Why comply? Risk and efficacy perceptions drive compliance in mass marketing scams.

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.

Compliance with mass marketing solicitation: The role of verbatim and gist processing.

INTRODUCTION: Mass marketing scams threaten financial and personal well-being. Grounded in fuzzy-trace theory, we examined whether verbatim and gist-based risk processing predicts susceptibility to scams and whether such processing can be altered. METHODS: Seven hundred and one participants read a solicitation letter online and indicated willingness to call an "activation number" to claim an alleged $500,000 sweepstakes prize. Participants focused on the solicitation's verbatim details (hypothesized to increase risk-taking) or its broad gist (hypothesized to decrease risk-taking). RESULTS: As expected, measures of verbatim-based processing positively predicted contact intentions, whereas measures of gist-based processing negatively predicted contact intentions. Contrary to hypotheses, experimental conditions did not influence intentions (43% across conditions). Contact intentions were associated with perceptions of low risk, high benefit, and the offer's apparent genuineness, as well as self-reported decision regret, subjective vulnerability to scams, and prior experience falling for scams. CONCLUSIONS: Overall, message perceptions and prior susceptibility, rather than experimental manipulations, mattered in predicting scam susceptibility.

Loneliness and Mental Health: Recommendations for Primary Care Intakes.

INTRODUCTION/OBJECTIVES: The healthcare intake process plays a significant role in informing medical personnel about patients' demographic information, subjective health status, and health complaints. Intake forms can help providers personalize care to assist patients in getting proper referrals and treatment. Previous studies examined factors that could be included in intake forms independently, but this study analyzed loneliness, religiousness, household income, and social integration together to see how the combined effect influences mental and physical health status. This study aims to determine which of those 4 variables better inform patients' mental versus physical health status. METHODS: One hundred and seventy-nine participants completed surveys, including the SF-12® Health Survey, measuring perceived physical and mental health, UCLA 3-item Loneliness Scale, and a demographics questionnaire with questions about household income and time spent dedicated to religious practice, if applicable. Additionally, individuals answered social integration questions about how often they contact close family and friends or volunteer in the community. Using loneliness, household income, religiousness, social integration as independent variables, and controlling for demographic variables such as age, gender, and race, 2 regression models were built with Mental and Physical Health Composite Scores from the the SF-12® Health Survey as dependent variables. RESULTS: Loneliness was associated with mental health measures (b = -2.190, P < .001), while household income was associated with physical health measures (b = 0.604, P = .019) above and beyond other variables in the regression models. CONCLUSIONS: Integrating the 3 loneliness questions into intake forms can help approximate an individual's mental health status. This would allow the provider to be able to assess mental health problems more effectively and provide needed resources.

Susceptibility to COVID-19 Scams: The Roles of Age, Individual Difference Measures, and Scam-Related Perceptions.

As the COVID-19 pandemic was unfolding, a surge in scams was registered across the globe. While COVID-19 poses higher health risks for older adults, it is unknown whether older adults are also facing higher financial risks as a result of COVID-19 scams. Here, we examined age differences in vulnerability to COVID-19 scams and individual difference measures (such as impulsivity, ad skepticism, and past experiences with fraud) that might help explain them. A lifespan sample (M = 48.03, SD = 18.56) of sixty-eight younger (18-40 years, M = 25.67, SD = 5.93), 79 middle-aged (41-64 years, M = 49.86, SD = 7.20), and 63 older adults (65-84 years, M = 69.87, SD = 4.50) recruited through Prolific completed questions and questionnaires online. In a within-subjects design, each participant responded to five COVID-19 solicitations, psychological measures, and demographic questions. Age group comparisons revealed that older adults were marginally less likely to perceive COVID-19 solicitations as genuine than middle-aged adults were. In addition, older adults perceived significantly fewer benefits than both younger and middle-aged adults did and perceived marginally higher risks than younger adults did. Hence, older adults did not exhibit greater vulnerability to COVID-19 scams. Regardless of age, intentions to respond to COVID-19 solicitations were positively predicted by higher levels of educational attainment, being married, past fraud victimization, and higher levels of positive urgency. As expected, stronger genuineness and benefit perceptions positively predicted action intentions, whereas stronger risk perceptions negatively predicted action intentions As such, COVID-19 scam susceptibility appears to be the result of a impulse control issue that is not easily inhibited, not even by past experiences of scam victimization.

Older and wiser: age differences in susceptibility to investment fraud: the protective role of emotional intelligence.

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.

Increasing Compliance with a New Interunit Handoff Process: A Quality Improvement Project.

INTRODUCTION: Current literature demonstrates that standardizing interunit patient handoff improves communication, information transfer, and patient safety. However, few studies have focused on increasing staff compliance with new handoff processes. The purpose of this quality improvement project was to incorporate both user input into process design and on-the-job coaching with a newly introduced nurse handoff process between the postanesthesia care unit and Medical/Surgical units. We hypothesized that staff compliance would be 100% within 90 days. METHODS: The team's intervention consisted of (1) involving representative frontline nursing staff in the standardization and modification of the handoff process and (2) providing on-the-job coaching as the new process was being trialed at the bedside. We designed the handoff process during a 2-day workshop and a 1.5-week pilot. Data included the number of observed noncompliant process elements and handoff duration. Three sequential 30-day plan-do-study-act cycles were followed, during which compliance observations and user feedback were used to refine the design and coaching iteratively. RESULTS: A total of 1,800 process elements were observed and coached throughout a 90-day trial period. The number of observed noncompliant elements decreased from 15% (92) to 4% (22) from the first 30-day interval to the final 30-day interval. There was no undesirable increase in handoff duration (mean, 8.05 ± 4.72 minutes), and several potential errors-related to orders, charting, and patient placement-were prevented by using the new handoff. CONCLUSIONS: User input and on-the-job coaching resulted in iteratively increasing frontline compliance with a new standardized handoff process.

Call to claim your prize: Perceived benefits and risk drive intention to comply in a mass marketing scam.

Mass marketing scams extract an enormous toll, yet the literature on scams is just emerging. In Experiment 1, 211 adults reviewed a solicitation and rated their intention of contacting an "activation number" for a prize. Scarcity and authority were manipulated. Many (48.82%) indicated some willingness to contact to "activate" the winnings. Intention of responding was inversely related to the perception of risk (b = -.441, p < .001) and positively associated with perception of benefits (b = .554, p < .001), but not with the experimental condition. In Experiment 2, 291 adults were randomly assigned to one of the three conditions (low, medium, or high activation fee), and were asked to report willingness to contact. Activation fees decreased intent to contact, but percentages remained high (25.70%), with higher perception of risk reducing contact rates (b = -.581, p < .001), and benefit perception increasing intent to contact (b = .381, p < .001). Our studies indicate that consumers are responding to perceived risks and benefits in their decision-making, regardless of persuasion elements used by scammers. In summary, our studies find that consumers with lower levels of education and high perception of benefits are at increased risk for mass marketing scams. (PsycINFO Database Record

Perianesthesia Nurses Are My Second Family: A Qualitative Descriptive Study.

PURPOSE: Identify the perceptions of perianesthesia nurses regarding behaviors that promote or detract from sustaining a safe, efficient, and satisfying work environment. DESIGN: Two focus groups and seven individual interviews (n=14) were conducted exploring the perceptions regarding team behavior of registered nurses in one pediatric perianesthesia unit. METHODS: Qualitative descriptive data collection, inductive content analysis. FINDINGS: Nurses described a responsive, engaged health care team whose leadership is available and directive when needed, as creating an effective, satisfying work environment. Primary themes that emerged were Leadership Sets the Tone, Playing Fair, No One Gets Hurt, and Why We Stay. This nursing team acknowledged that inattentive, distracted team members cause frustration, work inequities, and care delays, potentially undermining patient safety. CONCLUSIONS: Results demonstrate the need to create and sustain consistently respectful perianesthesia work cultures. Research focusing on unit specific approaches to work distribution, communication, leadership, and technology use is needed.

Financial Capacity and Financial Exploitation of Older Adults: Research Findings, Policy Recommendations and Clinical Implications.

BACKGROUND: Financial exploitation (FE) of older adults is a social issue that is beginning to receive the attention that it deserves in the mediathanks to some high profile cases, but empirical research and clinical guidelines on the topic are just emerging. OBJECTIVE: Our review seeks to synthesize the current research in the area and develop a concentpual model. METHOD: In this review, we describes the significance of the problem, proposes a theoretical model for conceptualizing FE, and summarizes related areas of research that may be useful to consider in the understanding of FE. RESULTS: We identify key structural issues that have limited interventions in the past and make specific public policy recommendations in lightof the largest intergenerational transfer of wealth in history. CONCLUSIONS: FE is a significant social problem, in this article we discuss implications for clinical practice.

Age and Adaptation: Stronger Decision Updating about Real World Risks in Older Age.

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.

The Role of Social Support in Elder Financial Exploitation Using a Community Sample.

BACKGROUND AND OBJECTIVE: Social support is known to be an important protective factor against elder financial exploitation (FE), yet few empirical studies have examined the relationship between FE and distinct components of social support. Perceived social support, social network size, and interactions with close network members (positive and negative) were measured separately and tested as potential predictors of FE. RESEARCH DESIGN AND METHODS: Three hundred and ninety-five community-dwelling adults aged 60 and older were recruited to complete a 90-minute survey and interview. We used OLS regression to examine the role of social support in FE. Other risk factors associated with FE including dependency, poor physical health, depression, cognition, and demographic characteristics were included as potential predictors. RESULTS: Negative interactions with close network members predicted FE, and remained predictive when all other variables and social support factors were included in the model. Other social support factors were not unique predictors of FE. DISCUSSION AND IMPLICATIONS: Negative social interactions with close network members are important to assess and consider in FE prevention and intervention programs; relationships between social interactions and other risk factors warrant further attention.

Importance of Numeracy as a Risk Factor for Elder Financial Exploitation in a Community Sample.

OBJECTIVES: To examine the role of numeracy, or comfort with numbers, as a potential risk factor for financial elder exploitation in a community sample. METHOD: Individually administered surveys were given to 201 independent, community-dwelling adults aged 60 and older. Risk for financial elder exploitation was assessed using the Older Adult Financial Exploitation Measure (OAFEM). Other variables of interest included numeracy, executive functioning, and other risk factors identified from the literature. Assessments were completed individually at the Wood Lab at Scripps College in Claremont, CA and neighboring community centers. RESULTS: After controlling for other variables, including education, lower numeracy was related to higher scores on the OAFEM consistent with higher risk for financial exploitation. Self-reported physical and mental health, male gender, and younger age were also related to increased risk. CONCLUSIONS: Results indicated that numeracy is a significant risk factor for elder financial exploitation after controlling for other commonly reported variables. These findings are consistent with the broader literature relating numeracy to wealth and debt levels and extend them to the area of elder financial exploitation.

Age differences in experiential and deliberative processes in unambiguous and ambiguous decision making.

Older adults experience declines in deliberative decisional capacities, while their affective or experiential abilities tend to remain intact (Peters & Bruine de Bruin, 2012). The current study used this framework to investigate age differences in description-based and experience-based decision-making tasks. Description-based tasks emphasize deliberative processing by allowing decision makers to analyze explicit descriptions of choice-reward information. Experience-based tasks emphasize affective or experiential processing because they lack the explicit choice-reward information, forcing decision makers to rely on feelings and information derived from past experiences. This study used the Columbia Card Task (CCT) as a description-based task where probability information is provided and the Iowa Gambling Task (IGT) as an experience-based task, where it is not. As predicted, compared to younger adults (N = 65), older adults (N = 65) performed more poorly on the CCT but performed similarly on the IGT. Deliberative capacities (i.e., executive control and numeracy abilities) explained the relationship between age and performance on the CCT, suggesting that age-related differences in description-based decision-making tasks are related to declines in deliberative capacities. However, deliberative capacities were not associated with performance on the IGT for either older or younger adults. Nevertheless, on the IGT, older adults reported more use of affect-based strategies versus deliberative strategies, whereas younger adults reported similar use of these strategies. This finding offers partial support for the idea that decision-making tasks that rely on deliberate processing are more likely to demonstrate age effects than those that are more experiential.

Neuropsychological profiles of victims of financial elder exploitation at the los angeles county elder abuse forensic center.

The current article examines neuropsychological correlates of financial elder exploitation in a sample of older adults who have been documented victims of financial elder exploitation. The purpose of this exploratory study was twofold. First, a subsample of the referrals at the Los Angeles County Elder Abuse Forensic Center (LACEAFC) was compared to community dwelling adults in terms of the specific cognitive domains linked to financial capacity including memory, calculation, and executive functioning. Next, the correlation between presence of neuropsychological data and the likelihood of filing a case with the LA County's District Attorney office was examined. Twenty-seven LACEAFC cases and 32 controls were assessed. Overall, the forensic center group performed worse than a community-based age-matched control group on the MMSE, calculation, and executive functioning (ps < .01). The presence of neuropsychological data was significantly correlated to an increased likelihood of a case being filed.

Risk-taking differences across the adult life span: a question of age and domain.

BACKGROUND: Older adults face important risky decisions about their health, their financial future, and their social environment. We examine age differences in risk-taking behaviors in multiple risk domains across the adult life span. METHODS: A cross-sectional study was conducted in which 528 participants from 18 to 93 years of age completed the Domain-Specific Risk-Taking (DOSPERT) scale, a survey measuring risk taking in 5 different domains. RESULTS: Our findings reveal that risk-taking tendencies in the financial domain reduce steeply in older age (at least for men). Risk taking in the social domain instead increases slightly from young to middle age, before reducing sharply in later life, whereas recreational risk taking reduces more steeply from young to middle age than in later life. Ethical and health risk taking reduce relatively smoothly with age. Our findings also reveal gender differences in risk taking with age. Financial risk taking reduced steeply in later life for men but not for women, and risk taking in the social domain reduced more sharply for women than for men. DISCUSSION: We discuss possible underlying causes of the domain-specific nature of risk taking and age.

Physician trainees' decision making and information processing: choice size and Medicare Part D.

Many patients expect their doctor to help them choose a Medicare prescription drug plan. Whether the size of the choice set affects clinicians' decision processes and strategy selection, and the quality of their choice, as it does their older patients, is an important question with serious financial consequences. Seventy medical students and internal medicine residents completed a within-subject design using Mouselab, a computer program that allows the information-acquisition process to be examined. We examined highly numerate physician trainees' decision processes, strategy, and their ability to pick the cheapest drug plan-as price was deemed the most important factor in Medicare beneficiaries' plan choice-from either 3 or 9 drug plans. Before adjustment, participants were significantly more likely to identify the lowest cost plan when facing three versus nine choices (67.3% vs. 32.8%, p<0.01) and paid significantly less in excess premiums ($60.00 vs. $128.51, p<0.01). Compared to the three-plan condition, in the nine-plan condition participants spent significantly less time acquiring information on each attribute (p<0.05) and were more likely to employ decision strategies focusing on comparing alternate plans across a single attribute (search pattern, p<0.05). After adjusting for decision process and strategy, numeracy, and amount of medical training, the odds were 10.75 times higher that trainees would choose the lowest cost Medicare Part D drug plan when facing 3 versus 9 drug plans (p<0.05). Although employing more efficient search strategies in the complex choice environment, physician trainees experienced similar difficulty in choosing the lowest cost prescription drug plans as older patients do. Our results add further evidence that simplifications to the Medicare Part D decision environment are needed and suggest physicians' role in their patients' Part D choices may be most productive when assisting seniors with forecasting their expected medication needs and then referring them to the Medicare website or helpline.

Subjective numeracy scale as a tool for assessing statistical numeracy in older adult populations.

BACKGROUND: Statistical numeracy, necessary for making informed medical decisions, is reduced among older adults who make more decisions about their medical care and treatment than at any other stage of life. Objective numeracy scales are a source of anxiety among patients, heightened among older adults. OBJECTIVE: We investigate the subjective numeracy scale as an alternative tool for measuring statistical numeracy with older adult samples. METHODS: Numeracy was assessed using objective measures for 526 adults ranging in age from 18 to 93 years, and all participants provided subjective numeracy ratings. RESULTS: Subjective numeracy correlated highly with objective measurements among oldest adults (70+ years; r = 0.51, 95% CI 0.32, 0.66), and for younger age groups. Subjective numeracy explained 33.2% of age differences in objective numeracy. CONCLUSION: The subjective numeracy scale provides an effective tool for assessing statistical numeracy for broad age ranges and circumvents problems associated with objective numeracy measures.

One fish, two fish, red fish, blue fish: effects of price frames, brand names, and choice set size on Medicare Part D insurance plan decisions.

Because many seniors choose Medicare Part D plans offering poorer coverage at greater cost, the authors examined the effect of price frames, brand names, and choice set size on participants' ability to choose the lowest cost plan. A 2×2×2 within-subjects design was used with 126 participants aged 18 to 91 years old. Mouselab, a web-based program, allowed participants to choose drug plans across eight trials that varied using numeric or symbolic prices, real or fictitious drug plan names, and three or nine drug plan options. Results from the multilevel models suggest numeric versus symbolic prices decreased the likelihood of choosing the lowest cost plan (-8.0 percentage points, 95% confidence interval=-14.7 to -0.9). The likelihood of choosing the lowest cost plan decreased as the amount of information increased suggesting that decision cues operated independently and collectively when selecting a drug plan. Redesigning the current Medicare Part D plan decision environment could improve seniors' drug plan choices.

Risky decision making in younger and older adults: the role of learning.

Are older adults risk seeking or risk averse? Answering this question might depend on both the task used and the analysis performed. By modeling responses to the Balloon Analogue Risk Task (BART), our results illustrate the value of modeling as compared to relying on common analysis techniques. While analysis of overall measures suggested initially that older and younger adults do not differ in their risky decisions, our modeling results indicated that younger adults were at first more willing to take greater risks. Furthermore, older adults may be more cautious when their decision making is based on initial perceptions of risk, rather than learning following some experience with a task.