psychological design, most interventions drew from the transtheoretical approach and were goal orientated, deploying numerous influence components aimed at showing users the consequences of their behavior, assisting them in reaching goals, and providing normative pressure. Inconclusive results suggest a relationship between the number of influence components and intervention efficacy. Despite one contradictory correlation, the evidence suggests that study adherence, intervention adherence, and behavioral outcomes are correlated.
CONCLUSIONS
These findings demonstrate that online interventions have the capacity to influence voluntary behaviors, such as those routinely targeted by social marketing campaigns. Given the high reach and low cost of online technologies, the stage may be set for increased public health campaigns that blend interpersonal online systems with mass-media outreach. Such a combination of approaches could help individuals achieve personal goals that, at an individual level, help citizens improve the quality of their lives and at a state level, contribute to healthier societies.
Topics: Adult; Behavior Therapy; Behavioral Medicine; Female; Health Behavior; Humans; Internet; Male; Motivation; Online Systems; Psychology; Social Marketing
PubMed: 21320854
DOI: 10.2196/jmir.1367