Social science & medicine
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Social science & medicine · Jul 2016
Identifying components in consent information needed to support informed decision making about trial participation: An interview study with women managing cancer.
Research governance requires patients give informed consent to participate in clinical trials. However, there are concerns that consent information may not support patient participation decisions. This study investigates the utility of consent information in supporting women's trial participation decisions when receiving treatment for cancer. ⋯ Designing trial information to represent explicitly the trial participation decision as being between standard care and study-related care options is more likely to effectively support patients in making informed decisions between standard care treatments and taking part in a trial.
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Social science & medicine · Jun 2016
Collaborative patient-provider communication and uptake of adolescent vaccines.
Recommendations from healthcare providers are one of the most consistent correlates of adolescent vaccination, but few studies have investigated other elements of patient-provider communication and their relevance to uptake. ⋯ Efficient communication styles were used rarely (≤2% across vaccines) but were highly effective for encouraging meningococcal and HPV vaccination. Intervention studies are needed to confirm that efficient communication approaches increase HPV vaccination among adolescents.
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Social science & medicine · Jun 2016
Living under surveillance: Gender, psychological distress, and stop-question-and-frisk policing in New York City.
A growing body of research highlights the collateral consequences of mass incarceration, including stop-and-frisk policing tactics. Living in a neighborhood with aggressive policing may affect one's mental health, especially for men who are the primary targets of police stops. We examine whether there is an association between psychological distress and neighborhood-level aggressive policing (i.e., frisking and use of force by police) and whether that association varies by gender. ⋯ Specifically, men exhibit more non-specific psychological distress and more severe feelings of nervousness, effort, and worthlessness in aggressively surveilled neighborhoods than do women. Male residents are affected by the escalation of stop-and-frisk policing in a neighborhood. Living in a context of aggressive policing is an important risk factor for men's mental health.
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Social science & medicine · Jun 2016
Latino residential segregation and self-rated health among Latinos: Washington State Behavioral Risk Factor Surveillance System, 2012-2014.
The relationship between Latino residential segregation and self-rated health (SRH) is unclear, but might be partially affected by social capital. We investigated the association between Latino residential segregation and SRH while also examining the roles of various social capital measures. Washington State Behavioral Risk Factor Surveillance System (2012-2014) and U. ⋯ The social capital measures were independently associated with SRH but had little effect on the relationship between Latino residential segregation and SRH. A convex relationship between Latino residential segregation and SRH could explain mixed findings of previous studies. Although important for SRH, social capital measures of neighborhood ties, collective socialization of children, and social control might not account for the relationship between Latino residential segregation and SRH.
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Social science & medicine · Jun 2016
The doctor-patient relationship as a toolkit for uncertain clinical decisions.
Medical uncertainty is a well-recognized problem in healthcare, yet how doctors make decisions in the face of uncertainty remains to be understood. This article draws on interdisciplinary literature on uncertainty and physician decision-making to examine a specific physician response to uncertainty: using the doctor-patient relationship as a toolkit. Additionally, I ask what happens to this process when the doctor-patient relationship becomes fragmented. ⋯ These challenges led to additional uncertainties and in some cases to poor outcomes for doctors and/or patients; they also raised concerns about the reproduction of inequality. Thus organization of care delivery mitigates the efficacy of doctors' use of the doctor-patient relationship toolkit for uncertain decisions. These findings have implications for theorizing about decision-making under conditions of medical uncertainty, for understanding how the doctor-patient relationship and model of care affect physician decision-making, and for forming policy on the optimal structure of medical work.