208,640 research outputs found

    The Use of Social Capital in Borrower Decision-Making

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    By looking beyond the financial characteristics of borrowers, this research brings to light the social factors that influence a borrower's choice of a lender and mortgage product. Previous research has indicated that distinct channels exist that funnel borrowers into lower or higher cost loan products (Apgar, Bendimerad, and Essene 2007). But little is known as to how borrowers seek out or are directed to such channels. A particular concern that this paper hopes to address is why black borrowers disproportionately have higher priced products.Some research indicates that even when credit worthiness is controlled for, blacks are overrepresented in the subprime sector and in higher-cost products (Bocian, Ernst, and Li 2006). Through in-depth interviews with 32 borrowers, this research (1) highlights how borrowers seek mortgage credit and evaluate their mortgage options, and (2) demonstrates how borrowers make use of their social networks (friends and family) when making their decisions.The preliminary findings indicate that borrowers' preferences and subsequent demands for mortgage products were shaped by the informal and formal advice they received. Those borrowers who consulted the most diverse sources of information had loans with lower interest rates. Those borrowers who received advice only from family and friends did not fare as well as those who received help from credit counselors. Thus, arguably, their loan outcomes varied not just based on if they consulted others, but especially whom they consulted. When given the right advice, potential homebuyers make better decisions in choosing both a lender and a loan

    Down's Syndrome: cost, quality and value of life

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    Routine prenatal screening is based on the assumption that it is reasonable for prospective parents to choose to prevent a life with Down's syndrome. This paper questions whether Down's syndrome necessarily involves the costs, limitations and suffering which are assumed in the prenatal literature, and examines the lack of evidence about the value and quality of life with Down's syndrome. Tensions between the aims of prenatal screening policies to support women's personal choices, prevent distress, and reduce the suffering and costs of disability, versus the inadvertent effects of screening which can undermine these aims, are considered. Strengths and weaknesses in medically and socially based models of research about disability, and their validity and reliability are reviewed. From exploratory qualitative research with 40 adults who have congenital conditions which are tested for prenatally, interviews with five adults with Down's syndrome are reported. Interviewees discuss their relationships, education and employment, leisure interests, hopes, aspects of themselves and of society they would like to change, and their views on prenatal screening. They show how some people with Down's syndrome live creative, rewarding and fairly independent lives, and are not inevitably non-contributing dependents. Like the other 35 interviewees, they illustrate the importance of social supports, and their problems with excluding attitudes and barriers. Much more social research with people who have congenital conditions is required, if prenatal screening policies and counselling are to be evidence based

    Refinement of the Shared Care Instrument-Revised: A Measure of a Family Care Interaction

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    This study’s purpose was to evaluate the psychometric properties of the Shared Care Instrument-Revised (SCI-R) in a sample of family care dyads. The SCI-R was developed to measure the construct of shared care, which is a system of three constructs (communication, decision making, reciprocity) used in family care to exchange support. An important aspect of evaluating the SCI-R was to create a measure that is statistically sound and meaningful for patient and caregivers. Surveys were mailed to randomly selected home health dyads, which included 223 patients and 220 caregivers. Reliability and confirmatory factor analysis, and concurrent validity were examined. Internal consistency reliability of the patient subscales ranged from 0.74 to 0.76, and from 0.72 to 0.78 for caregiver sub-scales. Factor analysis supported the underlying theoretical basis of the SCI-R. Construct validity also was supported using the hypothesis-testing approach. One major challenge in family care research is to develop methods and tools to study the dynamic characteristics of close relationships. The findings from this study support further use of SCI-R to study how shared care facilitates the exchange of support and the influence shared care has on outcomes for both patients and caregivers

    Simulating dynamic systems in health psychology : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand

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    Despite their advocacy of the biopsychosocial model, health psychologists use a relatively narrow repertoire of techniques for developing and testing theory. These techniques have limited application to research questions concerning phenomena that are multidimensional, multilevel and change over time. This thesis demonstrates an alternative, dynamic systems approach to such questions in health psychology. It introduces some ideas in systems and dynamics and how we might model these. It uses an example to demonstrate the use of these ideas to develop a dynamic systems model in a health psychology context. The example is drawn from the epidemiological finding of a positive correlation between income inequality and mortality, and the proposal that this relationship may be mediated by processes that result in social disruption. The thesis explores the construction of a dynamic systems model to examine how a change in income inequality might affect the network of social relationships in a population. Social relationship processes in the model are based on some findings from social psychology, and these are incorporated into a network model, which is realised as a computer simulation. Simulation runs suggested that an increase in income inequality can produce a ripple of relationship breakdowns. Contrary to intuition, the number of relationships lost was limited if the change was introduced suddenly, and if there was a high rate of making and breaking relationships. Further, reversing the change did not reverse the loss of relationships. The development process and the results obtained are discussed, and it is argued that dynamic systems simulation may be useful for developing and testing theory that applies to multilevel, multidimensional processes in health psychology

    Stop smoking practitioner consensus on barriers and facilitators to smoking cessation in pregnancy and how to address these: A modified Delphi survey.

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    Introduction Pregnant women can experience barriers and facilitators towards achieving smoking cessation. We sought consensus from smoking cessation practitioners on how influential pre-identified barriers and facilitators can be on pregnant women's smoking behaviour, and how difficult these might be to manage. Suggestions for techniques that could help overcome the barriers or enhance the facilitators were elicited and consensus sought on the appropriateness for their use in practice. Methods Forty-four practitioners who provided cessation support to pregnant women completed a three-round modified Delphi survey. Round one sought consensus on the ‘influence’ and ‘difficulty’ of the barriers and facilitators, and gathered respondents' suggestions on ways to address these. Rounds two and three sought further consensus on the barriers and facilitators and on ‘appropriateness’ of the respondent-suggested techniques. The techniques were coded for behaviour change techniques (BCTs) content using existing taxonomies. Results Barriers and facilitators considered to be the most important mainly related to the influence of significant others and the women's motivation & self-efficacy. Having a supportive partner was considered the most influential, whereas lack of support from partner was the only barrier that reached consensus as being difficult to manage. Barriers relating to social norms were also considered influential, however these received poor coverage of respondent-suggested techniques. Those considered the easiest to address mainly related to aspects of cessation support, including misconceptions surrounding the use of nicotine replacement therapy (NRT). Barriers and facilitators relating to the women's motivation & self-efficacy, such as the want to protect the baby, were also considered as being particularly easy to address. Fifty of the 54 respondent-suggested techniques reached consensus as being appropriate. Those considered the most appropriate ranged from providing support early, giving correct information on NRT, highlighting risks and benefits and reinforcing motivating beliefs. Thirty-three BCTs were identified from the respondent-suggested techniques. ‘Social support (unspecified)’, ‘Tailor interactions appropriately’ and ‘Problem solving’ were the most frequently coded BCTs. Conclusions Involving partners in quit attempts was advocated. Existing support could be potentially improved by establishing appropriate ways to address barriers relating to pregnant smokers' ‘social norms’. In general, providing consistent and motivating support seemed favourable

    Language Barriers in Health Care Settings: An Annotated Bibliography of Research Literature

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    Provides an overview of resources related to the prevalence, role, and effects of language barriers and access in health care

    Motivating social distancing during the Covid-19 pandemic: An online experiment. ESRI Working Paper No. 658 April 2020

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    Social distancing during the COVID-19 pandemic will save lives. We tested communication strategies to promote social distancing via an online experiment (N = 500) commissioned by Ireland’s Department of Health. A control group saw a current informational poster. Two treatment groups saw similar posters with messages that highlighted: (i) the risk of transmission to identifiable persons vulnerable to COVID-19; (ii) the exponential nature of transmission. We then measured judgements of behaviours previously identified by focus groups as “marginal” (meaning that people were not sure whether they were advisable, such meeting others outdoors, or visiting parents). We recorded intention to undertake behaviours and stated acceptability of behaviours. Our hypotheses, that both treatments would increase participants’ caution about marginal behaviours, were preregistered (i.e. lodged with an international organisation for open science before data collection). Results confirmed the hypotheses. The findings suggest that the thought of infecting vulnerable people or large numbers of people can motivate social distancing. This has implications for communications strategies. The stud
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