Dataset Information

A Values-Affirmation Intervention Does Not Benefit Negatively Stereotyped Immigrant Students in the Netherlands.

ABSTRACT: Previous research showed that a values-affirmation intervention can help reduce the achievement gap between African American and European American students in the US. In the present study, it was examined if these results would generalize to ethnic minority students in a country outside the US, namely the Netherlands, where there is also an achievement gap between native and ethnic minority students. This type of intervention was tested in two separate studies, the first among first-year pre-vocational students (n = 361, 84% ethnic minority), and the second among sixth grade students (n = 290, 96% ethnic minority). Most minority participants had a Turkish-Dutch or Moroccan-Dutch immigrant background. In the second study, a third condition was added to the original paradigm, in which students elaborated on either their affirmation- or a control exercise with the help of a teaching assistant. We also examined whether values affirmation affected the level of problem behavior of negatively stereotyped ethnic minority youth. Contrary to what was expected, multilevel analyses revealed that the intervention had no effect on the school achievement or the problem behavior of the ethnic minority students. Possible explanations for these findings, mainly related to contextual and cultural differences between the Netherlands and the US, are discussed.

SUBMITTER: de Jong EM

PROVIDER: S-EPMC4864537 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

A Values-Affirmation Intervention Does Not Benefit Negatively Stereotyped Immigrant Students in the Netherlands.

de Jong Elisabeth M EM Jellesma Francine C FC Koomen Helma M Y HM de Jong Peter F PF

Frontiers in psychology 20160513

Previous research showed that a values-affirmation intervention can help reduce the achievement gap between African American and European American students in the US. In the present study, it was examined if these results would generalize to ethnic minority students in a country outside the US, namely the Netherlands, where there is also an achievement gap between native and ethnic minority students. This type of intervention was tested in two separate studies, the first among first-year pre-voc ...[more]

PMID: 27242604

Similar Datasets

Project description:BACKGROUND:Medication nonadherence is a significant, modifiable contributor to uncontrolled hypertension. Stereotype threat may contribute to racial disparities in adherence by hindering a patient's ability to actively engage during a clinical encounter, resulting in reduced activation to adhere to prescribed therapies. OBJECTIVE:The Hypertension and Values (HYVALUE) trial aims to examine whether a values-affirmation intervention improves medication adherence (primary outcome) by targeting racial stereotype threat. METHODS:The HYVALUE trial is a patient-level, blinded randomized controlled trial comparing a brief values-affirmation writing exercise with a control writing exercise among black and white patients with uncontrolled hypertension. We are recruiting patients from 3 large health systems in the United States. The primary outcome is patients' adherence to antihypertensive medications, with secondary outcomes of systolic and diastolic blood pressure over time, time for which blood pressure is under control, and treatment intensification. We are comparing the effects of the intervention among blacks and whites, exploring possible moderators (ie, patients' prior experiences of discrimination and clinician racial bias) and mediators (ie, patient activation) of intervention effects on outcomes. RESULTS:This study was funded by the National Heart, Lung, and Blood Institute. Enrollment and follow-up are ongoing and data analysis is expected to begin in late 2020. Planned enrollment is 1130 patients. On the basis of evidence supporting the effectiveness of values affirmation in educational settings and our pilot work demonstrating improved patient-clinician communication, we hypothesize that values affirmation disrupts the negative effects of stereotype threat on the clinical interaction and can reduce racial disparities in medication adherence and subsequent health outcomes. CONCLUSIONS:The HYVALUE study moves beyond documentation of race-based health disparities toward testing an intervention. We focus on a medical condition-hypertension, which is arguably the greatest contributor to mortality disparities for black patients. If successful, this study will be the first to provide evidence for a low-resource intervention that has the potential to substantially reduce health care disparities across a wide range of health care conditions and populations. TRIAL REGISTRATION:ClinicalTrials.gov NCT03028597; https://clinicaltrials.gov/ct2/show/NCT03028597 (Archived by WebCite at http://www.webcitation.org/72vcZMzAB). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):DERR1-10.2196/12498.

Project description:ImportanceStereotype threat, or the fear of confirming a negative stereotype about one's social group, may contribute to racial differences in adherence to medications by decreasing patient activation to manage chronic conditions.ObjectiveTo examine whether a values affirmation writing exercise improves medication adherence and whether the effect differs by patient race.Design, setting, and participantsThe Hypertension and Values trial, a patient-level, blinded randomized clinical trial, compared an intervention and a control writing exercise delivered immediately prior to a clinic appointment. Of 20 777 eligible, self-identified non-Hispanic Black and White patients with uncontrolled hypertension who were taking blood pressure (BP) medications, 3891 were approached and 960 enrolled. Block randomization by self-identified race ensured balanced randomization. Patients enrolled between February 1, 2017, and December 31, 2019, at 11 US safety-net and community primary care clinics, with outcomes assessed at 3 and 6 months. Analysis was performed on an intention-to-treat basis.InterventionsFrom a list of 11 values, intervention patients wrote about their most important values and control patients wrote about their least important values.Main outcomes and measuresThe primary outcome of adherence to BP medications was measured using pharmacy fill data (proportion of days covered >90%) at baseline, 3 months, and 6 months. The secondary outcome was systolic and diastolic BP. Patient activation to manage their health was also measured.ResultsOf 960 patients, 474 (286 women [60.3%]; 256 Black patients [54.0%]; mean [SD] age, 63.4 [11.9] years) were randomly assigned to the intervention group and 486 (288 women [59.3%]; 272 Black patients [56.0%]; mean [SD] age, 62.8 [12.0] years) to the control group. Baseline medication adherence was lower (318 of 482 [66.0%] vs 331 of 412 [80.3%]) and mean (SE) BP higher among Black patients compared with White patients (systolic BP, 140.6 [18.5] vs 137.3 [17.8] mm Hg; diastolic BP, 83.9 [12.6] vs 79.7 [11.3] mm Hg). Compared with baseline, pharmacy fill adherence did not differ between intervention and control groups at 3 months (odds ratio [OR], 0.91 [95% CI, 0.57-1.43]) or at 6 months (OR, 0.86 [95% CI, 0.53-1.38]). There were also no treatment effect differences in pharmacy fill adherence by patient race (Black patients at 3 months: OR, 1.08 [95% CI, 0.61-1.92]; at 6 months: OR, 1.04 [95% CI, 0.58-1.87]; White patients at 3 months: OR, 0.68 [95% CI, 0.33-1.44]; at 6 months: OR, 0.55 [95% CI, 0.24-1.27]). Immediately after the intervention, the median patient activation was higher in intervention patients than in control patients, but this difference was not statistically significant in an unadjusted comparison (75.0 [IQR, 65.5-84.8] vs 72.5 [IQR, 63.1-80.9]; P = .06). In adjusted models, the Patient Activation Measure score immediately after the intervention was significantly higher in the intervention patients than in control patients (mean difference, 2.3 [95% CI, 0.1-4.5]).Conclusions and relevanceA values affirmation intervention was associated with higher patient activation overall but did not improve adherence or blood pressure among Black and White patients with hypertension.Trial registrationClinicalTrials.gov Identifier: NCT03028597.

Dataset Information

A Values-Affirmation Intervention Does Not Benefit Negatively Stereotyped Immigrant Students in the Netherlands.

Publications

A Values-Affirmation Intervention Does Not Benefit Negatively Stereotyped Immigrant Students in the Netherlands.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure