Browsing by Subject "Attitudes"

Now showing 1 - 10 of 15
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    Assessing the LGBT cultural competency of dementia care providers
    (Wiley, 2021-02-14) Nowaskie, Dustin Z.; Sewell, Daniel D.; Psychiatry, School of Medicine
    Introduction: Although dementia risk factors are elevated in lesbian, gay, bisexual, and transgender (LGBT) older adults and are perpetuated by a lack of cultural competency, no known studies have quantified LGBT cultural competency among dementia care providers. Methods: Dementia care providers (N = 105) across the United States completed a survey consisting of the 7-point Likert LGBT-Development of Clinical Skills Scale. Results: Dementia care providers reported very high affirming attitudes (M = 6.67, standard deviation [SD] = 0.71), moderate knowledge (M = 5.32, SD = 1.25), and moderate clinical preparedness (M = 4.93, SD = 1.23). Compared to previously published data, they reported significantly lower knowledge than medical students. There were no differences compared to psychiatry residents. Discussion: The current state of dementia care providers' LGBT cultural competency has significant, yet modifiable, gaps. Better education, including more LGBT patient exposure, is necessary to improve the care being provided to members of the LGBT community impacted by dementia illness.
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    Associations of trust and healthcare provider advice with HPV vaccine acceptance among African American parents
    (Elsevier, 2017-02-01) Fu, Linda Y.; Zimet, Gregory D.; Latkin, Carl A.; Joseph, Jill G.; Pediatrics, School of Medicine
    OBJECTIVE: Healthcare providers (HCPs) are advised to give all parents a strong recommendation for HPV vaccination. However, it is possible that strong recommendations could be less effective at promoting vaccination among African Americans who on average have greater mistrust in the healthcare system. This study examines the associations of parental trust in HCPs and strength of HCP vaccination recommendation on HPV vaccine acceptance among African American parents. METHODS: Participants were recruited from an urban, academic medical center between July 2012 and July 2014. We surveyed 400 African American parents of children ages 10-12years who were offered HPV vaccine by their HCPs to assess sociodemographic factors, vaccine beliefs, trust in HCPs, and the HPV vaccine recommendation received. Medical records were reviewed to determine vaccination receipt. RESULTS: In multivariable analysis, children whose parents were "very strongly" recommended the HPV vaccine had over four times higher odds of vaccine receipt compared with those whose parents were "not very strongly" recommended the vaccine. Having a parent with "a lot of" versus "none" or only "some" trust in HCPs was associated with over twice the odds of receiving HPV vaccine. Very strong HCP recommendations were associated with higher odds of vaccination among all subgroups, including those with more negative baseline attitudes toward HPV vaccine and those with lower levels of trust. Adding the variables strength of HCP recommendation and parental trust in HCPs to a multivariable model already adjusted for sociodemographic factors and parental vaccine beliefs improved the pseudo R2 from 0.52 to 0.55. CONCLUSIONS: Among participants, receiving a strong vaccine recommendation and having a higher level of trust in HCPs were associated with higher odds of HPV vaccination, but did not add much to the predictive value of a model that already adjusted for baseline personal beliefs and sociodemographic factors.
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    Conduct disorder symptoms and illicit drug use in juvenile justice involved youth: The reciprocal relationship between positive illicit drug use attitudes and illicit drug use
    (Taylor & Francis, 2018-07-03) Kolp, Haley M.; Hershberger, Alexandra R.; Sanders, Jasmyn; Um, Miji; Aalsma, Matthew; Cyders, Melissa A.; Psychology, School of Science
    Conduct disorder (CD) symptoms cooccur at high rates with illicit drug use in juvenile justice involved youth, which results in poorer outcomes; however, research has not identified where best to intervene in this relationship, limiting the identification of modifiable risk factors to reduce negative effects of CD symptoms. Two mediation models were examined to investigate the potential for CD symptoms to influence a reciprocal relationship between illicit drug use and positive drug attitudes, controlling for age, gender, and race. Data were examined for 245 juvenile justice involved youth (mean age = 15.46, SD = 1.30, range 12-18, 64.9% Black, 80.4% male) who completed court-ordered psychological assessments. Findings indicate: (1) Positive attitudes toward illicit drug use significantly mediated the relationship between CD symptoms and illicit drug use (β = 0.16, CI 0.09-0.27; test for indirect effect z = 4.17, p < .001) and (2) illicit drug use significantly mediated the relationship between CD symptoms and positive attitudes toward illicit drug use (β = 0.20, CI 0.12-0.32; test for indirect effect z = 4.87, p < .001). Overall, the present study suggests that CD symptoms impart risk for illicit drug use both indirectly, through more positive attitudes toward illicit drug use, and directly, which further strengthens positive attitudes toward illicit drug use.
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    Drinking and driving: a pilot study of subjective norms, attitudes and behaviors of German and American students
    (2014-11-13) Slagle, Bianca Annaliese; Goering, Elizabeth M.; Rhodes, Nancy; Shin, YoungJu
    Drinking and driving is increasingly becoming a detrimental behavior, especially amongst college-aged students in the U.S. and other countries. Additionally, research shows that college-age students in the U.S. are more likely to drink and drive, than college-age students in Germany. Fishbein and Ajzen’s Theory of Reasoned Action asserts that subjective norms and attitudes signify behavioral intentions. In order to test the TRA and understand the drinking and driving differences and similarities in the U.S. and Germany, focus groups of German and American college-age students were conducted to discuss subjective norms and attitudes surrounding drinking and driving behaviors, followed up by an electronic pilot study survey regarding same. The data collected illustrated that college-age drinking and driving is occurs more frequently in the U.S., and that American and German students differ in their attitudes and subjective norms surrounding drinking and driving. Future research would benefit the continued use and circulation of the electronic surveys for larger cross-cultural samples of college-age students to more effectively and quantitatively assess actual drinking and driving behaviors as it relates to subjective norms and attitudes, as suggested in the TRA.
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    Emergency Department Physician Attitudes, Practices, and Needs Assessment for the Management of Patients with Chest Pain Secondary to Anxiety and Panic
    (Office of the Vice Chancellor for Research, 2016-04-08) Lee, J. Austin; Musey Jr., Paul I.
    Background Chest pain is a common medical complaint, accounting for 7 million annual visits to US Emergency Departments (EDs) [1]. Most research and clinical resources are focused on the management of the life-threatening acute coronary syndrome (ACS); however, about 80% of all patients presenting to EDs with chest pain do not have a cardiopulmonary emergency [2-4]. Non-ACS chest pain can be caused by anxiety or a panic disorder, and such etiologies remain undiagnosed in almost 90% of cases, and frequently have worse outcomes [5-9]. Objective and Methods The study objective was to assess ED physician’s attitudes, practices, and needs in managing chest pain related to anxiety and panic. A REDCap survey of 15 Likert-style questions was constructed using expert consensus to ensure content validity then administered to all faculty and resident physicians in the IU Department of Emergency Medicine (113 individuals, 65.5% response-rate). Results ED providers believe a significant proportion (31.5%) of patients with chest pain at low risk for ACS are due to panic/anxiety. Providers give such patients instructions on how to manage their panic/anxiety only 34.8% of the time, while even fewer (19.0%) make a diagnosis of anxiety or panic disorder in their documentation. Most providers (77.0%) would welcome a narrative to aid in discussing anxiety/panic as a cause of chest pain and nearly all (85.1%) would find it helpful to have specific clinic information available to aid in follow-up. Conclusions A significant number of ED patients with chest pain are likely due to anxiety, and a majority of physicians report not having the resources necessary to manage these patients. Further work to develop relevant resources would aim to improve provider confidence in treating these patients, and would hope to improve management of anxiety or panic as a cause of chest pain in the ED.
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    Family and Peer Influences on Substance Attitudes and Use among Juvenile Justice-Involved Youth
    (Springer, 2019-02) Zapolski, Tamika C. B.; Clifton, Richelle L.; Banks, Devin E.; Hershberger, Alexandra; Aalsma, Matthew; Psychology, School of Science
    Juvenile justice-involved youth experience high rates of substance use, which is concerning given associated negative consequences, including health and functional deficits. Family and peer factors are associated with a high risk of substance use among justice-involved youth. It is hypothesized that this risk process operates through pro-drug attitudes. However, limited research has been conducted on the mechanisms through which family and peer factors increase risk for substance use among juvenile justice involved youth. The current study examined both the direct and indirect effects of family and peer substance use on youth's substance use (alcohol and illicit drug use). We also examined whether this relationship differs by race. 226 detained youth (81.9% male; 74.3% Black) were recruited from an urban county in the Midwest and completed a clinical interview and substance use assessment battery. A direct effect of family/peer risk on illicit drug use was found for all youth, though the effect was stronger among White youth. Results also supported the indirect effect pathway from family/peer risk to both illicit drug use and alcohol use through pro-drug attitudes. This pathway did not vary by race. These findings suggest that interventions should focus on targeting both family/peer risk and pro-drug attitudes to reduce substance use. Given the racial difference in the direct effect of family/peer risk on illicit drug use, there may be other factors that influence risk more strongly for White youth, which warrants further investigation.
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    How much is needed? Patient exposure and curricular education on medical students’ LGBT cultural competency
    (BMC, 2020-12-04) Nowaskie, Dustin Z.; Patel, Anuj U.; Psychiatry, School of Medicine
    Background: For medical students, providing exposure to and education about the lesbian, gay, bisexual, and transgender (LGBT) patient population are effective methods to increase comfort, knowledge, and confidence in caring for LGBT people. However, specific recommendations on the number of patient exposures and educational hours that relate to high LGBT cultural competency are lacking. Methods: Medical students (N = 940) at three universities across the United States completed a survey consisting of demographics, experiential variables (i.e., number of LGBT patients and LGBT hours), and the 7-point Likert LGBT-Development of Clinical Skills Scale (LGBT-DOCSS). LGBT-DOCSS scores were stratified by 1-point increments, and experiential variable means were computed per each stratification to characterize the mean LGBT patients and hours of medical students with higher scores and those with lower scores. Results: Medical students reported caring for some LGBT patients annually (M = 6.02, SD = 20.33) and receiving a low number of annual LGBT curricular hours (M = 2.22, SD = 2.85) and moderate number of annual LGBT extracurricular hours (M = 6.93, SD = 24.97). They also reported very high attitudinal awareness (M = 6.54, SD = 0.86), moderate knowledge (M = 5.73, SD = 1.01), and low clinical preparedness (M = 3.82, SD = 1.25). Medical students who cared for 35 or more LGBT patients and received 35 or more LGBT total hours reported significantly higher preparedness and knowledge. Conclusions: Medical students have shortcomings in LGBT cultural competency and limited LGBT patient exposure and education. To improve LGBT cultural competency, medical schools and accrediting bodies should consider providing medical students with at least a total of 35 LGBT patient contacts and 35 LGBT education hours (10 h of required curricular education and 25 h of supplemental education).
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    An overview of empirical research on ethics in entrepreneurial firms within the United States
    (Business Ethics Network of Africa, 2009-07) Baucus, Melissa; Cochran, Philip L.
    Scholars recognise that entrepreneurs may encounter different ethical issues and pressures than managers in larger corporations. This has fostered empirical research aimed at assessing ethics in entrepreneurial settings in the United States. Our emphasis on empirical research with little attention paid to purely conceptual papers allows us to highlight the narrow definition of entrepreneurship used in the US and how US researchers distinguish between entrepreneurship and other types of small businesses. This differs greatly from many other countries, especially those in which researchers equate entrepreneurship with the study of small and medium sized enterprises (SMEs). Researchers in the US often distinguish ethics from corporate social responsibility (CSR), corporate social performance (CSP), stakeholder theory and stakeholder management with different theoretical models proposed in each of these areas. After discussing these various definitional issues, we review the empirical research on ethics in entrepreneurial firms, discussing what the results tell us, identifying gaps in prior research and concluding with recommendations for future research that draws more heavily on theoretical frameworks in the field of ethics.
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    Predictors of Acceptance: Exploring Healthcare-Related Master's-Level Social Workers' Attitudes on Alcohol Use Disorder, Opioid Use Disorder, and Medication-Assisted Treatment
    (2022-08) Bartholomew, Joseph Brooks; Carlson, Joan M.; Lay, Kathy; Agley, Jon; Crabb, David; Kim, Hea-Won
    Heavy alcohol consumption and opioid overdose rates continue to increase in the United States (U.S.). Social workers provide approximately 70% of the behavioral healthcare in the U.S. Medication-assisted treatment (MAT) combines FDA-approved medications with psychosocial interventions to provide a comprehensive approach to recovery for alcohol use disorder (AUD) and opioid use disorder (OUD). However, stigmatized attitudes toward individuals with AUD, OUD, and MAT limit MAT’s use. Guided by critical social theory, this study explores factors that predict master’s-level social workers’ (MSWs) attitudes toward AUD and OUD and, by extension, factors that predict their acceptance of MAT. A repeated measures analysis of variance (ANOVA) identified MSWs from Indiana, Kentucky, and Ohio (N = 140) having more favorable statistically significant (p < 0.001) attitudes toward individuals with AUD than those with OUD. Multiple regression models used age, gender identity, political ideology, years working in addiction (tenure), social work licensure, and 12-step facilitation beliefs to predict AUD and OUD attitudes, with AUD and OUD attitudes included in the regression models for MAT acceptance. Increased years working in addiction (tenure) was a statistically significant predictor in elevating attitudes toward individuals with AUD (p < 0.05) and OUD (p < 0.01). A more liberal political ideology (p < 0.001), increased years working in addiction (tenure) (p < 0.05), and more favorable attitudes toward individuals with AUD and OUD (p < 0.001) were statistically significant predictors in MAT acceptance. These results warrant increasing MSWs’ education on addiction and research on factors that impact their acceptance of MAT. Increasing MSWs’ education on addiction may lower stigmatized attitudes toward individuals with AUD and OUD and increase MAT acceptance. MSWs’ increased acceptance of MAT could improve patient health outcomes.