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Building on West Virginia's innovative COVID-19 public health communication : associations between vaccination beliefs and vaccination messaging, partisanship, and social vulnerability
(2025-07-11) Totzkay, Dan; Fraustino, Julia Daisy; Costello, Lisa M.; Jarrett, Traci; Kristjansson, Alfgeir L.; Department of Psychology
Background: Building on our previous theory-guided research findings, this study investigated differences in COVID-19 vaccination-related beliefs across a number of relevant types of communication such as provider recommendations and aided recall of various vaccination campaign assets. We also explored the potential roles of political affiliation and social vulnerability in vaccination beliefs. Methods: A cross-sectional survey of West Virginia residents was administered in January 2022 online and via phone interview by Research America, Inc. (N = 756). Results: About 71 % of respondents had received at least one COVID-19 vaccine dose at the time of the survey. Two-thirds of the sample reported having a healthcare provider recommend vaccination, and around two-thirds reported seeing a vaccination TV advertisement. Despite varying strength of beliefs across political groups, there was a general openness to choosing to vaccinate against the virus that causes COVID-19, which reflects a social landscape conducive to vaccination communication and points toward the importance of understanding unique population segment needs, wants, and reservations, as well as the messengers from whom they trust to receive such information. Healthcare provider recommendation was consistently associated with stronger vaccination-related intentions and beliefs. Most observed differences in vaccine-related beliefs were between those who reported being politically liberal compared to both those who reported being politically moderate and politically conservative. Politically moderate and conservative participants, however, did not vary from one another. Social vulnerability index was mostly unrelated to vaccination beliefs. Conclusion: Participants had overall relatively supportive vaccination-related beliefs. While partisanship played some role surrounding vaccination-related beliefs, even politically conservative groups still exhibited positive attitudes and intentions toward vaccination– albeit to a lesser degree than their liberal counterparts. The social landscape was at least conducive to vaccination communication. Findings build on previous theory-driven communication science scholarship and hold practical implications for communication messengers and channels for ongoing health communication in a rural Appalachia.
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Anger and associated risk and protective factors among rural American adolescents : Implications for violence prevention
(2024-12) Mills, Rosalina; Lilly, Christa L.; Pollini, Robin A.; Zullig, Keith J.; Jarrett, Traci; Kristjansson, Alfgeir L.; Department of Psychology
Background: Adolescent violence in the United States is a prevalent public health problem and is understudied in rural settings. Anger is a significant risk factor for adolescent violence. To better craft adolescent violence interventions, it is important to examine anger and identify its most significant associated factors. Aims: This study examined (1) self-reported anger changes over time for rural American adolescents; and (2) structural, community, interpersonal, and individual level factors that may contribute to anger. Methods: We analyzed self-reported survey data from West Virginian middle schoolers (N = 2861) with anger as the outcome. Data was collected twice yearly from October 2020 through April 2023. Independent variables included perceptions of inequality, individual socioeconomic status (SES), neighborhood characteristics, family structure, support from adults at home and school, and harsh parenting. Analysis: Generalized estimating equation Poisson regression models for main effects and gender interaction were used. Parameter estimates were exponentiated and interpreted as Rate Ratios (RR). Self-reported gender was an effect modifier. Results: Significant main effects included perceived inequality (RR = 0.98, 95 % CI = 0.97–0.99), SES (RR = 0.99, 95 % CI = 0.98–0.99), supportive adults at school (RR = 0.99, 95 % CI = 0.98–0.99), primary caregiver support (RR = 0.99, 95 % CI = 0.98–0.99), and harsh parenting (RR = 1.10, 95 % CI = 1.05–1.05). Significant gender interaction terms included perceived harsh parenting (RR = 0.98, 95 % CI = 0.97–0.99) and supportive adults at school (RR = 1.01, 95 % CI = 1.00–1.02) for ‘other’ genders (i.e., participants identifying as neither boy nor girl) compared to boys. Conclusions: Findings underline the importance of examining rural adolescent anger development and associated risk factors for designing prevention approaches to curb downstream violent behavior.
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Beyond School Climate : Conceptualizing the School as a Protective Factor Approach*
(2024-11) Mann, Michael J.; Kristjansson, Alfgeir L.; Smith, Megan L.; Lilly, Christa L.; Thrisdottir, Inibjorg E.; Havlicak, Ashley; Department of Psychology
BACKGROUND: The school climate concept has been promising, but has long-standing critiques that have not been adequately addressed to date. The School as a Protective Factor approach represents one attempt to offer a new approach that builds on and extends beyond the concept of school climate while addressing previously identified limitations. CONTRIBUTIONS TO THEORY: The School as a Protective Factor approach offers a new framework for conceptualizing, measuring, and establishing protective school social and learning environments that co-promote academic achievement and student health in schools, especially student mental health and substance use/abuse prevention. This new framework includes clear definitions, explicit goals, firmly established constructs, validated measures, and an intentionally parsimonious approach that prioritizes the implementation of well-established, high-impact constructs. CONCLUSIONS AND IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: The School as a Protective Factor approach presents a simple, easy-to-use means of ensuring a school social environment that meets the developmental, academic, and health needs of all children and adolescents while maximizing protection across a range of desired outcomes. Perhaps most importantly, it does so in a manner that is manageable and easily integrated into every aspect of schooling, resonates with the practical experience of school personnel, and includes brief, effective, and free measurement tools.
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Social Support and Perceptions of COVID-19-related Emotional Impact on Mental Health Among Early Adolescents in Appalachia
(2023-05) Layman, Hannah M.; Mann, Michael J.; Smith, Megan L.; Kogan, Steven M.; Kristjansson, Alfgeir L.; Department of Psychology
Background: Young people who experience higher levels of social support from their schools and families have been shown to be less likely to develop symptoms of negative mental health outcomes such as depression and anxiety.1–4 This raises questions concerning how young people's stress and psychological changes due to the COVID-19 pandemic as well as social support during this time have affected their overall mental health. The aim of this study was to assess the association between sources of parental- and school-level social support and youth perceptions of COVID-19-related emotional impact on mental health among early adolescent girls and boys in Appalachia. Methods: Using linear regression, we analyzed the first and third wave of survey data from the larger parent study (Young Mountaineer Health Study) cohort, collected in 20 middle schools throughout West Virginia in the fall of 2020 and fall of 2021 (N = 1349, mean age: 11.5, response rate: 80.7%). Results: Approximately half of participants reported knowing someone that had been sick with COVID-19. Those experiencing higher levels of perceived COVID-19-related emotional impact reported greater levels of depression, anxiety, and anger. Both parental and school-level social support were associated with better mental health outcomes. Conclusions: Early adolescent perceptions of COVID-19-related emotional impact were associated with depression, anxiety, and anger and moderated by social support at home and in school among 11-12-year-old youth in Appalachia.
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Using an objective computer task (QbTest) to aid the identification of attention deficit hyperactivity disorder (ADHD) in the Children and Young People Secure Estate (CYPSE) : a feasibility randomised controlled trial
(2022-12-16) Chitsabesan, Prathiba; Hall, Charlotte Lucy; Carter, Lesley Anne; Reeves, Mindy; Mohammed, Vaseem; Beresford, Bryony; Young, Susan; Kraam, Abdullah; Trowse, Sally; Wilkinson-Cunningham, Lloyd; Lennox, Charlotte
Objectives QbTest has been shown to improve time to decision/diagnosis for young people with attention deficit hyperactivity disorder (ADHD). The aim was to assess the feasibility of QbTest for young people in prison. Design Single-centre feasibility randomised controlled trial (RCT), with 1:1 allocation. Concealed random allocation using an online pseudorandom list with random permuted blocks of varying sizes. Setting One Young Offenders Institution in England. Participants 355 young people aged 15-18 years displaying possible symptoms of ADHD were assessed for eligibility, 69 were eligible to take part and 60 were randomised. Intervention QbTest - a computer task measuring attention, activity and impulsivity. Main outcome measures Eligibility, recruitment and retention rates and acceptability of randomisation and trial participation. Results Of the 355 young people assessed for eligibility, 69 were eligible and 60 were randomised (n=30 QbTest plus usual care; n=30 usual care alone). The study achieved the specified recruitment target. Trial participation and randomisation were deemed acceptable by the majority of participants. 78% of young people were followed up at 3 months, but only 32% at 6 months, although this was also affected by COVID-19 restrictions. Secondary outcomes were mixed. Participants including clinical staff were mostly supportive of the study and QbTest; however, some young people found QbTest hard and there were issues with implementation of the ADHD care pathway. There were no serious adverse events secondary to the study or intervention and no one was withdrawn from the study due to an adverse event. Conclusions With adaptations, a fully powered RCT may be achievable to evaluate the effectiveness of QbTest in the assessment of ADHD in the Children and Young People Secure Estate, with time to decision (days) as the primary outcome measure. However, further programme developmental work is required to address some of the challenges highlighted prior to a larger trial. Trial registration number ISRCTN17402196.

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