Aaron Scherer, Ph.D. - US grants

When thinking about infectious diseases and making decisions about how to protect themselves, people often overreact to infectious diseases with low risk of infection, such as Ebola, and at other times fail to respond to infectious diseases with higher risk of infection, such as the flu. Both types of responses can lead to negative outcomes such as stress and anxiety, less productivity at work, and inefficient use of healthcare resources (either using too much or too little depending on the disease). We think that one reason that people may exhibit these responses to infectious diseases is that there may be a conflict between their beliefs about their risk and their feelings about their risk. This research will examine areas of misinformation and emotional responses to three infectious diseases: Ebola, the flu, and MERS. After identifying key areas of misinformation and excessive or subdued emotional responses to these three diseases, the research team develops and tests a number of communication strategies that best correct misinformation and resolve conflicts between beliefs and feelings of risk to motivate more appropriate responses to infectious diseases. After determining which strategies are better at doing those things than others, the research team creates a website to display "best-practices" in communicating about infectious diseases.

This research involves conducting a number of web studies to investigate when and for whom cognitive- and affective-based communication strategies work best at modifying cognitions, affect, and behavioral intentions towards pandemic risks. The research uses the theory of "risk-as-feelings". These studies will advance our understanding of risk-as-feelings in a number of ways. First, the research team examines the frequency of simultaneous contradictory responses (SCRs) - when beliefs and feelings of risk conflict - at least with these three infectious diseases. Second, the research team tests for the existence of simultaneous contradictory affective responses. Third, the team then assesses the relative influence of cognitive and affective sources of information on cognitions, affective reactions, and behavioral intentions, as well as in the possible resolution of SCRs. Fourth, the application of risk-as-feelings to determine optimal communication strategies about these infectious diseases should serve as a test-case for the utility of incorporating risk-as-feelings into public health theories of health behavior and communication. Fifth, due to its foundation in the theory of risk-as-feelings, insights gleaned from the current studies should help shape the way information is communicated about other public health issues beyond these disease. And finally, the research tests whether resolving SCRs is key to inducing appropriate responses to pandemic risks or whether improving knowledge, acknowledging fears, and/or improving feelings of efficacy, is sufficient to improve responses, as would be predicted by standard health behavior theories from public health.

PROJECT SUMMARY/ABSTRACT Candidate: Aaron Scherer, PhD is a social psychologist who utilizes insights from the psychological sciences to create innovative preventive healthcare interventions, primarily for health risks that affect adults aged ?50. Dr. Scherer?s long-term career objective is to become an independent investigator leading multidisciplinary research teams in the design and evaluation of innovative, patient-centered interventions to optimize the delivery and utilization of preventive health services for middle-aged and older adults. Research Context: Age-associated changes in immune function and chronic conditions coupled with suboptimal influenza vaccination rates (50%) result in adults aged ?50 accounting for 95% of the 50,000 influenza-associated deaths that occur every year. Unfortunately, vaccine messaging strategies that health organizations currently utilize to increase vaccine uptake have been ineffective and, in some cases have worsened vaccine attitudes. Motivations to satisfy psychological needs such as managing threats, reducing uncertainty, and achieve social goals may bias how people process vaccine-related information and vaccine outcomes. ?Motivational fit?, an alignment with a motive that undermines adult vaccine uptake, may be a more effective mechanism of behavior change to target with vaccine interventions than current approaches. Specific Aims: 1) Identify which motives have the strongest associations with vaccine outcomes for adults aged ?50; 2) Collaborate with vaccine-hesitant adults aged ?50 to create influenza vaccine messages that have motivational fit; 3) Conduct a pilot study to evaluate the feasibility of a vaccine messaging efficacy study. Research Plan: To accomplish these aims, Dr. Scherer will use a national, demographically-diverse online sample of adults aged ?50 to identify four motives that are most strongly associated with vaccine uptake (i.e., largest effect sizes) for adults aged ?50 and test whether scales measuring these motives need to be vaccine- specific. He will then collaborate with vaccine-hesitant adults aged ?50 to develop and test influenza vaccine messages targeting each of the four motives. Finally, he will conduct a pilot study with a clinical population to evaluate the feasibility of conducting planned efficacy studies of the motivational fit vaccine messages. Career Development Plan: Dr. Scherer will develop 1) foundational content knowledge in the aging process to engage in aging research, and expertise in 2) psychometrics; 3) patient-centered design; and 4) health services research with adults aged ?50. Dr. Scherer?s training goals will be supported by close mentorship from an interdisciplinary team; advanced didactic coursework; and other career development opportunities. Environment: The University of Iowa offers an ideal environment for Dr. Scherer to pursue his training; with mentorship from well-established experts, additional guidance from an advisory committee, and a department dedicated to his long-term success in becoming an independent investigator in healthy aging research.

PROJECT SUMMARY/ABSTRACT Suboptimal vaccination rates and the constantly shifting vaccine landscape resulting from changing vaccine recommendations; the development of novel vaccines or vaccine technologies; ?vaccine scares?; and outbreaks from vaccine preventable diseases means organizations that are responsible for creating vaccine recommendations, policies, etc. need information about health care providers and the general public to inform their decision-making by anticipating possible reactions to their efforts in these groups. Sentinel physician networks?pre-recruited groups of physicians?have been the predominant method for obtaining this information since 2004 but suffer from major methodological weaknesses: 1) repeatedly surveying a potentially biased set of respondents, months-long data collection, and inflexibility beyond established sentinel physician networks. As a result, there is a critical need to utilize new survey methodologies that has similar speed, costs, and representativeness as sentinel physician networks but overcomes its weaknesses. Without this knowledge, we will continue to collect information on immunization- related issues using a method that is potentially biased and lacks the speed and flexibility that CDC needs. The long-term goal of this proposal is to establish a new methodology for collecting data on immunization issues that provides this information more quickly, affordably, flexibly, and arguably more representative than sentinel physician networks. The overall objective of this application is to recruit health care workers and members of the general public via opt-in, online survey panels and use computer-assisted self-interviewing (CASI) instruments to meet the information needs of CDC and other groups who make vaccine recommendations, policies, and programs. To that end, our objectives for this proposal are listed below. ? Develop, revise, and finalize survey items within 4 weeks of identifying the survey topic ? Program the survey and conduct user testing within 2 weeks of survey items being finalized ? Obtain IRB approval from for each new survey within 2 weeks of submitting the IRB application ? Finish data collection for each survey in ?3 weeks if surveying pediatricians, family physicians, general internists, and/or obstetricians-gynecologists (N=300/specialty), or U.S. adults (N=1,000) ? Finish data collection in ?6 weeks if surveying other medical specialties (e.g., geriatricians) ? Analyze data within 3 weeks of finishing data collection ? Complete report of initial findings to the CDC within 4 weeks of finishing data collection ? Complete a minimum of 3 surveys of pediatricians, family physicians, & general internists each year ? Submit abstracts based on the survey results to at least 2 national or international conferences each year ? Submit 3 manuscripts based on survey results each year after Year 1 ? Present requested results to ACIP and other immunization-related organizations, at their request