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Funded by Department of Health and Human Services - National Institutes of Health Subcontracts

Funding Years: 2014.

Promoting physical activity and decreasing sedentary behavior are key goals in the fight against cancers; physical activity is associated with lower risk of several cancers [1-10], and lower overall morbidity and mortality [11-26]. Thus, theory-driven initiatives to change these behaviors are essential [1-10, 26-40]. PQ#3 highlights the necessity for new perspectives on the interplay of cognitive and emotional factors in promoting behavior change. Current theories, which focus primarily on predictors derived from self-report measures, do not fully predict behavior change. For example, recent meta-analyses suggest that on average, variables from the Theory of Planned Behavior account for ~27% of the variance in behavior change [41, 42]. This limits our ability to design optimally effective interventions [43], and invites new methods that may explain additional variance. Our team has shown that neural activation in response to health messages in hypothesized neural regions of interest can double the explained variance in behavior change, above and beyond self-reports of attitudes, intentions, and self-efficacy [44, 45]. We now propose a next leap, inspired by PQ3, to identify how cognitive and affective processes interact in the brain to influence and predict behavior change. Our core hypothesis is that the balance of neural activity in regions associated with self-related processing versus defensive counterarguing is key in producing health behavior change, and that self-affirmation (an innovative approach, relatively new to the health behavior area [46]) can alter this balance. Self-affirmation theory [47] posits that people are motivated to maintain a sense of self-worth, and that threats to self-worth will be met with resistance, often i the form of counterarguing. One common threat to self-worth occurs when people are confronted with self-relevant health messages (e.g. encouraging less sedentary behavior in overweight, sedentary adults). This phenomenon speaks to a classic and problematic paradox: those at highest risk are likely to be most defensive and least open to altering cancer risk behaviors [48]. A substantial, and surprisingly impressive, body of evidence demonstrates that affirmation of core-values (self-affirmation priming) preceding messages can reduce resistance and increase intervention effectiveness [46, 49-53]. Uncovering neural mechanisms of such affirmation effects [46], has transformative potential for intervention design and selection. To test our conceptual assumptions and core hypothesis we will: (1) Identify neural signals associated with processing health messages as self-relevant versus counterarguing; (2) Test whether self-affirmation alters the balance of these signals; (3) Use these neural signals to predict physical activity behavior change, above and beyond what is predicted by self-report measures alone. Our approach is innovative methodologically (using fMRI to understand and predict behavior change), and conceptually (self-affirmation may dramatically increase intervention effectiveness). Benchmarks will include objectively measured decreases in sedentary behavior in affirmed vs. control subjects (using accelerometers), and increases in predictive capacity afforded by neuroimaging methods, compared to self-report alone.

PI(s): Thad Polk

Co-I(s): Lawrence An, Sonya Dal Sin, Kenneth Resnicow, Victor Strecher

Tue, January 03, 2017

Reshma Jagsi was lead author on a recent study that found many patients with breast cancer unnecessarily choose double mastectomy. This study found that many patients consider contralateral prophylactic mastectomy (CPM), but their knowledge about the procedure is low and discussions with surgeons appear to be incomplete. CPM use is substantial among patients without clinical indications but is lower when patients report that their surgeon recommended against it. The study authors stress that more effective physician-patient communication about CPM is needed to reduce potential overtreatment.

CBSSM faculty, Sarah Hawley, was a co-author on this study.

Wed, February 01, 2017

Sarah Hawley and Reshma Jagsi are co-authors on two studies of the impact of doctor-patient communication on patients' perceptions of their breast cancer recurrence risk. They found that breast cancer patients commonly overestimate their risk of recurrence, which was a negative impact on their quality of life. The two studies were highlighted in a MHealth Lab Report. Brian Zikmund-Fisher was also co-author on one of these studies.

Wed, February 15, 2017

According to a study by Reshma Jagsi and colleagues, doctors often fail to recommend genetic testing for breast-cancer patients, even those who are at high risk for mutations linked to ovarian and other cancers. They surveyed 2,529 breast-cancer patients and found that although two-thirds of the women reported wanting genetic testing, less than a third actually got it. About 8 in 10 women at highest risk for BRCA mutations — because of family history or ancestry — said they had wanted testing, but only a little more than half received it.

Jacquelyn Miller, MA

Research Associate

Jackie re-joined CBSSM in spring of 2017. She currently works with Drs. Lesly Dossett and Tom Valley on projects related to the worries and concerns of those with loved ones in the ICU, feedback and disclosure of errors that have occurred in other hospital systems, and opioid prescribing after cancer surgery. She has a BS in Environmental Policy and Developing Country Studies (University of Michigan, School of Natural Resources and Environment) and a MA in Sociology, specializing in environmental justice, feminist sociology, and science and technology studies (Michigan State University).

Last Name: 
Miller

Teach-Out Course: Reach Out and RELATE: Communicating and Understanding Scientific Research

Fri, May 05, 2017, 8:00am
Location: 
Online

About this course
Everyone - non-scientists and scientists alike - has some form of expertise, but communicating across a gap in knowledge or experience is challenging. In this Teach-Out, we address this challenge by helping participants to develop core communication skills and more effectively communicate with one another. For more information or to enroll, click here.

What you'll learn

  • Understand why science communication is both important and challenging
  • Develop strategies to effectively bridge communications between public audiences and scientific researchers
  • Understand expert perspectives on different areas of public engagement with science
  • Shape a compelling, message-focused STEM narrative for a specific audience
  • Discuss important issues in science communication with others


Meet the instructors

Elyse L. Aurbach PhD
Co-Founder and Co-Director of RELATE

Brian J. Zikmund-Fisher PhD
Associate Professor of Health Behavior and Health Education

Brandon Patterson MS
Co-Director of RELATE

Katherine E. Prater PhD
Co-Founder and Co-Director of RELATE
 

Mon, April 17, 2017

A new piece by Brian Zikmund-Fisher and former CBSSM post-doc, Laura Scherer is out in the Conversation, "Maximizers vs. minimizers: The personality trait that may guide your medical decisions – and costs." They developed and validated a 10-item questionnaire that assesses a person’s maximizing or minimizing tendencies on a scale, from one (strong minimizing) to seven (strong maximizing). Across four studies, they found this difference predicts health care use across a range of medical interventions and health problems, from cancer screening preferences to vaccination. They hope that identifying variations in maximizing or minimizing tendencies may be useful in trying to address both overuse and underuse in health care.

Research Topics: 
Mon, April 17, 2017

Brian Zikmund-Fisher is quoted in a recent MarketWatch article, "How doctors are getting patients more involved in their own care." Dr. Zikmund-Fisher points out, "Patients are often overwhelmed by massive amounts of data they now have access to. The easier we make it for them to understand, the more likely it is they will use it and the less time the doctor has to spend explaining it.” The article goes on to cite a web-based application developed by Dr. Zikmund-Fisher and colleagues that allows health-care providers and researchers to create graphics that use icons in arrays that show risk information in ways that make it easier for people to grasp information.

A study by former CBSSM Co-Director, Angela Fagerlin, is also cited in the article.

"Concussion" Film Screening & Moderated Discussion

Thu, March 30, 2017, 7:00pm
Location: 
Forum Hall, Palmer Commons

"Concussion" Film Screening & Moderated Discussion

Free Admission

Moderator:    Raymond De Vries, PhD

Panelists:    

  • Ellen Arruda, PhD, Professor, Mechanical Engineering
  • Karen Kelly-Blake, PhD, Assistant Professor, Center for Ethics and Humanities in the Life Sciences, MSU
  • Matthew Lorincz, MD, PhD, Associate Professor, Neurology, Co-Director, Michigan NeuroSport

Refreshments provided.

Join us for a free screening of the award-winning film, Concussion. Watch the true story of Dr. Bennet Omalu, renowned forensic pathologist who discovered chronic traumatic encephalopathy (CTE), acclaimed as, "a gripping medical mystery and a dazzling portrait of the young scientist no one wanted to listen to." 

The film will be followed by a panel discussion related to key bioethical and scientific issues brought up by the film, as well as current research into brain injury and brain injury prevention.

Reach Out and RELATE: Communicating and Understanding Scientific Research


About this course
Everyone - non-scientists and scientists alike - has some form of expertise, but communicating across a gap in knowledge or experience is challenging. In this Teach-Out, we address this challenge by helping participants to develop core communication skills and more effectively communicate with one another. For more information or to enroll, click here.

What you'll learn

  •     Understand why science communication is both important and challenging
  •     Develop strategies to effectively bridge communications between public audiences and scientific researchers
  •     Understand expert perspectives on different areas of public engagement with science
  •     Shape a compelling, message-focused STEM narrative for a specific audience
  •     Discuss important issues in science communication with others


Meet the instructors

Elyse L. Aurbach PhD
Co-Founder and Co-Director of RELATE

Brian J. Zikmund-Fisher PhD
Associate Professor of Health Behavior and Health Education

Brandon Patterson MS
Co-Director of RELATE

Katherine E. Prater PhD
Co-Founder and Co-Director of RELATE

Click here for more information.

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