Evaluating complex interventions: Perspectives and issues for health behaviour change interventions

Objective: Health behaviour change interventions (HBCIs), used in health education, health promotion, patient education and psychotherapy areas, are considered complex interventions. The objective of this article is to discuss the value and limitations of using randomised clinical trials (RCTs) to asses HBCIs.

Methods: A scoping review of the literature was conducted to identify the main challenges of using RCTs for evaluating HBCIs. The issues were illustrated by case studies selected from research conducted by our multidisciplinary team.

Results: In complex interventions, effects are produced not only by the intervention, but are strongly linked to context. Issues relating to transferability of results are therefore critical, and require adjustments to the RCT model. Sampling bias, biases related to the experimental conditions and biases due to the absence of double-blindness were examined and illustrated by case studies.

Conclusion: The results underline the importance of a multidisciplinary approach. They call for adapted or alternative evaluation models that overcome the limitations of RCTs.     

Implicit bias,confabulation, and epistemic innocence

In this paper I explore the nature of confabulatory explanations of action guided by implicit bias. I claim that such explanations can have significant epistemic benefits in spite of their obvious epistemic costs, and that such benefits are not otherwise obtainable by the subject at the time at which the explanation is offered. I start by outlining the kinds of cases I have in mind, before characterising the phenomenon of confabulation by focusing on a few common features. Then I introduce the notion of epistemic innocence to capture the epistemic status of those cognitions which have both obvious epistemic faults and some significant epistemic benefit. A cognition is epistemically innocent if it delivers some epistemic benefit to the subject which would not be attainable otherwise because alternative (less epistemically faulty) cognitions that could deliver the same benefit are unavailable to the subject at that time. I ask whether confabulatory explanations of actions guided by implicit bias have epistemic benefits and whether there are genuine alternatives to forming a confabulatory explanation in the circumstances in which subjects confabulate. On the basis of my analysis of confabulatory explanations of actions guided by implicit bias, I argue that such explanations have the potential for epistemic innocence. I conclude that epistemic evaluation of confabulatory explanations of action guided by implicit bias ought to tell a richer story, one which takes into account the context in which the explanation occurs.     

Babyface effects: A double‐edged sword in healthcare service evaluations

We examine how a doctor's baby‐like facial appearance affects people's perceptions and judgments before and after a medical fraud occurs. A 2 (face type: babyfaced vs maturefaced) × 2 (doctor's gender: male vs female) × 2 (doctor's specialty: internal medicine vs surgery) between‐subjects experiment was conducted. The results indicate that a babyfaced doctor fares better than a maturefaced doctor in terms of patients' expectations, satisfaction and intended loyalty. However, having baby‐like facial features may work against a doctor who is involved in a medical fraud. The severity of a medical fraud is perceived to be greater when it involves either a babyfaced female doctor of internal medicine or a babyfaced male surgeon. After the medical fraud, this altered perception of the fraud's severity leads to reduced patient loyalty. Service evaluations based on the doctor‐patient relationship show that the doctor's baby face is a double‐edged sword.     

How does glance behavior influence crash and injury risk? A ‘what-if’ counterfactual simulation using crashes and near-crashes from SHRP2

As naturalistic driving data become increasingly available, new analyses are revealing the significance of drivers’ glance behavior in traffic crashes. Due to the rarity of crashes, even in the largest naturalistic datasets, near-crashes are often included in the analyses and used as surrogates for crashes. However, to date we lack a method to assess the extent to which driver glance behavior influences crash and injury risk across both crashes and near-crashes. This paper presents a novel method for estimating crash and injury risk from off-road glance behavior for crashes and near-crashes alike; this method can also be used to evaluate the safety impact of secondary tasks (such as tuning the radio). We apply a ‘what-if’ (counterfactual) simulation to 37 lead-vehicle crashes and 186 lead-vehicle near-crashes from lead-vehicle scenarios identified in the SHRP2 naturalistic driving data. The simulation combines the kinematics of the two conflicting vehicles with a model of driver glance behavior to estimate two probabilities: (1) that each event becomes a crash, and (2) that each event causes a specific level of injury. The usefulness of the method is demonstrated by comparing the crash and injury risk of normal driving with the risks of driving while performing one of three secondary tasks: the Rockwell radio-tuning task and two hypothetical tasks. Alternative applications of the method and its metrics are also discussed. The method presented in this paper can guide the design of safer driver–vehicle interfaces by showing the best tradeoff between the percent of glances that are on-road, the distribution of off-road glances, and the total task time for different tasks.     

Students' Expectations About Interviewees' and Interviewers' Achievement Emotions in Job Selection Interviews

The author investigated expectations about achievement emotions characterizing job selection interviews while considering literature on the influence of positive and negative affect. Study participants were 282 Italian 12th graders and university students who were given a questionnaire asking them to imagine being interviewees in a future interview and to evaluate the intensity of interviewees' and interviewers' emotions. Expectations varied according to the kind of emotion, and interviewees and interviewers differentiated in terms of activating and deactivating emotions. Positive emotions prevailed for interviewees, with younger students giving higher scores. Some emotions were linked to career self‐efficacy and job market experience. Results are discussed in light of applied relevance for employment counseling.     

The Impact of Job Insecurity on Counterproductive Work Behaviors: The Moderating Role of Honesty–Humility Personality Trait

The detrimental effects of job insecurity on individual and organizational well-being are well documented in recent literature. Job insecurity as a stressor is generally associated with a higher presence of negative attitudes toward the organization. In this article, the moderating role of Honesty–Humility personality trait was investigated. It was assumed that Honesty–Humility would function as a psychological moderator of the job insecurity impact on counterproductive work behaviors. Participants were 203 workers who were administered a self–reported questionnaire. Results confirmed that job insecurity was positively related to counterproductive work behaviors whereas Honesty–Humility was negatively associated to them. More importantly, Honesty–Humility moderated this relationship, even after controlling for gender, age, type of contract, and the other HEXACO personality traits. For individuals with low Honesty–Humility, job insecurity was positively related to counterproductive work behaviors, whereas for individuals with high Honesty–Humility, job insecurity turned out to be unrelated to counterproductive work behaviors.     

Perceived Overqualification: A Multi-Source Investigation of Psychological Predisposition and Contextual Triggers

ABSTRACT. Although employee (subjective) perceived overqualification (POQ) has recently been explored as a meaningful organizational construct, further work is needed to fully understand it. We extend the theoretical psychological underpinnings of employee POQ and examine both its determinants and outcomes based on established and newly proposed theoretical developments. Four-hundred and fifteen employees completed an online questionnaire and 208 of their supervisors completed corresponding surveys about the employees’ withdrawal behaviors and job-related attitudes, in order to explore potential predictors and outcomes of subjectively experienced POQ. Among the predictors, work conditions (uniform requirements and repetitive tasks) were most strongly associated with POQ. In terms of individual differences, narcissism predicted higher POQ while general mental ability only did when holding other variables constant. In addition, among the outcomes, higher POQ was related to lower job satisfaction and organizational commitment, but was not related to withdrawal behaviors such as truancy, absenteeism, and turnover intentions.     

How to bring the news … peak-end effects in children’s affective responses to peer assessments of their social behavior

The retrospective evaluation of an event tends to be based on how the experience felt during the most intense moment and the last moment. Two experiments tested whether this so-called peak-end effect influences how primary school students are affected by peer assessments. In both experiments, children (ages 7–12) assessed two classmates on their behaviour in school and then received two manipulated assessments. In Experiment 1 (N ?=?30), one assessment consisted of four negative ratings and the other of four negative ratings with an extra moderately negative rating added to the end. In Experiment 2 (N ?=?44), one assessment consisted of four positive ratings, and the other added an extra moderately positive rating to the end. Consistent with the peak-end effect, the extended assessment in Experiment 1 and the short assessment in Experiment 2 were remembered as more pleasant and less difficult to deal with, which shaped children’s peer assessment preferences and prospective choices of which assessment to repeat. These findings indicate that the process of peer assessment can be improved by ending the feedback with the most positive part of the assessment.     

Mixed matters: fluency impacts trust ratings when faces range on valence but not on motivational implications

Facial features that resemble emotional expressions influence key social evaluations, including trust. Here, we present four experiments testing how the impact of such expressive features is qualified by their processing difficulty. We show that faces with mixed expressive features are relatively devalued, and faces with pure expressive features are relatively valued. This is especially true when participants first engage in a categorisation task that makes processing of mixed expressions difficult and pure expressions easy. Critically, we also demonstrate that the impact of categorisation fluency depends on the specific nature of the expressive features. When faces vary on valence (i.e. sad to happy), trust judgments increase with their positivity, but also depend on fluency. When faces vary on social motivation (i.e. angry to sad), trust judgments increase with their approachability, but remain impervious to disfluency. This suggests that people intelligently use fluency to make judgments on valence-relevant judgment dimensions – but not when faces can be judged using other relevant criteria, such as motivation. Overall, the findings highlight that key social impressions (like trust) are flexibly constructed from inputs related to stimulus features and processing experience.     

Job satisfaction among Swedish soldiers: Applying the Job Characteristics Model to newly recruited military personnel

A professional military organization was introduced in Sweden in 2010. This means that the Swedish Armed Forces (SAF) need to attract and employ soldiers, and to retain them within the organization. This scenario creates new types of challenges in manning the organization. The transition to an all-volunteer force puts job satisfaction in focus in order to retain personnel. This cross-sectional study of the relations between working conditions and job involvement among 300 recently employed soldiers showed that the dimensions of the Job Characteristics Model related significantly to job satisfaction and work motivation and (negatively) to turnover intentions from the SAF. The results further showed that all the critical psychological states contributed independently to the variance in the outcome variables.