Theoretically motivated interventions for reducing sexual risk taking in adolescence: A randomized controlled experiment applying fuzzy-trace theory.

Reyna, Valerie F.; Mills, Britain A.

doi:10.1037/a0036717

Cited by 102 publications

(169 citation statements)

References 76 publications

(145 reference statements)

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“…This misconception – that bacterial and viral diseases can be lumped together and are both curable with antibiotics – has been used to explain risk judgments for sexually transmitted infections (6,7) and has been the target of successful interventions to reduce risk (14). However, fewer than half of patients in this study agreed with the misconception that antibiotics work against viruses.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, when the status quo changes such that the patient is now “sick” or has a finding, treatment will be preferred, even if it may not be warranted. Targeted educational interventions that directly address these gists are more likely to succeed than those that only address verbatim facts (e.g., 26, 27). Appropriate gist representations are also predicted to more reliably cue relevant social and moral values.…”

Section: Discussionmentioning

confidence: 99%

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Germs Are Germs, and Why Not Take a Risk? Patients’ Expectations for Prescribing Antibiotics in an Inner-City Emergency Department

2014

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Background Extensive use of unnecessary antibiotics has driven the emergence of resistant bacterial strains, posing a threat to public health. Physicians are more likely to prescribe antibiotics when they believe that patients expect them. Current attempts to change these expectations highlight the distinction between viruses and bacteria (“Germs are Germs”). Fuzzy Trace Theory further predicts that patients expect antibiotics because they make decisions based on categorical gist, producing strategies that encourage risk taking when the status quo is bad (i.e., “Why Not Take a Risk?”). We investigate both hypotheses. Methods We surveyed patients visiting the emergency department of a large urban hospital (72, 64%, were African-American) using 17 Likert-scale questions and two free-response questions regarding patient expectations for antibiotics. Results After the clinical encounter, 113 patients completed the survey. 54 (48%) patients agreed with items that assess the “Germs are Germs” hypothesis, whereas 86 (76%) agreed with items that assess the “Why Not Take a Risk?” hypothesis. “Why Not Take a Risk?” captures significant unique variance in a factor analysis, and is neither explained by “Germs are Germs,” nor by patients’ lack of knowledge regarding side effects. Of the 81 patients who rejected the “Germs are Germs” hypothesis, 61 (75%) still indicated agreement with the “Why Not Take a Risk?” hypothesis. Several other misconceptions were also investigated. Conclusions Our findings suggest that recent public health campaigns that have focused on educating patients about the differences between viruses and bacteria omit a key motivation for why patients expect antibiotics, supporting Fuzzy Trace Theory’s predictions about categorical gist. The implications for public health and emergency medicine are discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Germs Are Germs, and Why Not Take a Risk? Patients’ Expectations for Prescribing Antibiotics in an Inner-City Emergency Department

2014

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“…The preference to operate on the crudest gist, the fuzzy-processing preference, increases with experience or expertise (Reyna, 2008a; Reyna & Lloyd, 2006). In making decisions it is often more helpful to rely on these fuzzy gist representations (Reyna & Mills, 2014) provided they accurately capture decision-relevant information. Superior medical decision makers appear to distill their experience into flexible gist representations, and gist representations are also associated with better decisions about risk and health among laypersons (Fraenkel et al, 2012; Mills, Reyna, & Estrada, 2008; Reyna, Estrada, DeMarinis, Myers, Stanisz, & Mills.…”

Section: 31 Brca Gistmentioning

confidence: 99%

“…Superior medical decision makers appear to distill their experience into flexible gist representations, and gist representations are also associated with better decisions about risk and health among laypersons (Fraenkel et al, 2012; Mills, Reyna, & Estrada, 2008; Reyna, Estrada, DeMarinis, Myers, Stanisz, & Mills. 2011; Reyna & Mills, 2014). …”

Section: 31 Brca Gistmentioning

confidence: 99%

Understanding genetic breast cancer risk: Processing loci of the BRCA Gist Intelligent Tutoring System

Wolfe

Reyna

Widmer

et al. 2016

Learning and Individual Differences

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The BRCA Gist Intelligent Tutoring System helps women understand and make decisions about genetic testing for breast cancer risk. BRCA Gist is guided by Fuzzy-Trace Theory, (FTT) and built using AutoTutor Lite. It responds differently to participants depending on what they say. Seven tutorial dialogues requiring explanation and argumentation are guided by three FTT concepts: forming gist explanations in one’s own words, emphasizing decision-relevant information, and deliberating the consequences of decision alternatives. Participants were randomly assigned to BRCA Gist, a control, or impoverished BRCA Gist conditions removing gist explanation dialogues, argumentation dialogues, or FTT images. All BRCA Gist conditions performed significantly better than controls on knowledge, comprehension, and risk assessment. Significant differences in knowledge, comprehension, and fine-grained dialogue analyses demonstrate the efficacy of gist explanation dialogues. FTT images significantly increased knowledge. Providing more elements in arguments against testing correlated with increased knowledge and comprehension.

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“…There is evidence that focusing on bottom-line gist information leads to better health decision making than focusing on precise details (e.g., Reyna & Lloyd, 2006), which has been tested in randomized experiments training gist thinking in health decisions (e.g., Reyna & Mills, 2014), as well as patient medication decisions (e.g., Fraenkel et al, 2012). Teaching precise information can be less effective because people can get all the details right but still fail to comprehend the actual gist meaning that would lead to more informed decisions.…”

Section: Gist Explanationmentioning

confidence: 99%

Tutorial dialogues and gist explanations of genetic breast cancer risk

et al. 2015

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The intelligent tutoring system (ITS) BRCA Gist is a Web-based tutor developed using the Shareable Knowledge Objects (SKO) platform that uses latent semantic analysis to engage women in natural-language dialogues to teach about breast cancer risk. BRCA Gist appears to be the first ITS designed to assist patients' health decision making. Two studies provide fine-grained analyses of the verbal interactions between BRCA Gist and women responding to five questions pertaining to breast cancer and genetic risk. We examined how Bgist explanations^generated by participants during naturallanguage dialogues related to outcomes. Using reliable rubrics, scripts of the participants' verbal interactions with BRCA Gist were rated for content and for the appropriateness of the tutor's responses. Human researchers' scores for the content covered by the participants were strongly correlated with the coverage scores generated by BRCA Gist, indicating that BRCA Gist accurately assesses the extent to which people respond appropriately. In Study 1, participants' performance during the dialogues was consistently associated with learning outcomes about breast cancer risk. Study 2 was a field study with a more diverse population. Participants with an undergraduate degree or less education who were randomly assigned to BRCA Gist scored higher on tests of knowledge than those assigned to the National Cancer Institute website or than a control group. We replicated findings that the more expected content that participants included in their gist explanations, the better they performed on outcome measures. As fuzzy-trace theory suggests, encouraging people to develop and elaborate upon gist explanations appears to improve learning, comprehension, and decision making.

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Theoretically motivated interventions for reducing sexual risk taking in adolescence: A randomized controlled experiment applying fuzzy-trace theory.

Cited by 102 publications

References 76 publications

Germs Are Germs, and Why Not Take a Risk? Patients’ Expectations for Prescribing Antibiotics in an Inner-City Emergency Department

Germs Are Germs, and Why Not Take a Risk? Patients’ Expectations for Prescribing Antibiotics in an Inner-City Emergency Department

Understanding genetic breast cancer risk: Processing loci of the BRCA Gist Intelligent Tutoring System

Tutorial dialogues and gist explanations of genetic breast cancer risk

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