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1.
Proc Natl Acad Sci U S A ; 120(23): e2215572120, 2023 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-37252958

RESUMO

Does competition affect moral behavior? This fundamental question has been debated among leading scholars for centuries, and more recently, it has been tested in experimental studies yielding a body of rather inconclusive empirical evidence. A potential source of ambivalent empirical results on the same hypothesis is design heterogeneity-variation in true effect sizes across various reasonable experimental research protocols. To provide further evidence on whether competition affects moral behavior and to examine whether the generalizability of a single experimental study is jeopardized by design heterogeneity, we invited independent research teams to contribute experimental designs to a crowd-sourced project. In a large-scale online data collection, 18,123 experimental participants were randomly allocated to 45 randomly selected experimental designs out of 95 submitted designs. We find a small adverse effect of competition on moral behavior in a meta-analysis of the pooled data. The crowd-sourced design of our study allows for a clean identification and estimation of the variation in effect sizes above and beyond what could be expected due to sampling variance. We find substantial design heterogeneity-estimated to be about 1.6 times as large as the average standard error of effect size estimates of the 45 research designs-indicating that the informativeness and generalizability of results based on a single experimental design are limited. Drawing strong conclusions about the underlying hypotheses in the presence of substantive design heterogeneity requires moving toward much larger data collections on various experimental designs testing the same hypothesis.

2.
J Elder Abuse Negl ; 35(1): 1-33, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37042040

RESUMO

Using a mix-method design, we examined participants' willingness to respond to mass marketing scams (MMS). In Experiment 1, we examined the effect of age (young versus older) and letter style ("hot" versus "cold") on the intention to respond. The intention of responding was negatively associated with risk (p < .001) and having at least a high school education was positively associated with perception of benefits (b = .684, p < .001). In Experiment 2, we examined reward sensitivity on the intention to respond by manipulating reward amounts (low versus high) and the presence of an activation fee. The presence of an activation fee decreased intent to contact, but percentages remained high (25.75%). Analyses of qualitative data indicated that risk and benefit were both predicted by perceived self-efficacy. The results indicate that consumers' beliefs about their ability to control the outcomes of future interactions affected how they behaved when provided with MMS materials.


Assuntos
Abuso de Idosos , Idoso , Humanos , Marketing , Intenção
3.
Risk Anal ; 2022 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-36509696

RESUMO

The COVID-19 pandemic presented serious risks to the health and financial wellbeing of millions of people across the world. While many individuals adapted to these challenges through a variety of prosocial and protective behaviors (e.g., social distancing, working from home), many others also engaged in dishonest behaviors (e.g., lying to obtain vaccines or furlough payments). Hence, the COVID-19 pandemic provided a unique context in which to obtain a better understanding of the relationship between risk and dishonesty. Across three preregistered studies, we assessed whether objective risk and perceived risk influenced the decision to behave dishonestly in order to gain access to vaccines and furlough payments during a pandemic. We also assessed the extent to which such dishonesty was deterred by the probability of the dishonesty being detected. We found that heightened health risk perceptions were positively related with lying to obtain a vaccine (Studies 1 and 2), but found no evidence of the same relationship between financial risk perceptions and lying to access furlough payments (Study 2). We also found that the probability of dishonesty being detected had a negative relationship with dishonest behavior (Study 3). In addition, across the three studies, we found that (i) dishonesty was consistently evident in approximately one-third of all of our samples, and (ii) greater dishonesty was associated with older age. We discuss how our findings could be utilized by policy makers to better deter and detect dishonest behaviors during future similar crises.

4.
Cogn Emot ; 36(1): 106-119, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34886740

RESUMO

ABSTRACTExperiencing empathy for others has been linked to worsening others' feelings against their wishes. These paternalistic empathic goals have been theorised to happen at the dyad level when an agent aims to worsen a target's emotional state. They may also operate at a broader level when agents are third-party observers of COVID-19 lockdown rule violations. In these instances, agents can impact transgressors' affect engaging in Coronashaming. In three studies, we measured British people's (Ntotal = 767) vulnerability (Study 1), age (Studies 2 and 3), and empathy towards COVID-19 victims and presented them with different scenarios depicting a breach of lockdown rules to assess the emotions participants wanted to inflict in transgressor, the strategies used, and whether they wanted stricter rules to be enforced. Results confirmed shame as the emotion preferred to induce in violators, with this preference linked to higher use of engagement strategies (i.e. to make transgressors understand what they did wrong). Finally, empathy was positively linked to higher affect worsening and wanting stricter rules to be enforced. This suggests that empathy towards potential victims of COVID-19 rules violations can motivate people to worsen the feelings of transgressors.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis , Emoções , Empatia , Humanos , SARS-CoV-2
5.
Evid Based Dent ; 2022 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-36477677

RESUMO

Introduction UK dentists experience high levels of stress, anxiety and burnout. Poor mental health can lead practitioners to exit the profession, contributing to workforce and service loss. Therefore, there is a need to focus on interventions to protect the mental health and wellbeing of dental teams. Three levels of intervention can be deployed in the workplace to support mental health and wellbeing: primary prevention, secondary prevention, and tertiary prevention.Aim The aim of this systematic review was to identify evidence on interventions used to prevent, improve or tackle mental health issues among dental team members and dental profession students in countries of very high development.Methods This systematic review was conducted according to a predefined protocol and reported according to PRISMA guidelines. The MEDLINE, Embase CINAHL, DOSS, Scopus, and PsycINFO databases were searched. Prospective empirical studies were considered for inclusion. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) was used to assess the methodological quality of the included studies. The identified interventions were categorised according to level of prevention.Results The search yielded 12,919 results. Eight studies met the inclusion criteria. All of the studies concerned dentists or dental students. There were no studies for other groups of dental professionals. No primary prevention-level studies were identified. Secondary prevention-level studies (n = 4) included various psychoeducational interventions aiming to raise awareness and improve coping skills and led to significant improvements in stress levels and burnout of dentists and dental students. Tertiary prevention-level studies (n = 4) mainly employed counselling which was shown to be beneficial for dentists and students experiencing psychological ill-health.Conclusions Mental wellbeing awareness should be put at the centre of dental education and the workplace. Leadership and innovation are required to design primary-level interventions which can be implemented in the UK dental sector, with its distinct organisational and service characteristics.

6.
Risk Anal ; 41(9): 1662-1673, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33216398

RESUMO

Educational programs are the most common type of intervention to reduce risky driving behavior. Their success, however, depends on the content of the material used and the mode of delivery. In the present study, we examined the impact of fear versus positively framed road safety films and traditional technologies (2D) versus emerging technologies (VR) on young drivers' self-reported risky driving behaviors. One hundred and forty-six university students completed a similar set of questionnaires pre-intervention and post-intervention, two weeks later. In addition, they were randomly assigned to one of the four experimental conditions (VR vs. 2D; positive vs. negative). In the VR conditions, the film was presented using an HTC VIVE Virtual Reality headset. In the 2D conditions, the film was presented on a computer screen. Measures evaluating attitudes toward risky driving behavior were completed at both time frames, questions regarding the participants' emotional arousal were asked at pre-intervention as a manipulation check, and questions regarding willingness to take risks in potentially dangerous driving situations were asked at follow-up. The findings indicate that the positively framed films significantly decreased self-reported risky driving behaviors in both modalities, but especially when viewed in VR format. In contrast, the fear appeal film, when shown in VR, failed to reduce risky driving behaviors, and in fact, increased young drivers' self-reported risky driving behaviors. Theoretical frameworks regarding the strengths and weaknesses of fear appeals and positively framed appeals are discussed to aid future research to reduce risky driving. Practical implications on the future usage of VR are also considered.


Assuntos
Condução de Veículo/psicologia , Medo , Comportamento de Redução do Risco , Realidade Virtual , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
7.
J Elder Abuse Negl ; 32(2): 152-172, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32149596

RESUMO

There have been inconsistent results regarding whether older adults are more vulnerable to fraud than younger adults. The two main goals of this study were to investigate the claim that there is an age-related vulnerability to fraud and to examine whether emotional intelligence (EI) may be associated with fraud susceptibility. Participants (N = 281; 18-82 years; M = 53.4) were recruited via Amazon's Mechanical Turk and completed measures of EI, decision-making, and scam susceptibility. Participants who scored higher on "ability" EI were less susceptible to scams. The "younger" group (M = 2.50, SD = 1.06) was more susceptible to scams than the "older" group, p <.001, d = 0.56, while the "older" group (M = 4.64, SD = 1.52) reported the scams as being more risky than the "younger" group, p =.002, d = 0.37. "Older" participants were more sensitive to risk, less susceptible to persuasion, and had higher than average emotional understanding. Emotional understanding was found to be a partial mediator for age-related differences in scam susceptibility and susceptibility to persuasion.


Assuntos
Tomada de Decisões , Inteligência Emocional , Fraude/economia , Investimentos em Saúde/economia , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Proteção
8.
Gerontology ; 65(5): 547-559, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30566940

RESUMO

BACKGROUND AND OBJECTIVES: Proxy decision-making may be flawed by inaccurate perceptions of risk. This may be particularly true when older adults are the targets of the decisions, given the pervasive negative stereotypes about older adults. METHODS: In study 1, individuals aged 18- to 87 years (as target persons) as well as one of their close social partners (as informants) reported on the risks they perceived for the target person in various life domains. Study 2 additionally explored potential differences in how people make risky decisions on behalf of younger and older adult targets. Younger (age 18-35 years) and older (age 60-81 years) adults (as target persons of the risk evaluations) as well as informants reported on risk perceptions and the likelihood of risk-taking for health, financial, and social scenarios concerning the target persons. Congruence between self-rated and informant-rated risk perceptions and risk-taking were computed on a dyadic as well as a group level. RESULTS: Informants' risk perceptions were positively associated with the risks their partners perceived for themselves. Informants and their partners agreed that social risks vary little across adulthood, but they disagreed in terms of recreational, financial, and health risks, and in terms of the decisions they would make. CONCLUSION: Family members, partners, and close friends are sensitive to vulnerabilities of their social partners, but in some domains and according to their partners' age they perceive a greater (or smaller) risk than their partners perceive for themselves. In situations requiring surrogate decision-making, people may decide differently from how their social partners would decide for themselves.


Assuntos
Tomada de Decisões , Procurador , Medição de Risco , Assunção de Riscos , Autoimagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
9.
Risk Anal ; 39(4): 792-804, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30286526

RESUMO

People's perceptions of benefits and risks play a key role in their acceptance or rejection of medical interventions, yet these perceptions may be poorly calibrated. This online study with N = 373 adults aged 19-76 years focused on unrealistic optimism in the health domain. Participants indicated how likely they were to experience benefits and risks associated with medical conditions and completed objective and subjective numeracy scales. Participants exhibited optimistic views about the likelihood of experiencing the benefits and the side effects of treatment options described in the scenarios. Objective and subjective numeracy were not associated with more accurate ratings. Moreover, participants' underestimation of the risks was significantly greater than their overestimation of the benefits. From an applied perspective, these results suggest that clinicians may need to ensure that patients do not underestimate risks of medical interventions, and that they convey realistic expectations about the benefits that can be obtained with certain procedures.


Assuntos
Otimismo , Comportamento de Redução do Risco , Adulto , Idoso , Feminino , Comportamentos de Risco à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Inquéritos e Questionários , Adulto Jovem
10.
J Genet Couns ; 27(1): 59-68, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28616831

RESUMO

Funding policy and medico-legal climate are part of physicians' reality and might permeate clinical decisions. This study evaluates the influence of maternal age and government funding on obstetrician/gynecologist recommendation for invasive prenatal testing (i.e. amniocentesis) for Down syndrome (DS), and its association with the physician's assessment of the risk of liability for medical malpractice unless they recommend amniocentesis. Israeli physicians (N = 171) completed a questionnaire and provided amniocentesis recommendations for women at 18 weeks gestation with normal preliminary screening results, identical except aged 28 and 37. Amniocentesis recommendations were reversed for the younger ('yes' regardless of testing results: 6.4%; 'no' regardless of testing results: 31.6%) versus older woman ('yes' regardless of testing results: 40.9%; 'no' regardless of testing results: 7.0%; χ2 = 71.55, p < .01). About half of the physicians endorsed different recommendations per scenario; of these, 65.6% recommended amniocentesis regardless of testing results for the 37-year-old woman. Physicians routinely performing amniocentesis and those advocating for amniocentesis for all women ≥ age 35 were approximately twice as likely to vary their recommendations per scenario. Physicians who perceived risk of liability for malpractice as large were nearly one-and-a-half times more likely to vary recommendations. The results indicate physicians' recommendations are influenced by maternal age, though age is already incorporated in prenatal DS risk evaluations. The physician's assessment of the risk that they will be sued unless they recommend amniocentesis may contribute to this spurious influence.


Assuntos
Amniocentese/psicologia , Aconselhamento Genético/psicologia , Idade Materna , Diagnóstico Pré-Natal/psicologia , Adulto , Tomada de Decisões , Síndrome de Down/diagnóstico , Feminino , Aconselhamento Genético/métodos , Humanos , Programas de Rastreamento/psicologia , Gravidez , Segundo Trimestre da Gravidez/psicologia , Diagnóstico Pré-Natal/métodos
11.
Risk Anal ; 38(5): 917-928, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-27661782

RESUMO

Across adulthood, people face increasingly more risky medical problems and decisions. However, little is known about changes in medical risk taking across adulthood. Therefore, the current cross-sectional study investigated age-related differences in medical risk taking with N = 317 adults aged 20-77 years using newly developed scenarios to assess medical risk taking, and additional measures designed to evaluate risk-taking behavior in the medical domain. Greater expected benefits on the Domain-Specific Risk-Taking Scale-Medical (DOSPERT-M) predicted more active risk taking, whereas higher perceived risk predicted less active risk taking. Next, we examined differences in active and passive risk taking, where passive risk taking refers to risk taking that is associated with inaction. Age was associated with less passive risk taking, but not with active risk taking, risk perception, or expected benefits on the DOSPERT-M. Participants were overall more likely to opt for taking medical action than not, even more so for a scenario about a vaccine for a deadly flu than for a scenario about a chemotherapy treatment for cancer. Overall, participants were more likely to accept medication (vaccine or chemotherapy) for their child than for themselves. Increasing age was associated with a lower likelihood of accepting the treatment or vaccine for oneself. Taken together, our study provides important insights about changes in medical risk taking across adulthood when people face an increasing number of complex and risky medical decisions.

12.
BMC Health Serv Res ; 17(1): 729, 2017 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-29141639

RESUMO

BACKGROUND: Under the Affordable Care Act (ACA), millions of Americans have been enrolling in the health insurance marketplaces. Nearly 20% of them are tobacco users. As part of the ACA, tobacco users may face up to 50% higher premiums that are not eligible for tax credits. Tobacco users, along with the uninsured and racial/ethnic minorities targeted by ACA coverage expansions, are among those most likely to suffer from low health literacy - a key ingredient in the ability to understand, compare, choose, and use coverage, referred to as health insurance literacy. Whether tobacco users choose enough coverage in the marketplaces given their expected health care needs and are able to access health care services effectively is fundamentally related to understanding health insurance. However, no studies to date have examined this important relationship. METHODS: Data were collected from 631 lower-income, minority, rural residents of Virginia. Health insurance literacy was assessed by asking four factual questions about the coverage options presented to them. Adjusted associations between tobacco use and health insurance literacy were tested using multivariate linear regression, controlling for numeracy, risk-taking, discount rates, health status, experiences with the health care system, and demographics. RESULTS: Nearly one third (31%) of participants were current tobacco users, 80% were African American and 27% were uninsured. Average health insurance literacy across all participants was 2.0 (SD 1.1) out of a total possible score of 4. Current tobacco users had significantly lower HIL compared to non-users (-0.22, p < 0.05) after adjustment. Participants who were less educated, African American, and less numerate reported more difficulty understanding health insurance (p < 0.05 each.) CONCLUSIONS: Tobacco users face higher premiums for health coverage than non-users in the individual insurance marketplace. Our results suggest they may be less equipped to shop for plans that provide them with adequate out-of-pocket risk protection, thus placing greater financial burdens on them and potentially limiting access to tobacco cessation and treatment programs and other needed health services.


Assuntos
Reforma dos Serviços de Saúde/organização & administração , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde/estatística & dados numéricos , Cobertura do Seguro , Seguro Saúde , Grupos Minoritários , Patient Protection and Affordable Care Act , Uso de Tabaco/economia , Adulto , Feminino , Trocas de Seguro de Saúde/economia , Humanos , Cobertura do Seguro/economia , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/economia , Seguro Saúde/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Patient Protection and Affordable Care Act/legislação & jurisprudência , Patient Protection and Affordable Care Act/estatística & dados numéricos , Assunção de Riscos , Estados Unidos , Virginia , Populações Vulneráveis
13.
Risk Anal ; 37(9): 1632-1643, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28095602

RESUMO

In later life, people are faced with a multitude of risky decisions that concern their health, finance, and personal security. Older adults often exercise caution in situations that involve risk. In this research, we asked whether older adults are also more responsive to warnings about potential risk. An answer to this question could reveal a factor underlying increased cautiousness in older age. In Study 1, participants decided whether they would engage in risky activities (e.g., using an ATM machine in the street) in four realistic scenarios about which participants could be expected to have relevant knowledge or experience. They then made posterior decisions after listening to audio extracts of real reports relevant to each activity. In Study 2, we explored the role that emotions play in decision updating. As in Study 1, participants made prior and posterior decisions, with the exception that for each scenario the reports were presented in their original audio format (high emotive) or in a written transcript format (low emotive). Following each posterior decision, participants indicated their emotional valence and arousal responses to the reports. In both studies, older adults engaged in fewer risky activities than younger adults, indicative of increased cautiousness in older age, and exhibited stronger decision updating in response to the reports. Older adults also showed stronger emotional responses to the reports, even though emotional responses did not differ for audio and written transcript formats. Finally, age differences in emotional responses to the reports accounted for age differences in decision updating.

14.
J Health Commun ; 21(sup2): 155-163, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27676124

RESUMO

Poor Medicare knowledge is associated with worse health outcomes, especially in low-income patients. We examined the association of health literacy and cognition with actual and perceived Medicare knowledge in a sample of inner-city older adults. We conducted a cross-sectional analysis of data on 336 adults ages 65 years and older with Medicare coverage recruited from senior centers and low-income housing facilities in Manhattan, New York. Actual Medicare knowledge was determined by a summary score of 9 true/false questions about the Medicare program and perceived Medicare knowledge with a single item. Validated measures were used to assess health literacy and general cognition. Among respondents, 63.1% had high actual Medicare knowledge, and 36.0% believed that they knew what they needed to know about Medicare. Actual and perceived Medicare knowledge were poorly correlated (r = -.01, p > .05). In multivariable models, low health literacy was significantly associated with actual Medicare knowledge (ß = -8.30, SE = 2.71, p < .01) but not perceived Medicare knowledge (ß = 0.37, SE = 0.22, p = .09). Individuals with low health literacy were more likely to perceive their Medicare knowledge as adequate when actual Medicare knowledge was low (adjusted odds ratio = 3.30, 95% confidence interval [1.20, 9.05], p < .05). These results show that older adults with low health literacy are more likely to have poor understanding of the Medicare program and yet more likely to believe that their understanding of the program is adequate. This combination of factors may place them at increased risk for poor access to information about the Medicare program and diminish their ability to make fully informed choices.


Assuntos
Cognição , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde/estatística & dados numéricos , Medicare , População Urbana , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Cidade de Nova Iorque , Estados Unidos , População Urbana/estatística & dados numéricos
15.
Alcohol Clin Exp Res ; 39(6): 1100-7, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25939685

RESUMO

BACKGROUND: Cognitive behavioral therapy-based alcohol treatment programs have been widely used to break the link between alcohol and crime. While evidence exists on the connection between alcohol and crime, there is little data that demonstrate the effectiveness of different alcohol treatment programs in reducing criminal behavior. We tested whether male offenders who participate in alcohol treatment programs show lower rates of recidivism than a matched offender group who did not participate in an alcohol prevention program. METHODS: This is an observational matched case-control study. Participants were 564 male offenders with an alcohol problem related to offending. Participants were assigned by the courts to 1 of 3 alcohol treatment programs (141 offenders per treatment): Low Intensity Alcohol Program (LIAP), Alcohol Specified Activity Requirement, and Addressing Substance-Related Offending. A fourth matched group (n = 141) was not assigned to a program and served as a control group. Survival analysis was used to calculate participants' charged and reconviction rates over 4 time periods (0 to 3, 4 to 6, 7 to 9, and 10 to 12 months after completion of program or order). RESULTS: Offenders who did not participate in a program were more than twice as likely to be charged compared to offenders who participated in a program. Furthermore, offenders who did not participate in a program were over 2.5 times more likely to be reconvicted. Among the 3 alcohol treatment programs evaluated, the LIAP was the most cost-effective. CONCLUSIONS: Offenders enrolled in an alcohol treatment program showed a significant reduction in being charged with or reconvicted of a crime. With costs of keeping offenders in prison per year reaching close to £40,000 per offender per year (Mulheirn et al., 2010, www.smf.co.uk), assigning offenders to alcohol preventive programs-such as LIAP-are a promising way to reduce recidivism and reduce cost.


Assuntos
Transtornos Relacionados ao Uso de Álcool/terapia , Terapia Cognitivo-Comportamental , Criminosos/psicologia , Criminosos/estatística & dados numéricos , Adolescente , Adulto , Estudos de Casos e Controles , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Resultado do Tratamento , Reino Unido , Adulto Jovem
16.
Health Expect ; 18(6): 2799-810, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25186806

RESUMO

BACKGROUND: Shared decision making has become an integral part of medical consultation. Research has, however, reported wide differences in individuals' desires to be involved in the decision-making process, and these differences in preferences are likely to be the result of a number of factors including age, education and numeracy. OBJECTIVE: To investigate whether patients at genetic risk for cancer had preferences for shared decision making that differed depending on medical domain (general health vs. cancer) and whether decision preferences are linked to numeracy abilities. METHODS: Four hundred and seventy-six women who consented to participate in response to an email sent by a local branch of the U.S.-based Cancer Genetics Network (CGN) to its members. Participants completed the Control Preference Scale, as well as an objective and subjective numeracy scales. RESULTS: Decision domain (cancer vs. general health) was not associated with women's preferences for involvement in decision making. Objective and subjective numeracy predicted a preference for decision involvement in general, and only objective numeracy was predictive with regard to cancer. CONCLUSION: Participants were equally likely to state they wanted to play an active, collaborative or passive role in both medical domains (general and cancer). High-numeracy participants were more likely to express a desire for an active role in general and in case they were diagnosed with cancer. PRACTICE IMPLICATIONS: Health authorities' recommendations to clinicians to include patients in their medical decisions are supported by patients' desires, and clinicians should be cognizant of their patients' preferences as well as their numeracy skills.


Assuntos
Tomada de Decisões , Neoplasias/psicologia , Adulto , Neoplasias da Mama/etiologia , Neoplasias da Mama/genética , Neoplasias da Mama/psicologia , Feminino , Predisposição Genética para Doença/psicologia , Humanos , Pessoa de Meia-Idade , Neoplasias/etiologia , Neoplasias/genética , Preferência do Paciente , Fatores de Risco , Inquéritos e Questionários
17.
J Genet Couns ; 24(5): 744-51, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25519004

RESUMO

Single nucleotide polymorphisms (SNPs) have the potential to improve personalized medicine in breast cancer care. As new SNPs are discovered, further enhancing risk classification, SNP testing may serve to complement family history and phenotypic risk factors when assessed in a clinical setting. SNP analysis is particularly relevant to high-risk women who may seek out such information to guide their decision-making around risk-reduction. However, little is known about how high-risk women may respond to SNP testing with regard to clinical decision-making. We examined high-risk women's interest in SNP testing for breast cancer risk through an online survey of hypothetical testing scenarios. Women stated their preferences for sharing test results and selected the most likely follow-up action they would pursue in each of the test result scenarios (above average and below average risk for breast cancer). Four hundred seventy-eight women participated. Most women (89 %) did not know what a SNP was prior to the study. Once SNP testing was described, 75 % were interested in SNP testing. Participants stated an interest in lifestyle interventions for risk-reduction and wanted to discuss their testing results with their doctor or a genetic counselor. Women are interested in SNP testing and are prepared to make lifestyle changes based on testing results. Women's preference for discussing testing results with a healthcare provider aligns with the current trend towards SNP testing in a clinical setting.


Assuntos
Neoplasias da Mama/genética , Testes Genéticos/métodos , Polimorfismo de Nucleotídeo Único , Medicina de Precisão/métodos , Adulto , Neoplasias da Mama/diagnóstico , Tomada de Decisões , Feminino , Predisposição Genética para Doença/genética , Humanos , Pessoa de Meia-Idade
18.
Risk Anal ; 35(8): 1407-22, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25819576

RESUMO

Young people are exposed to and engage in online risky activities, such as disclosing personal information and making unknown friends online. Little research has examined the psychological mechanisms underlying young people's online risk taking. Drawing on fuzzy trace theory, we examined developmental differences in adolescents' and young adults' online risk taking and assessed whether differential reliance on gist representations (based on vague, intuitive knowledge) or verbatim representations (based on specific, factual knowledge) could explain online risk taking. One hundred and twenty two adolescents (ages 13-17) and 172 young adults (ages 18-24) were asked about their past online risk-taking behavior, intentions to engage in future risky online behavior, and gist and verbatim representations. Adolescents had significantly higher intentions to take online risks than young adults. Past risky online behaviors were positively associated with future intentions to take online risks for adolescents and negatively for young adults. Gist representations about risk negatively correlated with intentions to take risks online in both age groups, while verbatim representations positively correlated with online risk intentions, particularly among adolescents. Our results provide novel insights about the underlying mechanisms involved in adolescent and young adults' online risk taking, suggesting the need to tailor the representation of online risk information to different age groups.


Assuntos
Assunção de Riscos , Adolescente , Humanos , Adulto Jovem
19.
Psychooncology ; 23(10): 1142-8, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24733657

RESUMO

BACKGROUND: The majority of women (71%) who undergo BRCA1/2 testing-designed to identify genetic mutations associated with increased risk of cancer-receive results that are termed 'ambiguous' or 'uninformative negative'. How women interpret these results and the association with numerical ability was examined. METHODS: In this study, 477 women at increased risk for breast and ovarian cancer were recruited via the Cancer Genetics Network. They were presented with information about the four different possible BRCA1/2 test results-positive, true negative, ambiguous and uninformative negative-and asked to indicate which of six options represents the best response. Participants were then asked which treatment options they thought a woman receiving the results should discuss with her doctor. Finally, participants completed measures of objective and subjective numeracy. RESULTS: Almost all of the participants correctly interpreted the positive and negative BRCA1/2 genetic test results. However, they encountered difficulties interpreting the uninformative and ambiguous BRCA1/2 genetic test results. Participants were almost equally likely to think either that the woman had learned nothing from the test result or that she was as likely to develop cancer as the average woman. Highly numerate participants were more likely to correctly interpret inconclusive test results (ambiguous, OR = 1.62; 95% CI [1.28, 2.07]; p < 0.001; uninformative, OR = 1.40; 95% CI [1.10, 1.80]). DISCUSSION: Given the medical and psychological ramifications of genetic testing, healthcare professionals should consider devoting extra effort to ensuring proper comprehension of ambiguous and uninformative negative test results by women.


Assuntos
Neoplasias da Mama/genética , Genes BRCA1 , Genes BRCA2 , Predisposição Genética para Doença/psicologia , Testes Genéticos , Percepção , Incerteza , Adulto , Atitude Frente a Saúde , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/psicologia , Feminino , Aconselhamento Genético/psicologia , Inquéritos Epidemiológicos , Humanos , Internet , Pessoa de Meia-Idade , Mutação , Análise de Regressão , Medição de Risco , Fatores Socioeconômicos , Estresse Psicológico
20.
Risk Anal ; 34(10): 1870-81, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24913147

RESUMO

It has long been assumed that risk taking is closely associated with criminal behavior. One reason for placing criminals behind bars--aside from punishment and protecting the public--is to prevent them from engaging in further risky criminal activities. Limited attention has been paid to whether being inside or outside prison affects offenders' risk-taking behaviors and attitudes. We compared risk-taking behaviors and attitudes in five risk domains (ethical, financial, health/safety, recreational, social) among 75 incarcerated offenders (i.e., offenders who are currently in prison) and 45 ex-offenders (i.e., offenders who have just been released from prison). Ex-offenders reported higher likelihood of engaging in risky behavior, driven largely by a willingness to take more risks in the recreational and ethical domains. Benefits attributed to risk taking as well as risk perception did not differ between incarcerated and ex-offenders, indicating that the opportunity to take risks might underlie behavioral risk intentions. Our results also indicate that risk-taking activities are better predicted by the expected benefits rather than by risk perception, aside from the health/safety domain. These results highlight the importance of studying the person and the environment and examining risk taking in a number of content domains.


Assuntos
Atitude , Crime/psicologia , Prisioneiros/psicologia , Assunção de Riscos , Humanos
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