Preferences for arthritis care among urban African Americans: "I don't want to be cut".

Despite greater disability from knee osteoarthritis among Blacks, Whites are 3-5 times more likely to have total knee replacement (TKR). The authors explored whether beliefs among Blacks about arthritis and surgery contribute to this disparity. Ninety-four Blacks, ages 50 to 89, with knee arthritis underwent semistructured qualitative interviews regarding disability, beliefs about arthritis, beliefs about TKR, and treatment preferences. Content analyses yielded 6 themes: preference for natural remedies, negative expectations of surgery, beliefs about God's control, preference for continuing in their current state, relationships with specialists, and fear of surgery or death. Given its high levels of disability, this cohort had low expectations of TKR. Culturally sensitive educational programs might improve patient altitudes and beliefs regarding TKR, ultimately increasing appropriate usage.     

Computer-assisted intervention improves patient-centered diabetes care by increasing autonomy support.

OBJECTIVE: To determine if a patient-centered, computer-assisted diabetes care intervention increased perceived autonomy support, perceived competence (from self-determination theory), and if these constructs mediated the effect of the intervention on ADA/NCQA recommended diabetes care outcomes. DESIGN: A randomized controlled trial of 866 adult type 2 diabetes patients in heterogeneous primary care settings in Colorado. MAIN OUTCOME MEASURES: Perceived autonomy support, perceived competence, patient satisfaction, glycemic control (HbA1c), ratio of total to HDL cholesterol, diabetes distress, and depressive symptoms. RESULTS: The computer-assisted intervention increased patient perception of autonomy support relative to a computer-based control condition ( p = .05). Change in perceived competence partially mediated the effects of increased autonomy support on the change in lipids, diabetes distress, and depressive symptoms. The construct of autonomy support was found to be separate from that of patient satisfaction. CONCLUSIONS: A patient-centered, computer-assisted intervention was effective in improving diabetes self-management outcomes, in part, because it increased patients' perception that their autonomy was supported which changed perceived competence. These findings support the self-determination model for health behavior change and the chronic care model and support the further study of the use of these technologies to motivate patients to improve their health outcomes.     

Evaluating the quality and impact of mediators for learning when using associative memory strategies

Recently, a series of studies has reported much greater recall for factual information when students were asked to generate elaborations in response to ‘why’ questions (elaborative interrogation) relative to studying provided elaborations. The two experiments reported here extend and clarify research regarding the strategic benefits of generating elaborations versus providing elaborations. In both experiments, undergraduates studied 30 sentences, all of which described one particular man doing one activity. Students used one of three study strategies. In two conditions, students studied provided elaborations (PE). Half of the elaborations explained why the particular man engaged in the particular activity and half did not explain the specific relations. In the remaining condition, students generated their own elaborations. In both experiments, students were provided with their generated/provided elaborations as cues for recalling the fact at testing. When students were not explicitly cued to use the generated/ provided elaboration at recall, elaborative interrogation (EI) consistently outperformed the PE condition. Recall in the EI condition did not exceed recall in the PE condition, however, when students were provided with good explanatory elaborations and were cued with them at testing. These experiments demonstrate that the poorer performance associated with providing relative to generating elaborations can be mediated by encouraging more meaningful processing of materials and prompting students to access their mediators at recall.     

The Effects of Hindsight Bias and Causal Attribution on Human Response to Environmental Events1

This research examined the influence of hindsight bias and causal attribution on perceptions of a technological disaster. After reading a fictitious account of a toxic substance spill near a populated area, subjects were provided with information that disease rates had either increased or had remained stable (hindsight conditions), or were presented with no outcome information (control condition). Subjects were then asked to predict the likelihood of increases in disease rates and to make causal attributions regarding the target company and residents of the disaster community. When compared to subjects provided with either no outcome information or with information that disease rates remained stable (positive-outcome condition), subjects told that disease rates had increased (negative-outcome condition) showed elevated predictions regarding future disease rates, ascribed greater responsibility for the accident to the target company, and reported more anger toward the company and greater sympathy for the residents. Subjects receiving positive outcome information and no outcome information did not significantly differ on these measures. In addition, results from a path analysis supported the efficacy of attribution theory to account for the cognitive, affective, and behavioral consequences resulting from hindsight bias following a negative environmental event.     

Predictors of feminist social identity among college women

This study employed constructs derived from theories of social identity and collective action to test predictors of feminist social identity. The sample consisted of 95 Anglos, 36 African-Americans, 38 Asians, 43 Latinas, and 14 women who chose not to disclose their ethnicity. A two-step hierarchical multiple regression on these data showed that, as a group, positive evaluation of feminists, positive opinion of the feminist movement, exposure to feminism, recognition of discrimination against women, and belief in collective action contributed significantly to the prediction of feminist social identity, after support for feminist goals was entered into the equation. For a subsample of 36 African-American women, intercorrelations showed that racial identification, as well as a perception of conflict between racial identity and feminist identity, are compatible with aspects of feminist beliefs and values. Nevertheless, substantial differences between white women and women of color were found in willingness to socially identify as a feminist. Results support the importance of distinguishing between private feminist self-labeling and more social forms of feminist identification.