Negative consequences of self-presentation on disclosure of health information: A catch-22 for Black patients?

Louis, Kengthsagn; Crum, Alia J.; Markus, Hazel Rose

doi:10.1016/j.socscimed.2022.115141

Cited by 3 publications

(1 citation statement)

References 41 publications

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“…The framework is grounded in the authors’ expertise in the social psychology of culture, bias, and inequality and their work applying evidence-based insights to inform and assess organizational, institutional, and societal change efforts in real-world settings. For over a decade, they have studied these change processes systematically in collaboration with researchers and private and public sector leaders in criminal justice (e.g., Camp et al, 2021, 2023; Hetey, 2020; Rho et al, 2023; Voigt et al, 2017), economic mobility (e.g., Cheryan & Markus, 2020; Lyons-Padilla et al, 2019; Thomas et al, 2020, 2023), education (e.g., Darling-Hammond et al, 2023; Okonofua et al, 2016; Stephens et al, 2019), health (e.g., Hook & Markus, 2020; Howe et al, 2022; Louis et al, 2022), media (e.g., Griffiths et al, 2023; Reddan et al, 2023), and technology (e.g., Zhao et al, 2023). The framework is centered around the behavioral change aspects of intentional culture change 2…”

Section: Culture Change Is In the Airmentioning

confidence: 99%

We built this culture (so we can change it): Seven principles for intentional culture change.

Hamedani,

Markus,

Hetey

et al. 2024

American Psychologist

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Calls for culture change abound. Headlines regularly feature calls to change the "broken" or "toxic" cultures of institutions and organizations, and people debate which norms and practices across society are now defunct. As people blame current societal problems on culture, the proposed fix is "culture change." But what is culture change? How does it work? Can it be effective? This article presents a novel social psychological framework for intentional culture change-actively and deliberately modifying the mutually reinforcing features of a culture. Synthesizing insights from research and application, it proposes an integrated, evidence-based perspective centered around seven core principles for intentional culture change: Principle 1: People are culturally shaped shapers, so they can be culture changers; Principle 2: Identifying, mapping, and evaluating the key levels of culture helps locate where to target change; Principle 3: Culture change happens in both top-down and bottom-up ways and is more effective when the levels are in alignment; Principle 4: Culture change can be easier when it leverages existing core values and harder when it challenges deep-seated defaults and biases; Principle 5: Culture change typically involves power struggles and identity threats; Principle 6: Cultures interact with one another and change can cause backlash, resistance, and clashes; and Principle 7: Timing and readiness matter. While these principles may be broadly used, here they are applied to the issue of social inequality in the United States. Even though culture change feels particularly daunting in this problem area, it can also be empowering-especially when people leverage evidence-based insights and tools to reimagine and rebuild their cultures. Public Significance StatementCalls for culture change abound. Headlines regularly feature calls to change the "broken" or "toxic" cultures of the police, the workplace, U.S. politics, and more, and norms and practices across society are hotly debated. The proposed fix is "culture change." But what is culture change? How does it work? And can it be effective? This article presents an emerging social psychological framework for intentional culture change, with a focus on behavioral change and addressing societal disparities in the United States.

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Section: Culture Change Is In the Airmentioning

confidence: 99%

We built this culture (so we can change it): Seven principles for intentional culture change.

Hamedani,

Markus,

Hetey

et al. 2024

American Psychologist

View full text Add to dashboard Cite

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Unveiling the silent suffering: Examining the complexities of disclosure and concealment strategies in women living with obstetric fistula

Wood,

Kwamena Aidoo,

Orleans Lindsay

et al. 2024

Heliyon

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Mistrust and missed opportunities: BDSM practitioner experiences in healthcare

Jansen,

Fried,

Goetz

et al. 2024

The Journal of Sexual Medicine

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Background Stigma and discrimination have been shown to be significant barriers to healthcare utilization and provider trust among sexual minority groups including BDSM and kink communities. Aim This exploratory study sought to better understand medical mistrust and experiences of discrimination in primary care settings and how these factors predict hiding kink-related injuries from healthcare providers. Methods A total of 301 individuals who self-identified as being a member of the BDSM community and engaged in BDSM-play activities completed an online survey. Outcomes Participants completed measures including experiences with BDSM-play-related injuries, disclosure of BDSM activity to healthcare providers, measures addressing mistrust in in healthcare providers (such as avoidance of questions about sexual health or STI testing), and experiences with discrimination in healthcare settings because of BDSM group membership (such as perceptions of being insulted or receiving poor care). Results Nearly, 40% of participants indicated at least one experience with discrimination in the healthcare system because they identified as a member of the kink community. Over 20% of participants indicated there were BDSM-related concerns they would have liked to discuss with their primary care provider but did not. Participants who hid injuries from their primary care provider had higher levels of medical mistrust and more experiences with medical discrimination than those who disclosed their injuries. A stepwise logistic regression determined that medical mistrust served as a significant predictor of hiding injuries from healthcare providers. Clinical Implications Patients who are members of the BDSM community are likely to have had negative healthcare experiences, and these experiences impact their communication with and trust in future medical encounters. Strengths and Limitations Strengths of the study include addressing diverse components of stigma in healthcare including both experiences with discrimination as well as perceptions of the medical field. Furthermore, potential direct consequences of past negative experiences such as hiding injuries from healthcare providers were examined. Given the likely impact of race, gender, and BDSM group membership on experiences with discrimination, a limitation includes the limited representations of BDSM participants from minoritized racial and ethnic groups. Furthermore, in addressing injuries, the survey did not differentiate intended or expected injuries obtained in BDSM play from unintentional or unwanted injuries. Conclusion Mistrust in the medical system impacts members of the BDSM community’s willingness to disclose injuries to their healthcare provider.

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Negative consequences of self-presentation on disclosure of health information: A catch-22 for Black patients?

Cited by 3 publications

References 41 publications

We built this culture (so we can change it): Seven principles for intentional culture change.

We built this culture (so we can change it): Seven principles for intentional culture change.

Unveiling the silent suffering: Examining the complexities of disclosure and concealment strategies in women living with obstetric fistula

Mistrust and missed opportunities: BDSM practitioner experiences in healthcare

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