Large-Scale Online stimulus Norming and Surveys about Perceptions in Healthcare

大规模在线刺激规范和医疗保健认知调查

• 批准号: 10700657
• 负责人: Lauren Atlas
• 金额: $ 4.85万
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10700657
• 关键词: Affective; Alcohol abuse; American; Americas; Atlases; Awareness; Belief; Black race; COVID-19 pandemic effects; Clinic; Cues; Data; Data Collection; Distress; Emotions; Environment; Face; Facial Muscles; Female; Gender; Geography; Healthcare; Image; Individual; Journals; Judgment; Label; Laboratories; Literature; Manuscripts; Measures; Mental Health; Meta-Analysis; Movement; National Institute of Mental Health; Pain; Pain Measurement; Pain Threshold; Paper; Participant; Patients; Perception; Persons; Placebo Effect; Population Heterogeneity; Postdoctoral Fellow; Preparation; Process; Provider; Race; Reporting; Research; Research Activity; Research Design; Sampling; Science; Series; Sex Bias; Social Environment; Stereotyping; Stimulus; Survey Methodology; Surveys; Symptoms; Testing; Visual; Work; base; computer generated; contextual factors; expectation; experimental study; health disparity; male; pain outcome; pain relief; physical conditioning; racial bias; racial disparity; sex; social influence; socioeconomics

Pain can be modulated by interpersonal processes that support the patient-provider relationship, and contextual factors related to the treatment environment. For example, placebo effects reflect the positive influence of social contexts on pain relief, whereas health disparities in pain are subject to stereotypes and inequities in pain assessment and its treatment. In this project, we investigate large-scale norms and beliefs about healthcare in America, and how perceptions of people and other visual cues in the treatment environment influence expectations about pain during treatment and about the pain other people feel. This project uses online survey methodologies to measure large scale normed beliefs and expectations from a geographically, ethnically, and socioeconomically diverse population of Americans. The purpose of this project is to investigate healthcare beliefs that may enhance or diminish pain in the clinic, which can be used to design studies in the laboratory to test if manipulating these beliefs can be advantageous for pain outcomes. In the past year, we completed data collection on a series of experiments that evaluates whether individuals perceive pain differently based on the race or sex of a participant, and compares pain assessment with the assessment of emotion. Prior research suggests White individuals need stronger expressions before labeling a face as in pain when viewing the face of a Black actor relative to a White actor. However, these faces differed in identity, were actors, and were all male. We therefore ran a study in which we manipulated the same facial muscle movements (with action units determined based on the pain expression literature) but superimposed these on different identities. Therefore the expressions were identical, it was just the face they were imposed on that differed. We also decided to not only measure potential differences in pain judgments by race, but also by sex, such that female patients and research participants have lower pain tolerance and are less likely to be treated for pain than male patients, similar to the disparities between Black and White individuals regardless of sex. We completed three studies over the course of 2019-2020, including a period of racial unrest that led to increased awareness of racial disparities in the US. Following initial manuscript submission, we completed two additional studies suggested by reviewers that compared pain with basic emotions and tested whether findings from our computer generated stimuli generalized across individuals. We did not observe consistent gender or racial biases in pain assessment across studies based on meta-analysis. However, our fifth study demonstrated that pain was less accurately assessed than other basic emotions, and that regardless of emotion, individuals attributed lower intensity to Black, relative to White, individuals, and had lower confidence for female faces, even though faces displayed the same expressions regardless of race or gender. The fact that we did not observe consistent findings in pain assessment across the studies may reflect the changing context and awareness of racial disparities in the middle of 2020, but also highlights that pain assessment may be more subject to context than assessment of basic emotion. The paper is currently under revision at the journal Affective Science (Dildine, Amir, Atlas, Submitted). In addition, we also completed collaborative work with Dr. Joyce Chung (OD, formerly NIMH) that measures the impact of the covid-19 pandemic on mental and physical health. Postdocs in the lab are currently leading manuscript preparation on the association between expectations and worries and reported symptoms (Akintola et al., in prep) and the association between distress and problematic alcohol use (Yanes et al., In prep). Several other collaborative papers will also result from this longitudinal data.

疼痛可以通过支持医患关系的人际过程和与治疗环境相关的情境因素来调节。例如，安慰剂效应反映了社会环境对缓解疼痛的积极影响，而疼痛的健康差异则受到刻板印象和疼痛评估及其治疗方面的不平等的影响。在这个项目中，我们调查了美国医疗保健的大规模规范和信念，以及在治疗环境中对人的感知和其他视觉线索如何影响治疗期间对疼痛的预期以及其他人感受到的疼痛。该项目使用在线调查方法来测量来自地理、种族和社会经济不同的美国人口的大规模规范信仰和期望。本项目的目的是调查可能增加或减少临床疼痛的医疗保健信念，这可以用于设计实验室研究，以测试操纵这些信念是否有利于疼痛结果。