What can we learn from social cognition research? Advancing inquiry into the causes of race/ethnicity disparities in treatment received - PowerPoint PPT Presentation

About This Presentation

What can we learn from social cognition research? Advancing inquiry into the causes of race/ethnicity disparities in treatment received


Title: The Value and Implications of Research and Theory on Social Cognition and Interaction for Research and Intervention in Race/Ethnicity Disparities in Health Care – PowerPoint PPT presentation

Number of Views:368
Avg rating:3.0/5.0
Slides: 46
Provided by: VHAMIN3


Transcript and Presenter's Notes

Title: What can we learn from social cognition research? Advancing inquiry into the causes of race/ethnicity disparities in treatment received

What can we learn from social cognition research?
Advancing inquiry into the causes of
race/ethnicity disparities in treatment received
  • Michelle van Ryn, M.P.H., Ph.D.
  • Associate Professor, Division of Epidemiology,
  • University of Minnesota, Suite 300 1300 S. 2nd
  • Minneapolis, MN 55454-1015
  • Director, Colorectal Cancer Quality Enhancement
    Initiative and
  • Associate Director, Center for Chronic Disease
    Outcomes Research, Minneapolis VAMC
  • vanRyn_at_epi.umn.edu

Background and Problem
  • There is a massive body of evidence documenting
    race/ethnicity disparities in medical care,
    independent of clinical appropriateness, payer,
    and treatment site.
  • There is empirical evidence for a provider
    contribution to race/ethnicity inequities in
    access to kidney transplant and cardiac
    procedures, quality of in-hospital care,
    psychiatric care, and pain control.
  • Research on the contribution of provider behavior
    to disparities in care is in its infancy.

Theory and Research Driven Inquiry
  • What factors may be influencing the clinical
    decision-making process so as to result in
    systematically different treatment by patient
  • What areas of inquiry can be drawn on to inform
    inquiry in this understudied area?
  • What existing bodies of research and theory will
    provide insight into understanding of the effect
    of patient demographic characteristics on
    clinical decision-making?

Social Cognition Theory and Research Provides
Insight and a Framework For Inquiry.
  • Social cognition research and theory focuses on
    questions like...
  • How do we make sense of other people?
  • How do we develop our perceptions of others?
  • What factors influence the way we form beliefs
    about others?
  • How do we develop beliefs about reasons for their
    behavior (attributions)?
  • How do we make use of our social knowledge of
  • How do our beliefs about others influence our

  • There is considerable empirical evidence that
  • Demographic (age, race/ethnicity, sex) and other
    characteristics (sickness, pre-maturity,
    diagnosis) can influence physician affect
    towards, opinions, beliefs and behaviors towards
  • There is evidence that demographic
    characteristics influences the substantive
    content of encounters, including discussion of
    end-of-life care, advice to quit smoking,
    discussion of diet,exercise, mammography,
    prenatal preventive care advice regarding smoking
    cessation, alcohol use, and breastfeeding.
  • Provider behavior influences patient
    satisfaction, adherence, utilization, and
    outcomes .

Although understudied, there is some evidence
that stereotyping (social cognition) is one
mechanism through which provider treatment
recommendations are influenced by patient
  • Bogart and colleagues found that physicians were
    more likely to provide highly active
    antiretroviral therapy (HAART) to HIV/AIDS
    patients when they perceived them as likely to be
  • They then examined patient characteristics
  • associated with physician predictions of
    adherence by randomly assigning physicians to
    review patient vignettes that varied only on
    patient gender, disease severity, ethnicity, and
    risk group. African American patients were more
    likely to be rated as non-adherent independent of
    other factors.

Although understudied, there is some evidence
that stereotyping (social cognition) is one
mechanism through which provider treatment
recommendations are influenced by patient
  • van Ryn and colleagues found that physician
    ratings of patients' likelihood of having
    adequate social support and/or participating in
    cardiac rehabilitation as found to predict
    physicians' recommendations for
    revascularization, independent of clinical
    appropriateness for revascularization and other
    demographic characteristics.
  • In turn, this same group of physicians were more
    likely to rate African American patients as
    lacking in social support and unlikely to
    participate in cardiac rehabilitation than white

(No Transcript)
Primary Hypotheses
Physician Beliefs About Patient (Beliefs about
clinical factors, social and behavioral factors,
resources. Includes conscious and unconsciously
activated beliefs)
Physician Clinical Decision-making
(Diagnosis,Treatment Recommendation)
Patient Race/ethnicity
  • Providers treatment recommendations are
    influenced by perceptions of patients social and
    behavioral characteristics, which in turn are
    affected by patient demographic characteristics.

Physician Beliefs About Patient (Beliefs about
clinical factors, social and behavioral factors,
resources. Includes conscious and unconsciously
activated beliefs)
Provider Interpersonal Behavior (e.g.,
participatory style, warmth, content, information
giving, question-asking)
Patient Race/ethnicity
  • An additional hypothesized mechanism through
    which provider behavior may influence
    race/ethnicity disparities and outcomes is
    through variation in communication and
    interpersonal behaviors, which in turn may affect
    quality of care and outcomes.
  • There is considerable evidence that patient
    socio-demographic characteristics can affect
    provider participatory style, level of
    psychosocial talk, close-ended question asking,
    warmth, information giving, and communication

Stereotypes Not just for bigots
  • All humans share the cognitive strategy of making
    the world more manageable by using categorizing
    and generalizing techniques to simplify the
    massive amounts of complex information and
    stimuli to which they are exposed.
  • This generally adaptive process simplifies
    cognitive processing, reduces effort, and frees
    up cognitive resources.
  • In applying this process to the social world,
    people develop beliefs and expectations about
    categories or groups of people.
  • When individuals are mentally assigned to a
    particular class or group, the characteristics
    assigned to that group are unconsciously and
    automatically applied to the individual, a
    process referred to as stereotype application.

Stereotypes are social cognitions that contain
our knowledge, beliefs, expectations, and
feelings about a social group including
  • Causal theories about how they obtained given
  • Beliefs about degree of group variability.
  • Expectations about the traits, behaviors and
    circumstances likely for a given group or
  • Stereotypes may be connected to a feeling or
    elicit an emotional reaction (have an
    affective component).

Stereotypes are Efficient
  • Stereotypes, like all concepts, are mental
    representations of a category, or a class, of
    objects we believe belong together or hang
    together in some way. Apple, librarian, and
    cruise are all kinds concepts.
  • The use of stereotypes, like all concepts, is a
    efficient cognitive trick concepts help us
    extract meaning from the huge amount of
    information that surrounds us.
  • Stereotypes allow us to automatically activate
    and apply a great deal of information without
  • Think about what happens when you see an apple.
    What do you know about it without any conscious
    effort or thought? Do you test the degree to
    which this knowledge is true of each apple?

Stereotyping can serve to meet deep human needs
and motives.
  • The need for belonging (to ones own group vs.
  • The need to promote self-esteem through downward
    social comparison (feel superior to others).
  • The need to justify existing social order,
    distribution of resource.
  • The need to believe in a just world.

I believe in equal rights and justice I treat
all my clients/patients the same
  • Stereotype activation and application can be an
    automatic process
  • Stereotypes are often activated automatically
    (without intent).
  • Stereotypes can operate below conscious thought -
    individuals may not be aware of activation
    nor the impact on their perceptions, emotions and
  • Some studies found that stereotypes were
    activated more quickly than conscious cognition.

As a doctor, I have to be a good judge of a
patient's character.
  • Social cognition research suggests that beliefs
    about, judgments, predictions and attributions
    for others' traits and behavior are frequently
  • A massive body of communication, social
    interaction, and social cognition research has
    shown that it is common for people to apply...
  • Incorrect beliefs
  • Inaccurate theories
  • Inaccurate memories
  • Attributions errors (beliefs about causes or
    motives for others' behavior)
  • to their interpretations of others and the
    social world.

If a person doesn't fit the group stereotype it
will become clear during the encounter.
  • A large body of research shows that interactions
    tend to confirm our expectancies regardless of
  • Identical behaviors is interpreted differently
    depending on race of performer (e.g. white
    horseplay black violence).
  • There is ample evidence that people give
    different meaning to the same observed
    behavior depending on the race, class, or other
    characteristics of the person observed.

Provider-specific examples
  • Mental health diagnoses varied among adolescents
    exhibiting the identical behavior based on prior
    labeling and race.
  • Medical students and Israeli providers
    assessment of normal toddlers children was
    negatively influenced by whether they were told
    the child had been born prematurely or not.

The interpretive function of concepts lies at
the heart of one of the central lessons of
research in social cognition When we observe our
social world, we do not merely watch an objective
reality unfold before our eyes. Rather, we, take
part in shaping our own reality the concepts we
impose on events determine the meaning we extract
from them. Ziva Kunda
Our interpretation of others' behavior
influences our behavior.
  • Unconsciously activated stereotypes affect our
  • Our behavior toward others influences their
    behavior in turn (self-fulfilling prophecy).

Self-fulfilling prophesy
  • Extensively studied in educational and job
    interviewing domains. Interviewers' interpersonal
    behaviors influenced by race of applicant, and in
    turn, interviewer behavior influences application
  • White students primed by subliminal images of
    African American men were more hostile in a
    word-guessing game with a white partner. This
    hostility then elicited more hostility from naïve
    white partner.

I assess and treat each patient individually so
stereotyping isn't a problem.
  • Stereotypes are often applied in the presence of
    individuating information
  • If all we know about an individual is group
    category, we attribute characteristics of the
    group to the individual (serves a base-rate
  • Good news Individuating information does replace
    stereotypical beliefs in many cases.

Many cognitive processes result in confirmation
of expectancies (we process information in ways
that support our preconceived ideas).
  • Individual information is understood and
    interpreted through the filter of generalized
    beliefs (stereotypes) about the person.
  • This phenomena is exacerbated when individuals'
    behavior is at all ambiguous, which is more
    likely in cross-cultural communication.
  • Stereotypes have been shown to influence
    predictions about others' likely future behavior
    even in the presence of instances of stereotype-
    inconsistent behavior.

Factors that increase the likelihood of
stereotype activation characterize physicians'
  • Individuals are more likely to activate and apply
    stereotypes when they are
  • Tired
  • Distracted
  • Pressed for time
  • Anxious
  • These conditions may deplete the cognitive
    resources needed for processing individuating
    information and/or suppressing stereotypes.

Will cultural competency and anti-racism training
address this problem?
Maybe not We are often unconscious (no intention
or awareness) of the way activated stereotypes
affect our interpretation of another's behavior.
Maybe not Efforts at Stereotype Suppression can
  • When experimental participants are asked to
    suppress stereotypes in arriving at judgments of
    an individual, they can do so.
  • However, initial suppression of stereotypes leads
    to increased activation and use in other settings
    encountered shortly thereafter.

Maybe sometimes
  • There are individual and stimulus differences in
    automatic processing of stereotypes - those very
    low conscious prejudice less likely to
    automatically activate negative concepts/affect
    when stimulus is neutral, but equally likely when
    stimulus is negative.

Maybe Sometimes
  • Stereotype activation can be suppressed if it
    conflicts with other motives, such as boosting
    our feelings of self-worth.
  • If choices between alternate stereotypes and
    associated characteristics serves our interests,
    we will make that choice.
  • Desire to form rapid impressions increases
    stereotype activation and decreases attention to
    individuating information.

An Ongoing Major Debate in Social Cognition
  • How much control can we exert over automatic
    processes? Can we suppress unwanted stereotypes?

  • There is an ample body of evidence supporting the
    hypothesis that patient socio-demographic
    characteristics can independently influence
    physician expectations, perceptions, affect and
    behavior toward patients.
  • Common misunderstandings about the nature of
    social cognition in combination with unrealistic
    expectations of physicians have served as a
    barrier to advancing research and policy in this
  • The lack of research in this area profoundly
    limits our ability to develop effective

  • This literature on providers perceptions of
    patients is in its infancy and varies widely in
    type and quality of method used.
  • We do not know the circumstances under which
    provider perceptions will or will not be
    influenced by patient characteristics,
  • Nor can we predict the specific perceptions that
    will be influenced or the exact implications of a
    set of perceptions for patient care.
  • NOTE This presentation suggests a research
    agenda and a number of hypotheses to be tested
    rather than asserting proven causal relationships

Selected Challenges in Research on the Effect of
Social Cognition on Clinical Decision-Making
  • Frequently, R's must be blind to hypotheses.
  • Automatic or subconscious processes cannot be
    directly measured.
  • Unclear which specific beliefs/expectancies are
    relevant to treatment recommendations for a given
  • Measures must occur in close temporal proximity
    to exposure (encounter, videotape, etc.)
  • Responses to videotapes inadequately capture
    actual encounters and processes, unknown

Bibliography Abreu JM. Conscious and nonconscious
African American stereotypes impact on first
impression and diagnostic ratings by therapists.
J Consult Clin Psychol 1999 67(3)387-93. America
n Medical Association. 2000. Ref Type Internet
Communication Andersen SM, Klatzky RL, Murray J.
Traits and social stereotypes Efficiency
differences in the social information processing.
Journal of Personality and Social Psychology
1990 59192-201. Anderson KO, Mendoza TR, Valero
V, Richman SP, Russell C, Hurley J et al.
Minority cancer patients and their providers
pain management attitudes and practice. Cancer
2000 88(8)1929-38. Armstrong K, Berlin M,
Schwartz JS, Propert K, Ubel PA. Barriers to
influenza immunization in a low-income urban
population. Am J Prev Med 2001
20(1)21-5. Ayanian JZ, Cleary PD, Weissman JS,
Epstein AM. The effect of patients' preferences
on racial differences in access to renal
transplantation see comments. N Engl J Med
1999 341(22)1661-9. Bain DJ. Doctor-patient
communication in general practice consultations.
Med Educ 1976 10(2)125-31. Bargh J, Chen M,
Burrows L. Automaticity of Social Behavior.
Journal of Personality and Social Psychology
1996 71230-244. Bell PD, Hudson S. Equity in
the diagnosis of chest pain race and gender. Am
J Health Behav 2001 25(1)60-71. Benson PR.
Factors associated with antipsychotic drug
prescribing by southern psychiatrists. Med Care
1983 21(6)639-54. Bertakis KD, Callahan EJ,
Helms LJ, Azari R, Robbins JA, Miller J.
Physician practice styles and patient outcomes
differences between family practice and general
internal medicine. Med Care 1998
36(6)879-91. Bertakis KD, Roter D, Putnam SM.
The relationship of physician medical interview
style to patient satisfaction. J Fam Pract 1991
Bertakis KD, Roter D, Putnam SM. The relationship
of physician medical interview style to patient
satisfaction. J Fam Pract 1991
32(2)175-81. Bodenhausen GV, Kramer AM, Susser
K. Happiness and stereotypic thinking in social
judgement. Journal of Personality and Social
Psychology 1994 66621-632. Bodenhausen GV,
Sheppard LA, Kramer GP. Negative affect and
social judgement. European Journal of Social
Psychology 1994 2445-62. Bogart LM, Catz SL,
Kelly JA, Benotsch EG. Factors influencing
physicians' judgments of adherence and treatment
decisions for patients with HIV disease. Med
Decis Making 2001 21(1)28-36. Bogart LM, Kelly
JA, Catz SL, Sosman JM. Impact of medical and
nonmedical factors on physician decision making
for HIV/AIDS antiretroviral treatment. J Acquir
Immune Defic Syndr 2000 23(5)396-404. Borowsky
SJ, Rubenstein LV, Meredith LS, Camp P,
Jackson-Triche M, Wells KB. Who is at risk of
nondetection of mental health problems in primary
care? J Gen Intern Med 2000 15(6)381-8. Borum
ML, Lynn J, Zhong Z. The effects of patient race
on outcomes in seriously ill patients in SUPPORT
an overview of economic impact, medical
intervention, and end-of-life decisions. Study to
Understand Prognoses and Preferences for Outcomes
and Risks of Treatments. J Am Geriatr Soc 2000
48(5 Suppl)194-8. Brenes GA, Paskett ED.
Predictors of stage of adoption for colorectal
cancer screening. Prev Med 2000
31(4)410-6. Burk JP, Sher KJ. Labeling the child
of an Alcoholic Negative Stereotyping by Mental
Health Professionals and Peers. Journal of
Studies on Alcohol 1990 51(2)156-163. Chen,
Bargh J. Nonconscious behavioral confirmation
processes The self-fulfilling consequences of
automatic stereotype activation. Journal of
experimental social psychology 1997
33541-560. Cleeland CS, Gonin R, Baez L, Loehrer
P, Pandya KJ. Pain and treatment of pain in
minority patients with cancer. The Eastern
Cooperative Oncology Group Minority Outpatient
Pain Study. Ann Intern Med 1997
127(9)813-6. Cooper-Patrick L, Gallo JJ,
Gonzales JJ, Vu HT, Powe NR, Nelson C et al.
Race, gender, and partnership in the
patient-physician relationship. Jama 1999
Cuffe SP, Waller JL, Cuccaro ML, Pumariega AJ,
Garrison CZ. Race and gender differences in the
treatment of psychiatric disorders in young
adolescents. J Am Acad Child Adolesc Psychiatry
1995 34(11)1536-43. Curtis JR, Patrick DL,
Caldwell E, Greenlee H, Collier AC. The quality
of patient-doctor communication about end-of-life
care a study of patients with advanced AIDS and
their primary care clinicians. Aids 1999
13(9)1123-31. Darley JM, Gross PH. A hypothesis
confirming bias in labeling effects. In Stangor
C, editor. Sterotypes and Prejudice. Ann Arbor
Taylor and Francis Psychology Press,
2000. Delahanty J, Ram R, Postrado L, Balis T,
Green-Paden L, Dixon L. Differences in rates of
depression in schizophrenia by race. Schizophr
Bull 2001 27(1)29-38. DelBello MP, Lopez-Larson
MP, Soutullo CA, Strakowski SM. Effects of race
on psychiatric diagnosis of hospitalized
adolescents a retrospective chart review. J
Child Adolesc Psychopharmacol 2001
11(1)95-103. DeVellis BM, Adams JL, DeVellis RF.
Effects of information on patient stereotyping.
Res Nurs Health 1984 7(3)237-44. Devine PG.
Stereotypes and prejudice Their automatic and
controlled components. Journal of Personality and
Social Psychology 1989 565-18. Di Blasi Z,
Harkness E, Ernst E, Georgiou A, Kleijnen J.
Influence of context effects on health outcomes
a systematic review. Lancet 2001
357(9258)757-62. Doescher MP, Saver BG.
Physicians' advice to quit smoking. The glass
remains half empty. J Fam Pract 2000
49(6)543-7. Duncan BL. Differential social
perception and attribution. Journal of
Personality and Social Psychology 1976
3422-37. Dunning D, Sherman DA. Stereotypes and
tacit inference. Journal of Personality and
Social Psychology 1997 73459-471. Einbinder LC,
Schulman KA. The effect of race on the referral
process for invasive cardiac procedures. Med Care
Res Rev 2000 57(Suppl 1)162-80.
Einbinder LC, Schulman KA. The effect of race on
the referral process for invasive cardiac
procedures. Med Care Res Rev 2000 57(Suppl
1(12))162-80. Eisenberg JM. Sociologic
influences on decision-making by clinicians. Ann
Intern Med 1979 90(6)957-64. Epstein AM,
Ayanian JZ, Keogh JH, Noonan SJ, Armistead N,
Cleary PD et al. Racial disparities in access to
renal transplantation--clinically appropriate or
due to underuse or overuse? N Engl J Med 2000
343(21)1537-44. Epstein AM, Taylor WC, Seage
GR3. Effects of patients' socioeconomic status
and physicians' training and practice on
patient-doctor communication. Am J Med 1985
78(1)101-6. Etchason J, Armour B, Ofili E, Rust
G, Mayberry R, Sanders L et al. Racial and ethnic
disparities in health care. Jama 2001
285(7)883. Fiscella K, Franks P, Gold MR, Clancy
CM. Inequality in quality addressing
socioeconomic, racial, and ethnic disparities in
health care. Jama 2000 283(19)2579-84. Fiske
ST. Social cognition and social perception. Annu
Rev Psychol 1993 44155-94. Flaherty JA, Meagher
R. Measuring racial bias in inpatient treatment.
Am J Psychiatry 1980 137(6)679-82. Furth SL,
Garg PP, Neu AM, Hwang W, Fivush BA, Powe NR.
Racial differences in access to the kidney
transplant waiting list for children and
adolescents with end-stage renal disease.
Pediatrics 2000 106(4)756-61. Gerbert B.
Perceived likability and competence of simulated
patients Influence on physicians' management
plans. Social Science and Medicine 1984
181053-1059. Gilbert D.T, Hixon J.G. The trouble
of thinking Activation and application of
stereotypic beliefs. Journal of Personality and
Social Psychology 1991 60(4)509-517. Greenfield
S, Kaplan SH, Ware JE, Jr., Yano EM, Frank HJ.
Patients' participation in medical care effects
on blood sugar control and quality of life in
diabetes. J Gen Intern Med 1988
3(5)448-57. Greenlund KJ, Keenan NL, Anderson
LA, Mandelson MT, Newton KM, LaCroix AZ. Does
provider prevention orientation influence female
patients' preventive practices? Am J Prev Med
2000 19(2)104-10.
Haas JS, Weissman JS, Cleary PD, Goldberg J,
Gatsonis C, Seage GR3 et al. Discussion of
preferences for life-sustaining care by persons
with AIDS. Predictors of failure in
patient-physician communication. Arch Intern Med
1993 153(10)1241-8. Hall JA, Epstein AM,
DeCiantis ML, McNeil BJ. Physicians' liking for
their patients more evidence for the role of
affect in medical care. Health Psychol 1993
12(2)140-6. Hamilton DL. Cognitive processes in
stereotyping and intergroup behavior. Hillsdale,
NJ Erlbaum, 1981. Hamilton DL, Trolier TK.
Stereotypes and stereotyping An overview of the
cognitive approach. In Dovidio JF, Gaetner SL,
editors. Prejudice, Discrimination, and Racism.
San Diego Academic Press, 1986 127-163. Hannan
EL, van Ryn M, Burke J, Stone D, Kumar D, Arani D
et al. Access to coronary artery bypass surgery
by race/ethnicity and gender among patients who
are appropriate for surgery. Med Care 1999
37(1)68-77. Hooper EM, Comstock LM, Goodwin JM,
Goodwin JS. Patient characteristics that
influence physician behavior. Med Care 1982
20(6)630-8. Kales HC, Blow FC, Bingham CR,
Copeland LA, Mellow AM. Race and inpatient
psychiatric diagnoses among elderly veterans.
Psychiatr Serv 2000 51(6)795-800. Kales HC,
Blow FC, Bingham CR, Roberts JS, Copeland LA,
Mellow AM. Race, psychiatric diagnosis, and
mental health care utilization in older patients.
Am J Geriatr Psychiatry 2000 8(4)301-9. Kaplan
SH, Gandek B, Greenfield S, Rogers W, Ware JE.
Patient and visit characteristics related to
physicians' participatory decision-making style.
Results from the Medical Outcomes Study. Med Care
1995 33(12)1176-87. Kaplan SH, Greenfield S,
Ware JE, Jr. Assessing the effects of
physician-patient interactions on the outcomes of
chronic disease. Med Care 1989 27(3
Suppl)110-27. Kearney N, Miller M, Paul J, Smith
K. Oncology healthcare professionals' attitudes
toward elderly people. Ann Oncol 2000
11(5)599-601. Kelly CE. Bringing homophobia out
of the closet antigay bias within the
patient-physician relationship. Pharos Alpha
Omega Alpha Honor Med Soc 1992 55(1)2-8. Kelly
JA, St Lawrence JS, Smith S, Hood HV, Cook DJ.
Medical students' attitudes toward AIDS and
homosexual patients. J Med Educ 1987
Kelly JA, St Lawrence JS, Smith S, Jr., Hood HV,
Cook DJ. Stigmatization of AIDS patients by
physicians. Am J Public Health 1987
77(7)789-91. Kilgus MD, Pumariega AJ, Cuffe SP.
Influence of race on diagnosis in adolescent
psychiatric inpatients. J Am Acad Child Adolesc
Psychiatry 1995 34(1)67-72. Kogan MD,
Kotelchuck M, Alexander GR, Johnson WE. Racial
disparities in reported prenatal care advice from
health care providers see comments. Am J Public
Health 1994 84(1)82-8. Racial Variation in the
Provision of VA Dental Care The Case of Root
Canal Therapy. Washington D.C. 2001. Krupat E,
Irish JT, Kasten LE, Freund KM, Burns RB,
Moskowitz MA et al. Patient assertiveness and
physician decision-making among older breast
cancer patients. Soc Sci Med 1999
49(4)449-57. Kunda Z. Social Cognition Making
Sense of People. Cambridge, MA Bradford M.I.T.
Press, 1999. Kunda Z, Sherman-Williams B.
Stereotypes and the construal of individuating
information. Journal of Personality and Social
Psychology 1993 1990-99. Kunda Z, Sinclair L.
Motivated Reasoning with StereotypesActivatyion,
application and Inhibition. Psychological Inquiry
2001. Kunda Z, Sinclair L, Griffin D. Equal
ratings but separate meanings Steotypes and the
construal of traits. Journal of Personality and
Social Psychology 1997 72720-724. Kunda Z,
Thagard P. Forming impressions from stereotypes,
traits and behaviors. Psychological Review 1996
103284-208. Lalonde RN, Gardner RC. The
intergroup perspective on stereotype organization
and processing. British Journal of Social
Psychology 1989 28(4)289-303. Lane DS, Zapka J,
Breen N, Messina CR, Fotheringham DJ. A systems
model of clinical preventive care the case of
breast cancer screening among older women. For
the NCI Breast Cancer Screening Consortium. Prev
Med 2000 31(5)481-93. Larson PA. Nurse
perceptions of patient characteristics. Nurs Res
1977 26(6)416-21. .  
Lawson WB, Hepler N, Holladay J, Cuffel B. Race
as a factor in inpatient and outpatient
admissions and diagnosis. Hosp Community
Psychiatry 1994 45(1)72-4. Lepore L, Brown R.
Category and Stereotype Activation Is prejudice
inevitable? Journal of Personality and Social
Psychology 1997 72275-287. Lewis G,
Croft-Jeffreys C, David A. Are British
psychiatrists racist? Br J Psychiatry 1990
157410-5. Li VC, Coates TJ, Ewart CK, Kim YJ.
The effectiveness of smoking cessation advice
given during routine medical care physicians can
make a difference. Am J Prev Med 1987
3(2)81-6. Like R, Zyzanski SJ. Patient
satisfaction and the clinical encounter Social
psychological determinants. Social Science
Medicine 1987 24351-357. Locke V, MacLeod C,
Walker I. Automatic and controlled activation of
stereotypes Individual differences associated
with prejudice. British Journal of Social
Psychology 1994 3329-46. Locksley A, Hepburn C,
Ortiz V. Social stereotypes and judgements of
individuals An instance of the base-rate
fallacy. Journal of experimental social
psychology 1982 1823-42. Macrae N.C, Hewstone
M, Griffiths R.J. Processing load and memory for
stereotype based information. European Journal of
Social Psychology 1993 23(1)77-87. Macrae CN,
Bodenhausen GV. Social Cognition Categorical
person perception. British Journal of Social
Psychology 2001 92239-255. Macrae CN,
Bodenhausen GV, Milne AB. Out of Mind but Back in
Sight Stereotypes on the Rebound. Journal of
Personality and Social Psychology 1994
6737-47. Macrae CN, Milne AB, Bodenhausen GV.
Stereotypes as energy-saving devices A peek
inside the cognitive toolbox. Journal of
Personality and Social Psychology 1994 6633-47.
Martin TW. White therapists' differing
perceptions of black and white adolescents.
Adolescence 1993 28(110)281-9. May DS, Kiefe
CI, Funkhouser E, Fouad MN. Compliance with
mammography guidelines physician recommendation
and patient adherence. Prev Med 1999
28(4)386-94. Mayberry RM, Mili F, Ofili E.
Racial and ethnic differences in access to
medical care. Med Care Res Rev 2000 57(Suppl
1)108-45. Maynard C, Fisher LD, Passamani ER,
Pullum T. Blacks in the coronary artery surgery
study (CASS) race and clinical decision making.
Am J Public Health 1986 76(12)1446-8. McKinlay
JB, Burns RB, Feldman HA, Freund KM, Irish JT,
Kasten LE et al. Physician variability and
uncertainty in the management of breast cancer.
Results from a factorial experiment. Med Care
1998 36(3)385-96. McKinlay JB, Potter DA,
Feldman HA. Non-medical influences on medical
decision-making. Soc Sci Med 1996
42(5)769-76. McMahon LF, Wolfe RA, Huang S,
Tedeschi P, Manning W, Edlund MJ. Racial and
gender variation in use of diagnostic colonic
procedures in the Michigan Medicare population.
Med Care 1999 37(7)712-7. Monteith MJ, Sherman
JW, Devine PG. Suppression as a stereotype
control strategy. Personality and Social
Psychology Review 1998 263-82. Mouton C, Teno
JM, Mor V, Piette J. Communication of preferences
for care among human immunodeficiency
virus-infected patients. Barriers to informed
decisions? Arch Fam Med 1997 6(4)342-7. Naumburg
EH, Franks P, Bell B, Gold M, Engerman J. Racial
differentials in the identification of
hypercholesterolemia. J Fam Pract 1993
36(4)425-30. Nichol KL, Mac Donald R, Hauge M.
Factors associated with influenza and
pneumococcal vaccination behavior among high-risk
adults. J Gen Intern Med 1996 11(11)673-7. O'Mal
ley MS, Earp JA, Harris RP. Race and mammography
use in two North Carolina counties. Am J Public
Health 1997 87(5)782-6.
O'Malley MS, Earp JA, Hawley ST, Schell MJ,
Mathews HF, Mitchell J. The association of
race/ethnicity, socioeconomic status, and
physician recommendation for mammography who
gets the message about breast cancer screening?
Am J Public Health 2001 91(1)49-54. Porter JR,
Beuf AH. The effect of a racially consonant
medical context on adjustment of African-American
patients to physical disability. Med Anthropol
1994 16(1)1-16. Pratto, Bargh J. Stereotyping
based on apparently individuating information
Trait and global components of sex stereotypes
under attention overload. Journal of experimental
social psychology 1991 27(1)26-47. Rao JK,
Weinberger M, Kroenke K. Visit-specific
expectations and patient-centered outcomes a
literature review. Arch Fam Med 2000
9(10)1148-55. Rathore SS, Lenert LA, Weinfurt
KP, Tinoco A, Taleghani CK, Harless W et al. The
effects of patient sex and race on medical
students' ratings of quality of life. Am J Med
2000 108(7)561-6. Rayburn TM, Stonecypher JF.
Diagnostic differences related to age and race of
involuntarily committed psychiatric patients.
Psychol Rep 1996 79(3 Pt 1)881-2. Revenson TA.
Compassionate stereotyping of elderly patients by
physicians revising the social contact
hypothesis. Psychol Aging 1989
4(2)230-4. Rosenfield S. Race differences in
involuntary hospitalization psychiatric vs.
labeling perspectives. J Health Soc Behav 1984
25(1)14-23. Roter D. The enduring and evolving
nature of the patient-physician relationship.
Patient Educ Couns 2000 39(1)5-15. Roter
DLDSMPPSMMLMJMSWPITSM. Communication Patterns of
Primary Care PhysiciansThe Patient-Physician
Relationship. Jama 1997 277(4)350-356. Sagar
HA, Schofield JW. Racial and behavioral cues in
black and white children's perceptions of
ambiguously aggressive acts. Journal of
Personality and Social Psychology 1980
39590-598. Schneider AE, Davis RB, Phillips RS.
Discussion of hormone replacement therapy between
physicians and their patients. Am J Med Qual
2000 15(4)143-7.
Schulman KA, Berlin JA, Harless W, Kerner JF,
Sistrunk S, Gersh BJ et al. The effect of race
and sex on physicians' recommendations for
cardiac catheterization. N Engl J Med 1999
340(8)618-26. Sedlis SP, Fisher VJ, Tice D,
Esposito R, Madmon L, Steinberg EH. Racial
differences in performance of invasive cardiac
procedures in a Department of Veterans Affairs
Medical Center. J Clin Epidemiol 1997
50(8)899-901. Shortt S. Venerable or vulnerable?
Ageism in health care. J Health Serv Res Policy
2001 6(1)1-2. Sinclair L. Justifying desired
impressions of evaluators Motivated activation,
application and inhibition of stereotypes.
University of Waterloo, 1998. Sollner W, DeVries
A, Steixner E, Lukas P, Sprinzl G, Rumpold G et
al. How successful are oncologists in identifying
patient distress, perceived social support, and
need for psychosocial counselling? Br J Cancer
2001 84(2)179-85. Stangor C. Stereotypes and
Prejudice. Philadelphia Psychology Press,
2000. Stephan WG. Intergroup Relations. In
Lindsay, Aronson, editors. Handbook of Social
Psychology. 1985. Stern M, Arenson E. Childhood
cancer stereotype impact on adult perceptions of
children. J Pediatr Psychol 1989
14(4)593-605. Stern M, Moritzen SK, Carmel S,
Olexa-Andrews M. The prematurity stereotype in
Israeli health care providers. Med Educ 2001
35(2)129-33. Stern M, Ross S, Bielass M. Medical
students' perceptions of children modifying a
childhood cancer stereotype. J Pediatr Psychol
1991 16(1)27-38. Stewart M, Brown JB, Boon H,
Galajda J, Meredith L, Sangster M. Evidence on
patient-doctor communication. Cancer Prev Control
1999 3(1)25-30. Stewart M, Brown JB, Donner A,
McWhinney IR, Oates J, Weston WW et al. The
impact of patient-centered care on outcomes. J
Fam Pract 2000 49(9)796-804. Strakowski SM,
Hawkins JM, Keck PE, Jr., McElroy SL, West SA,
Bourne ML et al. The effects of race and
information variance on disagreement between
psychiatric emergency service and research
diagnoses in first-episode psychosis. J Clin
Psychiatry 1997 58(10)457-63.
Strakowski SM, Lonczak HS, Sax KW, West SA, Crist
A, Mehta R et al. The effects of race on
diagnosis and disposition from a psychiatric
emergency service. J Clin Psychiatry 1995
56(3)101-7. Strakowski SM, Shelton RC, Kolbrener
ML. The effects of race and comorbidity on
clinical diagnosis in patients with psychosis. J
Clin Psychiatry 1993 54(3)96-102. Taira DA,
Safran DG, Seto TB, Rogers WH, Tarlov AR. The
relationship between patient income and physician
discussion of health risk behaviors. Jama 1997
278(17)1412-7. Takei N, Persaud R, Woodruff P,
Brockington I, Murray RM. First episodes of
psychosis in Afro-Caribbean and White people. An
18-year follow-up population-based study. Br J
Psychiatry 1998 172147-53. Tates K, Meeuwesen
L. Doctor-parent-child communication. A (re)view
of the literature. Soc Sci Med 2001
52(6)839-51. Thomson GE. Discrimination in
health care. Ann Intern Med 1997
126(11)910-2. Todd KH, Deaton C, D'Adamo AP, Goe
L. Ethnicity and analgesic practice. Ann Emerg
Med 2000 35(1)11-6. Todd KH, Samaroo N, Hoffman
JR. Ethnicity as a risk factor for inadequate
emergency department analgesia. Jama 1993
269(12)1537-9. Trierweiler SJ, Neighbors HW,
Munday C, Thompson EE, Binion VJ, Gomez JP.
Clinician attributions associated with the
diagnosis of schizophrenia in African American
and non-African American patients. J Consult Clin
Psychol 2000 68(1)171-5. van Ryn M, Burke J.
The effect of patient race and socio-economic
status on physicians' perceptions of patients.
Soc Sci Med 2000 50(6)813-28. An Examination
of Factors Associated with Physician
Recommendation for Revascularization. 99
1999. Vassiliou V, Trandis H, Vassiliou G,
McGuire H. Interpersonal contact and
stereotyping. In Triandis H, editor. The
Analysis of Subjective Culture. New York Wiley,
1972. Weisse CS, Sorum PC, Sanders KN, Syat BL.
Do Gender and Race Affect Decisions About Pain
Management? J Gen Intern Med 2001
Whaley AL. Racism in the provision of mental
health services a social-cognitive analysis. Am
J Orthopsychiatry 1998 68(1)47-57. Whittle J,
Conigliaro J, Good CB, Joswiak M. Do patient
preferences contribute to racial differences in
cardiovascular procedure use? J Gen Intern Med
1997 12(5)267-73. Wissow LS, Roter DL, Wilson
ME. Pediatrician interview style and mothers'
disclosure of psychosocial issues. Pediatrics
1994 93(2)289-95. Won A, Lapane K, Gambassi G,
Bernabei R, Mor V, Lipsitz LA. Correlates and
management of nonmalignant pain in the nursing
home. SAGE Study Group. Systematic Assessment of
Geriatric drug use via Epidemiology. J Am Geriatr
Soc 1999 47(8)936-42. Word, Zanna MP, Cooper J.
The nonverbal mediation of self-fulfilling
prophecies in interracial interaction. Journal of
experimental social psychology 1974 10109-120
Write a Comment
User Comments (0)
About PowerShow.com