Design and Evaluation of a Decision Aid for Inviting Parents to Participate in a Fragile X Newborn Screening Pilot Study

The major objectives of this project were to develop and evaluate a brochure to help parents make an informed decision about participation in a fragile X newborn screening study. We used an iterative development process that drew on principles of Informed Decision Making (IDM), stakeholder input, design expertise, and expert evaluation. A simulation study with 118 women examined response to the brochure. An independent review rated the brochure high on informational content, guidance, and values. Mothers took an average of 6.5 min to read it and scored an average of 91.1 % correct on a knowledge test. Most women rated the brochure as high quality and trustworthy. When asked to make a hypothetical decision about study participation, 61.9 % would agree to screening. Structural equation modeling showed that agreement to screening and decisional confidence were associated with perceived quality and trust in the brochure. Minority and white mothers did not differ in perceptions of quality or trust. We demonstrate the application of IDM in developing a study brochure. The brochure was highly rated by experts and consumers, met high standards for IDM, and achieved stated goals in a simulation study. The IDM provides a model for consent in research disclosing complicated genetic information of uncertain value.     

Why Women Approve of Affirmative Action: The Study of a Predictive Model

The self-interest model has often been used to predict the reactions of advantaged groups to affirmative action. It is argued that self-interest also plays a role in the genesis of attitudes of disadvantaged groups, such as women. More precisely, it is hypothesised that considerations of personal interest have an impact on considerations of collective interest which in turn have an impact on the sense of collective relative deprivation (CRD). In the past, it was shown that women who felt collectively deprived approved of strategies designed to eliminate systemic barriers. No link was found, however, between CRD and preferential treatment. Women, in majority, were opposed to this strategy. On the basis of a model introduced by Taylor and McKirnan (1984), it is argued that women who have experienced discrimination on the basis of sex in spite of the introduction of affirmative action strategies may support preferential treatment. The hypotheses were integrated in a model and tested using LISREL causal modelling. In total, 197 female francophone workers participated in the study. They were all employed in a large firm where in the last five years attempts were made to reduce sex asymmetries. These efforts however were not successful; the percentage of women in non-traditional jobs increased by only 2%. The proposed model was tested successfully. The results are discussed in light of previous paradigms and practical implications.     

A Door to HIV‐Prevention Interventions: How Female‐Targeted Materials Can Enhance Female Participation1

The aim of this study was to examine the influence of gender on exposure to gender‐tailored HIV‐prevention brochures. During an unobtrusive observation of participants' reading of brochures, both men and women were likely to avoid gender‐mismatched brochures. However, women were more likely to selectively approach gender‐matched brochures over gender‐neutral brochures than were men. Furthermore, exposure to the female‐targeted brochure predicted accepting an HIV‐prevention video. This pattern was only the case for females and not for males or for the male‐targeted brochure. This finding implies that the gender‐tailored brochures are more useful for women than for men, and may open the door to other materials designed with preventive objectives.     

To Picture or Not to Picture: Levels of Erotophobia and Breast Self-Examination Brochure Techniques1

People's level of erotophobia influences their acceptance of sexually related situations, including the likelihood of engaging in sexually related health care such as breast self-examinations (BSE). Female college students (n= 61) completed a measure of erotophobia and read a BSE brochure that either did or did not contain instructional photographs showing a woman's breasts. As hypothesized when the brochure contained photographs, women high in erotophobia felt less competent in giving themselves BSE and were less likely to claim that they did things to improve their health. When the brochure contained no photographs, women low in erotophobia thought that the information was easier to understand and that BSE was more important.     

Influence of Church Attendance and Spirituality in a Randomized Controlled Trial to Increase Mammography Use Among a Low-Income, Tri-Racial, Rural Community

Background The influence of church attendance and spirituality on mammography use was studied among Native American, White, and African American women living in a rural county. Methods A randomized trial was conducted to increase mammography use. Women (n = 851) were randomly assigned to receive either an educational program delivered by a lay health advisor or a physician letter and brochure about cervical cancer screening (control group). Church attendance and spirituality were measured at baseline and mammography use was evaluated 12 months after enrollment using medical record review. Results Almost two-thirds of the women reported that they attended church at least once a week, and less than 4% were classified as having low spirituality. Church attendance (P = 0.299) or spirituality (P = 0.401) did not have a significant impact on mammography use. Conclusions Church attendance and spirituality did not impact mammography use.     

A structural model of acculturation and mental health status among Chinese Americans

This study examined the role of acculturation and its direct and indirect impact on depressive symptom severity through various correlates, including socioeconomic status (SES), stress, social support, personality negativity, and physical health perception. Using structural equation modeling, the proposed model was tested with 983 employed Chinese Americans from a representative community sample, the majority of whom were immigrants. The results demonstrated that acculturation, correlated with SES, contributed to depressive symptom severity only through indirect pathways. Higher acculturation was found associated with higher stress that in turn contributed to more elevated depressive symptoms. On the other hand, higher acculturation was also found strongly correlated with higher SES, which was associated with lower depressive symptoms directly or indirectly through several mediators. Better support, lower personality negativity, better health perception, and lower stress were found mediating the relationship between higher SES and lower depressive symptom severity. The simultaneous multigroup analysis showed that the final model was comparable for both men and women with very few differences.     

SEVERITY OF CHILD SEXUAL ABUSE AND REVICTIMIZATION: THE MEDIATING ROLE OF COPING AND TRAUMA SYMPTOMS

Child sexual abuse (CSA) has consistently been associated with the use of avoidant coping; these coping methods have been associated with increased trauma symptoms, which have, in turn, been linked to increased risk for adult sexual revictimization. Given these previous findings, the purpose of the current study was to test a model that conceptualized the relationships among these variables. Specifically, CSA severity was conceptualized as leading to the use of avoidant coping, which was proposed to lead to maintenance of trauma symptoms, which would, in turn, impact severity of revictimization indirectly. This comprehensive model was tested in a cross-sectional study of a large, geographically diverse sample of college women. Participants were 99 female undergraduates classified as having experienced CSA who completed measures of abuse history, coping style, current levels of trauma symptoms, and adult sexual revictimization. Multivariate path analysis indicated that the data fit the hypothesized model for verbally coercive, but not physically aggressive, revictimization. Specifically, increased CSA severity was associated with the use of avoidant coping, which, in turn, predicted greater levels of trauma symptomatology and severity of sexual coercion in adulthood. Although cross-sectional in nature, findings from this study suggest that coping strategies and trauma symptoms may represent modifiable factors that place women at increased risk for verbally coercive sexual revictimization.     

Increasing attendance at colorectal cancer screening: testing the efficacy of a mailed, psychoeducational intervention in a community sample of older adults.

This article describes a trial of a psychoeducational intervention designed to modify negative attitudes toward flexible sigmoidoscopy screening and thereby increase screening attendance. The intervention materials addressed the multiple barriers shown to be associated with participation in earlier studies. Adults ages 55-64 (N = 2,966), in a "harder-to-reach" group were randomized either to receive an intervention brochure or to a standard invitation group. Attitudes and expectations were assessed by questionnaire, and attendance at the clinic was recorded. Compared with controls, the intervention group had less negative attitudes, anticipated a more positive experience, and had a 3.6% higher level of attendance. These results indicate that psychoeducational interventions can provide an effective means of modifying attitudes and increasing rates of screening attendance.     

The flu shot study: Using multiattribute utility theory to design a vaccination intervention

Differences between the multiattribute utility (MAU) profiles of participants who had previously gotten flu shots and those who had not done so were used to design an informational brochure urging influenza vaccination. The effectiveness of the MAU brochure was evaluated in a VA ambulatory care clinic with a long-standing influenza vaccination program. The target population for the intervention was high-risk clinic patients who had not gotten a shot the previous year. Participants received either a letter urging them to get a flu shot, or a letter plus the informational brochure. A significantly larger proportion of the patients who received the brochure got shots; 36% versus 23% for the letter only. While a 13 percentage point increase is modest, influenza and related complications (preventable through vaccination) are the fourth-leading killers of older persons. Adding a MAU-based brochure to an ongoing vaccination program is inexpensive and may save additional lives.     

Reduced substance use as a secondary benefit of an indicated cognitive-behavioral adolescent depression prevention program

Our first aim was to test whether a group cognitive-behavioral (CB) depression prevention program reduces substance use escalation over 2-year follow-up relative to two active comparison interventions and a brochure assessment control. Our second aim examined whether reductions in depressive symptoms mediate intervention effects, as posited by the affect-regulation model of substance use. In this indicated prevention trial, 341 high school adolescents at risk for depression because of the presence of elevated depressive symptoms were randomized to a Group CB intervention, group supportive-expressive group intervention, CB bibliotherapy, or educational brochure control condition. Participants in Group CB had significantly lower rates of substance use compared with brochure control participants at both 1- and 2-year follow-up and lower substance use at 2-year follow-up relative to bibliotherapy participants; no other condition differences were significant. Mediational analyses suggested that reductions in depressive symptoms from baseline to posttest accounted for changes in substance use over 2 years for participants in Group CB relative to brochure control participants but did not mediate effects relative to those receiving bibliotherapy. Results suggest that a secondary benefit of this CB group indicated depression prevention program is lower rates of long-term substance use. Findings supported the hypothesis that, relative to a nonactive comparison condition, reductions in depressive symptoms mediated the effects of Group CB prevention on substance use escalation. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Women in danger: intimate partner violence experienced by women who qualify and do not qualify for a protective order.

Not all women who apply qualify for a civil protective order. This study compares the type and severity of violence reported by women who qualified with that experienced by women who did not qualify. Ninety women seeking a protective order against a male intimate were interviewed. Findings indicated that 28% of women applying for a protective order did not qualify primarily because of cohabitation requirements or childbearing status. Actual and threatened violence was measured with the 46-item Severity of Violence Against Women Scale. A 17-item questionnaire measured stalking behavior. Levels of reported violence for the preceding 3 months were measured for the two groups. The symbolic threat behavior only of throwing, smashing, or breaking an object was significantly higher for qualifying women. The physical abuse behavior only of being pushed, shoved, or pulled was significantly higher. None of the stalking behaviors were significantly different. Data are urgently needed that document the barriers to abused women receiving protective orders, the relevancy of qualifying criteria, and the effectiveness of protective orders issued.     

Persuasive Impact of Organizational Value Statements in a Recruitment Context1

Two experiments were conducted to examine the persuasive impact of different types of evidence supporting an organizational recruitment message. In the first experiment, information on organizational values, presented in a recruitment brochure, was supported using statistical, anecdotal, or no evidence. Graduating university students who were attending a job fair (N = 69) were most attracted to the company as an employer when statistical evidence was presented. In the second study, an employed sample (N= 172) received organizational value evidence in the context of either a recruitment brochure or a community newspaper article. Whereas we replicated the findings of the first study in the brochure condition, we found that anecdotal information was most persuasive in the newspaper condition. We conclude that predicting the persuasive impact of evidence for organizational values requires knowledge of both the type of evidence to be employed and the medium in which that evidence is conveyed.     

Entwicklung und Evaluation eines interaktiven Films für Jugendliche zur Vermittlung von Gerichtswissen

An interactive movie for juvenile witnesses produced by the author was evaluated in terms of its effectiveness to convey court relevant knowledge to 16-year-old and 17-year-old students. A control group design was used. Controls received a brochure containing information comparable to the movie which was also developed by the author. The aim of the study was to empirically evaluate the movie in order to make it available to juvenile witnesses as an instrument for court preparation in the future. A total of 52 students aged 16 and 17 years at a training college were investigated and court knowledge was measured prior to testing. Participants in the treatment group then viewed the movie, which was produced by the author. The control group received a brochure containing information very similar to the contents of the movie. Approximately 2 weeks later, court relevant knowledge was again assessed and both treatment and control groups showed a strong and significant increase in court relevant knowledge. Comparing the groups showed that the effects tended to be stronger for the treatment group than for the control group. It was also investigated if legal misconceptions could be reduced by the interventions. Analyses indicated that effects were not significant and there was no significant difference between the groups. A significant increase of court relevant knowledge could be found for both treatment conditions. The weak effects concerning the reduction of legal misconceptions could be due to the fact that they were not explicitly presented in the movie but were treated more indirectly by presenting correct knowledge only.     

Mind over matter: internalization of the thinness norm as a moderator of responsiveness to norm misperception education in college women.

The authors examine the effectiveness of norm misperception education in decreasing disordered eating. One hundred seven 1st-year college women completed questionnaires assessing their own and others' actual and ideal body size as well as their own disordered eating and were then randomly assigned to read either a norm misperception or a control brochure. Participants completed questionnaires immediately after reading the brochures and again 3 months later. Although there were no main effects of brochure condition at the follow-up, participants who primarily compared themselves with other college women and who read the norm misperception brochure had higher actual and ideal weight as well as less frequent disordered eating. The discussion focuses on the theoretical and applied implications of these findings.     

Depressive symptoms in early marriage: predictions from relationship confidence and negative marital interaction.

The authors proposed a model of depressive symptoms in early marriage in which relationship confidence, defined as perceived couple-level efficacy to manage conflicts and maintain a healthy relationship, mediates the effect of negative marital interactions on depressive symptoms. The model was tested in a sample of 139 couples assessed prior to marriage and 1 year later. As predicted, relationship confidence demonstrated simple negative associations with negative marital interaction and depressive symptoms for all participants. Longitudinal path analyses supported the mediational model for women only. In women but not men, negative marital interaction indirectly had an impact on depressive symptoms through the mediator of relationship confidence. Findings suggest that relationship confidence may be important to understanding links between marital distress and depressive symptoms, especially in women.     

Do written consent forms influence clients' first impressions of therapists?

Students (24 men, 105 women) rated a hypothetical psychologist after reading some combination of (a) a question sheet (Handelsman & Galvin, 1988), (b) a form designed to conform to a new Colorado law, and (c) a general brochure about psychologists. The legal form increased the likelihood of recommending "Dr. Doe" to a friend; when the brochure was included, the form also increased judgments of experience. The question sheet increased recommendations, judgments of likeability and trustworthiness, and (when the brochure was absent) the likelihood of going to Dr. Doe oneself. In a second study, students (44 men, 93 women) received the legal disclosure form; some also received the question sheet. They were told that Dr. Doe had 0, 9, or 19 years of experience. The question sheet increased ratings of trustworthiness and likelihood of going oneself. Therapists with at least 9 years of experience were recommended more.     

Client-therapist intimacy: responses of psychotherapy clients to a consumer-oriented brochure

Psychotherapy clients read two consumer-oriented brochures: a general brochure on psychology and a brochure on the topic of client-therapist intimacy. Half of the participants read the general brochure first and the brochure on client-therapist intimacy second, and half the participants did the reverse. Participants reported favorable reactions to the brochures, indicating they thought both should be made available to psychotherapy clients; that neither were too long, too sensitive, or too difficult to read; and that the brochures should be made available early during the therapeutic process. After reading the client-therapist intimacy brochure, participants also showed some changes in Likert-type scores measuring attitudes regarding intimate contact between clients and therapists. Although participants were more negative about issues of sexual misconduct after reading the client-therapist intimacy brochure, they did not indicate a decrease in trust of therapists, nor did they indicate a greater likelihood of filing a false complaint. We concluded that therapists' reservations about presenting clients with factual information regarding therapist sexual exploitation of clients are not empirically founded.