Thinking about Believing: Can Metacognitive Reflection Encourage Belief Updating?

People often cling to their beliefs even in the face of counterevidence. The current study explored metacognitive reflection as a potential driver for belief updating. In a randomized controlled experiment (n = 155), participants rated their degree of agreement with a statement regarding genetic modification in humans. Following this, participants were presented with a passage containing an argument counter to their indicated belief. Participants in the metacognition condition were asked to deeply reflect on the ways in which the passage was similar to or different from their current beliefs. Participants in the control condition were asked to engage in more shallow reflection on the composition of the passage. After reflecting on the counterevidence, participants were asked to again rate their agreement with the statement regarding human gene modification. Both groups updated their initial beliefs to be more consistent with the presented counterevidence. Although greater belief updating was observed in those who metacognitively reflected on the passage, this effect did not reach significance (p = .055). These findings suggest that reflecting on counterevidence has the potential to encourage belief updating, regardless of whether that reflection is metacognitive in nature, and provide promise for future work investigating the role of metacognition in belief updating.

Clinicians' Perspectives on Racism and Black Women's Maternal Health.

Objective: The objective of this study was to explore clinician perceptions of how racism affects Black women's pregnancy experiences, perinatal care, and birth outcomes. Materials and Methods: We conducted 25 semi-structured interviews with perinatal care clinicians practicing in the San Francisco Bay Area (January to March 2019) who serve racially diverse women. Participants were primarily recruited through "Dear Perinatal Care Provider" email correspondences sent through department listservs. Culturally concordant, qualitatively trained research assistants conducted all interviews in person. The interviews ranged from 30 to 60 minutes and were audio-recorded and professionally transcribed verbatim. We used the constant comparative method consistent with grounded theory to analyze data. Results: Most participants were obstetrician/gynecologists (n = 11, 44%) or certified nurse midwives (n = 8, 32%), had worked in their current role for 1 to 5 years (n = 10, 40%), and identified as white (n = 16, 64%). Three themes emerged from the interviews: provision of inequitable care (e.g., I had a woman who had a massive complication during her labor course and felt like she wasn't being treated seriously); surveillance of Black women and families (e.g., A urine tox screen on the Black baby even though it was not indicated, and they didn't do it on the white baby when, in fact, it was indicated); and structural care issues (e.g., the history of medical racial experimentation). Conclusion: Clinicians' views about how racism is currently operating and negatively impacting Black women's care experiences, health outcomes, and well-being in medical institutions will be used to develop a racial equity training for perinatal care clinicians in collaboration with Black women and clinicians.

Patient and provider perspectives on preterm birth risk assessment and communication.

OBJECTIVE: To describe and compare how obstetric patients and care providers view preterm birth risk assessment and communication. METHODS: We conducted eight focus groups with obstetric patients (n = 35) and 16 qualitative interviews with obstetric providers. Grounded theory was used to identify and analyze themes. RESULTS: Patients' knowledge about preterm birth varied greatly. Similar benefits and risks of preterm birth risk counseling were discussed by patients and providers with notable exceptions: patients cited preparedness as a benefit and providers cited maternal blame, patient alienation, and estimate uncertainty as potential risks. Most patients expressed a desire to know their personalized preterm birth risk during pregnancy. Providers differed in whether they offer universal versus selective, and quantitative versus qualitative, preterm birth risk counseling. Many providers expressed concern about discussing social and structural risk factors for preterm birth. CONCLUSION: While many patients desired knowing their personalized preterm birth risk, prenatal care providers' disclosure practices vary because of uncertainty of estimates, concerns about negative consequences and challenges of addressing systemic inequities and social determinants of health. PRACTICE IMPLICATIONS: Given the existing asymmetry of information about preterm birth risk, providers should consider patient preferences regarding and potential benefits and risks of such disclosure in their practice.

Components of metacognition can function independently across development.

It is often argued that metacognition includes 2 components: monitoring and control. However, it is unclear whether these components can operate independently, or whether they always operate as part of a hierarchy. The current study attempts to address this issue. In Experiment 1 (N = 90), age-related differences were assessed to examine the developmental trajectories of monitoring and control in 5- and 7-year-old children and adults. In Experiment 2 (N = 90) and Experiment 3 (N = 90), a scaffolding approach was taken with the same age groups to investigate correspondences in intervention-related changes in monitoring and control. Several dissociations between monitoring and control were found: In Experiment 2, strategy instruction affected metacognitive control, but not metacognitive monitoring, whereas in Experiment 3, performance feedback affected metacognitive monitoring, but not metacognitive control. These findings suggest that the monitoring and control components of metacognition can operate independently, challenging simple feed-forward models of metacognition. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Carving Metacognition at Its Joints: Protracted Development of Component Processes.

Two experiments investigated the development of metacognitive monitoring and control, and conditions under which children engage these processes. In Experiment 1, 5-year-olds (N = 30) and 7-year-olds (N = 30), unlike adults (N = 30), showed little evidence of either monitoring or control. In Experiment 2, 5-year-olds (N = 90) were given performance feedback (aimed at improving monitoring), instruction to follow a particular strategy (aimed at improving control), or both. Across conditions, feedback improved children's monitoring, and instruction improved both monitoring and control. Thus, children's poor metacognitive performance likely reflects a difficulty engaging the component processes spontaneously rather than a lack of metacognitive ability. These findings also suggest that the component processes are distinct, with both undergoing protracted development.

Preferences regarding contemporary prenatal genetic tests among women desiring testing: implications for optimal testing strategies.

OBJECTIVES: To compare utilities for prenatal testing outcomes among women inclined to continue their pregnancy despite abnormal results versus those inclined to terminate and to analyze how differences affect optimal prenatal testing strategies. METHOD: Time tradeoff utilities for 23 outcomes were elicited from 281 women. We compared utilities based on termination inclination and applied them to a decision-analytic framework. RESULTS: Of participants, 46.6% indicated that they would 'definitely' or 'probably' continue their pregnancy despite results indicating an intellectual disability. These women assigned higher utilities to abnormal testing results and having a child with an intellectual disability than women who would probably or definitely terminate. Primary cell-free DNA screening had the most quality-adjusted life years for women inclined to continue their pregnancy but yielded an incremental cost-effectiveness ratio (ICER) of $1 685 449. Multiple marker screening with either cell-free DNA or diagnostic testing as follow-up had an ICER of $9037. Primary diagnostic testing resulted in the most quality-adjusted life years for women inclined to terminate, with an ICER of $111 776. CONCLUSION: Women seeking testing vary in prenatal testing outcome preferences and termination inclinations in the context of results indicating an intellectual disability. How they envision utilizing prenatal testing information impacts their optimal testing strategy. © 2016 John Wiley & Sons, Ltd.

Divorce and eating behaviors: a 5-day within-subject study of preadolescent obesity risk.

BACKGROUND: Obesity rates have more than doubled among children and have tripled among adolescents since the 1980s, and currently more than one third of children and adolescents are overweight or obese. Parental divorce is a time of family upheaval, yet little is known about the family processes that link family structure and obesity. METHODS: The current study gathered a 5-day eating behavior questionnaire from 37 preadolescents (mean=10.26 years; standard deviation=1.32; 32.4% female) and one parent to explore whether marital status was linked to obesity risk behaviors (i.e., high consumption of sugar-sweetened beverages (SSBs), low consumption of produce, skipping breakfast, and eating dinners away from the home) and whether family context (e.g., parent time spent with child, parental acceptance, and family routines) mediated that link. RESULTS: Results showed that preadolescents in divorced families consumed more SSBs than preadolescents in married families, and there was a trend for less-frequent breakfast consumption among preadolescents in the divorced families. Of the three family context variables, only family routines explained the link between family structure and obesity risk. CONCLUSIONS: This study highlights the importance of family processes during divorce to understand the etiology and prevalence of child and adolescent obesity.