Lori J. Lange

Personal Models for Diabetes in Context and Patients’ Health Status

In a diverse sample of 452 adult diabetes patients, we investigated: (1) personal model dimensions for diabetes and expanded upon the literature by indexing fatalism, (2) the relationship between contextual factors and patients’ beliefs about the seriousness and controllability of diabetes, and (3) the unique contribution of illness representation combinations to clinical outcomes when controlling for baseline disease severity. Major categories of predictors included patients’ sociocultural characteristics, illness history (e.g., co-morbidities, diabetes complications) and recent physical symptoms. Illness representations were measured using the Personal Models of Diabetes Interview and questions that index fatalistic beliefs. Clinical outcome measures included patients’ glycemic control (HbA1c) and the patients physical and mental functions as measured by the SF-12. Analyses corroborated the literature by identifying seriousness and treatment effectiveness cognitive model dimensions for diabetes. Physical symptoms and other disease-related factors were strong predictors of patients’ seriousness beliefs for diabetes, whereas sociocultural factors (education, ethnicity) best explained representations related to the controllability of diabetes (i.e., treatment effectiveness, fatalism). Seriousness beliefs were good indicators of actual glucose control, except for cases in which patients were more fatalistic and believed diabetes to be less serious. Although patients had medically consistent views of their diabetes, variations in personal models of diabetes were related to specific contextual factors and independently explained diabetes control.

An Empirical Test of an Expanded Version of the Theory of Planned Behavior in Predicting Recycling Behavior on Campus

Abstract Background: The study and promotion of environmental health behaviors, such as recycling, is an emerging focus in public health. Purpose: This study was designed to examine the determinants of recycling intention on a college campus. Methods: Undergraduate students (N=189) completed a 35-item web-based survey past findings and an expanded version of the Theory of Planned Behavior (TPB). Path analytic models were examined with bootstrapping method. Results: The path coefficients revealed that all of the direct paths were statistically significant except the direct path from descriptive norm to behavioral intention. The model explained 49.3% of the variance in recycling intention. The strongest predictors of campus recycling intention were moral obligation and behavioral attitudes. Discussion: The expanded version of the TPB proved to be a sound theoretical framework to study the determinants of recycling on campus. Overall, the model components had a large effect on recycling intention. Translation to Health Education Practice: Using behavior change theory to understand recycling behavior is prerequisite to evidenced-based recycling interventions. These findings should be used to guide campus recycling interventions.

Exoneration Reduces Adult Conflict's Effects on Preschoolers' Cognitions, Behavioral Distress, and Physiology.

In this experiment, the authors investigated the influence of exoneration from blame on childrens overt behavioral distress and physiological reactivity following the presentation of overheard adult conflict. The participants were 48 children (48-71 months of age) and their mothers. Through random assignment, the authors presented 16 children with statements that exonerated them from an overheard disagreement between two adults, did not address 16 during a similar disagreement, and presented 16 with a neutral discussion of difficulties. Exonerated children responded with less distress than did nonaddressed children, but did not differ from children presented the neutral discussion, except for overt behavioral distress. Nonaddressed children most often blamed themselves for the argument. Exonerating statements may protect children from attributional error and resultant physiological arousal during adult conflict.

Perceptions of Accident Foreseeability and Stress and Coping During the Evacuation Period of Technological Disaster

The public depends on experts to manage risks of technologies and to prevent or warn of a possible mishap. Perceptions of experts’ ability to predict accidents were investigated in evacuees and controls during the threat of explosion from the derailment of a train carrying liquid propane. Evacuees showed elevated stress response levels compared to controls across psychological, behavioral, and physiological modalities. Perceptions of transportation accident foreseeability moderated physiological stress for evacuees, with stronger perceptions of accident predictability associated with lower stress hormone levels. Perceptions of transportation accident foreseeability also were associated with a reactance-style response to the disaster and problem-solving coping style in evacuees. Perceptions associated with greater secondary predictability moderated the physiological stress effects of the accident on evacuees during the acute phase of the disaster and furthermore, was associated with more efforts to regain control through more active coping.