Surviving Racism and Sexism: What Votes in the Television Program Survivor Reveal About Discrimination.

We examined whether there is evidence for racial and gender bias in the voting patterns of contestants on Survivor, a reality-television zero-sum game in which contestants compete for up to 39 days to win $1 million. Among 731 contestants across 40 seasons, we found evidence of racial and gender bias at multiple stages of Survivor. Compared with men, women were more likely to be voted out of their tribe first and were less likely to make it to the individual-competition stage of the game (i.e., the "merge"). They were also less likely to win Survivor. Black, Indigenous, and people of color (BIPOC) contestants, compared with White contestants, were more likely to be voted out of their tribe first and were less likely to make it to the individual-competition stage of the game. These findings suggest a systemic bias in favor of White men and against women of color.

Uncertainty in healthcare and health decision making: Five methodological and conceptual research recommendations from an interdisciplinary team.

Uncertainty is prevalent in various health contexts. It is imperative to understand how health-related uncertainty can impact individuals' healthcare experiences and health decision making. The purpose of the present paper is to provide five overarching recommendations from an interdisciplinary team of experts to address gaps in the literature on health-related uncertainty. We present a case study of health-related uncertainty within the specific context of alcohol use to demonstrate these gaps and provide context for the recommendations. The five recommendations concerning health-related uncertainty include: (1) use common, consistent terminology to discuss uncertainty, (2) clarify measures of individual differences in response to uncertainty, (3) increase research on uncertainty and affect, (4) investigate the impact of the channel through which uncertainty is communicated, and (5) develop theory-driven interventions to improve uncertainty management. We conclude by reviewing health contexts in which health-related uncertainty exists and note how our recommendations complement existing reviews and data.

Social Threat Reduces Alcohol Consumption among College Students.

AIMS: Past research suggests that people report a greater desire to consume alcohol when they experience social threat-or threats to their social selves, such as social exclusion. Nevertheless, experimental research on the role of social threat in alcohol consumption is limited. The present study examined the causal relationship between social threat and wine consumption. METHODS: Undergraduate students (N = 83; Mage = 21.8 years old, SDage = 1.62 years old; 72.3% women; 61.4% Latinx/Hispanic) participated in a study under the pretense that they were in a focus group gauging students' opinions of a bar being constructed at their university. During the study, participants and two confederate researchers completed a group activity in which they selected design elements for the bar. Participants were randomly assigned to one of two conditions. In the social threat condition, confederates rejected participants' design choices and socially excluded them during a follow-up task. In the social acceptance condition, confederates supported participants' choices and did not socially exclude them. All participants then completed a wine taste test. RESULTS: Contrary to predictions, an independent-samples t-test revealed that participants who experienced social threat consumed significantly less wine than those who were socially accepted, t(81) = -2.22, P = 0.03, d = -0.49. Furthermore, a linear regression test revealed that this effect persisted even when controlling for typical alcohol-consumption behavior, b = 56.09, t = -2.50, P = 0.02, d = -0.61. CONCLUSION: The relationship between social threat and alcohol consumption may be more nuanced than anticipated. Discussion centers around two potential moderators including positive affect and identity.

When belongingness backfires: experienced discrimination predicts increased cardiometabolic risk among college students high in social belonging.

Research implicates experiences of discrimination in exacerbating cardiometabolic disease (CMD) risk. Belongingness has been suggested as a buffer against the adverse effects of discrimination. However, when discrimination occurs in an environment to which one feels they belong, then the potential benefits of belongingness may dissipate or even exacerbate the effects of discrimination. In the present study, we examined these competing hypotheses on how campus belonging might moderate the relationship between discrimination experienced on campus and CMD risk. College students (n = 160, 60.9% Latino/a/x) reported the frequency of on-campus discrimination and campus belongingness, and then completed items assessing risk for CMD. More frequent discrimination related to higher comparative CMD risk among those who reported high campus belongingness, even after adjusting for relevant covariates. These findings highlight the complicated nature of belongingness in the context of physical health. Future research is needed to better understand the role of environment when considering morbidity among college students.

Outcomes of Physicians' Communication Goals During Patient Interactions.

During healthcare visits, physicians may set communication goals such as providing their patient with information about treatment; however, no recommendations exist regarding which goals physicians should prioritize during their often-brief interactions with patients. Two studies examined five communication goals (providing information, reducing distress, increasing patient satisfaction, increasing patient adherence, and encouraging hope) in the context of physician-patient interactions and their relationship with patient and physician outcomes. In Study 1, audio-recordings of physician-patient interactions were coded by research assistants for goal-related content. In Study 2, patients reported their physician's use of each goal during the interaction. In both studies, patients and physicians reported visit outcomes. Within-study meta-analyses suggested that the goal of reducing distress, but not the other goals, was consistently related to improved outcomes in Study 1. All goals were related to improved outcomes in Study 2. We then computed sample-size-weighted meta-analytic effects of each goal on each outcome across both studies. These results suggested that all of the goals had similar-sized positive relationships with patient and physician outcomes across studies. These findings suggest that physicians should generally approach consultations with communication goals in mind, but prioritizing efforts to reduce distress may be particularly beneficial.

Culture, COVID-19, and collectivism: A paradox of American exceptionalism?

Do geographic differences in collectivism relate to COVID-19 case and death rates? And if so, would they also replicate across states within arguably the most individualistic country in the world-the United States? Further still, what role might the U.S.'s history of ethnic strife and race-based health disparities play in either reinforcing or undermining state-level relations between collectivism and COVID-19 rates? To answer these questions, we examined archival data from 98 countries (Study 1) and the 48 contiguous United States (Study 2) on country/state-level collectivism, COVID-19 case/death rates, relevant covariates (per-capita GDP, population density, spatial dependence), and in the U.S., percent of non-Whites. In Study 1, country-level collectivism negatively related to both cases (r = -0.28) and deaths (r = -0.40) in simple regressions; however, after controlling for covariates, the former became non-significant (r p = -0.07), but the latter remained significant (r p = -0.20). In Study 2, state-level collectivism positively related to both cases (r = 0.56) and deaths (r = 0.41) in simple regressions, and these relationships persisted after controlling for all covariates except race, where a state's non-White population dominated all other predictors of COVID-19 cases (r p = 0.35) and deaths (r p = 0.31). We discuss the strong link between race and collectivism in U.S. culture, and its implications for understanding COVID-19 responses.

Psychological threat avoidance as a barrier to HIV testing in gay/bisexual men.

The present study examined how three psychosocial barriers-anticipated HIV stigma, HIV infectiousness-reduction beliefs, and optimism about available HIV treatments-related to HIV testing history and acceptance of an at-home HIV test among men who have sex with men. We also examined the mediating role of a variable that affects medical screening for other health conditions but has not yet been investigated in HIV contexts: the tendency to avoid psychologically threatening information. Volunteers completed a paper and pencil survey and were offered a free at-home HIV test during the 2015 Atlanta Pride Festival in Atlanta, GA. Anticipated HIV stigma, infectiousness beliefs, and treatment optimism were inconsistently related to HIV testing history and acceptance of an at-home HIV test, but all had direct effects on the desire to avoid HIV information. In a mediation model, each of these psychosocial barriers had indirect effects on both HIV testing outcomes via information avoidance. These findings suggest that information avoidance is an important proximal HIV testing barrier, thus providing a novel target for interventions and information campaigns.

Assessing the consequences of unrealistic optimism: Challenges and recommendations.

Of the hundreds of studies published on unrealistic optimism (i.e., expecting a better personal future than is reasonably likely), most have focused on demonstrating the phenomenon, examining boundary conditions, or documenting causes. Few studies have examined the consequences of unrealistic optimism. In this article, we provide an overview of the measurement of unrealistic optimism, review possible consequences, and identify numerous challenges confronting investigators attempting to understand the consequences. Assessing the consequences of unrealistic optimism is tricky, and ultimately probably impossible when researchers assess unrealistic optimism at the group level (which reveals if a group of people is displaying unrealistic optimism on average) rather than the individual level (which reveals whether a specific individual displays unrealistic optimism). We offer recommendations to researchers who wish to examine the consequences of unrealistic optimism.

Investigating the role of implicit prototypes in the prototype willingness model.

One useful theory to predict health behavior is the prototype-willingness model (PWM), which posits that people are more willing to engage in behavior to the extent that they have a positive view of the prototypical person who performs that behavior. The goal of the present research is to test whether adding an implicit measure of prototype favorability might improve explanatory power in the PWM. Two studies examined whether implicit prototype favorability uniquely predicted White women's intentions to engage in healthy sun behavior over the next 3-6 months, and their willingness to engage in risky sun behavior, should the opportunity arise. The results suggested that implicit prototype favorability, particularly implicit prototypes of those who engage in risky UV-related behaviors, uniquely predicted intentions to engage in healthy sun behavior and willingness to engage in risky sun behavior in the PWM.

Is waiting bad for subjective health?

The present study examined the possibility that waiting is bad for one's subjective health. Specifically, we examined longitudinal trends in the self-reported health, self-reported sleep disruption, distress, and emotion regulation strategies of law school graduates waiting for their bar exam results. Multilevel analyses suggest that waiting was particularly detrimental to participants' self-reported health and sleep disruption at the beginning and end of the waiting period. Moreover, distress and most emotion regulation efforts were associated with poorer subjective health on average, and personal increases in distress and emotion regulation were largely associated with personal increases in poor self-reported health and sleep disruption. Our results suggest that waiting periods can take a toll on subjective health and that individual and temporal variations in distress and emotion regulation efforts are associated with these health trajectories.

Predicting Scheduling and Attending for an Oral Cancer Examination.

BACKGROUND: Oral and pharyngeal cancer is highly treatable if diagnosed early, yet late diagnosis is commonplace apparently because of delays in undergoing an oral cancer examination. PURPOSE: We explored predictors of scheduling and attending an oral cancer examination among a sample of Black and White men who were at high risk for oral cancer because they smoked. METHODS: During an in-person interview, participants (N = 315) from rural Florida learned about oral and pharyngeal cancer, completed survey measures, and were offered a free examination in the next week. Later, participants received a follow-up phone call to explore why they did or did not attend their examination. RESULTS: Consistent with the notion that scheduling and attending an oral cancer exam represent distinct decisions, we found that the two outcomes had different predictors. Defensive avoidance and exam efficacy predicted scheduling an examination; exam efficacy and having coping resources, time, and transportation predicted attending the examination. Open-ended responses revealed that the dominant reasons participants offered for missing a scheduled examination were conflicting obligations, forgetting, and confusion or misunderstanding about the examination. CONCLUSIONS: The results suggest interventions to increase scheduling and attending an oral cancer examination.

A survey of barriers to screening for oral cancer among rural Black Americans.

OBJECTIVE: Research documents a disparity between Black and White Americans in mortality for oral cancer that appears to result in part from behaviors such as lower oral cancer screening among Black Americans. We examined barriers to oral cancer screening among Black Americans. METHODS: We surveyed Black Americans (N = 366) living in rural Florida to identify barriers to getting screened for oral cancer. RESULTS: Low knowledge/social attention, lack of resources, and fear/defensive avoidance predicted screening intentions, with lack of resources emerging as the largest barrier. Participants also reported that a recommendation from their provider was most likely to increase screening intentions, whereas encountering financial barriers was most likely to decrease screening intentions. CONCLUSIONS: Low knowledge/social attention, lack of resources, and fear/defensive avoidance emerged as independent barriers to oral cancer screening, with the latter two barriers accounting for the most variance in intentions to get screened.

The liking-similarity effect: perceptions of similarity as a function of liking.

In these two studies, we examined whether the inferences people make about likable and dislikable targets align with the predictions of balance theory. We hypothesized that people exhibit a liking-similarity effect by perceiving greater similarity with a likable person than a dislikable person. To test this hypothesis, we manipulated the likability of a target person and then assessed participants' perceptions of similarity to that target person. In both studies, people rated likable others as more similar to themselves than dislikable others across a variety of domains (e.g., attitudes, personality characteristics, behaviors). In Study 2, individual differences in self-concept clarity, self-esteem, and preference for consistency moderated the liking-similarity effect.

Information avoidance: An interchangeable strategy of self-protection.

Across two studies, using five samples (N = 1,850), we examined whether health information avoidance-the deliberate decision to remain ignorant of available but unwanted personal health information-serves a defensive purpose and is interchangeable with other defensive strategies. We tested this idea by examining the relationship between health information avoidance-both as a dispositional tendency and deliberate decision-and feedback derogation. In Study 1, we experimentally demonstrated that a situation known to reduce defensiveness-self-uncertainty-decreased both proactive avoidance and reactive defensiveness relative to a control group. Study 2 demonstrated, across four samples, that people with a greater defensive orientation toward personal health information were more likely to derogate health information. These results are consistent with the idea that feedback derogation replaced the decision to avoid feedback. Together, results suggest that health information avoidance is likely part of a broader self-protective system and is replaceable with other motivated self-protection strategies.

Self-administered mindfulness interventions reduce stress in a large, randomized controlled multi-site study.

Mindfulness witnessed a substantial popularity surge in the past decade, especially as digitally self-administered interventions became available at relatively low costs. Yet, it is uncertain whether they effectively help reduce stress. In a preregistered (OSF https://doi.org/10.17605/OSF.IO/UF4JZ ; retrospective registration at ClinicalTrials.gov NCT06308744 ) multi-site study (nsites = 37, nparticipants = 2,239, 70.4% women, Mage = 22.4, s.d.age = 10.1, all fluent English speakers), we experimentally tested whether four single, standalone mindfulness exercises effectively reduced stress, using Bayesian mixed-effects models. All exercises proved to be more efficacious than the active control. We observed a mean difference of 0.27 (d = -0.56; 95% confidence interval, -0.43 to -0.69) between the control condition (M = 1.95, s.d. = 0.50) and the condition with the largest stress reduction (body scan: M = 1.68, s.d. = 0.46). Our findings suggest that mindfulness may be beneficial for reducing self-reported short-term stress for English speakers from higher-income countries.

Reducing health-information avoidance through contemplation.

Despite the importance of learning about one's health, people sometimes opt to remain ignorant. In three studies, we investigated whether prompting people to contemplate their reasons for seeking or avoiding information would reduce avoidance of personal health information. In Study 1, people were more likely to opt to learn their risk for type 2 diabetes if they had completed a motives questionnaire prior to making their decision than if they had not. In Study 2, people were more likely to opt to learn their risk for cardiovascular disease if they had first listed and rated reasons for seeking or avoiding the information than if they had not. Study 3 replicated Study 2 but also showed that contemplating reasons for avoiding versus seeking reduced avoidance of personal-risk information only when the risk condition was treatable.

Barriers to oral cancer screening: a focus group study of rural Black American adults.

OBJECTIVE: Mortality from mouth and throat cancer (MTC) is higher among Black Americans than White Americans partially because of late stage detection through screening. The disparity in mortality is particularly problematic among Black Americans living in rural areas who have limited access to preventative resources. Our study explored barriers to screening for MTC among Black Americans. METHODS: We conducted nine focus groups among rural Black Americans age 40 years and older (N = 80). RESULTS: Content coding of the transcripts of the focus groups revealed three primary barriers to screening. Lack of knowledge (e.g., not knowing about MTC and not knowing MTC symptoms) accounted for 31.8% of all barriers mentioned, lack of resources (e.g., lack of money and health insurance) accounted for 25.0% of all barriers mentioned, and fear (e.g., fear of screening and diagnosis) accounted for 22.9% of all barriers mentioned. CONCLUSIONS: We placed these barriers within the Theory of Planned Behavior and conclude that interventions aimed at increasing MTC screening among rural Black Americans should first focus on changing people's attitudes about screening by increasing knowledge about MTC and reducing fear.

Behavioral obligation and information avoidance.

BACKGROUND: Although knowledge can be powerful and bring a variety of important benefits, people often opt to remain ignorant. PURPOSE: We propose that people are particularly inclined to remain ignorant when learning information could obligate undesirable behavior. METHOD: In three studies, participants completed an online risk calculator and then learned that receiving high-risk feedback from the calculator would obligate them to engage in a behavior that was either highly undesirable (e.g., undergoing a cervical exam and taking medication for the rest of their life) or only slightly undesirable (e.g., having their cheek swabbed and taking medication for 2 weeks). We then offered participants the opportunity to receive risk feedback from the calculator. RESULTS: Across all studies, participants more often avoided feedback when it could obligate highly undesirable behavior compared with mildly undesirable behavior. CONCLUSION: People decline learning their risk information more often when doing so obligates undesirable behavior in response.

Eating together more but feeling worse: Discrepancies between observed and reported well-being of Latino(a/x) students at a Hispanic-Serving Institution.

Objective. Past research suggests that eating alone is associated with less social support and poorer physical health. The current study examines the comparative health and well-being of Hispanic/Latino(a/x) and non-Hispanic/Latino(a/x) students, with a focus on comparing self-reported well-being to the observed marker of social well-being that is eating alone.Participants. Undergraduate students from a college dining hall completed online surveys in exchange for a gift card.Methods. Participants completed measures of eating alone in the dining hall, food choices, social support, quality of life, and overall health.Results. Although, compared to their non-Hispanic/Latino(a/x) peers, Hispanic/Latino(a/x) students were much more likely to be eating with others, both groups reported similar levels of social support and life satisfaction. Furthermore, Hispanic/Latino(a/x) students reported poorer physical health and chose unhealthier meals.Conclusion. Although Hispanic/Latino(a/x) students appeared to be more socially connected than their peers, these connections did not translate to better well-being.

Associations between perceived everyday discrimination and health among college students at a Hispanic-serving institution.

Despite efforts by universities to promote racial/ethnic, gender, and socioeconomic diversity, college students continue to report discrimination. In two studies, we examined the frequency, predictors, and health consequences of experiencing everyday discrimination at a Hispanic-Serving Institution. Findings show the majority of students reported experiencing discrimination at the university, with most experiences attributed to their gender and aspects of their physical appearance. More frequent discrimination was associated with poorer physical and psychological health. Furthermore, most participants cited other students as the source of their discrimination. These findings offer important insight into students' experiences of everyday discrimination at a diverse setting.