Judith Pizarro

The Effects of Message Framing and Ethnic Targeting on Mammography Use Among Low-Income Women

The authors examined the effects that differently framed and targeted health messages have on persuading low-income women to obtain screening mammograms. The authors recruited 752 women over 40 years of age from community health clinics and public housing developments and assigned the women randomly to view videos that were either gain or loss framed and either targeted specifically to their ethnic groups or multicultural. Loss-framed, multicultural messages were most persuasive. The advantage of loss-framed, multicultural messages was especially apparent for Anglo women and Latinas but not for African American women. These effects were stronger after 6 months than after 12 months.

Matching health messages to monitor-blunter coping styles to motivate screening mammography.

This study examined whether providing messages matched to womens monitor-blunter coping styles is effective in encouraging mammography utilization. Female callers to a cancer information hotline were assessed at the end of their regular telephone call and classified as monitors or blunters. A randomly assigned message promoting mammography utilization, tailored for monitors or blunters, was delivered on the telephone, and a similarly tailored brochure and refrigerator magnet were mailed to participants immediately after their call. Women were telephoned 6 and 12 months later to determine whether they had obtained a mammogram. Messages matched to a womans monitor-blunter coping style encouraged mammography after 6 months more effectively than mismatched messages and were significantly more effective for blunters but not for monitors.

Message Framing and Pap Test Utilization among Women Attending a Community Health Clinic

In a randomized experiment, women (N = 441) watched either a loss- or gain-framed video emphasizing the prevention or detection functions of the Pap test to test the hypothesis that loss- and gain-framed messages differentially influence health behaviors depending on the risk involved in performing the behavior. As predicted, loss-framed messages emphasizing the costs of not detecting cervical cancer early (a risky behavior) and gain-framed messages emphasizing the benefits of preventing cervical cancer (a less risky behavior) were most persuasive in motivating women to obtain a Pap test.

Matching health messages to health locus of control beliefs for promoting mammography utilization

This field experiment examined the persuasiveness of matching health messages to individuals’ health locus of control beliefs in an effort to promote screening mammography. Women (N = 499) who called the New England regional office of the Cancer Information Service were stratified by their health locus of control and randomly assigned to receive a telephone message and follow-up print materials matched to either an internal or external health locus of control orientation. As expected, women who received information consistent with their health locus of control beliefs generally were more likely to obtain a mammogram 6 and 12 months after the intervention than women who received information that was not consistent with their health locus of control orientation.

The Efficacy of Art and Writing Therapy: Increasing Positive Mental Health Outcomes and Participant Retention After Exposure to Traumatic Experience

Research has shown that traumatic stress has negative effects on overall health and well-being. Traumatic exposure has been linked to higher rates of psychological and physical health problems. Writing about trauma or stress has been shown to improve health and reduce stress, but can negatively affect mood. The purpose of this study was to examine whether art therapy is as effective as writing therapy in improving psychological and health outcomes. Participants in the writing condition, but not the art therapy condition, showed a decrease in social dysfunction. However, participants who completed artwork reported more enjoyment, were more likely to continue with the study, and were more likely to recommend the study to family and friends. Future research could combine writing and art therapy to determine whether a mixed design would both improve health and maximize participant retention.

A Source of Error in Self-Reports of Pap Test Utilization

The prevention and early detection of cervical cancer is achieved through womens regular use of Pap tests. Ascertaining adherence to Pap screening guidelines is often based on self-report, which may be unreliable. This study examined the reliability of Pap test self-reports and one potential source of error in them. We predicted that women having any gynecological examination (other than Pap tests) would falsely report having had a Pap test more often than women who had not experienced gynecological procedures. We compared self-reported Pap test utilization with medical records among 161 low-income women. Women with no Pap test in their medical record but who had experienced other gynecological procedures falsely reported a Pap test significantly more often than those women who actually received a Pap test or who had not received any gynecological procedure. Confusion over what type of gynecological procedures these women received could result in their under-utilization of Pap tests. Further, these findings question the validity of study findings based only on self-reported outcomes.

9/11: Mental Health in the Wake of Terrorist Attacks: Coping with a national trauma: a nationwide longitudinal study of responses to the terrorist attacks of September 11

The terrorist attacks of September 11, 2001, exposed every person in the USA to an experience that, in recent decades, was unprecedented in its scope and traumatic impact. Perhaps over 100,000 individuals directly witnessed these events, and many others viewed the attacks and their aftermath via the media (Yehuda, 2002). It has been argued that this national trauma “influenced and will continue to influence the clinical presentation of patients seeking health care services” in the USA (Yehuda, 2002, p. 108). A wide range of responses can be expected following traumatic life events. Research conducted after the Oklahoma City, OK, bombing indicates that responses to a terrorist attack are likely to be highly variable (North et al. , 1999). Research in the broader field of stress and coping has also demonstrated considerable variability in emotional and cognitive responses to stressful experiences (Silver & Wortman, 1980;Wortman & Silver, 1989, 2001). Despite advances in understanding reactions to traumatic events, our understanding of responses to community-level events in general, and terror attacks in particular, is limited. Progress in understanding the social and psychological process following such occurrences requires examination of how responses to a variety of stressful events are similar and different at both the group and individual level. Research has matured to the point that large-scale, prospective, longitudinal studies with the scope to examine mediators and moderators of adjustment processes are not only possible, but also necessary (North & Pfefferbaum, 2002). Moreover, the threat of future terrorist attacks demands that a higher level of urgency and research sophistication be directed not only at understanding the effects of such attacks, but also at the individual and social variables that predict psychological outcomes to such events over time.

Need for Cognition and Message Complexity in Motivating Fruit and Vegetable Intake Among Callers to the Cancer Information Service

This field experiment examined the impact of an individuals need for cognition (NFC; the tendency to enjoy thinking deeply about issues), complex versus simple messages, and the interaction of NFC and message type on encouraging fruit and vegetable consumption. Callers to the Cancer Information Service of the National Cancer Institute (N = 517) were asked to participate in the experiment at the end of their call. Individual NFC was assessed, and participants were assigned randomly to receive a telephone message promoting fruit and vegetable consumption that was either complex and multifaceted or simple and straightforward. Similarly constructed brochures were mailed immediately following the call, and additional brochures were mailed 2 and 3 months later. Although NFC did not predict intake, complex messages were more effective than simple messages in motivating fruit and vegetable consumption 1 and 4 months later.

Exploring the Myths of Coping with a National Trauma: A Longitudinal Study of Responses to the September 11th Terrorist Attacks

Summary A longitudinal investigation of psychological responses to the September 11, 2001 terrorist attacks was conducted on a U.S. national probability sample. Using an anonymous Web-based survey methodology, data were collected among over 1,900 adults at 2 weeks and 12 months post-9/11 to consider whether direct and proximal exposure were necessary preconditions for high levels of acute and posttraumatic stress symptoms, and whether greater exposure/proximity led to greater traumatic stress symptoms. Results suggest that the requirement of direct and proximal exposure to the attacks and the expectation of a dose-response relationship between exposure and traumatic stress response are myths.