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      Evidence-based health messages increase intention to cope with loneliness in Germany: a randomized controlled online trial

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          Abstract

          Loneliness poses a formidable global health challenge in our volatile, post-pandemic world. Prior studies have identified promising interventions to alleviate loneliness, however, little is known about their effectiveness. This study measured the effectiveness of educational entertainment (“edutainment”) and/or evidence-based, written health messages in alleviating loneliness and increasing intention to cope with loneliness. We recruited 1639 German participants, aged 18 years or older. We compared three intervention groups who received: (A) edutainment and written health messages, (B) only edutainment, or (C) only written health messages, against (D) a control group that received nothing. The primary outcomes were loneliness and intention to cope with loneliness. Participants were also invited to leave comments about the interventions or about their perception or experiences with loneliness. We found a small ( d = 0.254) but significant effect of the written messages on increased intention to cope with loneliness ( b = 1.78, t(1602) = 2.91, P = 0.004), while a combination of edutainment and written messages significantly decreased loneliness scores ( b = −0.25, t(1602) = −2.06, P = 0.04) when compared with the control, even after adjusting for covariables including baseline values, self-esteem, self-efficacy, and hope. We also observed significantly higher self-esteem scores after exposure to a combination of edutainment and written messages ( b = 0.821, t(1609) = 1.76, one-tailed P = 0.039) and significantly higher hope scores after exposure to edutainment-only ( b = 0.986, t(1609) = 1.85, one-tailed P = 0.032) when compared with the control group. Our study highlights the benefits of using written messages for increasing intention to cope with loneliness and a combination of edutainment and written messages for easing loneliness. Even in small “doses” (less than 6 min of exposure), edutainment can nurture hope, and edutainment combined with written messages can boost self-esteem.

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          G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences

          G*Power (Erdfelder, Faul, & Buchner, 1996) was designed as a general stand-alone power analysis program for statistical tests commonly used in social and behavioral research. G*Power 3 is a major extension of, and improvement over, the previous versions. It runs on widely used computer platforms (i.e., Windows XP, Windows Vista, and Mac OS X 10.4) and covers many different statistical tests of the t, F, and chi2 test families. In addition, it includes power analyses for z tests and some exact tests. G*Power 3 provides improved effect size calculators and graphic options, supports both distribution-based and design-based input modes, and offers all types of power analyses in which users might be interested. Like its predecessors, G*Power 3 is free.
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            The theory of planned behavior

            Icek Ajzen (1991)
            Organizational Behavior and Human Decision Processes, 50(2), 179-211
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              Efficacy of the Theory of Planned Behaviour: A meta-analytic review

              The Theory of Planned Behaviour (TPB) has received considerable attention in the literature. The present study is a quantitative integration and review of that research. From a database of 185 independent studies published up to the end of 1997, the TPB accounted for 27% and 39% of the variance in behaviour and intention, respectively. The perceived behavioural control (PBC) construct accounted for significant amounts of variance in intention and behaviour, independent of theory of reasoned action variables. When behaviour measures were self-reports, the TPB accounted for 11% more of the variance in behaviour than when behaviour measures were objective or observed (R2s = .31 and .21, respectively). Attitude, subjective norm and PBC account for significantly more of the variance in individuals' desires than intentions or self-predictions, but intentions and self-predictions were better predictors of behaviour. The subjective norm construct is generally found to be a weak predictor of intentions. This is partly attributable to a combination of poor measurement and the need for expansion of the normative component. The discussion focuses on ways in which current TPB research can be taken forward in the light of the present review.
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                Author and article information

                Contributors
                till.baernighausen@uni-heidelberg.de
                Journal
                NPJ Digit Med
                NPJ Digit Med
                NPJ Digital Medicine
                Nature Publishing Group UK (London )
                2398-6352
                29 April 2024
                29 April 2024
                2024
                : 7
                : 105
                Affiliations
                [1 ]Department of Psychiatry and Psychotherapy (Campus Charité Mitte), Charité—Universitätsmedizin Berlin, ( https://ror.org/001w7jn25) Berlin, Germany
                [2 ]German Center for Mental Health (DZPG), Berlin and Heidelberg, Germany
                [3 ]Department of Education and Psychology, Freie Universität Berlin, ( https://ror.org/046ak2485) Berlin, Germany
                [4 ]Columbia University Mailman School of Public Health, ( https://ror.org/00hj8s172) New York, NY USA
                [5 ]Icahn School of Medicine at Mt. Sinai, ( https://ror.org/04a9tmd77) New York, NY USA
                [6 ]Heidelberg Institute of Global Health (HIGH), Heidelberg University, ( https://ror.org/038t36y30) Heidelberg, Germany
                [7 ]Africa Health Research Institute, ( https://ror.org/034m6ke32) Durban, South Africa
                [8 ]GRID grid.38142.3c, ISNI 000000041936754X, Harvard Center for Population and Development Studies, ; Cambridge, MA USA
                [9 ]GRID grid.168010.e, ISNI 0000000419368956, Department of Pediatrics, , Stanford University School of Medicine, ; Stanford, CA USA
                [10 ]GRID grid.168010.e, ISNI 0000000419368956, Center for Digital Health, Department of Medicine, , Stanford University School of Medicine, ; Stanford, CA USA
                Author information
                http://orcid.org/0000-0002-4182-4212
                Article
                1096
                10.1038/s41746-024-01096-7
                11059282
                38684903
                8627caa0-2cb5-416f-999b-da6095452f5b
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 16 October 2023
                : 29 March 2024
                Funding
                Funded by: Internal research funds from Charité – Universitätsmedizin Berlin (S.L.) and Heidelberg Institute of Global Health (T.B.). For the publication fee, we acknowledge financial support by Deutsche Forschungsgemeinschaft within the funding programme “Open Access Publikationskosten” as well as by Heidelberg University.
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                © Springer Nature Limited 2024

                quality of life,education
                quality of life, education

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