A model of stage of change to recommend colonoscopy among urban primary care physicians.

Theory is little used in the prediction of physician cancer screening stage of change. Structural equation modeling was used to evaluate the theoretical predictors of stage of change to recommend colonoscopy among 235 urban physicians. Constructs from the theory of planned behavior, social-cognitive theory, and the transtheoretical model were systematically tested. As predicted, contextual factors, such as the physicians' ages, their race-ethnicities, patient race-ethnicity, and office-related barriers to preventive care were associated with stage of change through self-efficacy, normative beliefs, and negative behavioral beliefs. The findings demonstrate the relevance of these models to studying the behavior of physicians and support the development of interventions that are tailored to normative beliefs and specific physician cognitions for colonoscopy recommendation.     

Grading the ‘cultural literacy’ project

The essay examines the argument advanced by E.D. Hirsch, Jr., for instituting ‘cultural literacy’ as a fundamental priority of schools. A number of confusions and equivocations in Hirsch's reasoning are identified, and the propensity of his project to indoctrinate is exposed. Among the features of Hirsch's argument shown to be troubling are his shifting construal of ‘language’, his inconsistency about the requirements of cultural literacy, and his uncritical relation to traditional images of the American past and present. The upshot is to raise the question why Hirsch's project has elicited wide support and praise.