Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding,Engagement, and Communication

“The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS?, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS? report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS? reports were released to 14 families (N?=?28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N?=?24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS? reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS? report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594).     

Intersectional experiences of discrimination in a low‐resource urban community: An exploratory latent class analysis

There have been increasing calls for the application of an intersectionality framework to understand and address discrimination and health inequities among diverse communities. Yet there have been theoretical debates regarding to whom intersectionality applies and how intersectional experiences of discrimination are associated with health outcomes. The current study aimed to contribute to these theoretical debates and inform practical applications to reduce health inequities. Data were drawn from a community health survey in New Haven, CT (N = 1,293 adults) and analysed using latent class analysis. Results yielded 4 classes. Members of the 4 classes were similar sociodemographically. Three classes of participants reported experiencing discrimination, and members of these classes had greater stress, higher rates of smoking and sleep disruption, and worse overall health than members of the class reporting no discrimination. Members of 2 classes made multiple, or intersectional, attributions for discrimination, and members of these classes reported the most frequent discrimination. Findings suggest that community members who are sociodemographically similar may have diverse discrimination experiences. Multilevel interventions that address multiple forms of discrimination (e.g., racism and sexism) may hold promise for reducing discrimination and, ultimately, health inequities within low‐resource urban community settings.     

The Role of Ethnic Socialization,Ethnic Identity and Self-Esteem: Implications for Bi-ethnic Adolescents’ School Adjustment

Bi-ethnic adolescents of marriage migrant mothers in Korea are often encouraged to be “pure” Koreans for their adjustments and not given the opportunities to explore their ethnic identity or to learn about their mother’s culture of origin. Existing studies conducted with mono-ethnic minorities in other countries, however, do not support this belief. We tested a conceptual model on the role of ethnic socialization, ethnic identity and self-esteem on school adjustment among bi-ethnic adolescents in Korea based on social identity theory and theoretical models of ethnic socialization and ethnic identity. We used data from 2015 National Survey of Multicultural Families. The study sample consisted of 296 adolescents aged 9–18 who were born between Korean fathers and Vietnamese marriage migrant mothers. We used structural equation modeling to specifically examine the association between ethnic socialization in terms of parents’ linguistic socialization and adolescents’ school adjustment mediated by ethnic identity in the form of ethnic regard and self-esteem among bi-ethnic adolescents. The results verified the hypothesized model, showing positive relationships between linguistic socialization and ethnic regard, ethnic regard and self-esteem, self-esteem and school adjustment, and ethnic regard and school adjustment. Additionally, the results of bootstrapping test showed that the indirect effect of linguistic socialization on self-esteem through ethnic regard was significant. The indirect effect of ethnic regard on school adjustment through self-esteem was significant and the indirect effect of linguistic socialization on school adjustment via ethnic regard and self-esteem was also significant. These results shed light on the important role of ethnic identity fostered at home among bi-ethnic adolescents of marriage migrant mothers in Korea.     

Changing Identities to Change the World: Identity Motives in Lifestyle Politics and Its Link to Collective Action

In this article, we assume an interdisciplinary approach to the study of why and how people transpose political considerations to their lifestyles. Our aims are threefold: to understand the meanings and perceptions of people engaged in lifestyle politics and collective action; to examine the motives guiding individual change; and to explore the linkage processes between lifestyle politics and collective action. Identity process theory is considered as a lens to examine the processes and the motives of identity via a thematic analysis of 22 interviews. This study combined interviews with people seeking social change through their lifestyles with interviews with members of action groups and social movements. We found that each participant's identity is guided by identity motives such as distinctiveness, continuity, and psychological coherence. Besides, lifestyle politics is evaluated as an effective way to bring about social change, depending on the individual experience of perceived power to bring about change through collective action. Overall, lifestyle politics states the way in which the participants decided to live, to construct their identities, and to represent their beliefs about the right thing to do. Lifestyle politics complements collective action as a strategy to increase the potential of bringing about social change. The implications of this research are discussed in relation to the importance of understanding the processes of identity and lifestyle change in the context of social, environmental, and political change.     

Deradicalizing Detained Terrorists

Deradicalization of terrorists constitutes a critical component of the global “war on terror.” Unfortunately, little is known about deradicalization programs, and evidence for their effectiveness is derived solely from expert impressions and potentially flawed recidivism rates. We present the first empirical assessment of one such program: the Sri Lankan rehabilitation program for former members of the Liberation Tigers of Tamil Eelam (a terrorist organization that operated in Sri Lanka until their defeat in 2009). We offer evidence that deradicalization efforts that provided beneficiaries with sustained mechanisms for earning personal significance significantly reduced extremism after 1 year (Study 1). We also found that upon release, beneficiaries expressed lower levels of extremism than their counterparts in the community (Study 2). These findings highlight the critical role of personal significance in deradicalization efforts, offer insights into the workings of deradicalization, and suggest practical methods for improving deradicalization programs worldwide.     

Support for Leader's Decisions in Conflict and Negotiation: Women Do Not Benefit From Relevant Expertise While Men Do

In the present research, we examined the role of leaders' domain‐specific expertise and gender as affecting individuals' evaluation of proposals related to intergroup conflict. Across three studies, conducted in two different conflict‐related contexts (Israeli‐Palestinian conflict and the refugee crisis in Europe), we showed that men and women do not equally benefit from domain‐specific expertise. Having high (compared to low) domain‐specific expertise positively affected participants' attitudes towards the proposal when its author was a man but not when she was a woman. We further demonstrate that specific characteristics of the proposal (i.e., security relevance) and of the participants (i.e., level of sexism) affect reactions to different negotiation proposals. Our findings suggest that even when women acquire relevant knowledge and experience, they do not benefit from them as much as men. One implication of these findings is that training and enhancing women's expertise may not be enough to eliminate gender bias.     

Agents of Prosociality: Agency Affirmation Promotes Mutual Prosocial Tendencies and Behavior Among Conflicting Groups

Members of conflicting groups are motivated to restore their ingroup's agency, leading to antisocial tendencies against the outgroup. The present research tested the hypothesis that affirming conflicting groups' agency would increase their members' mutual prosociality. The effectiveness of agency affirmation was demonstrated in three contexts of conflict between groups: Switzerland and the EU following the 2014 referendum (Study 1), Israelis and Palestinians (Study 2), and Israeli rightists and leftists (Study 3). Study 1 found that in a nonconflictual context Swiss participants prioritized their moral (prosocial) over agentic goals, yet in the context of conflict with the EU, they prioritized their agentic over moral goals. This “primacy‐of‐agency” effect, however, was eliminated once their ingroup's agency was affirmed. Studies 2 and 3 demonstrated the positive effect of agency affirmation on prosociality among Israelis referring to Palestinians and Israeli rightists and leftists referring to the adversarial political camp. This effect was mediated by group members' readiness to relinquish some power for the sake of morality. Pointing to the importance of the affirmation's specific content, Studies 2 and 3 demonstrated that morality affirmation failed to increase prosociality. As such, the present research puts forward a promising strategy to reduce hostility and promote prosociality between conflicting groups.