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Objective This preliminary study examined the effect of gain versus loss-framed messaging as well as culturally targeted personal prevention messaging on African Americans' receptivity to colorectal cancer (CRC) screening. This research also examined mechanistic functions of perceived racism in response to message framing. Design and methods Community samples of African Americans (N = 132) and White Americans (N = 50) who were non-compliant with recommended CRC screening completed an online education module about CRC, and were either exposed to a gain-framed or loss-framed message about CRC screening. Half of African Americans were exposed to an additional and culturally targeted self-control message about personal prevention of CRC. Theory of planned behavior measures of attitudes, normative beliefs, perceived behavioural control, and intentions to obtain a CRC screen served as primary outcomes. The effect of messaging on perceived racism was also measured as an outcome. Results Consistent with prior research, White Americans were more receptive to CRC screening when exposed to a loss-framed message. However, African Americans were more receptive when exposed to a gain-framed message. The contrary effect of loss-framed messaging on receptivity to screening among African Americans was mediated by an increase in perceived racism. However, including an additional and culturally targeted prevention message mitigated the adverse effect of a loss-framed message. Conclusion This study identifies an important potential cultural difference in the effect of message framing on illness screening among African Americans, while also suggesting a culturally relevant linking mechanism. This study also suggests the potential for simultaneously presented and culturally targeted messaging to alter the effects of gain and loss-framed messaging on African Americans. Statement of contribution What is already known on this subject? African Americans are at an increased risk of both developing and dying from colorectal cancer (CRC). These disparities can be attributed in large part to deficits in the use of CRC screening among African Americans. Guided by prospect theory, available literature suggests that selectively pairing gain and loss-framed messaging with illness prevention and detection can better promote adaptive health behaviour. Specifically, loss-framed messages that emphasize the potential costs of failing to act may promote better use of illness detection behaviours, such as CRC screening. Emerging literature highlights the potential for cultural differences in the effects of gain and loss messaging on health behaviour, especially among collectivist or interdependent cultures. What does this study add? This study is the first to identify a potential and important cultural difference in the effect of message framing on cancer screening among African Americans, whereby gain-framed messaging better compelled receptivity to CRC screening. This study is also the first to show that the use of loss-framed messaging may reduce receptivity to CRC screening among African Americans by increasing perceived racism. This study demonstrates that simultaneously including a culturally targeted personal prevention message may attenuate the negative effects of loss-framed messaging on CRC screening among African Americans.

Harsh treatment of others can reflect an underlying motivation to view the world as fair and just and also a dispositional tendency to believe in justice. However, there is a critical need to refine and expand existing knowledge, not only to identify underlying psychological processes but also to better understand how justice may be implicated in support for exclusionary policies. Across two studies, we show that support for policies that restrict immigrants is exclusively associated with thoughts about fair outcomes for other people (distributive justice for others). In Study 1, Americans' dispositional tendency to believe in distributive justice for others was associated with greater support for a policy proposing to further restrict immigrant job seekers' capacity to gain employment in the United States. In Study 2, we experimentally primed thoughts about justice in a sample of U.S. police officers. Support for a policy that mandated stricter policing of illegal immigration was strongest among officers who first thought about fair outcomes for other people, relative to other unique justice primes. Across both studies, distributive justice for others was associated with greater collective angst—perceived threat towards the future existence of Americans. Moreover, collective angst mediated the link between distributive justice for others and support for restrictive policies. Overall, this research suggests that thoughts about distributive justice for others can especially diminish compassion towards immigrants and other underprivileged groups via support for exclusionary policies. In addition, merely thinking about distributive justice for others may be sufficient to amplify social callousness.

In this dyadic study, we examined diabetes distress experienced by male and female patients and their spouses (N = 185 couples), and its association with depressive symptoms using the Actor-Partner Interdependence Model. Diabetes-related distress reported by both patients and spouses was associated with each partner's own depressive symptoms (actor effects) but generally was not associated with the other's depressive symptoms (partner effects). Moreover, diabetes distress was associated with depressive symptoms more strongly for male than for female patients, but this association did not differ between female and male spouses. Findings underscore the dyadic nature of managing chronic illness in that disease-related distress was experienced by patients and by their spouses and consistently was associated with poorer affective well-being. Key Words: chronic illness management, diabetes, dyadic analysis, marriage and health. A growing literature affirms that marital partners often face chronic illness together, and yet studies often emphasize the health and well-being of patients and give less attention to the experiences of their spouses (Berg & Upchurch, 2007). Spouses often are actively involved in the day-to-day management of their partners' illness. Moreover, involvement of spouses is associated not only with their partners' diseaserelated outcomes (Franks et al., 2006), but also with their own emotional well-being (Coyne & Smith, 1991). Our dyadic study of married partners' responses to chronic illness was guided by the developmental-contextual model of couples coping with chronic illness put forth by Berg and colleagues (Berg & Upchurch). Drawing from this model, we investigated patients' and spouses' concerns associated with managing diabetes, referred to as diabetes distress (Polonsky et al., 1995), and the association of their diabetes distress with their own and their partners' depressive symptoms. We further explored potential gender differences in the association between diabetes distress and depressive symptoms of married patients and their spouses in light of potential differences in the way that women and men respond to the health needs and emotional distress of their ill partners (Berg & Upchurch; Kiecolt-Glaser, & Newton, 2001). DAILY MANAGEMENT OF DIABETES Diabetes affects approximately one in five Americans over the age of 60 and is among the leading causes of death in the United States (Centers for Disease Control and Prevention, 2008). Type 2 diabetes is a chronic disorder of the endocrine system involving insufficient secretion of insulin and resistance to insulin that lessens the ability of cells to absorb glucose from the bloodstream. This type of diabetes accounts for the vast majority of cases of diabetes (only 5-10% of individuals with diabetes have Type 1 diabetes, which involves insulin deficiency resulting from autoimmune destruction of jo-cells of the pancreas; American Diabetes Association, 2010). The management of diabetes requires vigilant and sustained adherence to a complex and coordinated treatment regimen comprising multiple health behaviors, including diet, exercise, and use of prescribed medications (Halter, 1999). Proper daily management of diabetes reduces patients' risk of serious complications such as heart disease and stroke, neuropathy and nephropathy (Gonder-Frederick, Cox, & Ritterband, 2002; Halter). Despite encouragement from healthcare providers and warnings about the harmful consequences of treatment nonadherence, many patients are unsuccessful in sustaining recommended lifestyle behaviors. For instance, although individualized nutrition education often is emphasized in diabetes education, some patients do not recall receiving nutrition recommendations from their healthcare provider, and many patients who receive nutrition recommendations do not closely adhere to them (Rubin, Peyrot, & Saudek, 1991). Notably, the importance of family support for sustaining patients' treatment adherence is recognized in that national standards for diabetes self-management education specifically address education of patients' families and caregivers to promote effective self-management of diabetes (Funnell et al. …

Social support is broad term encompassing a variety of constructs, including support perceptions (perceived support) and receipt of supportive behaviors (received support). Of these constructs, only perceived support has been regarded as consistently linked to health, and researchers have offered differing assessments of the strength of the received-perceived support relationship. An overall estimate of the received-perceived support relationship would clearly further the dialogue on the relationship between received and perceived support and thus assist in the theoretical development of the field. This study evaluated all available studies using the Inventory of Socially Supportive Behaviors (ISSB; Barrera, Sandler, & Ramsey, 1981, American Journal of Community Psychology, 9, 435–447) and any measure of perceived social support. Using effect sizes from 23 studies, we found an average correlation of r = .35, p < .001. Implications of this estimate for further development of models of social support as well as interventions to enhance social support are discussed.