Decisional Capacity Among Minors With HIV: A Model for Balancing Autonomy Rights With the Need for Protection

The purpose of this article is threefold: (a) to describe the relevant ethical and legal issues associated with decisional capacity among minors and to discuss the importance of these concepts for children and adolescents living with HIV, (b) to provide a framework for assessing the decisional capacity of children and adolescents with HIV, and (c) to present a model for thinking about how to use this assessment data to guide action along the protection-autonomy continuum.     

Development and validation of an appearance motivation attitudes scale for sun protection

A reliable two-factor instrument measuring appearance motivation attitudes for sun protection was developed using a longitudinal sample of beachgoers. At baseline, data on sun protection and appearance motivation attitudes were collected on 2324 individuals. Principal components analyses (PCA) indicated a two-factor solution measuring attitudes toward tan attractiveness and skin protection with only 2 items loading on the skin protection factor. At 12-months, the instrument was revised and shortened but including 3 new skin protection items. Split-half analyses were conducted to further refine and develop the instrument. PCA on half of the sample revealed a two-factor solution, which was confirmed using structural equation modeling on the remaining half. This resulted in a two correlated-factor, 10-item measure. Each factor was summed to create two scales. Both scales were internally consistent and demonstrated good external validity, correlating with sun protection specific Transtheoretical model variables. The tan attractiveness attitudes scale significantly improved prediction of sun protection outcomes over 24 months, over and above TTM variables.     

Why and how we should care about the General Data Protection Regulation

Abstract

The General Data Protection Regulation (GDPR) is the new European Union-wide (EU) law on data protection, which is a great step towards more comprehensive and more far-reaching protection of individuals' personal data. In this editorial, we describe why and how we – as researchers within the field of health psychology – should care about the GDPR. In the first part, we explain when the GDPR is applicable, who is accountable for data protection, and what is covered by the notions of personal data and processing. In the second part, we explain aspects of the GDPR that are relevant for researchers within the field of health psychology (e.g., obtaining informed consent, data minimisation, and open science). We focus on questions that researchers may ask themselves in their daily practice. Compliance with the GDPR requires adopting research practices (e.g., data minimisation and anonymization procedures) that are not yet commonly used, but serve the fundamental right to protection of personal data of study participants.     

Book Review of Health and the Construction of the Individual. J. Ogden. London: Routledge, 2002. i–viii + 130 pages ISBN 0415233070

Abstract

Recent theoretical and empirical research has challenged the assumption of health psychologists employing social cognitive models that beliefs can confidently be inferred on the basis of questionnaire responses. It is charged that responses to questionnaires are a function of the intelligibility of the items, constructs and theoretical framework to survey participants. To investigate this contention, cognitions specified by Protection Motivation Theory (PMT) were measured with respect to intentions to use a condom and intentions to use dental floss. Three alternative formats of a questionnaire which varied the order of presentation of PMT items were distributed to student samples. Analyses showed that while questionnaire format did not affect the reliability of cognition measures, there was some variation in the significance and strength of correlations between PMT cognitions across formats. Individual differences in social desirability and salience of the target behaviour had small and predictable effects upon reliabilities and intercorrelations. Implications for the measurement of health beliefs and the status of questionnaire responses are outlined and suggestions are made for controlling bias associated with respondents' capacity to “read” a questionnaire.     

Ecological issues of justice

In the first part of this article the author explores the implications for justice of the wider range of parties holding moral standing that environmental ethics has recently disclosed. These implications concern the equitable treatment of future generations and nonhuman creatures, and are relevant both to policies, such as approaches to global warming, and procedures, which may need to be revised to give an equitable voice to unrepresented interests. Later the author considers some radical implications of regarding humanity as stewards of the planetary environment, a view defended in his recent book Creation, Evolution and Meaning. If all adult humans have this role, but many are prevented from discharging it by poverty and related constraints, then those who are thus disempowered need to be empowered to exercise this role. This requirement of equity would arise not from their moral patienthood but from what is involved in respecting them as moral agents. Some approaches to tackling global warming are considered in this connection.     

Critical reflection in midwifery practice: the protection motivation theory

Background: The aim of this paper is to shed light on the notion of fear and inter-personal working relationships, and to promote safe midwifery practice, by critically reflecting on our practice and being aware of fear appeals and the protection motivation theory (PMT).

Theory: PMT provides a general account of the impact of persuasive communication, emphasising the cognitive processes that mediate behaviour change and questions whether ‘fear appeals’ could influence behaviour. Discussion: It is possible that when a midwife decides on a particular care pathway, she determines the degree and perception of the four elements of the PMT; severity, vulnerability, response-efficacy and self-efficacy. If the midwife decides that both the degree of severity and her perception of vulnerability are high, whereas response and self-efficacy perceptions are low, she will probably decide against her original care pathway. For the PMT to be used safely, an appropriate judgement call is required and is based on full understanding of the situation, effective communication with the multidisciplinary team, full knowledge of the proposed care, and competence and confidence in the proposed care. Conclusion: By critically reflecting on their practice and using the PMT, the author believes that midwives will be able to work in partnership with obstetricians to provide safe and effective care within their sphere of practice and in the absence of fear.     

Communicating power and resistance: exploring interactions between aboriginal youth and non-aboriginal staff members in a residential child welfare facility

Aboriginal youth are highly overrepresented within the child welfare system. High-risk youth are often placed in out-of-community residential placements. Such residential placements have been described by some as a continuation of colonial practices. Using communication theory as a conceptual model, we propose a qualitative analysis of micro-interactions that take place between Aboriginal youth and non-Aboriginal workers during the management of high-risk behaviors within a residential program. Three broad categories of interaction emerge from the data: complementary, symmetrical/complementary (where youth show a form of submission despite resistance), and symmetrical (characterized by a power struggle). Despite the diversity of interactions along this symmetrical to complementary continuum, interventions always start and finish in the same fashion. Moreover, the nature of interactions depended mostly on how quickly youth accepted the consequences of their behaviors. We also extracted five categories related to culture, race or context that are perceived as influencing the interactions that take place between staff and youth. The analysis of micro-interactions within clinical, organizational, social and historical contexts points to mechanisms by which asymmetrical power relations may be replicated on a day-to-day basis despite the best intentions of residential workers.     

The Future of Training and Credentialing in Group Psychotherapy

High-quality group psychotherapy training is seen as more important than ever in the current health care environment. The training opportunities available at present are assessed. It is argued that there is a body of knowledge about generic group psychotherapy that can and should be taught, and that there are appropriate people to teach it. Credentialing is discussed, and it is suggested that the assessment of actual work in clinical situations must be emphasized if such efforts are to be meaningful.