Effects of Stereotype Threat on the Health-Related Outcomes of African Americans

描述（由申请人提供）：刻板印象威胁是一种现象，当被污名化的个体面临确认负面的、基于群体的刻板印象的风险时，他们会面临额外的压力。这被公认为是黑人和女性数学成绩差的主要原因。没有人研究过刻板印象威胁的激活是否会影响健康行为。例如，刻板印象威胁可能会导致黑人男性在听到“黑人前列腺癌发病率几乎是其他人的两倍”的信息时，避免接受前列腺特异性抗原检测，而听到“阿拉巴马州的前列腺癌发病率很高”的信息时，这种动机会更好。这项拨款检验了黑人中的刻板印象威胁也适用于健康领域的假设，它(1)影响对健康信息的反应和处理；(2)降低记忆健康信息的能力；(3)降低了寻求诊断性个人健康信息的持久性；(4)影响预防保健的决策。采用两阶段实验对这些影响进行了实验评估。第一阶段通过播放公共服务公告（psa）来激活治疗组黑人（而不是白人）的威胁，这些公共服务公告主要是关于影响黑人的健康问题。第二阶段包括针对不同群体的实验，涉及对健康信息的选择性关注（参与者观看模糊的健康视频的努力程度），寻求健康信息的持久性（在告知他们可以在36个问题后停止，但随着他们完成越来越多的问题，他们的健康状况将得到越来越准确的评估时，他们完成了717项健康风险评估中的多少项），以及（通过对psa的评估和健康教育计划）健康信息回忆和健康信息对风险评估和行动决心的影响（例如，进行高血压筛查或减少盐摄入量）。评估将探讨激活后的回忆差异是发生在所有信息中，还是仅仅发生在关于刻板印象主题的健康信息中，以及威胁调用是否影响所有回忆（和改变意图），还是仅仅影响调用后的回忆。这些实验将支持制定指导方针，发展对定型观念威胁敏感的卫生教育。将修改传统的高血压健康教育方案，以符合指导方针，并进行试点测试，以表明它可以更好地保留知识并增强改变的决心。证明刻板印象威胁影响健康行为将对那些设计健康教育和健康风险评估反馈的人具有重要意义，并有助于区分文化能力的有效方法和适得其反的方法。它还将提出一系列后续研究问题，包括对其他少数群体的适用性、调解人和调解人、与健康有关的威胁产生的方式，以及与健康有关的威胁条件与更普遍的威胁条件的不同影响（例如，作为房间中唯一的少数群体）。

DESCRIPTION (provided by applicant): Stereotype threat is a phenomenon whereby stigmatized individuals face added pressure when they are at risk of confirming negative, group-based stereotypes. It is well-established as a major cause of poor academic performance of Blacks and of women in math. No one has examined whether activation of stereotype threat influences health behavior. For example, stereotype threat might cause a Black man to avoid getting a prostate- specific antigen test in response to a message that "The Black prostate cancer rate is almost twice the rate for other people" with a message that "The prostate cancer rate in Alabama is high" motivating much better. This grant tests the hypothesis that stereotype threat among Blacks also applies to the health domain where it (1) influences reactivity toward and processing of health messaging; (2) reduces capacity to remember health information; (3) decreases persistence toward seeking diagnostic personal health information; and (4) affects decisions about preventive health care. These affects are evaluated experimentally using two-stage experiments. The first stage activates threat among Blacks (but not Whites) in the treatment group by showing Public Service Announcements (PSAs) about health problems that disproportionately affect Blacks. The second stage includes experiments that, for different groups, address selective attention to health information (how hard participants work to watch a blurred health video), persistence in seeking health information (how much of a 717-item health risk appraisal battery they complete when told they are allowed to stop after 36 questions but that their health status will be assessed increasingly accurately as they complete more and more questions), and (through evaluation of the PSAs and a health education program) health information recall and the influence of health information on risk appraisal and resolve to act (e.g., to get hypertension screening or reduce salt intake). The assessment will explore whether post-activation recall differences occur for all messages or just for health messages on stereotypical topics and whether threat invocation affects all recall (and intent to change) or just recall for post-invocation messages. The experiments will support the creation of guidelines for developing stereotype-threat-sensitive health education. A traditional health education program on hypertension will be modified to comply with the guidelines and pilot-tested to show it leads to better knowledge retention and increased resolve to change. Demonstrating that stereotype threat affects health behavior would have important implications for those designing health education and health risk appraisal feedback, as well as helping to differentiate effective from counter-productive approaches to cultural competency. It also would raise a host of follow-up research questions on applicability to other minority groups, mediators and moderators, ways that health-related threat arises, and differential effects of health-related versus more generalized threat conditions (e.g., being the only minority in the room). PUBLIC HEALTH RELEVANCE: This project will determine whether stereotype threat affects the health information processing and health behavior decisions of Blacks. If threat is a problem, the project will develop guidelines for designing health communication and refining cultural competency training and practice that avoid raising stereotype threat.