TY  - JOUR
AU  - Purić, Danka
AU  - Petrović, Marija
AU  - Živanović, Marko
AU  - Lukić, Petar
AU  - Zupan, Zorana
AU  - Branković, Marija
AU  - Ninković, Milica
AU  - Lazarević, Ljiljana
AU  - Stanković, Sanda
AU  - Žeželj, Iris
PY  - 2023
UR  - http://reff.f.bg.ac.rs/handle/123456789/4631
AB  - Objectives We aimed to (1) develop a novel instrument, suitable for the general population, capturing intentional non-adherence (iNAR), consisting of non-adherence to prescribed therapy, self-medication and avoidance of seeking medical treatment; (2) differentiate it from other forms of non-adherence, for example, smoking; and (3) relate iNAR to patient-related factors, such as sociodemographics, health status and endorsement of irrational beliefs (conspiratorial thinking and superstitions) and to healthcare-related beliefs and experiences ((mis)trust and negative experiences with the healthcare system, normalisation of patient passivity).

Design То generate iNAR items, we employed a focus group with medical doctors, supplemented it with a literature search and invited a public health expert to refine it further. We examined the internal structure and predictors of iNAR in an observational study.

Setting Data were collected online using snowball sampling and social networks.

Participants After excluding those who failed one or more out of three attention checks, the final sample size was n=583 adult Serbian citizens, 74.4% female, mean age 39.01 years (SD=12.10).

Primary and secondary outcome measures The primary, planned outcome is the iNAR Questionnaire, while smoking was used for comparison purposes.

Results Factor analysis yielded a one-factor solution, and the final 12-item iNAR Questionnaire had satisfactory internal reliability (alpha=0.72). Health condition and healthcare-related variables accounted for 14% of the variance of iNAR behaviours, whereas sociodemographics and irrational beliefs did not additionally contribute.

Conclusions We constructed a brief yet comprehensive measure of iNAR behaviours and related them to health and sociodemographic variables and irrational beliefs. The findings suggest that public health interventions should attempt to improve patients' experiences with the system and build trust with their healthcare practitioners rather than aim at specific demographic groups or at correcting patients’ unfounded beliefs.
T2  - BMJ Open
T1  - Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia
IS  - 6
SP  - e069978
VL  - 13
DO  - 10.1136/bmjopen-2022-069978
ER  - 

@article{
author = "Purić, Danka and Petrović, Marija and Živanović, Marko and Lukić, Petar and Zupan, Zorana and Branković, Marija and Ninković, Milica and Lazarević, Ljiljana and Stanković, Sanda and Žeželj, Iris",
year = "2023",
abstract = "Objectives We aimed to (1) develop a novel instrument, suitable for the general population, capturing intentional non-adherence (iNAR), consisting of non-adherence to prescribed therapy, self-medication and avoidance of seeking medical treatment; (2) differentiate it from other forms of non-adherence, for example, smoking; and (3) relate iNAR to patient-related factors, such as sociodemographics, health status and endorsement of irrational beliefs (conspiratorial thinking and superstitions) and to healthcare-related beliefs and experiences ((mis)trust and negative experiences with the healthcare system, normalisation of patient passivity).

Design То generate iNAR items, we employed a focus group with medical doctors, supplemented it with a literature search and invited a public health expert to refine it further. We examined the internal structure and predictors of iNAR in an observational study.

Setting Data were collected online using snowball sampling and social networks.

Participants After excluding those who failed one or more out of three attention checks, the final sample size was n=583 adult Serbian citizens, 74.4% female, mean age 39.01 years (SD=12.10).

Primary and secondary outcome measures The primary, planned outcome is the iNAR Questionnaire, while smoking was used for comparison purposes.

Results Factor analysis yielded a one-factor solution, and the final 12-item iNAR Questionnaire had satisfactory internal reliability (alpha=0.72). Health condition and healthcare-related variables accounted for 14% of the variance of iNAR behaviours, whereas sociodemographics and irrational beliefs did not additionally contribute.

Conclusions We constructed a brief yet comprehensive measure of iNAR behaviours and related them to health and sociodemographic variables and irrational beliefs. The findings suggest that public health interventions should attempt to improve patients' experiences with the system and build trust with their healthcare practitioners rather than aim at specific demographic groups or at correcting patients’ unfounded beliefs.",
journal = "BMJ Open",
title = "Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia",
number = "6",
pages = "e069978",
volume = "13",
doi = "10.1136/bmjopen-2022-069978"
}

Purić, D., Petrović, M., Živanović, M., Lukić, P., Zupan, Z., Branković, M., Ninković, M., Lazarević, L., Stanković, S.,& Žeželj, I.. (2023). Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia. in BMJ Open, 13(6), e069978.
https://doi.org/10.1136/bmjopen-2022-069978

Purić D, Petrović M, Živanović M, Lukić P, Zupan Z, Branković M, Ninković M, Lazarević L, Stanković S, Žeželj I. Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia. in BMJ Open. 2023;13(6):e069978.
doi:10.1136/bmjopen-2022-069978 .

Purić, Danka, Petrović, Marija, Živanović, Marko, Lukić, Petar, Zupan, Zorana, Branković, Marija, Ninković, Milica, Lazarević, Ljiljana, Stanković, Sanda, Žeželj, Iris, "Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia" in BMJ Open, 13, no. 6 (2023):e069978,
https://doi.org/10.1136/bmjopen-2022-069978 . .

TY  - CONF
AU  - Ninković, Milica
AU  - Puhalo, Srđan
AU  - Petrović, Marija
AU  - Purić, Danka
AU  - Lukić, Petar
AU  - Žeželj, Iris Lav
PY  - 2023
UR  - http://reff.f.bg.ac.rs/handle/123456789/5879
AB  - Traditional, complementary, and alternative medicine (TCAM) refers to healthcare practices that are not a part of conventional health systems. Their use can be subsumed into four domains: Alternative medical systems (e.g., homeopathy), New age practices (e.g., art therapy), Natural product-based practices (e.g., herbal balms), and Rituals/Customs (e.g., prayers for health). These practices can be used in three distinct ways: for preventive purposes, together with official medical practices, or as an alternative to them, with the latter being the most problematic. Psychological roots of the tendency to resort to these practices is repeatedly proved to be an “irrational mindset” (IM), a composite of irrational beliefs and cognitive biases. Here we explored whether IM (Superstition, Magical health beliefs, Conspiracy mentality, and Naturalness bias) can differentiate between different types of TCAM use. To this end, for each of the four domains participants indicated the way they typically use it. We recruited 470 participants from Bosnia and Herzegovina (Mage = 44.9, SDage = 10.2; 65 % women). Using Linear discriminant analysis (LDA), we explored the relation between ways of TCAM use and IM. Since only Natural product-based medicine had frequency of alternative use > 4 %, we ran LDA to explore how IM predicts the way of use for this TCAM domain. Discriminant function indicated that IM has a role in predicting the way people use natural product-based medicine (Wilk’s Λ = .96, χ2 (12) = 21.06, R = .20, p = .050), with Superstition and Naturalness bias as the crucial predictors. The obtained function best
differentiates the individuals who used natural product-based medicine as an alternative to the conventional treatments from the others. Our results show that people who tend to abandon official medical practices for TCAM are those prone to superstition and searching for naturalness. The official health communication could be tailored to specifically target these beliefs.
PB  - Odsjek za psihologiju Filozofskog fakulteta Sveučilišta u Zagrebu
C3  - Book of Abstracts, 26th Ramiro and Zoran Bujas Days
T1  - Who replaces conventional medicine with herbs and supplements? The role of irrational mindset
SP  - 102
DO  - 10.17234/DRZB26
ER  - 

@conference{
author = "Ninković, Milica and Puhalo, Srđan and Petrović, Marija and Purić, Danka and Lukić, Petar and Žeželj, Iris Lav",
year = "2023",
abstract = "Traditional, complementary, and alternative medicine (TCAM) refers to healthcare practices that are not a part of conventional health systems. Their use can be subsumed into four domains: Alternative medical systems (e.g., homeopathy), New age practices (e.g., art therapy), Natural product-based practices (e.g., herbal balms), and Rituals/Customs (e.g., prayers for health). These practices can be used in three distinct ways: for preventive purposes, together with official medical practices, or as an alternative to them, with the latter being the most problematic. Psychological roots of the tendency to resort to these practices is repeatedly proved to be an “irrational mindset” (IM), a composite of irrational beliefs and cognitive biases. Here we explored whether IM (Superstition, Magical health beliefs, Conspiracy mentality, and Naturalness bias) can differentiate between different types of TCAM use. To this end, for each of the four domains participants indicated the way they typically use it. We recruited 470 participants from Bosnia and Herzegovina (Mage = 44.9, SDage = 10.2; 65 % women). Using Linear discriminant analysis (LDA), we explored the relation between ways of TCAM use and IM. Since only Natural product-based medicine had frequency of alternative use > 4 %, we ran LDA to explore how IM predicts the way of use for this TCAM domain. Discriminant function indicated that IM has a role in predicting the way people use natural product-based medicine (Wilk’s Λ = .96, χ2 (12) = 21.06, R = .20, p = .050), with Superstition and Naturalness bias as the crucial predictors. The obtained function best
differentiates the individuals who used natural product-based medicine as an alternative to the conventional treatments from the others. Our results show that people who tend to abandon official medical practices for TCAM are those prone to superstition and searching for naturalness. The official health communication could be tailored to specifically target these beliefs.",
publisher = "Odsjek za psihologiju Filozofskog fakulteta Sveučilišta u Zagrebu",
journal = "Book of Abstracts, 26th Ramiro and Zoran Bujas Days",
title = "Who replaces conventional medicine with herbs and supplements? The role of irrational mindset",
pages = "102",
doi = "10.17234/DRZB26"
}

Ninković, M., Puhalo, S., Petrović, M., Purić, D., Lukić, P.,& Žeželj, I. L.. (2023). Who replaces conventional medicine with herbs and supplements? The role of irrational mindset. in Book of Abstracts, 26th Ramiro and Zoran Bujas Days
Odsjek za psihologiju Filozofskog fakulteta Sveučilišta u Zagrebu., 102.
https://doi.org/10.17234/DRZB26

Ninković M, Puhalo S, Petrović M, Purić D, Lukić P, Žeželj IL. Who replaces conventional medicine with herbs and supplements? The role of irrational mindset. in Book of Abstracts, 26th Ramiro and Zoran Bujas Days. 2023;:102.
doi:10.17234/DRZB26 .

Ninković, Milica, Puhalo, Srđan, Petrović, Marija, Purić, Danka, Lukić, Petar, Žeželj, Iris Lav, "Who replaces conventional medicine with herbs and supplements? The role of irrational mindset" in Book of Abstracts, 26th Ramiro and Zoran Bujas Days (2023):102,
https://doi.org/10.17234/DRZB26 . .

TY  - CONF
AU  - Petrović, Marija
AU  - Puhalo, Srđan
AU  - Ninković, Milica
AU  - Purić, Danka
AU  - Lukić, Petar
AU  - Žeželj, Iris Lav
PY  - 2023
UR  - http://reff.f.bg.ac.rs/handle/123456789/5878
AB  - To preserve their health, people are increasingly resorting to traditional, complementary and alternative medicine (TCAM). While its appeal grows, it is still lacking a strong evidence base and can lead to adverse effects. In a previous study in Serbia, we developed a new instrument to measure the lifetime use of diverse TCAM practices (e.g., acupuncture, art therapy, herbal balms, prayer, etc.) and explored its psychological antecedents. The results showed that the pattern of use of TCAM practices can be classified into four domains: Alternative medical systems, Natural product-based practices, New age medicine, and Rituals/Customs. Moreover, an irrational mindset (IM; consisting of irrational beliefs and cognitive biases) contributed to the prediction of TCAM use, over and above socio-demographics, ideological beliefs, and self-reported health status. To conceptually replicate the results, we validated the measure in a novel setting (Bosnia and Herzegovina). Participants first reported their lifetime TCAM use (N = 580). Using CFA, we replicated a four-factor structure of TCAM domains (CFI = 0.94; TLI = 0.93; RMSEA = .03 (95 % CI .03-.04)). Next, for the participants who filled out all measures (N = 470, 65 % women; Mage = 44.9, SDage = 10.2), we explored whether IM variables (magical health beliefs, conspiracist thinking, superstition, and the naturalness bias) contributed to the prediction of TCAM use. As expected, after controlling for sociodemographics, ideological beliefs, and self-reported health 
status, IM significantly contributed to the prediction (ΔF (4,457) = 20.33, p < .001, ΔR2 = .127), with magical health beliefs, superstition, and naturalness bias contributing over and above other predictors. Magical health beliefs were the strongest predictor, alongside gender. We find that our
results largely replicate in a novel setting, offering further evidence of the importance of
including IM when considering the susceptibility to TCAM use.
C3  - Book of Abstracts, 26th Ramiro and Zoran Bujas Days
T1  - Some superstition, some magical health, but all natural: beliefs that makes us prone to traditional, complementary and alternative medicine practices
SP  - 109
DO  - 10.17234/DRZB26
ER  - 

@conference{
author = "Petrović, Marija and Puhalo, Srđan and Ninković, Milica and Purić, Danka and Lukić, Petar and Žeželj, Iris Lav",
year = "2023",
abstract = "To preserve their health, people are increasingly resorting to traditional, complementary and alternative medicine (TCAM). While its appeal grows, it is still lacking a strong evidence base and can lead to adverse effects. In a previous study in Serbia, we developed a new instrument to measure the lifetime use of diverse TCAM practices (e.g., acupuncture, art therapy, herbal balms, prayer, etc.) and explored its psychological antecedents. The results showed that the pattern of use of TCAM practices can be classified into four domains: Alternative medical systems, Natural product-based practices, New age medicine, and Rituals/Customs. Moreover, an irrational mindset (IM; consisting of irrational beliefs and cognitive biases) contributed to the prediction of TCAM use, over and above socio-demographics, ideological beliefs, and self-reported health status. To conceptually replicate the results, we validated the measure in a novel setting (Bosnia and Herzegovina). Participants first reported their lifetime TCAM use (N = 580). Using CFA, we replicated a four-factor structure of TCAM domains (CFI = 0.94; TLI = 0.93; RMSEA = .03 (95 % CI .03-.04)). Next, for the participants who filled out all measures (N = 470, 65 % women; Mage = 44.9, SDage = 10.2), we explored whether IM variables (magical health beliefs, conspiracist thinking, superstition, and the naturalness bias) contributed to the prediction of TCAM use. As expected, after controlling for sociodemographics, ideological beliefs, and self-reported health 
status, IM significantly contributed to the prediction (ΔF (4,457) = 20.33, p < .001, ΔR2 = .127), with magical health beliefs, superstition, and naturalness bias contributing over and above other predictors. Magical health beliefs were the strongest predictor, alongside gender. We find that our
results largely replicate in a novel setting, offering further evidence of the importance of
including IM when considering the susceptibility to TCAM use.",
journal = "Book of Abstracts, 26th Ramiro and Zoran Bujas Days",
title = "Some superstition, some magical health, but all natural: beliefs that makes us prone to traditional, complementary and alternative medicine practices",
pages = "109",
doi = "10.17234/DRZB26"
}

Petrović, M., Puhalo, S., Ninković, M., Purić, D., Lukić, P.,& Žeželj, I. L.. (2023). Some superstition, some magical health, but all natural: beliefs that makes us prone to traditional, complementary and alternative medicine practices. in Book of Abstracts, 26th Ramiro and Zoran Bujas Days, 109.
https://doi.org/10.17234/DRZB26

Petrović M, Puhalo S, Ninković M, Purić D, Lukić P, Žeželj IL. Some superstition, some magical health, but all natural: beliefs that makes us prone to traditional, complementary and alternative medicine practices. in Book of Abstracts, 26th Ramiro and Zoran Bujas Days. 2023;:109.
doi:10.17234/DRZB26 .

Petrović, Marija, Puhalo, Srđan, Ninković, Milica, Purić, Danka, Lukić, Petar, Žeželj, Iris Lav, "Some superstition, some magical health, but all natural: beliefs that makes us prone to traditional, complementary and alternative medicine practices" in Book of Abstracts, 26th Ramiro and Zoran Bujas Days (2023):109,
https://doi.org/10.17234/DRZB26 . .

TY  - CONF
AU  - Lazić, Aleksandra
AU  - Petrović, Marija
AU  - Branković, Marija
AU  - Žeželj, Iris
PY  - 2023
UR  - https://2023.ehps.net/wp-content/uploads/2023/09/EHPS_2023_Abstracts_UPLOAD.pdf
UR  - http://reff.f.bg.ac.rs/handle/123456789/4878
AB  - Background: When the media does not adhere to reporting guidelines regarding traditional, complementary, and alternative medicine (TM/CAM), this may deceive or mislead consumers about the safety and efficacy of these practices. We analyzed whether Serbian online media adheres to reporting guidelines and described dominant psychological appeals used to promote TM/CAM. Methods: We conducted a content analysis of 182 articles from six news and six magazine websites, published July–December 2021. Findings: Biologically based treatments – predominantly herbal products – were the most common (205/289 practices). TM/CAM practices were claimed to improve general health (71/386 claims), as well as to alleviate respiratory problems, boost the immunity, and detox the body. The tone was overwhelmingly positive, with most of the positive articles (145/176) neglecting to disclose the potential harms of TM/CAM. Few articles provided a recommendation to speak with a healthcare provider (24/176). Articles tended to appeal to TM/CAM’s long tradition of use (115/176), naturalness (80/176), and convenience (72/176). They used vague pseudoscientific jargon (105/176) and failed to cite sources for the claims that TM/CAM use is supported by science (39/176). Discussion: Given that TM/CAM use may lead to harmful outcomes (such as adverse events, avoidance of official treatment or interaction with it), Serbian online media reports on TM/CAM are inadequate to assist consumers’ decision-making. Our findings highlight issues that need to be addressed towards ensuring more critical health reporting, and, ultimately, better informed TM/CAM consumption choices.
C3  - 37th Annual Conference of the European Health Psychology Society, 4-8 September
T1  - ‘What is old and natural is harmless’: Traditional, complementary, and alternative medicine in online media
DO  - 10.17605/OSF.IO/8Y4TK
ER  - 

@conference{
author = "Lazić, Aleksandra and Petrović, Marija and Branković, Marija and Žeželj, Iris",
year = "2023",
abstract = "Background: When the media does not adhere to reporting guidelines regarding traditional, complementary, and alternative medicine (TM/CAM), this may deceive or mislead consumers about the safety and efficacy of these practices. We analyzed whether Serbian online media adheres to reporting guidelines and described dominant psychological appeals used to promote TM/CAM. Methods: We conducted a content analysis of 182 articles from six news and six magazine websites, published July–December 2021. Findings: Biologically based treatments – predominantly herbal products – were the most common (205/289 practices). TM/CAM practices were claimed to improve general health (71/386 claims), as well as to alleviate respiratory problems, boost the immunity, and detox the body. The tone was overwhelmingly positive, with most of the positive articles (145/176) neglecting to disclose the potential harms of TM/CAM. Few articles provided a recommendation to speak with a healthcare provider (24/176). Articles tended to appeal to TM/CAM’s long tradition of use (115/176), naturalness (80/176), and convenience (72/176). They used vague pseudoscientific jargon (105/176) and failed to cite sources for the claims that TM/CAM use is supported by science (39/176). Discussion: Given that TM/CAM use may lead to harmful outcomes (such as adverse events, avoidance of official treatment or interaction with it), Serbian online media reports on TM/CAM are inadequate to assist consumers’ decision-making. Our findings highlight issues that need to be addressed towards ensuring more critical health reporting, and, ultimately, better informed TM/CAM consumption choices.",
journal = "37th Annual Conference of the European Health Psychology Society, 4-8 September",
title = "‘What is old and natural is harmless’: Traditional, complementary, and alternative medicine in online media",
doi = "10.17605/OSF.IO/8Y4TK"
}

Lazić, A., Petrović, M., Branković, M.,& Žeželj, I.. (2023). ‘What is old and natural is harmless’: Traditional, complementary, and alternative medicine in online media. in 37th Annual Conference of the European Health Psychology Society, 4-8 September.
https://doi.org/10.17605/OSF.IO/8Y4TK

Lazić A, Petrović M, Branković M, Žeželj I. ‘What is old and natural is harmless’: Traditional, complementary, and alternative medicine in online media. in 37th Annual Conference of the European Health Psychology Society, 4-8 September. 2023;.
doi:10.17605/OSF.IO/8Y4TK .

Lazić, Aleksandra, Petrović, Marija, Branković, Marija, Žeželj, Iris, "‘What is old and natural is harmless’: Traditional, complementary, and alternative medicine in online media" in 37th Annual Conference of the European Health Psychology Society, 4-8 September (2023),
https://doi.org/10.17605/OSF.IO/8Y4TK . .