The roles of social norms and leadership in health communication in the context of COVID-19

The global struggle with the COVID-19 pandemic has lasted for almost three years. Although national and local leaders have often called on the public to comply with preventive measures through health communication, large sections of society sometimes violated precautions and did not adequately follow these calls. We propose that social norms and leaders' identity entrepreneurship characteristics could be essential in effective health communication. In line with this notion, we investigated the effects of social norm types and leadership on complying with preventive measures, the intention to be vaccinated, and prosocial behavioral tendency through a high-powered experiment that focused on three factors: leadership quality (presence/lack of entrepreneurship), descriptive norm (supportive/obstructive), and injunctive norm (supportive/obstructive). Results showed that when support for injunctive and descriptive norms was present, people tended to more readily adhere to preventive measures, get vaccinated, and engage in prosocial behavior. There was also a significant effect of the interaction between descriptive and injunctive norms on compliance with preventive measures. The compliance level was highest when both norm types were supportive and lowest when both were obstructive. The effect decreased in the discrepant norms condition, where one type of norm was supportive and the other obstructive. There is also a significant interaction between leadership and the descriptive norm, indicating that a combination of an entrepreneur leader and a supportive descriptive norm increases compliance with the preventive measure. We discussed the role of leadership and social norms in effective health communication

Protocol for a randomized controlled trial: peer-to-peer Group Problem Management Plus (PM+) for adult Syrian refugees in Turkey

Background: A large proportion of Syrians have been exposed to potentially traumatic events, multiple losses, and breakdown of supportive social networks and many of them have sought refuge in host countries where they also face post-migration living difficulties such as discrimination or integration problems or both. These adversities may put Syrian refugees at high risk for common mental disorders. In response to this, the World Health Organization (WHO) developed a trans-diagnostic scalable psychological intervention called Problem Management Plus (PM+) to reduce psychological distress among populations exposed to adversities. PM+ has been adapted for Syrian refugees and can be delivered by non-specialist peer lay persons in the community. Methods: A randomized controlled trial (RCT) will be conducted with 380 Syrian refugees in Turkey. After providing informed consent, participants with high levels of psychological distress (scoring above 15 on the Kessler-10 Psychological Distress Scale (K10)) and functional impairment (scoring above 16 on the WHO Disability Assessment Schedule 2.0, or WHODAS 2.0) will be randomly assigned to Group PM+/enhanced care as usual (Group PM+/E-CAU) (n = 190) or E-CAU (n = 190). Outcome assessments will take place 1 week after the fifth session (post-assessment), 3 months after the fifth session and 12 months after baseline assessment. The primary outcome is psychological distress as measured by the Hopkins Symptom Checklist (HSCL-25). Secondary outcomes include functional impairment, post-traumatic stress symptoms, self-identified problems, and health system and productivity costs. A process evaluation will be conducted to explore the feasibility, challenges and success of the intervention with 25 participants, including participants, facilitators, policy makers and mental health professionals. Discussion: The treatment manual of the Syrian-Arabic Group PM+ and training materials will be made available through the WHO once the effectiveness and cost-effectiveness of Group PM+ have been established. Trial registration: Clinical Trial Registration: ClinicalTrials.gov Identifier NCT03960892. Unique protocol ID: 10/2017. Prospectively registered on 21 May 2019

Social support and resilience among Syrian refugees: The mediating role of self-efficacy

Refugees are exposed to potentially traumatic events before, during, and after the forced displacement. Related to these events, they are at risk of developing mental health problems. From a public-health perspective, it is important to investigate factors fostering resilience among refugee population. This study aimed to explore the mediation role of self-efficacy between social support and resilience among Syrian refugees living in Istanbul, Turkey. A cross-sectional survey of 339 Syrian refugees aged 18 and older was conducted between September 2018 and March 2019 in Istanbul. The Connor-Davidson Resilience Scale (CD-RISC) was used to measure resilience, the Multidimensional Scale of Perceived Social Support (MSPSS) assessed social support, and self-efficacy was measured by the General Self-Efficacy Scale (GSE). The simple mediation model analysis showed the mediating effect of self-efficacy on the social support and resilience relationship. Among the demographic factors, males and individuals with higher education levels reported increased resilience. Findings illuminated the importance of self-efficacy in promoting resilience among refugee population. Implications were discussed in a culturally appropriate way to enhance self-efficacy among Syrian refugees

Culturally Adapted Cognitive Behavioral Therapy for Syrian Refugee Women in Turkey: A Randomized Controlled Trial

Clinical Impact Statement A Syrian version of CA-CBT was effective (large effect sizes for the HTQ), feasible, and potentially scalable (easy application, conducted with trained facilitators, short-term therapy, group format), and acceptable (as evidenced by very low drop out and no adverse events). Thus, the Syrian version of CA-CBT appears to be a valuable psychological intervention for traumatized Syrian refugees, particularly given the lack of effective treatments for this group

Together we stand? Belonging motive moderates the effect of national ingroup salience on attitudes towards ethnic minorities

Common ingroup categorization reduces outgroup prejudice. This link is moderated by distinctiveness motives (i.e., individuals perceiving this identity as too inclusive). Yet, Optimal Distinctiveness Theory states that both distinctiveness and belonging motives shape intergroup attitudes. For the first time we tested the hypothesis that belonging and distinctiveness motives jointly moderate common ingroup categorization effects. Using a flag-priming paradigm, two studies showed that, when national ingroup identity was salient, only belonging motives predicted positive attitudes towards outgroups (Study1: Syrians in Turkey, N = 184; Study 2: Maghrebis in France N = 151). This was corroborated by sensitivity analyses on aggregated data (N = 335). These results suggest that national identification may lead to positive outgroup attitudes for individuals who derive belonging from it

The roles of social norms and leadership in health communication in the context of COVID-19

The global struggle with the COVID-19 pandemic has lasted for almost three years. Although national and local leaders have often called on the public to comply with preventive measures through health communication, large sections of society sometimes violated precautions and did not adequately follow these calls. We propose that social norms and leaders' identity entrepreneurship characteristics could be essential in effective health communication. In line with this notion, we investigated the effects of social norm types and leadership on complying with preventive measures, the intention to be vaccinated, and prosocial behavioral tendency through a high-powered experiment that focused on three factors: leadership quality (presence/lack of entrepreneurship), descriptive norm (supportive/obstructive), and injunctive norm (supportive/obstructive). Results showed that when support for injunctive and descriptive norms was present, people tended to more readily adhere to preventive measures, get vaccinated, and engage in prosocial behavior. There was also a significant effect of the interaction between descriptive and injunctive norms on compliance with preventive measures. The compliance level was highest when both norm types were supportive and lowest when both were obstructive. The effect decreased in the discrepant norms condition, where one type of norm was supportive and the other obstructive. There is also a significant interaction between leadership and the descriptive norm, indicating that a combination of an entrepreneur leader and a supportive descriptive norm increases compliance with the preventive measure. We discussed the role of leadership and social norms in effective health communication

Los roles de las identidades y los líderes nacionales y globales en la aceptación de las vacunas contra la COVID-19 desarrolladas por diferentes países

The current paper aims to study the social-psychological factors that would play roles in COVID-19 vaccine acceptance. Specifically, we examined whether national and global identifications and the leaders whom people think being in charge of managing the COVID-19 pandemic on a national scale could explain people's acceptance of the COVID-19 vaccines developed by different countries. We proposed a model in which people's assessment of the leader in terms of identity-leadership mediates the relationship between different identification types (i.e., global and national) and acceptance of Western, Asian or national vaccines. The model was tested on self-reported data collected in Turkey (N = 694) utilizing Structural Equation Modelling (SEM) in R software. The results revealed that national identification positively predicted acceptance of national vaccines and negatively predicted acceptance of Western vaccines; both of the relationships were also mediated by people's assessments of the leader in terms of identity-leadership dimensions. On the other side, global identification positively predicted acceptance of Western vaccines. The implications of the findings were discussed in terms of their practical contributions along with their theoretical relevance.Este documento tiene por objetivo estudiar los factores socio-psicológicos que desempeñarían roles en la aceptación de las vacunas contra la COVID-19. Específicamente, hemos analizado si las identificaciones y los líderes nacionales y globales, de quienes las personas piensan que están a cargo de gestionar la pandemia de la COVID-19 a escala nacional, podrían explicar la aceptación de las personas de las vacunas contra la COVID-19 desarrolladas por diferentes países. Propusimos un modelo en el cual la evaluación del líder por parte de las personas, en términos de identidad-identificación nacional, media la relación entre diferentes tipos de identificación (es decir, global y nacional) y la aceptación de vacunas occidentales, asiáticas o nacionales. El modelo fue probado con datos auto-reportados en Turquía (N = 694) utilizando Modelos de Ecuación Estructural (MEE) en un software R. Los resultados revelaron que la identificación nacional prededecía positivamente la aceptación de vacunas nacionales, y predecía negativamente la aceptación de vacunas occidentales; ambas relaciones también estuvieron mediadas por las evaluaciones que las personas hicieron del líder en términos de dimensiones identidad-liderazgo. Por otro lado, la identificación global predijo positivamente la aceptación de vacunas occidentales. Las implicaciones de los hallazgos se debatieron en términos de sus contribuciones prácticas junto con su importancia teórica

Social Identification and Collective Action Participation in the Internet Age: A Meta-Analysis

There is a debate about the dynamics of participation in collective actions in the Internet age whether different or not from the engage in conventional ones. Some scholars claimed that the role of shared social identity is relatively unimportant in the Internet age. In order to clarify whether collective actions in the digital age still rely on social identification or not, we conducted a meta-analysis of 40 studies (N = 16,933) focused on digitally-mediated collective actions. We examined the relationship between social identification and collective action, and the possible moderator effects of group type, participation type, and WEIRDness of sample. We found a strong relationship between social identification and collective action participation. Group type was a significant moderator showing the relationship is much stronger in the emergent group compared to the pre-existing group. We discussed the theoretical implications of the results emphasized the basic dynamics of collective actions

Traumatic experiences, acculturation, and psychological distress among Syrian refugees in Turkey: The mediating role of coping strategies

Turkey hosts the largest number of refugees in the world. So far, many studies investigated the mental health problems among Syrian refugees in Turkey and other hosting countries. However, little attention has been paid to the acculturation process of Syrian refugees in Turkey. A crosssectional study was conducted with 409 Syrian refugees in Mardin, Turkey. Results showed that traumatic experiences depleted problem-focused, emotion-focused, and maladaptive coping strategies. Emotion-focused coping strategies mediated the relationship between traumatic experiences and maintenance of the heritage culture and adoption of the destination culture. To conclude, our findings underscore the importance of traumatic experiences and emotion-focused coping strategies for integration of Syrian refugees in Turkey. Psychosocial interventions enhancing emotion-focused coping capacities might mitigate the adverse impact of traumatic experiences on integration. We discussed the strengths and limitations of the study considering the current literature