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Excluding numeric side-effect information produces lower vaccine intentions. Vaccine 2022; 40:4262-4269. [PMID: 35697576 DOI: 10.1016/j.vaccine.2022.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 11/21/2022]
Abstract
Encouraging vaccine uptake is important to reducing the impact of infectious disease. However, negative attitudes and vaccine hesitancy, due in part to worry about side effects, are obstacles to achieving high vaccination rates. Provided vaccine information sheets typically include a list of side effects without numeric information about their likelihoods, but providing such numbers may yield benefits. We investigated the effect of providing numeric information about side-effect likelihood (e.g., "1%") and verbal labels (e.g., "uncommon") on intentions to get a hypothetical vaccine, reasons for the vaccination decision, and risk overestimation. In a diverse, online, convenience sample (N = 595), providing numeric information increased vaccine intentions-70% of those who received numeric information were predicted to be moderately or extremely likely to vaccinate compared to only 54% of those who did not receive numeric information (p<.001), controlling for age, gender, race, education, and political ideology. Participants receiving numeric information also were less likely to overestimate side-effect likelihood. Verbal labels had additional benefits when included with numeric information, particularly among the vaccine hesitant. For these participants, verbal labels increased vaccine intentions when included with numeric information (but not in its absence). Among the vaccine-hesitant, 43% of those provided numeric information and verbal labels were predicted to be moderately or extremely likely to get vaccinated vs. only 24% of those given a list of side effects (p<.001). We conclude that the standard practice of not providing numeric information about side-effect likelihood leads to a less-informed public who is less likely to vaccinate.
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Conducting a representative national randomized control trial of tailored clinical decision support for nurses remotely: Methods and implications. Contemp Clin Trials 2022; 118:106712. [PMID: 35235823 PMCID: PMC9851662 DOI: 10.1016/j.cct.2022.106712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/12/2022] [Accepted: 02/16/2022] [Indexed: 01/22/2023]
Abstract
Clinical Decision Support (CDS) systems, patient specific evidence delivered to clinicians via the electronic health record (EHR) at the right time and in the right format, has the potential to improve patient outcomes. Unfortunately, outcomes of CDS research are mixed. A potential cause lies in its testing. Many CDS are implemented in practice without sufficient testing, potentially leading to patient harm. When testing is conducted, most research has focused on "what" evidence to provide with little attention to the impact of the CDS display format (e.g., textual, graphical) on the user. In an adequately powered randomized control trial with 220 hospital based registered nurses, we will compare 4 randomly assigned CDS format groups (text, text table, text graphs, tailored to subject's graph literacy score) for effects on decision time and simulated patient outcomes. We recruit using state based professional registries, which allows access to participants from multiple institutions across the nation. We use online survey software (REDCap) for efficient study workflow including screening, informed consent documentation, pre-experiment demographic data collection including a graph literacy questionnaire used in randomization. The CDS prototype is accessed via a web app and the simulation-based experiment is conducted remotely at a subject's local computer using video-conferencing software. Also included are 6 post intervention surveys to assess cognitive workload, usability, numeracy, format preference, CDS utilization rationale, and CDS interpretation. Our methods are replicable and scalable for testing of health information technologies and have the potential to improve the safety and effectiveness of these technologies across disciplines.
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Soler-Hampejsek E, Kangwana B, Austrian K, Amin S, Psaki SR. Education, Child Marriage, and Work Outcomes Among Young People in Rural Malawi. J Adolesc Health 2021; 69:S57-S64. [PMID: 34809901 DOI: 10.1016/j.jadohealth.2021.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE School attainment has increased and gender gaps narrowed in many settings without commensurate declines in child marriage and with persistent gender gaps in work. This paper investigates whether child marriage changes young people's ability to translate education into paid work in rural Malawi. METHODS Using data from a longitudinal study of adolescents in rural Malawi followed through young adulthood, individual-level fixed-effects regressions that account for time-invariant factors were used to investigate differences in child marriage status on the extent to which grade attainment, reading, and numeracy skills lead to higher participation in paid work and reduce participation in unpaid work. Gender differences in these relationships were explored. RESULTS Prevalence of child marriage is high for young women (53% vs. 6% for men), and participation in paid work low (7% vs. 42% for men). Attainment of six grades among young married women and nine grades among young married men was associated with paid work irrespective of child marriage. Reading with comprehension in two languages was associated with paid work for young men married as adults (coefficient = .27, p ≤ .01). Numeracy was associated with paid work among unmarried young women (coefficient = .04, p ≤ .01). Negative associations between grade attainment and unpaid work were found for young women married at ages 16-17 and unmarried, while positive associations were found for young unmarried men. CONCLUSIONS The relationship between education and work among young people in Malawi is compromised by related challenges of poor learning and continued high levels of child and young adult marriage.
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Baten J, Llorca-Jaña M. Inequality, low-intensity immigration and human capital formation in the regions of Chile, 1820-1939. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101030. [PMID: 34171763 DOI: 10.1016/j.ehb.2021.101030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/08/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
This article traces inequality and numeracy development in the regions of Chile during the 19th and early 20th century. Inequality, measured with anthropometric methods, was associated with a lower speed of human capital formation. Not all talents received the necessary education to make full use of their talent for the regional economy, especially in the south in the early period. However, Chile became slightly less unequal over time and more numerate during the late 19th century. In addition, we study the correlates of low-intensity immigration in Chile. Regions with a relatively high share of North European migrants developed faster in terms of numeracy.
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Schonger M, Sele D. Intuition and exponential growth: bias and the roles of parameterization and complexity. MATHEMATISCHE SEMESTERBERICHTE 2021; 68:221-235. [PMID: 34795462 PMCID: PMC8386158 DOI: 10.1007/s00591-021-00306-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
Exponential growth bias is the phenomenon that humans intuitively underestimate exponential growth. This article reports on an experiment where treatments differ in the parameterization of growth: Exponential growth is communicated to one group in terms of growth rates, and in terms of doubling times to the other. Exponential growth bias is much smaller when doubling times are employed. Considering that in many applications, individuals face a choice between different growth rates, rather than between exponential growth and zero growth, we ask a question where growth is reduced from high to low. Subjects vastly underestimate the effect of this reduction, though less so in the parameterization using doubling times. The answers to this question are more severely biased than one would expect from the answers to the exponential growth questions. These biases emerge despite the sample being highly educated and exhibiting awareness of exponential growth bias. Implications for teaching, the usefulness of heuristics, and policy are discussed.
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Revisiting the Open Sampling format: Improving risky choices through a novel graphical representation. Psychon Bull Rev 2021; 29:648-659. [PMID: 34731442 PMCID: PMC9038808 DOI: 10.3758/s13423-021-02018-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/08/2022]
Abstract
When making risky choices, people often fall short of the norm of expected value (EV) maximization. Previous research has shown that presenting options in the Open Sampling (OSa) format, a 10-by-10 matrix of randomly arranged outcomes, can improve choices and reduce decision times. First, the current research aims to replicate and extend the findings on the OSa format. To this end, we compare OSa to the common description-based format as well as further graphical representations, and investigate the resulting accordance with EV maximization and decision time. Second, we study whether people lower (vs. higher) in numeracy, the ability to use probabilistic and mathematical concepts, particularly benefit from a graphical representation of options. We conducted five high-powered studies (total N = 1,575) in which participants chose repeatedly between two risky gambles, using different populations and gamble-problem sets. Overall, we could not find a benefit of the OSa format in terms of EV accordance in any of the five studies. However, three studies also tested a novel variant of the OSa format with grouped outcomes and found that it consistently improved EV accordance compared with all other formats. All graphical formats led to faster decisions without harming decision quality. The effects of presentation format were not moderated by numeracy in three of the four studies that assessed numeracy. In conclusion, our research introduces a new presentation format which consistently improves risky choices and can also be used to communicate risks in applied contexts such as medical decision making.
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Why do early mathematics skills predict later mathematics and reading achievement? The role of executive function. J Exp Child Psychol 2021; 214:105306. [PMID: 34655996 DOI: 10.1016/j.jecp.2021.105306] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 11/22/2022]
Abstract
A robust association between young children's early mathematical proficiency and later academic achievement is well established. Less is known about the mechanisms through which early mathematics skills may contribute to later mathematics and especially reading achievement. Using a parallel multiple mediator model, the current study investigated whether executive function (integration of working memory, inhibition, and cognitive flexibility) can explain the relations between early mathematics skills and elementary school mathematics and reading achievement. Data in this longitudinal study were collected from 243 children during the last year of early childhood education and care (kindergarten ages 5 and 6 years), 1 year later in first grade, and 5 years later when the children were in fifth grade. Background variables (maternal education, age, sex, and immigrant status), kindergarten baseline skills, and mediating effects of first-grade mathematics, phonological awareness, vocabulary, and possible omitted variables were controlled. Results showed that first-grade executive function mediated the effects of kindergarten mathematics on fifth-grade mathematics and on reading achievement. These findings suggest that executive function may work as a mechanism that may help to explain the frequently found strong association between children's early mathematics skills and later mathematics and reading achievement.
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Becker M, Litkowski EC, Duncan RJ, Schmitt SA, Elicker J, Purpura DJ. Parents' math anxiety and mathematics performance of pre-kindergarten children. J Exp Child Psychol 2021; 214:105302. [PMID: 34624707 DOI: 10.1016/j.jecp.2021.105302] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 09/01/2021] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Abstract
Prior research demonstrates that individuals' math anxiety may be negatively related to their mathematics performance. However, little research has examined how caregivers' math anxiety is associated with children's mathematics performance prior to kindergarten. The purpose of this study was to investigate the relation between parents' math anxiety and the change in children's mathematics performance during the preschool year. Participants were 310 preschool-age children (155 female; 4.12-5.78 years of age, M = 5.20 years, SD = 0.29). Structural equation modeling results demonstrated that parents' math anxiety was significantly negatively related to change in children's mathematics performance during the pre-kindergarten year when controlling for fall mathematics performance and demographics. Moreover, multigroup path analyses revealed that this association did not differ for male versus female children.
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Edward JS, Rayens MK, Zheng X, Vanderpool RC. The association of health insurance literacy and numeracy with financial toxicity and hardships among colorectal cancer survivors. Support Care Cancer 2021; 29:5673-5680. [PMID: 33594514 PMCID: PMC8368090 DOI: 10.1007/s00520-021-06036-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE In this study, we examined the association of financial hardship measured by material financial burden and financial toxicity with health insurance literacy and numeracy among colorectal cancer survivors. The lack of evidence on the impact of cost-related health literacy, specifically health insurance literacy and numeracy, on financial toxicity among cancer survivors warrants further research. METHODS Between January and November 2019, we used a cross-sectional research design to collect surveys from 104 colorectal cancer survivors (diagnosed within last 5 years) from the Kentucky Cancer Registry. Survey items assessed health insurance literacy (measured by confidence and behaviors in choosing and using health insurance), numeracy, material financial burden, and financial toxicity, in addition to socio-demographic variables. Survey data were subsequently linked to the participant's cancer registry record. Data were analyzed using descriptive, bivariate, and multiple linear regression analyses. RESULTS The mean financial toxicity score was 24.5, with scores ranging from 3 to 43 (higher scores indicating greater financial toxicity). Eighty percent of participants indicated they had experienced one or more material burdens related to their cancer. The majority had adequate health insurance (79%); however, the majority also had low numeracy (84%). After controlling for socio-demographic covariates, significant predictors of greater financial toxicity were high material burden scores, low health insurance literacy, and low numeracy. CONCLUSIONS Findings indicate the need to develop programs and interventions aimed at improving health insurance literacy and numeracy as a strategy for reducing financial toxicity and hardships among colorectal cancer survivors.
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Shoots-Reinhard B, Goodwin R, Bjälkebring P, Markowitz DM, Silverstein MC, Peters E. Ability-related political polarization in the COVID-19 pandemic. INTELLIGENCE 2021; 88:101580. [PMID: 34566199 PMCID: PMC8455947 DOI: 10.1016/j.intell.2021.101580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/08/2021] [Accepted: 08/07/2021] [Indexed: 11/10/2022]
Abstract
In two large-scale longitudinal datasets (combined N = 5761), we investigated ability-related political polarization in responses to the COVID-19 pandemic. We observed more polarization with greater ability in emotional responses, risk perceptions, and product-purchase intentions across five waves of data collection with a diverse, convenience sample from February 2020 through July 2020 (Study 1, N = 1267). Specifically, more liberal participants had more negative emotional responses and greater risk perceptions of COVID-19 than conservative participants. Compared to conservatives, liberal participants also interpreted quantitative information as indicating higher COVID-19 risk and sought COVID-related news more from liberal than conservative news media. Of key importance, we also compared verbal and numeric cognitive abilities for their independent capacity to predict greater polarization. Although measures of numeric ability, such as objective numeracy, are often used to index ability-related polarization, ideological differences were more pronounced among those higher in verbal ability specifically. Similar results emerged in secondary analysis of risk perceptions in a nationally representative longitudinal dataset (Study 2, N = 4494; emotions and purchase intentions were not included in this dataset). We further confirmed verbal-ability-related polarization findings on non-COVID policy attitudes (i.e., weapons bans and Medicare-for-all) measured cross-sectionally. The present Study 2 documented ability-related polarization emerging over time for the first time (rather than simply measuring polarization in existing beliefs). Both studies demonstrated verbal ability measures as the most robust predictors of ability-related polarization. Together, these results suggest that polarization may be a function of the amount and/or application of verbal knowledge rather than selective application of quantitative reasoning skills.
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Benda NC, Yang Z, Li H, Zhang T, Ancker JS. Lower objectively and subjectively assessed numeracy are both associated with poorer self-rated health. BMC Res Notes 2021; 14:321. [PMID: 34419167 PMCID: PMC8379725 DOI: 10.1186/s13104-021-05737-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/11/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To compare an objective with a subjective numeracy assessment for association with self-reported health status, where numeracy refers to “the degree to which individuals have the capacity to access, process, interpret, communicate, and act on numerical, quantitative, graphical, biostatistical, and probabilistic health information needed to make effective health decisions” Results We completed a secondary analysis of two population-based surveys, the Empire State Poll (n = 763) and the Program for the International Assessment of Adult Competencies (PIAAC; n = 2609). The first survey assessed numeracy with a 3-item subjective instrument. The second assessed numeracy with more than 20 math problems. Both used the same measure for self-reported health status. Lower numeracy, whether subjectively or objectively assessed, was associated with worse self-reported health, even after controlling for education and other sociodemographic confounders. The odds ratios for the association were very similar (0.91 and 0.90 respectively). A lengthy objective numeracy assessment and a brief self-report assessment had similar associations with health status. A brief self-report measure of numeracy has similar properties to a lengthy objective assessment and is likely to be more feasible to use to screen patients in practice. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05737-y.
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Abstract
Covariation information can be used to infer whether a causal link plausibly exists between two dichotomous variables, and such judgments of contingency are central to many critical and everyday decisions. However, individuals do not always interpret and integrate covariation information effectively, an issue that may be compounded by limited numeracy skills, and they often resort to the use of heuristics, which can result in inaccurate judgments. This experiment investigated whether presenting covariation information in a composite bar chart increased accuracy of contingency judgments, and whether it can mitigate errors driven by low numeracy skills. Participants completed an online questionnaire, which consisted of an 11-item numeracy scale and three covariation problems that varied in level of difficulty, involving a fictitious fertilizer and its impact on whether a plant bloomed or not. Half received summary covariation information in a composite bar chart, and half in a 2 × 2 matrix that summarized event frequencies. Viewing the composite bar charts increased accuracy of individuals both high and low in numeracy, regardless of problem difficulty, resulted in more consistent judgments that were closer to the normatively correct value, and increased the likelihood of detecting the correct direction of association. Findings are consistent with prior work, suggesting that composite bar charts are an effective way to improve covariation judgment and have potential for use in the domain of health risk communication.
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Gunderson EA, Hildebrand L. Relations among spatial skills, number line estimation, and exact and approximate calculation in young children. J Exp Child Psychol 2021; 212:105251. [PMID: 34333360 DOI: 10.1016/j.jecp.2021.105251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 06/25/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
Decades of research have established that spatial skills correlate with numerical skills. However, because both spatial and numerical skills are multidimensional, we sought to determine how specific spatial skills relate to specific numeracy skills. We used a cohort-sequential design, assessing a large diverse sample of students (N = 612, initially in pre-kindergarten [pre-K]-3rd grade, 4-9 years of age) at four time points spanning 2 years. We examined how initial levels of five spatial skills (visuospatial working memory [VSWM], mental transformation, mental rotation, proportional reasoning, and analog magnitude system [AMS] acuity) related to initial levels and growth rates in exact and approximate calculation skills, and we further investigated number line estimation as a potential mediator. We found unique patterns of relations between spatial skills and numeracy. Initial levels of mental rotation, proportional reasoning, and AMS acuity related to initial levels of exact calculation skill; initial levels of AMS acuity related to initial levels of approximate calculation; and initial levels of proportional reasoning related to initial levels of number line estimation. VSWM and mental transformation did not relate to numeracy skills after controlling for other spatial skills. Initial levels of number line estimation related to both exact and approximate calculation after controlling for spatial skills. Notably, neither spatial skills nor number line estimation predicted growth in exact or approximate calculation skills. These results indicate that there is specificity in the time-invariant relations between spatial skills and numeracy, and they suggest that researchers and educators should treat spatial skills and numeracy as multidimensional constructs with complex and unique interrelations.
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Garrido D, Petrova D, Cokely E, Carballo G, Garcia-Retamero R. Parental Risk Literacy is Related to Quality of Life in Spanish Families of Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:2475-2484. [PMID: 33000393 DOI: 10.1007/s10803-020-04733-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Families of children with autism spectrum disorder (ASD) often experience much more negative perceptions of their family quality of life (FQoL). To investigate key factors that may shape these experiences, we conducted a case-control study of sixty-one Spanish families (29 with a child with ASD) using a broad psychosocial assessment (e.g., ASD severity, social support, demographics), including the first direct test of the relationship between FQoL and parental risk literacy (i.e., the ability to evaluate and understand risk, as measured by numeracy). Results revealed that numeracy was associated with differences in perceived FQoL among families of children with ASD (R2 = .10), a finding that held across several models statistically controlling for the influence of other variables. Findings suggest that parental risk literacy skills may generally be associated with differences in decision making vulnerabilities (e.g., risk evaluation and interpretation) that influence family outcomes including FQoL.
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Byrd N, Białek M. Your health vs. my liberty: Philosophical beliefs dominated reflection and identifiable victim effects when predicting public health recommendation compliance during the COVID-19 pandemic. Cognition 2021; 212:104649. [PMID: 33756152 PMCID: PMC8599940 DOI: 10.1016/j.cognition.2021.104649] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 12/16/2022]
Abstract
In response to crises, people sometimes prioritize fewer specific identifiable victims over many unspecified statistical victims. How other factors can explain this bias remains unclear. So two experiments investigated how complying with public health recommendations during the COVID19 pandemic depended on victim portrayal, reflection, and philosophical beliefs (Total N = 998). Only one experiment found that messaging about individual victims increased compliance compared to messaging about statistical victims-i.e., "flatten the curve" graphs-an effect that was undetected after controlling for other factors. However, messaging about flu (vs. COVID19) indirectly reduced compliance by reducing perceived threat of the pandemic. Nevertheless, moral beliefs predicted compliance better than messaging and reflection in both experiments. The second experiment's additional measures revealed that religiosity, political preferences, and beliefs about science also predicted compliance. This suggests that flouting public health recommendations may be less about ineffective messaging or reasoning than philosophical differences.
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Sanders M, Tobin JN, Cassells A, Carroll J, Holder T, Thomas M, Luque A, Fiscella K. Can a brief peer-led group training intervention improve health literacy in persons living with HIV? Results from a randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2021; 104:1176-1182. [PMID: 33221117 DOI: 10.1016/j.pec.2020.10.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/13/2020] [Accepted: 10/24/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The goal of this study was to determine if a 6-week, peer-led intervention improves health literacy and numeracy among people living with HIV (PLWH). METHODS We used a randomized controlled trial with repeated measurements, which included six, 90-minute, group-based training sessions. We recruited PLWH participants (n = 359) from safety-net practices in the New York City Metropolitan area and Rochester, NY. Participants were randomly assigned (1:1) to an intervention group (n = 180) or a control group (n = 179). Outcome measures were collected at baseline, eight weeks post-baseline, and at six months using the Brief Estimate of Health Knowledge and Action-HIV (BEHKA-HIV), the Electronic Health Literacy Scale (eHEALS), the Rapid Estimate of Adult Literacy (REALM), and the Newest Vital Sign (NVS). RESULTS The intervention group had statistically significant improvements in eHealth literacy and BEHKA-HIV compared to the control group. There were no statistically significant changes in general health literacy or numeracy in either group. The intervention had the greatest impact on participants with the lowest levels of eHealth literacy at baseline. CONCLUSION The intervention had a positive impact on participants' HIV health literacy and eHealth literacy. PRACTICE IMPLICATIONS Our findings have implications for broadening the function of peer-workers in the health care continuum.
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Mulas I, Ruiu M, Fastame MC. The role of cognitive reserve as mediator for addition and multiplication skills in late adulthood. Aging Clin Exp Res 2021; 33:1377-1382. [PMID: 32557230 DOI: 10.1007/s40520-020-01632-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/09/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The role played by cognitive reserve for the maintenance of numeracy skills in late adulthood is still not sufficiently explored. AIMS This study mainly investigated whether cognitive reserve (i.e., vocabulary) mediates on the relationship between non-verbal reasoning and addition and multiplication skills of older individuals. Moreover, the impact of schooling and gender on written calculation was examined, controlling for the effect of cognitive decline. METHODS One hundred and six 68-94-year-old participants completed a battery of tests assessing numeracy, executive functions, and cognitive reserve skills. RESULTS Significant correlations were found between age, cognitive reserve, numeracy, and executive functions measures. Besides, mediation analyses indicated that cognitive reserve and non-verbal reasoning explain 23% and 29% of the variance in written addition and multiplication conditions, respectively. Finally, more educated individuals performed better numeracy tasks, whereas the solution of additions and multiplications was not impact by gender. CONCLUSIONS Cognitive reserve impacts numeracy in late adulthood.
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Davis KW, Roter DL, Schmidlen T, Scheinfeldt LB, Klein WMP. Testing a best practices risk result format to communicate genetic risks. PATIENT EDUCATION AND COUNSELING 2021; 104:936-943. [PMID: 33131927 PMCID: PMC8053732 DOI: 10.1016/j.pec.2020.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 08/09/2020] [Accepted: 10/15/2020] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To investigate the effect of a genetic report format using risk communication "best-practices" on risk perceptions, in part to reduce risk overestimates. METHODS Adults (N = 470) from the Coriell Personalized Medicine Collaborative (CPMC) were randomized to a 2 × 2 experimental design to receive a hypothetical "personalized" genetic risk result for leukemia (relative risk = 1.5 or 2.5) through either the standard CPMC report (N = 232) or an enriched report informed by best practices (N = 238). A one-time, online survey assessed numeracy and risk perceptions including "feelings of risk" and a numerical estimate. RESULTS Regardless of numeracy, participants who received the enriched report had fewer overestimates of their lifetime risk estimate (LRE; odds ratio = 0.19, p < .001) and lower feelings of risk on two of three measures (p < .001). Participants with higher numeracy scores had fewer overestimates of LRE (OR = 0.66, p < .001) and lower feelings of risk on two out of three measures (p ≤ .01); the interaction between numeracy and report format was non-significant. CONCLUSION The enriched report produced more accurate LRE and lower risk perceptions regardless of numeracy level, suggesting the enriched format was helpful to individuals irrespective of numeracy ability. PRACTICE IMPLICATIONS Best practice elements in risk reports may help individuals form more accurate risk perceptions.
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Sabates R, Carter E, Stern JMB. Using educational transitions to estimate learning loss due to COVID-19 school closures: The case of Complementary Basic Education in Ghana. INTERNATIONAL JOURNAL OF EDUCATIONAL DEVELOPMENT 2021; 82:102377. [PMID: 36570641 PMCID: PMC9758600 DOI: 10.1016/j.ijedudev.2021.102377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 02/01/2021] [Accepted: 02/18/2021] [Indexed: 05/31/2023]
Abstract
Learning loss is expected for millions of children who have been out of school as a result of the current COVID-19 pandemic. Unfortunately, it is uncertain how much learning will be lost and how wide the gaps may be for disadvantaged children. This paper uses a unique longitudinal dataset to estimate learning loss during a three-month transition from Complementary Basic Education to government schools in Ghana. Our results show an average learning loss of 66 % of previous learning gains in foundational numeracy during this transition period. More importantly, we estimate widening gaps in learning loss according to lack of home learning support, as well as lack of home learning resources. Our results have implications for the provision of learning activities and support at home, not just during current school closures due to COVID-19, but also during transitions between academic years.
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Qu C, Szkudlarek E, Brannon EM. Approximate multiplication in young children prior to multiplication instruction. J Exp Child Psychol 2021; 207:105116. [PMID: 33677334 DOI: 10.1016/j.jecp.2021.105116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/23/2020] [Accepted: 01/21/2021] [Indexed: 01/29/2023]
Abstract
Prior work indicates that children have an untrained ability to approximately calculate using their approximate number system (ANS). For example, children can mentally double or halve a large array of discrete objects. Here, we asked whether children can perform a true multiplication operation, flexibly attending to both the multiplier and multiplicand, prior to formal multiplication instruction. We presented 5- to 8-year-olds with nonsymbolic multiplicands (dot arrays) or symbolic multiplicands (Arabic numerals) ranging from 2 to 12 and with nonsymbolic multipliers ranging from 2 to 8. Children compared each imagined product with a visible comparison quantity. Children performed with above-chance accuracy on both nonsymbolic and symbolic approximate multiplication, and their performance was dependent on the ratio between the imagined product and the comparison target. Children who could not solve any single-digit symbolic multiplication equations (e.g., 2 × 3) on a basic math test were nevertheless successful on both our approximate multiplication tasks, indicating that children have an intuitive sense of multiplication that emerges independent of formal instruction about symbolic multiplication. Nonsymbolic multiplication performance mediated the relation between children's Weber fraction and symbolic math abilities, suggesting a pathway by which the ANS contributes to children's emerging symbolic math competence. These findings may inform future educational interventions that allow children to use their basic arithmetic intuition as a scaffold to facilitate symbolic math learning.
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Albrechtsen RD, Goodman MS, Bather JR, Kaphingst KA. Impact of numeracy preferences on information needs for genome sequencing results. PATIENT EDUCATION AND COUNSELING 2021; 104:467-472. [PMID: 33036816 PMCID: PMC7965229 DOI: 10.1016/j.pec.2020.09.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 09/05/2020] [Accepted: 09/22/2020] [Indexed: 05/30/2023]
Abstract
OBJECTIVE This study investigated how self-reported numeracy ability and preferences predict preferences for the amount and types of information provided about genome sequencing results among 1080 women diagnosed with breast cancer at age 40 or younger. METHODS Participants reported their level of interest in 14 topics related to genome sequencing results on a survey. We calculated a Participant Information Needs (PIN) value based on the number of topics for which a participant wanted "a lot" of information. Numeracy was assessed using the Subjective Numeracy Scale. Analyses examined associations between the numeracy ability and preferences subscales, information needs for individual content topics, and PIN. RESULTS Higher preference for numeric data was correlated with increased PIN (β = 0.60, p < 0.01), while numeric ability was not correlated (β=0.16, p = 0.22). Family composition and knowledge about sequencing benefits were also significant covariates. Patients most preferred information on topics related to disease risk and health implications. CONCLUSION There may be utility in separating numeracy ability and preferences into two components in future research in order to investigate how numeracy impacts the return of genetic testing results. PRACTICE IMPLICATIONS These data suggest that numeracy preferences may be important to inform strategies for the return of genetic results.
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Maessen S, Schaughency E, Dawes P, Galland B. Emergent academic skills growth in New Zealand pre-school children undergoing treatment for sleep disordered breathing: a case-control pilot study. Sleep Med 2021; 80:77-85. [PMID: 33581386 DOI: 10.1016/j.sleep.2021.01.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The main objective of this study was to explore the feasibility and treatment sensitivity of measures of preschool oral language and emergent literacy and numeracy for assessing developing skills of preschool children with sleep disordered breathing (SDB) in New Zealand following adenotonsillectomy. METHODS Eight preschool children aged 3 years 1 month-4 years 5 months were recruited from a surgical waiting list and matched to controls for age (±3 months) and sex. Tasks designed to be sensitive to growth in oral language and emergent literacy and numeracy were reviewed for contextual fit, adapted as necessary for the New Zealand context, and administered before surgery (baseline), three months post-surgery, and at a seven-month follow-up alongside other measures. RESULTS Growth in oral language and emergent literacy was greater for case children than matched controls, suggesting that the tasks were sensitive to treatment effects. No such effect was observed for early numeracy tasks. Case children had more symptoms of SDB and behavioral and emotional difficulties than matched controls prior to surgery, and improvements were reported in these domains following surgery. CONCLUSIONS Oral language and emergent literacy measures trialled in the present research showed potential for evaluating treatment outcomes in pre-schoolers with SDB, and provided preliminary evidence that early treatment of SDB could have positive effects on learning in these domains.
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Drelles K, Pilarski R, Manickam K, Shoben AB, Toland AE. Impact of Previous Genetic Counseling and Objective Numeracy on Accurate Interpretation of a Pharmacogenetics Test Report. Public Health Genomics 2021; 24:26-32. [PMID: 33445171 DOI: 10.1159/000512476] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/20/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Pharmacogenetic (PGx) testing can be useful for providing information about a patient's drug response by increasing drug efficacy and decreasing the incidence of adverse drug events. While PGx tests were previously only offered to patients under healthcare provider supervision, they are now available as direct to consumer (DTC) tests. This study aimed to assess how accurately individuals from the general population were able to interpret a sample PGx test report and if accuracy differed based on individuals' numeracy or prior genetic counseling (GC). METHODS We surveyed 293 individuals from the general population, ascertained through ResearchMatch. The survey included questions about PGx test interpretation, numeracy, and genetic literacy. RESULTS In our cohort, numeracy level impacted PGx result interpretation, with those of high numeracy performing statistically significantly better on both the table format and graphical format (p value = 0.002 and p value <0.001, respectively) and genetic knowledge questions (p value <0.001) than those with low/average numeracy. In addition, previous GC did not impact test interpretation or genetic knowledge, but the number of individuals with prior GC was small (n = 26). DISCUSSION/CONCLUSION We found that numeracy had a significant impact on correct interpretation of PGx test reports. Because many individuals in the USA have low numeracy levels, it is extremely important that patients do not make their own medication management decision based on the test results and that they consult with their physicians about their PGx testing. The importance of consultation and discussion with providers about results should be emphasized on the test report.
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van Weert JCM, Alblas MC, van Dijk L, Jansen J. Preference for and understanding of graphs presenting health risk information. The role of age, health literacy, numeracy and graph literacy. PATIENT EDUCATION AND COUNSELING 2021; 104:109-117. [PMID: 32727670 DOI: 10.1016/j.pec.2020.06.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/27/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To investigate 1) younger (< 65) and older (> 65) adults' preference for and understanding of graph formats presenting risk information, and 2) the contribution of age, health literacy, numeracy and graph literacy in understanding information. MATERIALS AND METHODS To assess preferences, participants (n = 219 < 65 and n = 227>65) were exposed to a storyboard presenting six types of graphs. Understanding (verbatim and gist knowledge) was assessed in an experiment using a 6 (graphs: clock, bar, sparkplug, table, pie vs pictograph) by 2 (age: younger [<65] vs older [>65]) between-subjects design. RESULTS Most participants preferred clock, pie or bar chart. Pie was not well understood by both younger and older people, and clock not by older people. Bar was fairly well understood in both groups. Table yielded high knowledge scores, particularly in the older group. Lower age, higher numeracy and higher graph literacy contributed to higher verbatim knowledge scores. Higher health literacy and graph literacy were associated with higher gist knowledge. DISCUSSION AND CONCLUSION Although not the preferred format, tables are best understood by older adults. PRACTICE IMPLICATIONS Graph literacy skills are essential for both verbatim and gist understanding, and are important to take into account when developing risk information.
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Follong BM, Prieto-Rodriguez E, Miller A, Collins CE, Bucher T. Integrating nutrition into the mathematics curriculum in Australian primary schools: protocol for a randomised controlled trial. Nutr J 2020; 19:128. [PMID: 33243231 PMCID: PMC7694306 DOI: 10.1186/s12937-020-00640-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/29/2020] [Indexed: 11/18/2022] Open
Abstract
Background Nutrition education programs in schools have been effective in improving children’s knowledge and behaviours related to food and nutrition. However, teachers find it challenging to implement such programs due to overcrowded curricula. Integrating nutrition with core subjects such as mathematics could potentially address time constraints and improve the learning of both. The primary aim of this randomized controlled trial (RCT) is to evaluate the impact of a cross-curricular nutrition and mathematics program on primary school students’ portion size estimation skills. Secondary aims include impact on their nutrition knowledge, attitudes towards mathematics and evaluating the quality of the lessons. Methods Twelve Year 3–4 classes from Catholic schools in New South Wales, Australia will be randomised to intervention (n = 6) or control (n = 6) groups. Teachers in the intervention group will receive a professional development workshop and resources to teach 4–5 lessons on portion size and measurements across 1–4 weeks. Outcome measures include portion size estimation skills, nutrition knowledge and attitudes towards mathematics, with data collected during three school visits (pre-intervention, immediately post-intervention, 4 weeks post-intervention). Additionally, teaching quality will be assessed in both intervention and control groups and process evaluation undertaken using teacher interviews and student focus groups. Discussion This RCT uses an innovative approach to improve both nutrition and mathematics related learning outcomes among primary school children. It has the potential to impact teaching practices regarding integration of nutrition into curricula and enhance the implementation of nutrition education interventions. Trial registration Australian and New Zealand Clinical Trials Register ACTRN12619001071112 31/07/2019.
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