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

描述(由申请者提供)：刻板印象威胁是一种现象，当被污名化的个人面临确认负面的、基于群体的刻板印象的风险时，他们面临额外的压力。它被公认为黑人和女性数学学习成绩不佳的主要原因。还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，刻板印象的威胁可能会导致黑人男性避免接受前列腺癌特定抗原测试，因为他收到了一条信息，即“黑人前列腺癌的发病率几乎是其他人的两倍”，而这条信息是“阿拉巴马州的前列腺癌发病率很高”，这是一个更好的激励因素。这项拨款测试了这样一个假设，即黑人中的刻板印象威胁也适用于健康领域，在这些领域，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)降低寻求诊断性个人健康信息的坚持性；以及(4)影响关于预防性保健的决策。使用两个阶段的实验对这些影响进行了实验评估。第一阶段通过展示关于对黑人影响不成比例的健康问题的公共服务公告(PSA)，在治疗组中激活黑人(但不是白人)中的威胁。第二阶段包括针对不同群体的实验，解决对健康信息的选择性关注(参与者努力观看模糊的健康视频)，寻求健康信息的持久性(他们在36个问题后被告知可以停止健康风险评估单元时完成了多少，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)，以及(通过对PSA的评估和健康教育计划)健康信息的回忆以及健康信息对风险评估和行动决心(例如，进行高血压筛查或减少盐摄入量)的影响。评估将探讨激活后召回差异是否发生在所有消息上，还是仅发生在陈规主题上的健康消息上，以及威胁调用是否影响所有召回(和更改意图)或仅影响调用后消息的召回。这些实验将支持制定指导方针，以发展刻板印象-威胁敏感的健康教育。关于高血压的传统健康教育计划将进行修改，以符合指南并进行试点测试，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影响，并有助于区分对文化能力采取有效和适得其反的方法。它还会提出一系列后续研究问题，如是否适用于其他少数群体、调解人和主持人、与健康有关的威胁的产生方式以及与健康有关的威胁条件与更普遍的威胁条件(例如，作为会议室中唯一的少数群体)的不同影响。 公共卫生相关性：该项目将确定刻板印象威胁是否会影响黑人的健康信息处理和健康行为决策。如果威胁是一个问题，该项目将制定指导方针，以设计健康沟通和完善文化能力培训和做法，以避免引发刻板印象的威胁。

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.