Doctor’s Orders

“Is it just me, or was that doctor [a jerk]*?”

It wasn’t just her. He was judgemental, condescending, and refused to listen to us. My housemates and I may not have been doctors, but we were not ignorant. I was three-quarters of the way through a genetics degree and four months later, the two of them were accepted into med school. We knew a little bit about the human body.  Still, the doctor clearly saw us as three foolish clubbers.

As an accident prone child, I have dealt with a lot of hospital doctors over the years. Most of the time they are efficient, concerned and proffessional. Still, communication between health care proffessionals and lay people can be improved.

According to Lee and Garvin (2003) the general assumption of health care providers is that people act unhealthly because they don’t know any better. Therefore, if you just give people more information they will improve their health. Tell people they need to get pap tested regularly to avoid dying of cervical cancer and they will go get pap tests.  Except this ideology doesn’t take into account social factors such as being too poor to pay for medical tests, transportation or medication should something actually be wrong.

Sometimes a person’s physical well-being looses out to thier social well-being. I know I’ve done some ill-advised things to fit in. What if you know drinking and smoking are bad, but you come from a culture where you cannot refuse a senior collegue who is offering you a smoke and a drink?  I know sun tanning causes cancer, but my society insists people are much more attractive with a tan. What to do? Well I suppose I could move to China where pale skin is sexy, but that seems a bit extreame. In these situations usually people will just ignore the health advice.

Besides blaming the individual for their poor life choices, health care providers also tend to assume that they understand the situation best, based on the fact they are the experts and lay people are not. I may not know all the symptoms of cerbral palsy but I know my body. This ‘I am a doctor and therefore I know better than you’ leads to a monologue where the doctors/experts just tell their patients (lay public) what they should know.

Instead of this one way information transfer Lee and Garvin suggest health care should move to a two way information exchange. In the future if you tell a doctor that you have tried a medication before without any results then the doctor should listen to you instead of prescribing it anyway.

Still, I think about about all the pseudoscience cures the public can access online and wonder what new challenges an information exchange between the public and health care systems will bring. Do you think it’s important for doctor and patients to discuss both homeopathy and chemotherapy when choosing how to treat cancer? Will an exchange be more or less beneficial? Please leave your comments below so that we too can engage in an information exchange.

*as this is a university assignment I felt it necessary to sensor the actual quote.

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DeTurk, M. (2009). Adam’s a doctor [photo]. Retrieved from http://www.flickr.com/photos/dalboz17/4274454323/

Lee, R. & Garvin T. (2003). Moving from information transfer to information exchanged in health and health care. Social science & Medicine, 56, 449-464.

Scientific Scandal – A Look at the Deficit Model

Is a lack of scientific knowledge the main reason the public can be at odds with the scientific community? Would people be more supportive of nuclear technologies and genetic research if they simply knew more about it?

The assumption that it is a lack of public understanding or knowledge that has led to the present climate of scepticism toward science underpins what has become to be known as the ‘deficit model’. (Layton, 1993)

Not surprisingly this model has come under a lot of critiscm; there are surely other reasons such as culture, religion or world-views, such as environmentalism (Slovic and Peters, 1998), that can lead to misperceptions of risk. The model is seen as too normative and simple, and so Sturgis and Allum try to re-evaluate it and find out how important knowledge is when addressing public discontent with the scientific community and their research.

Through a series of quantitative tests we end up with an interesting conclusion. Our response to scientific news can be closely related to our response to political events. Those with low levels of political knowledge tend to see political scandals as much more serious than those with higher levels of political knowledge. We all know about the scandal involving former US president Bill Clinton: The research suggests that those with higher levels of political knowledge and experience would not have attributed the behaviour to his character unlike those with less political knowledge.

Sturgis and Allum relate this evidence to science, arguing that ‘with a greater degree of political understanding and awareness, it may be that people are less likely to attribute the less fortunate outcomes of scientific development to the bad character of scientists or politicians but to a more complex set of institutional, political and other ‘situational’ factors.’

So at the end of the day it seems this paper confirms that scientific knowledge (or at least, knowledge of the wider range of circumstances surrounding the science) can be a major factor of a persons response and could explain why the public react badly to some scientific advancements where other contextual factors are barely present.

Do you think this study is accurate? To what degree does already existing knowledge (both scientific and political) play a part in the public’s reaction to science?

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Written by Aaron Cull.

Based on the paper: Sturgis, & Allum, N. (2004). Science in Society: Re-Evaluating the Deficit Model of Public Attitudes. Public Understanding of Science, 13(1), 55-74. [Full Paper]

References:

D. Layton, E. Jenkins, S. McGill and A. Davey, Inarticulate science? perspectives on the public understanding of science and some implications for science education (East Yorkshire: Studies in Education Ltd, 1993).

P. Slovic and E. Peters, “The Importance of Worldviews in Risk Perception,” Journal of Risk Decision and Policy, volume 3, 2 1998, pp. 165-170.

Can you change your behavior?

Last semester, I put on 7kg.  Since then, I have kept saying “I need to lose weight!  I need to exercise!”  However, till now, I haven’t done any exercise.  I guess it is not only me who has experienced a diet failure.

“Be friendly to environment” is another example of a failure to change behavior. The media says we need to act friendly towards the environment.

But can you shorten your shower time starting tonight for water conservation?

Can you stop driving a car and take a bus starting tomorrow to decrease the amount of CO₂ emission?

Anja K. (2010) mentioned in her paper that even though a lot of research has been done, no definitions for representing the gap between having environmental knowledge and being environmentally aware, and displaying a pro-environmental behavior have been found.  She disserts the factors that have been found to have some positive or negative effects on pro-environmental behavior, such as demographic factors, external factors and internal factors.  She also describes why people act environmentally and what the barriers to pro-environmental behavior are.

Changing people’s behavior is one of the big goals of science communicators.  However, from my experience with dieting, I know that it is really hard to change behavior in daily life even though it is required to improve ourselves, and it is even harder to change behavior just for the environment.

Anja K also mentioned that pro-environmental behavior is affected by “Situational factors”.

You might be able to ride a bicycle to university instead of driving a car if you have time and enthusiasm.  This would help you get in shape.  However, you definitely would pick a car if you are in hurry, and I have to say we are in hurry in most cases!

So, how can we force ourselves to change our behavior? Please let me know your opinion.

What happen when you mix the framing of messages and the psychology of choice?

Combining the article ‘The Framing of Decisions and the Psychology of Choice” by Amos Tversky and Daniel Kahneman and the science communication lecture “Framing Animal Welfare” by Miriam Sullivan, I will be discussing how different framing messages influence decision-makers.

What do you get when the framing of decisions and the psychology of choice combine?

Firstly, I would like to define the term “framed message”. We use this term to describe how we convey the key message to the audience. As science communicators, it is important to determine which type of frames would help the audience to understand the key message and get them to act on the message. We can adopt gain-framed (positive) or loss-framed (negative) messages as the two main strategies for persuading the audiences to make a certain choice.  Taking problems illustrated in the article, I will elaborate on how the effect of variations in framing can be powerful and useful in influencing the choices people make.

People (N = 150) were asked in a survey to make:

Decision (i) choose between:

1. A sure gain of $240 (result = 84% chose option A)
2. 25% chance to gain $1000 and 75% chance to gain nothing (result = 16% chose option B)

Decision (ii) choose between:

1. A sure loss of $750 (result = 13% chose option C)
2. 75% chance to lose $1000, and 25% chance to lose nothing (result = 87% chose option D)

From this study, the outcomes are expressed as positive and negative deviations (gain and looses).

The majority choice in decision (i) is risk adverse, in which the prospect of certainly wining $240 is more attractive compared to a risky prospect of equal or even greater expected value à this is the choice involves gaining.

On the other hand, in decision (ii), the majority of choice in decision is risk taking. The certain loss of money is less acceptable than a fairly low chance to lose nothing à this is the choice involves losing.

We can see that the two decisions are identical, but with different variations in framing, we received inconsistent responses. The question here is that why there is a switch in attitude and decision when there is a shift from risk adverse to risk taking?

From the study, they have concluded that the displeasure associated with losing a sum of money is greater than the pleasure associated with winning the same amount of money. Plus, the response to losses is more extreme compared to the responses to gains. Therefore, with these psychological principles, communicators can influence the choices people make.

Displeasure associated with losing > pleasure associated with winning

However, we should keep in mind that the principle of framing messages and the psychology of choice are useful tools for delivering the key message and it doesn’t necessarily mean that we can use these tools to manipulate people’s thoughts, decisions and actions.  This is when ethical issue kicks in!

References:

Tversky, A and Kahneman, D. 1981. The Framing of Decisions and the Psychology of Choice. Science 211
(4481): 453-458.

Drink, Drunk, Drugged

Many people in our society don’t recognise alcohol as a drug, but it is actually one of the most commonly used and abused drugs throughout the world. Even though drinking alcohol is legal after a certain age it does not mean that constant drinking is safe or healthy. It is important that people recognize the dangers of alcohol abuse.

We’ve all seen alcohol risk marketing on television and heard it on the radio. How many slogans can you remember?

Issue Involvement in a Persuasive Message

“Why is it that we rejoice at a birth and grieve at a funeral? It is because we are not the person involved.” Mark Twain

Message framing is a term used to describe the way in which a message is presented to give either positive or negative connotations.

An effectively framed message can essentially influence someone’s opinion and shape the way they think about an issue – a pretty powerful skill to have!

It’s no surprise therefore that countless studies have been conducted all over the world so that this technique can be perfected and used to convince people to buy your product, vote for you, wear sunscreen, and the list goes on.

What’s interesting is the studies have produced contradictory results. Some found that putting a positive spin (focusing on benefits gained) on a message was more persuasive than putting a negative spin (focusing on benefits lost) on a message, whilst other studies showed the reverse was true.

Several theories as to why this might be so have been put forward, one of which is issue involvement.

Issue involvement refers to your level of association with the subject matter.

Maheswaran and Myers-Levy studied the role it plays, and found that when issue involvement was high, negatively framed messages were more persuasive, whereas when issue involvement was low, positively framed messages were more persuasive.

What this means for science communication is that we really need to look our target audience and how personally relevant the message you are trying to communicate is to them.

If your goal were to convince people to accept a new bird flu vaccination, how would you frame your message in a publication such as Mother and Baby?

a)     Make an appointment to vaccinate your child today.

b)     Vaccinations can save lives

c)      If you don’t vaccinate your child they may get sick from bird flu

d)     Vaccinate your child to prevent them from getting bird flu

e)      Many lives were lost in the recent bird flu pandemic

 

Reference:

Maheswaran, D., & Meyers-Levy, J. (1990). The influence of message framing and issue involvement. Journal of Marketing Research, 27, 361-367.

 

The Psychology of Choice

In the article ‘The Framing of Decisions and the Psychology of Choice’ by Amos Tversky and Daniel Kahneman, the event of decision making is explored.

A problem that was described in the article that I thought really outlined its magnitude was this,

The Us is is preparing for the outbreak of an unusual Asian disease, which is expected to kill 600 people. two alternative programs to combat the disease have been proposed. Assume that the exact scientific estimate of the consequences of the program are as follows:

if program A is adopted, 200 people will be saved

if program B is adopted, there is a 1/3 probability that 600 people will be saved and a 2/3 probability that no people will be saved.

When asked this in a survey 72 percent of people chose program A and 28 percent chose program B.

Yet when the same question was asked with program A being phrased as ‘if program A is adopted, 400 people will die‘ the statistics changed hugely with only 22 percent of people choosing program A and then 78 percent choosing program B- showing a complete shift in the peoples choices!

I think this example really highlights how psychology and framing could be used to influence other people decisions. this example is very effective as it uses peoples lives in a risk taking example, but the same concept could really be applied to any decision whether it be a life changing event or simply choosing which brand of hairdryer to buy.

when using psychology to get people to make certain decisions the certainty effect and the pseudocertainty effect are also important elements. the certainty effect can appear when there is a certain outcome rather than just a probable one, the pseudocertainty effect is when there is an unjustified sense of certainty. For example a previous win of $10 in a game with friends might lead you to make the same decision that led to the win rather than reevaluating new options.

This article really makes you think about decisions, when someone gives you an choice to make- is it really an obvious decision or does it just seem like it is? is it possible to be given a choice and it not be influenced psychologically? for the statement to be completely unframed? and finally is it ethical to purposely frame a decision when presenting a choice to someone else?

References:

Tversky, A and Kahneman, D. 1981. The Framing of Decisions and the Psychology of Choice. Science 211
(4481): 453-458.