Whose Signals Are Being Amplified? Toward a More Equitable Clinical Psychophysiology.

Research using psychophysiological methods holds great promise for refining clinical assessment, identifying risk factors, and informing treatment. Unfortunately, unique methodological features of existing approaches limit inclusive research participation and, consequently, generalizability. This brief overview and commentary provides a snapshot of the current state of representation in clinical psychophysiology, with a focus on the forms and consequences of ongoing exclusion of Black participants. We illustrate issues of inequity and exclusion that are unique to clinical psychophysiology, considering intersections among social constructions of Blackness and biased design of current technology used to measure electroencephalography, skin conductance, and other signals. We then highlight work by groups dedicated to quantifying and addressing these limitations. We discuss the need for reflection and input from a wider variety of stakeholders to develop and refine new technologies, given the risk of further widening disparities. Finally, we provide broad recommendations for clinical psychophysiology research.

Influence of mental health on information seeking, risk perception and mask wearing self-efficacy during the early months of the COVID-19 pandemic: a longitudinal panel study across 6 U.S. States.

BACKGROUND: Understanding factors that influence information seeking, assessment of risk and mitigation behaviors is critical during a public health crises. This longitudinal study examined the influence of self-reported mental health during the early months of the COVID-19 pandemic on information seeking, risk perception and perceived mask wearing ability. Mental health screener items included fear, anger, and hopelessness in addition to avoidance, diminished functional ability and global distress. Theoretical models inform hypotheses linking mental health items and outcomes. METHODS: The research employed a longitudinal 6-state 3-wave online panel survey, with an initial sample of 3,059 participants (2,232 included in longitudinal analyses). Participants roughly represented the states' age, race, ethnicity, and income demographics. RESULTS: Women, those who identified as Hispanic/Latinx, Black Americans and lower income participants reported higher overall rates of distress than others. Information seeking was more common among older persons, Democrats, retirees, those with higher education, and those who knew people who had died of COVID-19. Controlling for such demographic variables, in multivariable longitudinal models that included baseline mental health measures, distress and fear were associated with increased information seeking. Distress and fear were also associated with increased risk perception, and feelings of hopelessness were associated with lower reported mask-wearing ability. CONCLUSIONS: Results advance understanding of the role mental health can play in information seeking, risk perception and mask wearing with implications for clinicians, public health practitioners and policy makers.

Structural Racism and the COVID-19 Experience in the United States.

The long, fallacious history of attributing racial disparities in public health outcomes to biological inferiority or poor decision making persists in contemporary conversations about the COVID-19 pandemic. Given the disproportionate impacts of this pandemic on communities of color, it is essential for scholars, practitioners, and policymakers to focus on how structural racism drives these disparate outcomes. In May and June 2020, we conducted a 6-state online survey to examine racial/ethnic differences in exposure to COVID-19, risk mitigation behaviors, risk perceptions, and COVID-19 impacts. Results show that Black and Hispanic individuals were more likely than White respondents to experience factors associated with structural racism (eg, living in larger households, going to work in person, using public transportation) that, by their very nature, increase the likelihood of exposure to COVID-19. Controlling for other demographic and socioeconomic characteristics, non-White respondents were equally or more likely than White respondents to take protective actions against COVID-19, including keeping distance from others and wearing masks. Black and Hispanic respondents also perceived higher risks of dying of the disease and of running out of money due to the pandemic, and 40% of Black respondents reported knowing someone who had died of COVID-19 at a time when the US death toll had just surpassed 100,000 people. To manage the current pandemic and prepare to combat future health crises in an effective, equitable, and antiracist manner, it is imperative to understand the structural factors perpetuating racial inequalities in the COVID-19 experience.

Clinicians, cooks, and cashiers: Examining health equity and the COVID-19 risks to essential workers.

In Spring/Summer 2020, most individuals living in the United States experienced several months of social distancing and stay-at-home orders because of the coronavirus (COVID-19) pandemic. Clinicians, restaurant cooks, cashiers, transit operators, and other essential workers (EWs), however, continued to work outside the home during this time in order to keep others alive and maintain a functioning society. In the United States, EWs are often low-income persons of color who are more likely to face socioeconomic vulnerabilities, systemic racism, and health inequities. To assess the various impacts of COVID-19 on EWs, an online survey was distributed to a representative sample of individuals residing in six states during May/June 2020. The sample included 990 individuals who identified as EWs and 736 nonessential workers (NWs). We assessed differences between EW and NW respondents according to three categories related to health equity and social determinants of health: (1) demographics (e.g. race/ethnicity); (2) COVID-19 exposure risk pathways (e.g. ability to social distance); and (3) COVID-19 risk perceptions (e.g. perceived risk of contracting COVID-19). EWs were more likely to be Black or Hispanic than NWs and also had lower incomes and education levels on average. Unsurprisingly, EWs were substantially more likely to report working outside the home and less likely to report social distancing and wearing masks indoors as compared to NWs. EWs also perceived a slightly greater risk of contracting COVID-19. These findings, which we discuss in the context of persistent structural inequalities, systemic racism, and health inequities within the United States, highlight ways in which COVID-19 exacerbates existing socioeconomic vulnerabilities faced by EWs.

A Systematic Review of Literature on Effectiveness of Training in Emergency Risk Communication.

Although disaster preparedness training is regularly conducted for a range of health-related professions, little evidence-based guidance is available about how best to actually develop capacity in staff for conducting emergency risk communication. This article presents results of a systematic review undertaken to inform the development of World Health Organization guidelines for risk communication during public health and humanitarian emergencies. A total of 6,720 articles were screened, with 24 articles identified for final analysis. The majority of research studies identified were conducted in the United States, were either disaster general or focused on infectious disease outbreak, involved in-service training, and used uncontrolled quantitative or mixed method research designs. Synthesized findings suggest that risk communication training should include a focus on collaboration across agencies, training in working with media, and emphasis on designing messages for specific audience needs. However, certainty of findings was at best moderate due to lack of methodological rigor in most studies.

Uncertainty and information-seeking patterns: A test of competing hypotheses in the context of health care reform.

This article integrates three uncertainty frameworks (i.e., uncertainty reduction, motivation to reduce uncertainty, predicted outcome value) to examine the relationship between uncertainty and information seeking in the context of health care reform. The study consisted of a pretest to assess model variables, tracking of online information seeking (by monitoring website use), and a posttest. Results indicate predicted outcome value theory is the best predictor of information seeking, which is subsequently associated with greater certainty and information recall. The data suggest uncertainty alone is not enough to motivate information seeking; individuals must perceive information to have appreciable value in order to spend time seeking it. Theoretical and practical applications, as well as avenues for future research, are presented.

Anatomy and humanity: Examining the effects of a short documentary film and first anatomy laboratory experience on medical students.

Medical students begin their education inside a laboratory dissecting cadavers to learn human gross anatomy. Many schools use the course experience as a way to instill empathy and some have begun integrating video and recorded interviews with body donors to humanize the experience, but their impact has yet to be measured. This study examines the effects of a brief documentary film and the initial cadaver encounter on student perceptions and attitudes towards the laboratory experience. A pre-test, exposure, post-test design was used with 77 first-year medical students at the University of Central Florida. A previously validated questionnaire was adapted to measure attitudes, emotions, initial reaction to cadaver, perception of the donor as a person, and impressions of the film. An online questionnaire was completed before the first day of laboratory, in which students watched the film Anatomy and Humanity and handled their respective cadavers (no dissection was performed). The post-test was administered immediately following the activities of the first laboratory day. Results indicate an increase in negative attitudes towards dissection, but a more positive initial reaction to the cadaver than originally anticipated. Students also experienced a decrease in emotions like sadness and guilt regarding anatomy laboratory and were less likely to view the cadaver as a once-living person. Findings suggest a higher comfort level, but also greater detachment toward the cadavers from day one despite the video intervention. These results provide novel insight that may aid other interventions aimed at promoting humanism in the anatomy laboratory experience.

Translating and testing breast cancer risk reduction messages for mothers of adolescent girls.

Emerging scientific findings regarding breast cancer science are typically presented only in discipline specific journals in which the general public and those at risk have limited access, creating a development-to-delivery gap between the state of the science and public knowledge. A lack of collaboration between scientists, communication experts, and community partners further compounds this lack of information available to the public. The present study translates recent scientific findings about environmental breast cancer risks into palatable magazine-style messages for mothers of young daughters as a strategy to meet the call for greater translation and dissemination of scientific results to the lay public. Results from focus groups indicate that mothers actually want more science in messages and greater explication of findings that indicate causality. Mothers also expect polished, professional messages that are representative of their daughters and provide a source for further information seeking purposes. Recommendations for future translation and message design endeavors are discussed.

Investigating the impact of message format, involvement, scientific literacy, and education on attitude toward reducing cancer risk through regulation.

Recent research links perfluorooctanoic acid (PFOA) to increased breast cancer risk. Efforts to inform the lay public about potential risks associated with PFOA need to be accessible in their content as many individuals, including highly educated ones, have low scientific literacy. This study investigates the role of message format, as well as personal involvement, scientific literacy, and education in influencing attitudes about PFOA regulation. Participants (N = 2,078) were exposed to one of three message formats about PFOA and then responded to survey questions related to their attitude about the need for new regulation. Results revealed that issue involvement was positively related to favorable attitude regarding new regulation, while education and advocacy status were negatively related; cancer experience, scientific literacy, and message format did not influence attitude about new regulation. Implications of the results are discussed as they relate to communicating uncertain risk information to inform and influence lay individuals.

Concern as motivation for protection: an investigation of mothers' concern about daughters' breast cancer risk.

The present study surveyed mothers with daughters (N = 386) to investigate how mothers' concern about their daughters' breast cancer risk influenced intentions to engage in preventive behaviors. Using protection motivation theory as a framework, self-efficacy, response efficacy, and level of concern were posited to influence protective behavioral intention in distinct ways. Results from regression analyses indicate that self-efficacy, response efficacy, and mothers' concern are significant predictors of intentions to engage in preventive behaviors with daughters. In addition, a content analysis of mothers' open-ended reasons for their concern about their daughters' breast cancer risk yield a list of specific concerns and trends that vary by concern level and individual comment valence. The authors discuss implications for incorporating mothers' concerns into breast cancer prevention messages as a novel strategy for campaign designers.

Mothers' Intentions to Teach Adolescent Daughters about Breast Cancer Risk Reduction Activities: The Influence of Self-Efficacy, Response Efficacy, & Personal Responsibility.

The current study examined whether self-efficacy (SE), response efficacy (RE), and personal responsibility (PR) affect mothers' intentions (N=139) to teach their adolescent and pre-adolescent daughters about breast cancer risk reduction measures such as maintaining a healthy diet, exercising on a regular basis, and avoiding chemical exposures. Results showed that both SE and RE were related to mothers' intentions to teach their daughters how to maintain a healthy diet, engage in regular exercise behavior, and avoid chemical exposures. However, PR was not related to any behavioral intention. Implications for breast cancer message development for communication campaigns are discussed.