Biomedical subjects

Noel T Brewer

Publications and source records attributed to Noel T Brewer.

7 recordsLinked to original sources

PubMed2006

Subjective and objective risk as predictors of influenza vaccination during the vaccine shortage of 2004-2005.

BACKGROUND: We aimed to identify the role of objective risk status and subjective risk beliefs in influenza vaccination decisions during the recent rationing of influenza vaccine. METHOD: A random sample of 300 Americans, obtained through random-digit dialing, was interviewed regarding influenza vaccination practices and beliefs in September 2004 and again in March 2005. RESULTS: One-half of individuals at high risk of influenza did not know that they were at high risk and, therefore, were not vaccinated. Respondents at high objective risk were more likely to report having been vaccinated than respondents who were not at high objective risk (36% vs. 6%, respectively; odds ratio, 8.31; 95% confidence interval, 3.65-18.88). However, a more powerful predictor of self-reported vaccination was subjective risk (64% vs. 7%, respectively; odds ratio, 24.02; 95% confidence interval, 12.18-48.09). Subjective risk fully mediated the relationship between objective risk and vaccination. Other predictors of vaccination included physician recommendation, habit, prior vaccination intention, belief that the influenza vaccine is safe and effective, perceived likelihood of getting influenza, and trait neuroticism. CONCLUSION: Health communication efforts must be more effective in persuading adults with chronic illness and individuals in contact with persons at risk that they should be vaccinated against influenza.

Adolescent↗

PubMed2006

Why people believe they were exposed to biological or chemical warfare: a survey of Gulf War veterans.

The study sought to understand better how people come to believe they have been exposed to biological and chemical warfare. We conducted telephone interviews with 1,009 American veterans (65% response rate) deployed and not deployed to the Gulf War, a conflict during which there were credible threats that such warfare could be used. Only 6% of non-Gulf War veterans reported exposure to biological or chemical warfare, but most of Gulf War veterans reported exposure (64%). The majority of these were unsure whether the exposure was chemical or biological in nature. The most commonly reported exposure indicators were receiving an alert from the military and having physical symptoms. Veterans who were certain of the type of exposure (biological or chemical) were more likely to recall having been told by the military and to recall physical symptoms. Future communications with soldiers and the general public about biological and chemical warfare may need to emphasize the uncertain nature of such risk information. Evaluations of exposure diagnostic technologies should take into account the problem of people initially believing, but not later discounting, false positive results.

Adult↗

PubMed2006

Military deployment to the Gulf War as a risk factor for psychiatric illness among US troops.

BACKGROUND: Several studies document an excess of psychiatric symptoms among veterans of the the 1991 Gulf War. However, little is known about the prevalence of psychiatric disorders in those who were deployed to that conflict. AIMS: To compare the 12-month prevalence and associated risk factors for DSM Axis I psychiatric diagnoses between random samples of Gulf War-deployed veterans and veterans of the same era not deployed to the Persian Gulf (era veterans). METHOD: Interview data from 967 Gulf War veterans and 784 era veterans were examined to determine current health status, medical conditions, symptoms and Axis I psychiatric disorders. Logistic regression models evaluated risk factors for psychiatric disorder. RESULTS: Gulf War veterans had a significantly higher prevalence of psychiatric diagnoses, with twice the prevalence of anxiety disorders and depression. Lower rank, female gender and divorced or single marital status were significant independent predictors of psychiatric disorder. CONCLUSIONS: Deployment to the Gulf War is associated with a range of mental health outcomes more than 10 years after deployment.

Adult↗

PubMed2004

Why do people report better health by phone than by mail?

CONTEXT: Past research shows that fewer health symptoms are reported by phone than by mail. OBJECTIVES: We sought to examine whether interview mode-dependent differences in health symptom reporting are the result of socially desirable responding or to expending less cognitive effort when formulating responses, a behavior known as satisficing. DESIGN: Participants were randomly assigned to telephone interview only or to mail interview followed 2 weeks later by telephone interview. SETTING & PARTICIPANTS: Participants were American veterans from the Gulf War Registry (n=719). MAIN OUTCOME MEASURES: Our main outcome measure was the number of mild, moderate, or severe symptoms reported (of 48 possible). RESULTS: Veterans reported an average of 5 more symptoms via mail than via telephone, F (1, 709) = 32.50, P < 0.001. The difference was mainly the result of symptoms reported by mail as mild but not reported at all by phone. Veterans with higher social desirability scores reported fewer symptoms by phone and mail, F (1, 709) = 10.11, P = 0.001, but social desirability scores did not interact with interview mode. Furthermore, embarrassing symptoms such as genital complaints were no less likely to be reported by phone. CONCLUSIONS: Reporting of better health in phone surveys is the result of fewer mild symptoms reports but not of socially desirable responding. The findings are consistent with phone interviews encouraging satisficing by limiting the recall of less severe health states. Researchers should handle mild symptom reports with some skepticism.

Adult↗

PubMed2004

Risk perceptions and their relation to risk behavior.

BACKGROUND: Because risk perceptions can affect protective behavior and protective behavior can affect risk perceptions, the relations between these 2 constructs are complex and incorrect tests often lead to invalid conclusions. PURPOSE: To discuss and carry out appropriate tests of 3 easily confused hypotheses: (a). the behavior motivation hypothesis (perceptions of personal risk cause people to take protective action), (b). the risk reappraisal hypothesis (when people take actions thought to be effective, they lower their risk perceptions), and (c). the accuracy hypothesis (risk perceptions accurately reflect risk behavior). METHODS: Longitudinal study with an initial interview just after the Lyme disease vaccine was made publicly available and a follow-up interview 18 months later. Random sample of adult homeowners (N = 745) in 3 northeastern U.S. counties with high Lyme disease incidence. Lyme disease vaccination behavior and risk perception were assessed. RESULTS: All 3 hypotheses were supported. Participants with higher initial risk perceptions were much more likely than those with lower risk perceptions to get vaccinated against Lyme disease (OR = 5.81, 95% CI 2.63-12.82, p <.001). Being vaccinated led to a reduction in risk perceptions, chi2(1, N = 745) = 30.90, p <.001, and people vaccinated correctly believed that their risk of future infection was lower than that of people not vaccinated (OR =.44, 95% CI.21-.91, p <.05). CONCLUSIONS: The behavior motivation hypothesis was supported in this longitudinal study, but the opposite conclusion (i.e., that higher risk led to less protective behavior) would have been drawn from an incorrect test based only on cross-sectional data. Health researchers should take care in formulating and testing risk-perception-behavior hypotheses.

Adult↗

PubMed2003

Contrast effects in judgments of health hazards.

Researchers commonly use 2 models to explain contrast effects (CEs): the standard-of-comparison model and the set-reset model. The 2 models focus on the role of categorization to predict when a CE (instead of an assimilation effect) will happen, while minimizing the role of knowledge accessibility and relevance in determining whether any effect will occur. A 3rd model, the selective-accessibility model (F. Strack & T. Mussweiler, 1997), focuses on knowledge accessibility and relevance, but it is a model of assimilation effects in the anchoring bias. In the present study of CEs, the authors tested 3 predictions implied by the selective-accessibility model. The authors found a CE only when anchor- and target-rating dimensions matched and only in the 1st of multiple targets rated. The CE required a minimum amount of attention to the anchor. These results support the account that selective knowledge accessibility and relevance play an important role in CEs.

Attitude to Health↗

PubMed2003

Reported exposures, stressors, and life events among Gulf War Registry veterans.

We investigated the association of 15 exposures, 10 stressors, and 18 life events with illness symptoms reported by 978 veterans who believe they suffer from Gulf War-related illnesses. A mail survey was completed by veterans (60% response rate) from the Gulf War Health Registry. Variables most associated with high symptom group membership were reported chemical/biologic warfare (CBW), concerns with infection and faulty equipment, feelings of mistrust in the military, and disability leading to work stoppage within 2 years after the war. These data suggest that belief in CBW exposure, and the experience of war stress and serious negative life events after the war, are important concomitants of Gulf War illness. Models seeking to explain Gulf War symptoms need to incorporate a range of exposure and psychosocial factors to fully account for important influences.

Adult↗