A global experiment on motivating social distancing during the COVID-19 pandemic

Significance Communicating in ways that motivate engagement in social distancing remains a critical global public health priority during the COVID-19 pandemic. This study tested motivational qualities of messages about social distancing (those that promoted choice and agency vs. those that were forceful and shaming) in 25,718 people in 89 countries. The autonomy-supportive message decreased feelings of defying social distancing recommendations relative to the controlling message, and the controlling message increased controlled motivation, a less effective form of motivation, relative to no message. Message type did not impact intentions to socially distance, but people’s existing motivations were related to intentions. Findings were generalizable across a geographically diverse sample and may inform public health communication strategies in this and future global health emergencies. Abstract Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

Estudo caso-controle sobre exposição precoce ao leite de vaca e ocorrência de Diabetes Mellitus tipo 1 em Campina Grande, Paraíba Case-control study on early exposure to cow's milk and the occurrence of Diabetes Mellitus type 1 in Campina Grande in the State of Paraíba

OBJETIVOS: estudar a relação entre exposição precoce ao leite de vaca e ocorrência de Diabetes Mellitus tipo 1 entre menores de 18 anos atendidos no Hospital Universitário Alcides Carneiro, em Campina Grande. MÉTODOS: estudo caso-controle. A amostra foi constituída por 128 indivíduos de ambos os sexos. Foram entrevistadas 64 mães de portadores de Diabetes Mellitus e 64 mães de controles. Análises univariadas e multivariadas foram utilizadas. RESULTADOS: 84,4% dos indivíduos diabéticos foram expostos ao leite de vaca antes dos quatro meses de idade, enquanto que no grupo controle este percentual foi de 64,1%. A análise univariada identificou uma associação estatisticamente significante entre exposição precoce ao leite de vaca e Diabetes (p = 0,01). Na análise multivariada, essa associação permaneceu e a razão chances estimada foi de 4,09 (IC95%: 1,19 - 14,04; p = 0,01). CONCLUSÕES: os resultados indicam uma forte associação entre exposição precoce ao leite de vaca e ocorrência de Diabetes Mellitus tipo1 na população estudada. Assim, crianças expostas precocemente ao leite de vaca apresentam uma chance maior de adquirir a doença quando comparadas àquelas que receberam aleitamento materno exclusivo até pelo menos quatro meses após o nascimento.<br>OBJECTIVES: to study the relationship between early exposure to cow's milk and Diabetes Mellitus, type 1 among children under 18 years old seen at the Hospital Universitário Alcides Carneiro, in Campina Grande. METHODS: case-control study. Sample of 128 individuals of both sexes. Sixty-four mothers with Diabetes Mellitus type 1 and 64 mothers of a control group. Univariate and multivariate analysis was accomplished through logistic and conditional regression. RESULTS: 84,4% of diabetic individuals were exposed to cow mild before four months of age while in the control group this percentage was 64,1%. Univariate analysis determined a significant statistic association between early exposure to cow's milk and Diabetes (p = 0,01). In multivariate analysis this association remained and estimated odds ratio was of 4,09 (95% CI: 14,04; p = 0,01). CONCLUSIONS: results indicate a strong association between children with early exposure to cow's milk and Diabetes Mellitus type 1 events in the population studied. Therefore, children with early exposure to cow's milk have a higher chance of acquiring the disease when compared with those who were exclusively breastfed until at least until four months old