Eating together more but feeling worse: Discrepancies between observed and reported well-being of Latino(a/x) students at a Hispanic-Serving Institution

Objective. Past research suggests that eating alone is associated with less social support and poorer physical health. The current study examines the comparative health and well-being of Hispanic/Latino(a/x) and non-Hispanic/Latino(a/x) students, with a focus on comparing self-reported well-being to the observed marker of social well-being that is eating alone.Participants. Undergraduate students from a college dining hall completed online surveys in exchange for a gift card.Methods. Participants completed measures of eating alone in the dining hall, food choices, social support, quality of life, and overall health.Results. Although, compared to their non-Hispanic/Latino(a/x) peers, Hispanic/Latino(a/x) students were much more likely to be eating with others, both groups reported similar levels of social support and life satisfaction. Furthermore, Hispanic/Latino(a/x) students reported poorer physical health and chose unhealthier meals.Conclusion. Although Hispanic/Latino(a/x) students appeared to be more socially connected than their peers, these connections did not translate to better well-being.

Associations Between Primary Residence and Mental Health in Global Marginalized Populations

Scholars suggest that marginalized people in non-urban areas experience higher distress levels and fewer psychosocial resources than in urban areas. Researchers have yet to test whether precise proximity to urban centers is associated with mental health for marginalized populations. We recruited 1733 people who reported living in 45 different countries. Participants entered their home locations and completed measures of anxiety, depression, social support, and resilience. Regression and thematic analyses were used to determine what role distance from legislative and urban centers may play in mental health when marginalized people were disaggregated. Greater distance from legislative center predicted higher anxiety and resilience. Greater distance from urban center also predicted more resilience. Thematic analyses yielded five categories (e.g., safety, connection) that further illustrated the impact of geographic location on health. Implications for community mental health are discussed including the need to better understand and further expand resilience in rural areas.

The role of uncertainty, worry, and control in well-being: Evidence from the COVID-19 outbreak and pandemic in U.S. and China

Uncertainty about the future often leads to worries about what the future will bring, which can have negative consequences for health and well-being. However, if worry can act as a motivator to promote efforts to prevent undesirable future outcomes, those negative consequences of worry may be mitigated. In this article, we apply a novel model of uncertainty, worry, and perceived control to predict psychological and physical well-being among four samples collected in China (Study 1; during the early COVID-19 outbreak in China) and the United States (Studies 2-4, during 4 weeks in May 2020, 4 weeks in November 2020, and cross-sectionally between April and November 2020). Grounded in the feeling-is-for-doing approach to emotions, we hypothesized (and found) that uncertainty about one's COVID-19 risk would predict greater worry about the virus and one's risk of contracting it, and that greater worry would in turn predict poorer well-being. We also hypothesized, and found somewhat mixed evidence, that perceptions of control over 1's COVID-19 risk moderated the relationship between worry and well-being such that worry was related to diminished well-being when people felt they lacked control over their risk for contracting the virus. This study is one of the first to demonstrate an indirect path from uncertainty to well-being via worry and to demonstrate the role of control in moderating whether uncertainty and worry manifest in poor well-being. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Surviving Racism and Sexism: What Votes in the Television Program Survivor Reveal About Discrimination

We examined whether there is evidence for racial and gender bias in the voting patterns of contestants on Survivor, a reality-television zero-sum game in which contestants compete for up to 39 days to win $1 million. Among 731 contestants across 40 seasons, we found evidence of racial and gender bias at multiple stages of Survivor. Compared with men, women were more likely to be voted out of their tribe first and were less likely to make it to the individual-competition stage of the game (i.e., the "merge"). They were also less likely to win Survivor. Black, Indigenous, and people of color (BIPOC) contestants, compared with White contestants, were more likely to be voted out of their tribe first and were less likely to make it to the individual-competition stage of the game. These findings suggest a systemic bias in favor of White men and against women of color.

Comparing Foodie Calls in Poland, the United Kingdom, and the United States: A Registered Replication Report

Collisson et al. (2020) found Dark Triad traits and gender role beliefs predicted "foodie calls," a phenomenon where people go on a date with others, to whom they are not attracted, for a free meal. Because gender roles and dating norms differ across cultures, we conducted a registered replication across different cultures by surveying 1838 heterosexual women from Poland, the United Kingdom (UK), and the United States (US). Relying on the structural equation modeling, as conducted in the original study, our findings revealed gender role beliefs best predicted foodie calls and their perceived acceptability, whereas the Dark Triad's general factor was nonsignificant. Analyses at the country level yielded mixed results. The original findings were replicated in the UK and Poland, but not in the US, where only narcissism predicted foodie calls. In the US, gender role beliefs predicted foodie call acceptability, but the Dark Triad general factor did not. Potential reasons for why traditional gender roles, but not the Dark Triad, predicted foodie calls in the US are discussed.

Associations between perceived everyday discrimination and health among college students at a Hispanic-serving institution

Despite efforts by universities to promote racial/ethnic, gender, and socioeconomic diversity, college students continue to report discrimination. In two studies, we examined the frequency, predictors, and health consequences of experiencing everyday discrimination at a Hispanic-Serving Institution. Findings show the majority of students reported experiencing discrimination at the university, with most experiences attributed to their gender and aspects of their physical appearance. More frequent discrimination was associated with poorer physical and psychological health. Furthermore, most participants cited other students as the source of their discrimination. These findings offer important insight into students' experiences of everyday discrimination at a diverse setting.

Psychosocial stressors predict lower cardiovascular disease risk among Mexican-American adults living in a high-risk community: Findings from the Texas City Stress and Health Study

The objective of this study was to examine the link between systemic and general psychosocial stress and cardiovascular disease (CVD) risk in a group of U.S. Latinos as a function of acculturation and education within the blended guiding conceptual framework of the biopsychosocial model of the stress process plus the reserve capacity model. We analyzed data from self-identifying Mexican-origin adults (n = 396, 56.9% female, Mage = 58.2 years, 55.5% < 12 years of education, 79% U.S.-born) from the Texas City Stress and Health Study. We used established measures of perceived stress (general stress), neighborhood stress and discrimination (systemic stress) to capture psychosocial stress, our primary predictor. We used the atherosclerotic CVD calculator to assess 10-year CVD risk, our primary outcome. This calculator uses demographics, cholesterol, blood pressure, and history of hypertension, smoking, and diabetes to compute CVD risk in the next 10 years. We also created an acculturation index using English-language use, childhood interaction, and preservation of cultural values. Participants reported years of education. Contrary to expectations, findings showed that higher levels of all three forms of psychosocial stress, perceived stress, neighborhood stress, and perceived discrimination, predicted lower 10-year CVD risk. Acculturation and education did not moderate the effects of psychosocial stress on 10-year CVD risk. Contextualized within the biopsychosocial and reserve capacity framework, we interpret our findings such that participants who accurately reported their stressors may have turned to their social networks to handle the stress, thereby reducing their risk for CVD. We highlight the importance of examining strengths within the sociocultural environment when considering cardiovascular inequities among Latinos.

A Multisite Preregistered Paradigmatic Test of the Ego-Depletion Effect

We conducted a preregistered multilaboratory project (k = 36; N = 3,531) to assess the size and robustness of ego-depletion effects using a novel replication method, termed the paradigmatic replication approach. Each laboratory implemented one of two procedures that was intended to manipulate self-control and tested performance on a subsequent measure of self-control. Confirmatory tests found a nonsignificant result (d = 0.06). Confirmatory Bayesian meta-analyses using an informed-prior hypothesis (δ = 0.30, SD = 0.15) found that the data were 4 times more likely under the null than the alternative hypothesis. Hence, preregistered analyses did not find evidence for a depletion effect. Exploratory analyses on the full sample (i.e., ignoring exclusion criteria) found a statistically significant effect (d = 0.08); Bayesian analyses showed that the data were about equally likely under the null and informed-prior hypotheses. Exploratory moderator tests suggested that the depletion effect was larger for participants who reported more fatigue but was not moderated by trait self-control, willpower beliefs, or action orientation.

Outcomes of Physicians' Communication Goals During Patient Interactions

During healthcare visits, physicians may set communication goals such as providing their patient with information about treatment; however, no recommendations exist regarding which goals physicians should prioritize during their often-brief interactions with patients. Two studies examined five communication goals (providing information, reducing distress, increasing patient satisfaction, increasing patient adherence, and encouraging hope) in the context of physician-patient interactions and their relationship with patient and physician outcomes. In Study 1, audio-recordings of physician-patient interactions were coded by research assistants for goal-related content. In Study 2, patients reported their physician's use of each goal during the interaction. In both studies, patients and physicians reported visit outcomes. Within-study meta-analyses suggested that the goal of reducing distress, but not the other goals, was consistently related to improved outcomes in Study 1. All goals were related to improved outcomes in Study 2. We then computed sample-size-weighted meta-analytic effects of each goal on each outcome across both studies. These results suggested that all of the goals had similar-sized positive relationships with patient and physician outcomes across studies. These findings suggest that physicians should generally approach consultations with communication goals in mind, but prioritizing efforts to reduce distress may be particularly beneficial.

Coping self-efficacy influences health information avoidance

Avoiding information about one's health can have long-term implications for health and well-being. Two studies examined the relationship between health information avoidance and coping self-efficacy, or a sense that one can effectively cope. In Study 1, coping self-efficacy, but not general self-efficacy, was associated with information avoidance. In Study 2, participants who reflected on their positive coping strategies were less likely to avoid learning their risk for disease as compared to those who did not reflect on their coping strategies. These findings suggest that coping self-efficacy is a good target for future interventions aimed at reducing health information avoidance.

Self-Esteem in 60 Seconds: The Six-Item State Self-Esteem Scale (SSES-6)

With 20 items, the State Self-Esteem Scale (SSES) can be cumbersome in settings that demand efficiency. The present research created an efficient six-item version of the SSES that preserves score reliability and validity and its three-dimensional structure: social, appearance, and performance self-esteem. Item response theory and confirmatory factor analyses identified the "best" six items-two from each dimension (Study 1). Participants completed the SSES four times at 2-week intervals (Studies 2 and 3). The six-item SSES' scores showed adequate test-retest reliability, explained substantial variance in trait-relevant measures, and showed convergent validity with related self-esteem measures. Participants completed the SSES and a laboratory experiment where they received negative feedback on an essay they had written and could retaliate against their evaluator by allocating hot sauce for them to consume (Study 4). The six-item SSES interacted with self-esteem instability in expected ways to predict hot sauce allocated.

Fulfilling psychological needs predicts less sleep disruption and worry while awaiting uncertain news

Research on self-determination theory suggests that people have fundamental needs to feel autonomous, competent, and socially connected and that fulfilling these needs is critical for well-being. In the present study, we examined whether fulfilling psychological needs is associated with physical and psychological well-being-specifically sleep disruption and worry, two key indicators of well-being during waiting periods-while managing the unique stress of awaiting uncertain news. In a study of law graduates during the 4 months while they awaited their California bar exam (the exam one is required to pass before practicing law) results, personal increases in need fulfilment related to temporally congruent reductions in sleep disruption and worry. In addition, those whose needs were most fulfilled during the waiting period responded less negatively to failing the bar exam. The picture for need frustration was mixed; only autonomy frustration was associated with concurrent increases in worry, although those whose needs were more frustrated in general also experienced greater worry and sleep disruption on average. On the whole, our findings suggest that self-determination theory needs may be a fruitful target for interventions that can protect well-being while people wait and even once their uncertainty is resolved.

Foodie Calls: When Women Date Men for a Free Meal (Rather Than a Relationship)

A foodie call occurs when a person, despite a lack of romantic attraction to a suitor, chooses to go on a date to receive a free meal. The present study examines predictors of a deceptive form of the foodie call in the context of male–female dates: when a woman purposefully misrepresents her romantic interest in a man to dine at his expense. In two studies, we surveyed women regarding their foodie call behavior, dark triad personality traits, traditional gender role beliefs, and online dating history. We found 23–33% of women surveyed had engaged in a foodie call. In Study 1, dark triad and traditional gender role beliefs significantly predicted previous foodie call behavior and its perceived acceptability. Study 2 employed fuller measures and suggested again that dark triad traits predicted foodie calls and their perceived acceptability.

Bracing Later and Coping Better: Benefits of Mindfulness During a Stressful Waiting Period

People frequently await uncertain news, yet research reveals that the strategies people naturally use to cope with uncertainty are largely ineffective. We tested the role of mindfulness for improving the experience of a stressful waiting period. Law graduates awaiting their bar exam results either reported their trait mindfulness (Study 1; N = 150) or were instructed to practice mindfulness meditation (Study 2; N = 90). As hypothesized, participants who were naturally more mindful or who practiced mindfulness managed their expectations more effectively by bracing for the worst later in the waiting period and perceived themselves as coping better. Additionally, participants who were low in dispositional optimism and high in intolerance of uncertainty benefited most from mindfulness (relative to control) meditation. These findings point to a simple and effective way to wait better, particularly for those most vulnerable to distress.

Investigating the role of implicit prototypes in the prototype willingness model

One useful theory to predict health behavior is the prototype-willingness model (PWM), which posits that people are more willing to engage in behavior to the extent that they have a positive view of the prototypical person who performs that behavior. The goal of the present research is to test whether adding an implicit measure of prototype favorability might improve explanatory power in the PWM. Two studies examined whether implicit prototype favorability uniquely predicted White women's intentions to engage in healthy sun behavior over the next 3-6 months, and their willingness to engage in risky sun behavior, should the opportunity arise. The results suggested that implicit prototype favorability, particularly implicit prototypes of those who engage in risky UV-related behaviors, uniquely predicted intentions to engage in healthy sun behavior and willingness to engage in risky sun behavior in the PWM.

Spontaneous self-affirmation is associated with psychological well-being: Evidence from a US national adult survey sample

Emerging evidence suggests that individuals spontaneously self-affirm, by reflecting on values and strengths, in response to daily threats. We examined the prevalence and demographic and well-being correlates of spontaneous self-affirmation in the general population. Participants ( n = 3185) completed the cross-sectional, nationally representative 2013 Health Information National Trends Survey (HINTS 4, Cycle 3), and answered questions about spontaneous self-affirmation, demographic factors, well-being, and affect. The majority of the population reported spontaneously self-affirming. Black and Hispanic respondents reported engaging in more spontaneous self-affirmation. Engaging in spontaneous self-affirmation was related to greater happiness, hopefulness, optimism, subjective health, and personal health efficacy, and less anger and sadness.

Establishing an Information Avoidance Scale

People differ in their openness to different types of information and some information may evoke greater avoidance than does other information. We developed an 8-item measure of people's tendency to avoid learning information. The flexible instrument can function as both a predictor and outcome measure. The results from 4 studies involving 7 samples and 4,393 participants reveal that scores on the measure are generally internally consistent, remain relatively stable across time, and correlate modestly with measures of similar constructs and with avoidance behavior. The measure is adaptable to a variety of types of information (e.g., health outcomes, attractiveness feedback) and is internally consistent in several distinct populations (e.g., high school students, college students, U.S. adults, low-socioeconomic-status adults). Discussion centers on potential uses for the scale and an online supplement discusses a 2-item version of the scale. (PsycINFO Database Record

Implicit and explicit evaluations of feminist prototypes predict feminist identity and behavior

Many people who endorse gender equality do not personally identify as feminists. The present research offers a novel explanation for this disconnect by examining people’s attitudes toward feminist prototypes—the central, representative feminist that comes to mind when they think of feminists as a group. Results from two samples support the hypothesis that both implicit and explicit attitudes toward feminist prototypes predict unique variance in feminist identity beyond gender-equality attitudes. Results from a second study show feminist identity to mediate between implicit prototypes and self-reported willingness to engage in feminist behaviors. Lastly, a third study shows feminist identity to mediate between implicit prototypes and actual feminist behavior. This is the first study to specifically examine the role of implicit attitudes and prototype favorability in understanding feminist identity and behavior, and the results suggest that promoting positive prototypes of feminists may be an effective route to encouraging feminist identity.

Avoiding cancer risk information

RATIONALE

Perceived risk for health problems such as cancer is a central construct in many models of health decision making and a target for behavior change interventions. However, some portion of the population actively avoids cancer risk information. The prevalence of, explanations for, and consequences of such avoidance are not well understood.

OBJECTIVE

We examined the prevalence and demographic and psychosocial correlates of cancer risk information avoidance preference in a nationally representative sample. We also examined whether avoidance of cancer risk information corresponds with avoidance of cancer screening.

RESULTS

Based on our representative sample, 39% of the population indicated that they agreed or strongly agreed that they would "rather not know [their] chance of getting cancer." This preference was stronger among older participants, female participants, and participants with lower levels of education. Preferring to avoid cancer risk information was stronger among participants who agreed with the beliefs that everything causes cancer, that there's not much one can do to prevent cancer, and that there are too many recommendations to follow. Finally, the preference to avoid cancer risk information was associated with lower levels of screening for colon cancer.

CONCLUSION

These findings suggest that cancer risk information avoidance is a multi-determined phenomenon that is associated with demographic characteristics and psychosocial individual differences and also relates to engagement in cancer screening.

Associations of spontaneous self-affirmation with health care experiences and health information seeking in a national survey of US adults

OBJECTIVE

Self-affirming--such as by reflecting on one's strengths and values--reduces defensiveness to threatening information, reduces negative effects of stereotype threat and promotes prosociality. These outcomes may promote physical health, highlighting a need to examine the role of self-affirmation in medical and health contexts.

DESIGN

Data were collected as part of the nationally representative, cross-sectional, 2013 Health Information National Trends Survey. Items were completed by 2731 respondents.

MAIN OUTCOME MEASURES

Respondents answered questions about spontaneous self-affirmation tendencies, perceptions of providers and health care, involvement in medical appointments, health information seeking and engagement in medical research.

RESULTS

Spontaneous self-affirmation was associated with more positive perceptions of communication with one's provider, better perceived quality of care, greater likelihood of asking questions in a medical appointment, greater information seeking for oneself and multiple indices of surrogate information seeking (i.e. seeking information for others). Four of eight significant associations remained significant when controlling for optimism. The associations of self-affirmation with aspects of the patient-provider relationship were not modified by factors likely to be associated with stereotype threat (e.g. race or BMI).

CONCLUSION

Spontaneous self-affirmation was related to positive outcomes in health contexts. Experimental research is needed to further explore the causal nature of these associations.

Caught in the Middle

This study used archival data to examine how White, Black, and biracial Black/White people respond to implicit attitude feedback suggesting that they harbor racial bias that does not align with their self-reported attitudes. The results suggested that people are generally defensive in response to feedback indicating that their implicit attitudes differ from their explicit attitudes. Among monoracial White and Black individuals, this effect was particularly strong when they learned that they were implicitly more pro-White than they indicated explicitly. By contrast, biracial Black/White individuals were defensive about large discrepancies in either direction (more pro-Black or more pro-White implicit attitudes). These results pinpoint one distinct difference between monoracial and biracial populations and pave the way for future research to further explore how monoracial majority, minority, and biracial populations compare in other types of attitudes and responses to personal feedback.

The decision to counsel adolescents about HPV

OBJECTIVES

To examine factors influencing dentists' intentions to counsel adolescents.

METHODS

Florida dentists (N = 929) responded to 3 descriptions of an office visit by an adolescent patient. In the standard-of-care condition the patient consumed excessive sugar. In the other 2 conditions, a reliable source or patient's mother revealed the patient was sexually active and exposed to HPV.

RESULTS

Dentists expressed lower intentions to counsel about HPV than sugar consumption. In the 2 HPV conditions, dentists reported higher intentions to counsel when the mother, rather than another reliable source, disclosed the sexual activity. Perceived social pressure against counseling explained differences between conditions in intention to counsel.

CONCLUSIONS

Parent /public approval were primary barriers to HPV-counseling.

A survey of barriers to screening for oral cancer among rural Black Americans

OBJECTIVE

Research documents a disparity between Black and White Americans in mortality for oral cancer that appears to result in part from behaviors such as lower oral cancer screening among Black Americans. We examined barriers to oral cancer screening among Black Americans.

METHODS

We surveyed Black Americans (N = 366) living in rural Florida to identify barriers to getting screened for oral cancer.

RESULTS

Low knowledge/social attention, lack of resources, and fear/defensive avoidance predicted screening intentions, with lack of resources emerging as the largest barrier. Participants also reported that a recommendation from their provider was most likely to increase screening intentions, whereas encountering financial barriers was most likely to decrease screening intentions.

CONCLUSIONS

Low knowledge/social attention, lack of resources, and fear/defensive avoidance emerged as independent barriers to oral cancer screening, with the latter two barriers accounting for the most variance in intentions to get screened.

Reducing Health-Information Avoidance Through Contemplation

Despite the importance of learning about one’s health, people sometimes opt to remain ignorant. In three studies, we investigated whether prompting people to contemplate their reasons for seeking or avoiding information would reduce avoidance of personal health information. In Study 1, people were more likely to opt to learn their risk for type 2 diabetes if they had completed a motives questionnaire prior to making their decision than if they had not. In Study 2, people were more likely to opt to learn their risk for cardiovascular disease if they had first listed and rated reasons for seeking or avoiding the information than if they had not. Study 3 replicated Study 2 but also showed that contemplating reasons for avoiding versus seeking reduced avoidance of personal-risk information only when the risk condition was treatable.

Managing the Threat of Impending Implicit Attitude Feedback

People facing potentially threatening feedback sometimes opt to avoid it in an attempt to preserve a cherished self-view. In three studies, we examined whether people would adopt such a strategy in the context of the Black–White Implicit Association Test (IAT), which has the potential to reveal implicit prejudice. Study 1 demonstrated that people expect their IAT results to indicate less implicit prejudice than the results actually do, and perceive feedback from the Black–White IAT as potentially threatening. In addition, people who would rather avoid learning their results regretted receiving their feedback. In Studies 2 and 3, more participants declined to learn their IAT results when cued to expect unfavorable, rather than favorable, IAT results. Importantly, participants who received no expectation cue generally opted to receive their IAT feedback, suggesting that participants likely expect favorable IAT feedback.

Service evaluation of patients with orofacial granulomatosis and patients with oral Crohn's disease attending a paediatric oral medicine clinic

AIM

Presenting features associated with orofacial granulomatosis (OFG) and oral Crohn's disease (OCD) are varied, making successful diagnosis and management difficult. The aim of this service evaluation was to establish a profile of patients with these conditions attending a paediatric oral medicine clinic and to determine their overall satisfaction with the care received.

STUDY DESIGN

A retrospective case note analysis to establish the patient profile and a postal patient satisfaction questionnaire for service evaluation.

METHODS

All patients with OFG and OCD who had attended the joint paediatric dentistry/oral medicine clinic at Charles Clifford Dental Hospital, Sheffield in the previous 14 years were included in the study. Hospital case notes were retrospectively reviewed and patient demographics, clinical features, investigations, diagnosis, treatment and outcomes of treatment were recorded. An anonymous patient satisfaction questionnaire using the Healthcare Satisfaction Generic Module of the Paediatric Quality of Life Inventory (PedsQLTM) was distributed to all patients by mail.

RESULTS

A total of 24 patients (13 females and 11 males) were identified. Median age at presentation was 11 years (SD± 3.79, range 2-15). Fifteen patients (63%) were diagnosed with OCD, and 9 (37%) with OFG. Overall, the most common orofacial feature was oral ulceration (75%) followed by lip/facial swelling (71%), angular cheilitis (67%) and mucosal cobblestoning (67%). Differences in presentation were seen between the two conditions with oral ulceration (87%) and mucosal cobblestoning (80%) being the most frequently observed features of OCD and lip swelling (78%) and angular cheilitis (67%) being the most common features of OFG. 58% of patients reported relief of symptoms through treatment. Thirteen patient satisfaction questionnaires were completed (54%). 85% (n=11) felt the overall care received in the clinic was 'excellent'.

CONCLUSIONS

This service evaluation highlights the variety of presenting features of OFG and OCD. Despite only a moderate response to treatment, patient satisfaction with the service was high, emphasising the importance of good communication when managing children with chronic, debilitating conditions.

Barriers to oral cancer screening: a focus group study of rural Black American adults

OBJECTIVE

Mortality from mouth and throat cancer (MTC) is higher among Black Americans than White Americans partially because of late stage detection through screening. The disparity in mortality is particularly problematic among Black Americans living in rural areas who have limited access to preventative resources. Our study explored barriers to screening for MTC among Black Americans.

METHODS

We conducted nine focus groups among rural Black Americans age 40 years and older (N = 80).

RESULTS

Content coding of the transcripts of the focus groups revealed three primary barriers to screening. Lack of knowledge (e.g., not knowing about MTC and not knowing MTC symptoms) accounted for 31.8% of all barriers mentioned, lack of resources (e.g., lack of money and health insurance) accounted for 25.0% of all barriers mentioned, and fear (e.g., fear of screening and diagnosis) accounted for 22.9% of all barriers mentioned.

CONCLUSIONS

We placed these barriers within the Theory of Planned Behavior and conclude that interventions aimed at increasing MTC screening among rural Black Americans should first focus on changing people's attitudes about screening by increasing knowledge about MTC and reducing fear.

Reducing information avoidance through affirmation

Although screening for medical problems can have health benefits, the potentially threatening nature of the results can lead people to avoid screening. In three studies, we examined whether affirming people's self-worth reduces their avoidance of medical-screening feedback. Participants completed an online risk calculator for a fictitious medical condition and then were offered a choice to receive or not receive their risk feedback. Our results showed that affirmation decreased participants' avoidance of risk feedback (Study 1) and eliminated the increased avoidance typically observed when risk feedback might obligate people to engage in undesired behavior (Study 2) and when feedback is about risk for an untreatable disease (Study 3). These findings suggest that affirmation may be an effective strategy for increasing rates of medical screening.