Widespread public engagement with antibiotic stewardship is essential to stem the rising incidence of antibiotic-resistant infections; however, campaigns that focus on increasing knowledge have not ...been effective. Beliefs about who is responsible for causing and solving antibiotic resistance (AR) likely influences engagement in antibiotic stewardship behaviors. This study assesses the U.S. public's AR causal and solution responsibility attributions and the capacity for changing these attributions to inform future antibiotic stewardship campaigns. U.S. participants (N= 1,014) diverse across race, education, and geographic region were surveyed on their beliefs about responsibility for AR for themselves, the general public, healthcare providers, scientists, and drug companies. Substantial percentages of participants held causal and solution beliefs about antibiotic resistance that likely inhibit antibiotic stewardship behaviors. Participants' beliefs that they and the general public are responsible for causing and solving AR were lower than their beliefs that healthcare providers, scientists, and drug companies are responsible. Beliefs about causal responsibility for any given person or group were significantly and positively associated with beliefs about solution responsibility for that same person or group. Responsibility beliefs differed by age, education level, and racial/ethnic background. Results highlight the need for antibiotic stewardship campaigns to incorporate responsibility attribution messaging to motivate stewardship.
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Advice is a common but potentially problematic way to respond to someone who is distressed. Politeness theory (Brown & Levinson, 1987) suggests advice threatens a hearer's face and predicts that the ...speaker‐hearer relationship and the use of politeness strategies can mitigate face threat and enhance the effectiveness of advice messages. Students (N=384) read 1 of 16 hypothetical situations that varied in speaker power and closeness of the speaker‐hearer relationship. Students then read 1 of 48 advice messages representing different politeness strategies and rated the message for regard shown for face and for effectiveness. However, neither speaker‐hearer relationship nor politeness strategies was consistently associated with perceived threat to face or perceived advice effectiveness. We suggest revisions to politeness theory and additional factors that may affect judgments of face sensitivity and advice effectiveness.
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Enhancing knowledge about antibiotic-associated risks is key to reducing injudicious antibiotic use and slowing antibiotic resistance. Using the Risk Information Seeking and Processing (RISP) model, ...the study identified predictors of individuals' seeking and avoidance of information about antibiotic risks and tested the effectiveness of exposure to a RISP-informed video intervention against exposure to a CDC-produced video and a control group. In a national sample (N = 1000), risk judgment led to greater negative affect toward risks of antibiotics and lower positive affect toward antibiotic usefulness. In turn, positive and negative affect shaped information insufficiency, which interacted with perceived information gathering capacity to influence risk information seeking and avoidance. In addition, informational subjective norms and affective responses directly shaped individuals' information behavior. Results showed that relative to the control group, participants viewing the RISP-informed video had greater risk judgment, perceived current knowledge about antibiotic risks, perceived information gathering capacity, and informational subjective norms, as well as lower levels of positive affect toward antibiotics. The RISP-informed video and CDC-produced video performed equivalently well. Implications of the findings for the design of antibiotic stewardship messages are discussed
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Gender differences in the provision and receipt of emotional support may result from differences in the formation of responsibility and effort attributions in support-seeking interactions. ...Participants (N = 1,211, primarily middle-class, European American college students) read support-seeking scenarios that varied in support-seeker gender, responsibility for the problem, and effort to resolve the problem, as well as the problem itself, and completed measures of responsibility, effort attributions, and emotions (anger, sympathy). Results indicated qualified and subtle gender differences in attributions, emotions, and attribution-emotion associations, which are broadly consistent with the application of gendered moral orientations and instrumentality norms. These findings are discussed with respect to theorizing about gender differences in attribution processes and emotional support behavior.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, ODKLJ, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Abstract
Background: Multiple studies indicate that the choice of contralateral prophylactic mastectomy (CPM) is increasing, predominantly in women younger than 50. This is despite the lack of ...demonstrated survival advantage for removing the non-cancerous breast, and contradicts expert medical recommendations, such as those of The National Comprehensive Cancer Network, that discourage CPM unless the patient is at elevated risk for breast cancer (e.g., BRCA1/2 mutation).
An underexplored area with regard to selection of CPM is the influence of patients' social and support networks. Breast cancer patients typically involve one or more intimates in their treatment decisions. Further, breast cancer is rarely stigmatized, making it acceptable to disclose the condition, even to non-intimates. Thus, others, in person or using social media, are likely to know when patients are making treatment choices, and may provide information, opinions, or advice that affects these choices. The scope and strength of social network influence on CPM decision-making remains unexplored to date.
Methods: Potential participants for this study were identified from Indiana University and Wishard Health Services billing records using the procedure code for bilateral mastectomy during the years 2007-2012. The lists were then curated to identify patients who had undergone CPM. These patients were mailed an introductory letter and study information sheet, after which they were contacted by telephone and the questionnaire administered to those who agreed. Questions focused on the people with whom participants discussed the CPM decision.
Results: 117 women of 326 invited agreed to participate. 88% of participants were Caucasian and 11% African-American. The mean age at diagnosis was 50. Most respondents (97%) discussed their surgical options with at least one person other than their surgeons (median = 3, mean = 6.7). The individuals most frequently consulted were spouses/partners, and friends or relatives who had experienced breast cancer. Children, relatives and friends who had not experienced breast cancer, and health care providers or counseling professionals were also engaged in discussion. Most respondents (92%) reported that at least one of the people they talked with (median = 2, mean = 2.6) had some degree of influence on the CPM decision. The average influence of these individuals was 3.2 on a 5-point scale (5 = played a strong role in the decision). Children had the strongest average influence (3.7/5), followed by spouses, and friends or relatives who had experienced breast cancer. Consistent with the sample (all respondents had elected CPM), most people who influenced the respondents were reported to be positive or neutral toward CPM. In the few instances in which the advisor was negative with regard to CPM, respondents reported that this person did not influence their decision.
Conclusion: The current study corroborates prior research indicating that breast cancer patients discuss their treatment options with others, and underscores the potential for social and support networks to influence CPM decisions. To reduce the incidence of CPM, it may be necessary for health care professionals to educate and inform large segments of the lay public about the actual benefits and risks of CPM.
Citation Format: Baptiste D, Venetis MK, MacGeorge EL, Lagoon J, Mouton A, Pastor R, Friley LB, Clare SE, Bowling MW. Social networks and the decision to undergo contralateral prophylactic mastectomy. abstract. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-12-23.
Michaud and Warner (1997) and Basow and Rubenfeld (2003) recently reported studies of gender differences in "troubles talk" that allegedly provide support for the different cultures thesis, that is, ...the notion that men and women communicate in such different ways that they should be regarded as members of different communication cultures or speech communities. In this article, we identify several limitations in these two studies that, collectively, have the effect of casting doubt on their conclusions. We then report three studies that show that men and women provide and respond to supportive messages ("troubles talk") in ways that are much more similar than different. The current findings, in conjunction with other recent findings, suggest that the different cultures thesis is a myth that should be discarded. PUBLICATION ABSTRACT
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, ODKLJ, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
The current study examines cognitive and emotional influences on the formation of interaction goals. Specifically, it develops and assesses an extension of Weiner's attribution-emotion-intention ...model of helping (e.g., Weiner, 1995) to the prediction of support providers' goals. 608 college students read situations manipulating attributions of responsibility, stability, and effort with regard to a friend who was seeking support. They subsequently responded to measures of emotional response (anger, sympathy), interaction goals, and attributions. Attributions were found to influence goals both directly and through the mediation of emotion, though the character of this influence depended strongly on the goal. The results suggest that at least some variability in the effectiveness and sensitivity of supportive communication can be explained by support providers' goals. They also indicate the need for continued, closer examination of cognitive and emotional influences on interaction goals and behaviors.
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Prior research has given insufficient attention to the effects of interaction behavior on responses to advice. We drew on theories of advice evaluation and supportive communication to propose ...hypotheses about the influence of problem-focused behavior (advice, planning, offers, and requests) and its interactional placement for advice outcomes. After naturalistic support interactions with friends, advice recipients (N = 165) completed measures of advice quality, intention to implement advice, advisor helpfulness, and conversational satisfaction. The interactions were coded for quantity of advice, offers, plans, and requests. Advice, planning, and requests affected outcomes in theoretically relevant ways. Findings are discussed with respect to improving theory, and practical implications for advisors.
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Perceptions of advice in supportive interactions are known to be influenced by the threat advice poses to a recipient's face. However, research has given little attention to factors that may moderate ...the influence of face concerns on advice evaluations. This study examined how evaluator sex, target responsibility and effort, and advice content influenced evaluations of advice given bluntly, with aggravating facework, or with mitigating facework. Participants (N = 305) evaluated advice directed at a student depicted as upset about failing an exam. The student's responsibility and effort with regard to the failure was manipulated within scenarios. Facework was found to have a substantial main effect on evaluations of advice, with mitigating facework producing the most positive evaluations. This effect was moderated to varying degrees by each of the contextual factors examined.
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Although researchers have proposed a skill deficit account for observed gender differences in the provision of emotional support, few studies have directly tested the claim that men are less capable ...of providing effective support. This study advances an alternative account for gender differences in the effectiveness of supportive communication, arguing that gender differences may emerge because men and women respond differently to situational factors that influence the motivation to provide sensitive emotional support. Participants produced emotional support messages in response to scenarios varying in target gender, target responsibility for the problem, and target effort to resolve the problem, as well as in response to the problem itself (a replication factor included to increase generalizability). Women produced messages exhibiting greater emotional sensitivity than those of men across the other factors examined, providing support for the skill deficit account and failing to provide evidence of differential motivation.
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