Longitudinal Service Learning in Medical Education: An Ethical Analysis of the Five-Year Alternative Curriculum at Stritch School of Medicine

In this article, the author explores a model of alternative medical education being pioneered at Loyola University Chicago Stritch School of Medicine. The five-year Global Health Fieldwork Fellowship (GHFF) track allows two students per year to complete an extra year of medical education while living and working in a free rural clinic in the jungle lowlands of Bolivia. This alternative curricular track is unique among other existing models in that it is (a) longitudinally immersive for at least one full additional year of medical education, (b) grounded in clinical and service learning, and (c) heavily focused upon global health and the social components of medicine. Studies have shown that both longitudinal alternative medical curricular tracks and short-term global health electives have long-term benefits upon the professional development of participants, suggesting that the GHFF is likely to do the same. The author also argues that the GHFF is an advantageous model of global health education compared to standard offerings and provides a unique curricular model by which to foster the development of social values—such as professionalism, advocacy, and social justice—that are widely considered lacking in today’s medical education.     

Mapping the Connections between Politics and Morality: The Multiple Sociopolitical Orientations Involved in Moral Intuition

According to moral foundations theory (Haidt & Joseph, 2004), five foundations are central to moral intuition. The two individualizing foundations—harm/care and fairness/reciprocity—hinge on the rights of the individual, whereas the three binding foundations—in‐group/loyalty, authority/respect, and purity/sanctity—focus on communal bonds. Recent work suggests that reliance on the various foundations varies as a function of sociopolitical orientation: liberals consistently rely on the individualizing foundations, whereas conservatives rely on both the individualizing and binding foundations. In an effort to further explore the relationship between sociopolitical orientation and morality, we argue that only certain types of sociopolitical attitudes and beliefs should relate to each cluster of foundations. Drawing on dual‐process models of social and political attitudes, we demonstrate that the individualizing foundations are aligned with attitudes and beliefs relevant to preferences for equality versus inequality (i.e., SDO and competitive‐jungle beliefs), whereas the binding foundations are aligned with attitudes and beliefs relevant to preferences for openness versus social conformity (i.e., RWA and dangerous‐world beliefs). We conclude by discussing the consequences of these findings for our understanding of the relationship between sociopolitical and moral orientations.     

The Temporal Reciprocity of Values and Beliefs: A Longitudinal Study within a Major Life Transition

Values and beliefs (or social axioms) are important personality constructs, but little previous work has examined the relationship between the two, and none has examined their real‐life longitudinal effects on one another. Major life transitions—such as moving to a new culture—can challenge existing values and beliefs and therefore provide a particularly useful context for the analysis of value and belief change. The main aim of this research was to examine whether values may predict theoretically meaningful belief change and vice versa. Polish migrants participated in the study shortly after their arrival in the UK and at two, subsequent, nine‐month intervals (N = 172). Cross‐lagged effects suggested reciprocal effects of values and beliefs, depending on the value involved. Findings are discussed in light of current debates over personality change, as well as the broader impact of significant life transitions on personality. Copyright © 2011 John Wiley & Sons, Ltd.     

Attribution Through the Layperson's Lens: Development and Preliminary Validation of an Inclusive,International Measure of Beliefs About the Causes of Mental Illness

Attributions, or beliefs about the causes of mental illness, have traditionally been dichotomized based on their locus, controllability, specificity, and stability. However, scholars have introduced an alternative lay beliefs model identifying attributions related to specific biological, social, and spiritual attributions. This research describes the potential benefits of this alternative model and outlines the validation of a comprehensive, international measure of lay beliefs, the Mental Illness Attribution Questionnaire (MIAQ). Validation included piloting, qualitative rating, confirmatory factor analysis, and evaluation of internal consistency, convergent validity, and test–retest reliability with a sample of 680 U.S.-based international students representing 94 nations. Scales measured attributions related to supernatural forces, social stress, lifestyle, health, substance use, heredity, and personal weakness. This structure was tested across 3 conditions—schizophrenia, depression, and alcoholism—demonstrating strong psychometric properties. The lay beliefs model appears to closely reflect the manner in which laypersons attribute cause for mental health problems, making it a natural fit for community-based research. Further, its validation with 2 international samples supports its utility in diverse populations. Together, the results support the MIAQ as a valid and reliable measure of mental illness attribution with potential for examining help-seeking and stigmatizing behavior across cultures.     

Religious beliefs,patient–doctor interaction and resilience as predictors for treatment decisions and health outcomes of heart patients

Treatment decision-making in chronic illness poses long-lasting effects on the health status of patients. In Western individualistic cultures, they are independently taken by the individual in collaboration with doctors contrary to the collectivistic Indian context, where it’s decided by families with little or no involvement of patients. Religious beliefs, patient–doctor interaction, and resilience measures of 100 CAD patients were used to assess their religious beliefs, patient–doctor interaction, and resilience (predictors). Hierarchical Regression Analysis was conducted to test for the significance of the proposed model. Religious beliefs, patient–doctor interaction, and resilience collectively predicted the significant change in decision-making styles, somatic symptoms, anxiety, social dysfunctions, depression, and general health total of the participants. While the treatment decision-making is heavily contingent upon the social factors namely – religious beliefs, patient–doctor interaction, and resilience, there may yet be some underlying psychological factors that have not been explored in the present study.     

COVID-19 attitudes,cognitions, and behaviors in association with personal ideology and social media exposure: Findings from emerging adults in the Southern United States

In the U.S., the COVID-19 pandemic has been highly politicized and has been the subject of large-scale media misinformation. Personal ideologies—including religiosity and political leanings (i.e., conservative, liberal)—have heavily guided responses to the pandemic, particularly in the Southern United States. However, microenvironments like Southern U.S. universities provide a unique perspective into the juxtaposition of larger societal conservatism and the liberalism associated with higher education. In the current study, we examined Southern university students' political beliefs, religiosity, and social media exposure in association with their COVID-19 attitudes, cognitions, and behaviors. Participants' political beliefs were associated with their COVID-19 concern, myth acceptance, vaccination status, and likelihood to receive a future vaccination. Religiosity and social media exposure were more nuanced. Future research into personal ideologies as emerging adults develop their independent identities away from their parents, and how this process can impact health behaviors, is needed.     

Health promotion from the perspective of social cognitive theory

Abstract

This article examines health promotion and disease prevention from the perspective of social cognitive theory. The areas of overlap with some of the most widely applied psychosocial models of health are identified. The models of health promotion and disease prevention have undergone several generational changes. We have shifted from trying to scare people into health, to rewarding them into health, to equipping them with self-regulatory skills to manage their health habits, to shoring up their habit changes with dependable social supports. These transformations have evolved a multifaceted approach that addresses the reciprocal interplay between self-regulatory and environmental determinants of health behavior. Social cognitive theory addresses the socio structural determinants of health as well as the personal determinants. A comprehensive approach to health promotion requires changing the practices of social systems that have widespread detrimental effects on health rather than solely changing the habits of individuals. Further progress in this field requires building new structures for health promotion, new systems for risk reduction and greater emphasis on health policy initiatives. People's beliefs in their collective efficacy to accomplish social change, therefore, play a key role in the policy and public health approach to health promotion and disease prevention.     

Natural kind and entitative beliefs in relation to prejudice toward mental disorders

Mental health campaigns often promote biogenetic beliefs to reduce stigma, but their effectiveness may vary across disorders. Our study (N = 127) examined two components of essentialist beliefs—entitative (i.e., characterizing groupness) and natural kinds (i.e., biogenetic)—about two stigmatized mental disorders (schizophrenia, alcoholism) as well as a somatic disorder (Parkinson's disease), and their relation to prejudice. The three disorders significantly differed in natural kind beliefs (Parkinson's highest, then schizophrenia, and alcoholism lowest) and prejudice (alcoholism highest, then schizophrenia, and Parkinson's lowest), but not entitative beliefs. Entitative beliefs, however, was a stronger predictor of prejudice against schizophrenia than natural kind beliefs even after controlling for social dominance orientation and prior contact. Implications for anti‐stigma efforts and strategies are discussed.     

Testing compensatory health beliefs in a UK population

Compensatory health beliefs, beliefs that healthy behaviours can compensate or neutralise unhealthy behaviours, have been proposed as one way of understanding why people engage in health-risk behaviours (Kn?uper, B., Rabiau, M., Cohen, O., & Patriciu, N. (2004). Compensatory health beliefs scale development and psychometric properties. Psychology and Health, 19, 607-624). However, measuring compensatory health beliefs has proved a challenge, with several recent studies being unable to replicate the psychometric properties of Kn?uper et al.'s (2004) scales. The aims of this study were to: (1) test the factor structure of the compensatory health beliefs scale in the UK, (2) examine the predictive validity of the scale by testing the relationships between compensatory health beliefs and health behaviours over a six-month time interval and (3) assess the 6-month test-retest reliability of the scale. A total of 393 participants completed measures of compensatory health beliefs and health behaviours at two time points separated by six months. The findings were potentially problematic for research into compensatory health beliefs: the factor structure was not confirmed, there was little evidence of predictive validity, and test-retest reliability was poor. Further research is required to understand the operation of compensatory health beliefs and to develop the measurement of compensatory health beliefs.     

Testing compensatory health beliefs in a UK population

Compensatory health beliefs, beliefs that healthy behaviours can compensate or neutralise unhealthy behaviours, have been proposed as one way of understanding why people engage in health-risk behaviours (Knäuper, B., Rabiau, M., Cohen, O., & Patriciu, N. (2004). Compensatory health beliefs scale development and psychometric properties. Psychology and Health, 19, 607–624). However, measuring compensatory health beliefs has proved a challenge, with several recent studies being unable to replicate the psychometric properties of Knäuper et al.'s (2004) scales. The aims of this study were to: (1) test the factor structure of the compensatory health beliefs scale in the UK, (2) examine the predictive validity of the scale by testing the relationships between compensatory health beliefs and health behaviours over a six-month time interval and (3) assess the 6-month test–retest reliability of the scale. A total of 393 participants completed measures of compensatory health beliefs and health behaviours at two time points separated by six months. The findings were potentially problematic for research into compensatory health beliefs: the factor structure was not confirmed, there was little evidence of predictive validity, and test–retest reliability was poor. Further research is required to understand the operation of compensatory health beliefs and to develop the measurement of compensatory health beliefs.     

Perceptions of South African Emerging Adult FET College Students on Sexual Practices in Relation to Religion

HIV and AIDS are rapidly spreading amongst the world’s 15- to 24-year age group, particularly in sub-Saharan Africa. Despite vigorous government interventions and campaigns, 10 % of South African youth in the age cohort 15–24 are infected with HIV and AIDS. Furthermore, for the first time in history the world has its largest number of individuals under the age of 30 years. Researchers are desperately seeking a solution and have found religion to play an important role in moderating risky sexual behaviour amongst youth. This exploratory qualitative study aims to increase our understanding of emerging adult Further Education and Training (FET) students’ perceptions of the role of religion and religious beliefs in their sexual decision-making and practices. The qualitative data emerged from five focus group discussions, each consisting of 12 heterosexual emerging adult FET college students aged 18–24 years, selected using random sampling. Participants were representative of all the major South African racial groups (Blacks, Whites, Coloured and Indians) as well as different religious and cultural groupings. Secularisation theory was used as a theoretical framework for this study. These focus group discussions revealed the following themes: Theme 1—religious institutions need to embrace change in order to become effective social agents of change. Theme 2—a need for open discussion and communication concerning current issues related to young people’s sexual health (by religious institutions/religious leaders). Theme 3—perceptions of religion’s negative sanctions towards sexual behaviour. Theme 4—religious leaders’ indifference and abdication of responsibility to the problems that youth face. Theme 5—religion and condom-related beliefs. Theme 6—perceptions of religious leaders as role models. Theme 7—emerging adults general concern for the moral decay of society. Theme 8—perceptions of whether religion has an influence on young people’s sexual decision-making and practices.     

Psychological resources, positive illusions, and health

Psychological beliefs such as optimism, personal control, and a sense of meaning are known to be protective of mental health. Are they protective of physical health as well? The authors present a program of research that has tested the implications of cognitive adaptation theory and research on positive illusions for the relation of positive beliefs to disease progression among men infected with HIV. The investigations have revealed that even unrealistically optimistic beliefs about the future may be health protective. The ability to find meaning in the experience is also associated with a less rapid course of illness. Taken together, the research suggests that psychological beliefs such as meaning, control, and optimism act as resources, which may not only preserve mental health in the context of traumatic or life-threatening events but be protective of physical health as well.     

Core religious beliefs and providing support to others in late life

A number of studies suggest that people who have strong social support systems at church tend to enjoy better mental and physical health. Yet little is known about the factors that promote strong church-based social support networks. The purpose of this study is to show that key religious beliefs may have something to do with it. A new construct—spiritual connectedness–is introduced for this purpose. Spiritual connectedness refers to an awareness of the bond that exists among all people and the sense of the interdependence among them. Data from a nationwide longitudinal survey of older people in the United States reveal that a strong sense of spiritual connectedness is associated with providing more emotional support and tangible assistance to fellow church members over time. The data further reveal that older people with a strong sense of spiritual connectedness are more likely to pray for others, as well.     

Contamination Appraisals,Pollution Beliefs,and the Role of Cultural Inheritance in Shaping Disease Avoidance Behavior

Despite the upsurge of research on disgust, the implications of this research for the investigation of cultural pollution beliefs has yet to be adequately explored. In particular, the sensitivity of both disgust and pollution to a common set of elicitors (e.g., bodily emissions, disease, and death) suggests a common psychological basis, though several obstacles have prevented an integrative account, including methodological differences between the relevant disciplines. Employing a conciliatory framework that embraces both naturalistic (evolutionary) and humanistic levels of explanation, this article examines the dynamic reciprocal process by which contamination/contagion appraisals in individuals serve to shape—and are in turn shaped by—culture‐specific pollution beliefs. This complex interrelationship is illustrated by examining ancient Near Eastern and modern ethnographic documentation of pollution beliefs, highlighting the underappreciated function of these pollution beliefs as folk theories for the spread of infectious disease. By evaluating how pollution beliefs (as also modern germ theory) shape contamination appraisals in individuals, it will be argued that cultural inheritance has played a much larger role in guiding disease avoidance behavior than has been previously recognized.     

Emotion Beliefs and Cognitive Behavioural Therapy for Social Anxiety Disorder

Despite strong support for the efficacy of cognitive behavioural therapy (CBT) for social anxiety disorder (SAD), little is known about mechanisms of change in treatment. Within the context of a randomized controlled trial of CBT, this study examined patients' beliefs about the fixed versus malleable nature of anxiety—their ‘implicit theories’—as a key variable in CBT for SAD. Compared to waitlist (n = 29; 58% female), CBT (n = 24; 52% female) led to significantly lower levels of fixed beliefs about anxiety (M_baseline = 11.70 vs. M_Post = 7.08, d = 1.27). These implicit beliefs indirectly explained CBT-related changes in social anxiety symptoms (κ² = .28, [95% CI = 0.12, 0.46]). Implicit beliefs also uniquely predicted treatment outcomes when controlling for baseline social anxiety and other kinds of maladaptive beliefs (perceived social costs, perceived social self-efficacy, and maladaptive interpersonal beliefs). Finally, implicit beliefs continued to predict social anxiety symptoms at 12 months post-treatment. These findings suggest that changes in patients' beliefs about their emotions may play an important role in CBT for SAD.     

Health Promotion,Health Locus of Control,and Health Behavior: Two Field Experiments1

In spite of a sizable body of research on the effects of information promotions on health knowledge and health behavior, relatively little is known about how such efforts affect change (or why they do not). This paper addresses that problem by exploring the particular role that health locus of control (HLC) beliefs play in individual responses to health promotion efforts aimed at encouraging preventive health behaviors. Two field experiments are presented. The first experiment examined the extent to which HLC beliefs are related to differences in individual levels of health knowledge following the distribution of an informational booklet on health. Internals high on health value who received the information booklet demonstrated greater health knowledge three months later than did other subjects, although this difference was greater among men than among women. The second experiment explored how HLC beliefs interact with differently framed “control” messages to promote behavior change in breast self-examination (BSE). HLC beliefs interacted with the control language of the BSE promotional message and a neutral reminder to affect subsequent BSE practice. Together, these studies suggest a more influential role for health locus of control beliefs in shaping responses to health messages than has previously been documented in field settings.     

Women’s Health Promotion in the Rural Church: A Canadian Perspective

The rural church may be an effective health resource for rural Canadian women who have compromised access to health resources. The purpose of this paper is to explore the relevance of the Christian church and faith community nurses in promoting the health of rural Canadian women in the evolving rural context. The findings from an extensive literature search reveal that religion and spirituality often influence the health beliefs, behaviors, and decisions of rural Canadian women. The church and faith community nurses may therefore be a significant health resource for rural Canadian women, although this phenomenon has been significantly understudied.     

Depressive symptoms and conspiracy beliefs

Conspiratorial beliefs can endanger individuals and societies by increasing the likelihood of harmful behaviors such as the flouting of public health guidelines. While scholars have identified various correlates of conspiracy beliefs, one factor that has received scant attention is depressive symptoms. We use three large surveys to explore the connection between depression and conspiracy beliefs. We find a consistent association, with the extent of the relationship depending on individual and situational factors. Interestingly, those from relatively advantaged demographic groups (i.e., White, male, high income, educated) exhibit a stronger relationship between depression and conspiracy beliefs than those not from such groups. Furthermore, situational variables that ostensibly increase stress—such as having COVID-19 or parenting during COVID-19—exacerbate the relationship while those that seem to decrease stress, such as social support, vitiate it. The results provide insight about the development of targeted interventions and accentuate the need for theorizing about the mechanisms that lead depression to correlate with conspiracy beliefs.     

青少年的自主期望、对父母权威的态度与亲子冲突和亲合

通过对704名城乡高一和高三年青少年的问卷调查,探讨了高中阶段青少年－父母关系、青少年的行为自主期望和对父母权威的态度的特点,以及青少年—父母关系与青少年的行为自主期望和对父母权威的态度之间的关系。结果显示,我国城乡青少年对父母权威的认同程度较高,而期望获得行为自主的年龄较晚;青少年的行为自主期望、对父母权威的态度与青少年—父母冲突与亲合在某些方面存在城乡、性别和年级差异;青少年对父母权威的认同程度越高,对与父母发生分歧的接受性越高,其与父母的关系越亲密;那些期望在较晚年龄获得行为自主的青少年,与父亲的冲突较多,但与母亲较亲密