The present work provides best practice recommendations to using speeded self-report measures to assess implicit attitudes. Research on dual process models suggest that people use two cognitive processes in forming attitudes about evaluative targets: automatic, implicit processes which are then adjusted for by controlled, explicit processes. In contrast to explicit attitudes, implicit attitudes are thought to be automatic, uncontrollable cognitions that people are often unable to self-report. Researchers have long sought the best ways to indirectly capture implicit attitudes, but several problems exist with such indirect measures. Speeded-self report is a recent tool developed ad-hoc to circumvent common problems with traditional implicit attitude measures by allowing direct measurement of implicit attitudes. Nevertheless, this tool has yet to be validated or standardized for best practice use. Despite appearing in a number of publications, there has been no empirical examination of how properties of the speeded self-report might affect its utility and outcomes. To address this gap, I conducted 4 studies observing response distributions and error rates to establish best practice recommendations for using (1) words or picture stimuli; (2) target and filler trials, (3) response keys, and (4) response anchors. In Study 1 words yielded slightly better results than did images and a comparison of three timing conditions suggested that trials are optimal at 1000ms (with 800ms being too short). Study 2 showed that including only 25% of target stimuli over 20 trials produced results similar to including 50% target stimuli over 40 trials—suggesting four attitudes can be measured simultaneously in a short number of trials. Studies 3 and 4 showed little evidence to support the use of certain keys or response anchors in speeded self-report trials, suggesting these features should be determined primarily by study objectives. Overall, these studies add to an emerging body of work aiming to improve the ways we identify implicit attitudes, biases, and beliefs.

As the healthcare profession has become more diverse, physicians may encounter patients who discriminate against them based on their group identity. Most past research has focused on addressing healthcare workers’ negative bias toward patients, yet incidents of patient bias toward healthcare workers also occur. Patient bias is prejudice, racism, and/or discrimination against healthcare workers by patients experienced during patient-provider interactions and decision-making. Experiencing discrimination due to these biases can negatively influence healthcare workers’ health and well-being and reduce their persistence in their careers. Yet, to my knowledge, no studies have measured patients’ implicit bias toward healthcare workers. Thus, in two studies, I examined patients’ implicit bias toward Hispanic physicians and two important qualities for physician-patient interaction: trustworthiness and competence. I also examined how these biases related to whether people chose a Hispanic physician, their perceptions of care by a Hispanic physician, and their intentions to adhere to medical advice from Hispanic physicians. Across both studies, participants implicitly rated White physicians more favorably (i.e., more implicitly trustworthy and competent) than Hispanic physicians. Results suggested that people were more likely to choose a Hispanic physician to the extent that they implicitly associated Hispanic physicians with competence and more likely to adhere to physicians to the extent that they rated Hispanic physicians as implicitly competent and trustworthy. Additionally, results suggested Hispanic participants were more sensitive to physician ethnicity than were White participants. Specifically, Hispanic participants who were assigned a Hispanic physician were more likely to be confident in the diagnosis to the extent they reported implicit trustworthiness and competence ratings for Hispanic physicians. Additionally, Hispanic participants who were assigned a Hispanic physician were more likely to believe the diagnosis to the extent they reported implicit trustworthiness ratings for Hispanic physicians. Finally, Hispanic participants assigned a White physician were more likely to request a second opinion and less likely to be confident in the physician’s diagnosis to the extent they reported implicit trustworthiness ratings for Hispanic physicians.

Despite the potential negative implications of avoiding information about one’s health, research finds that people sometimes avoid this information. Current theorizing on avoidance implies that information is avoided to the extent that it is unwanted, however, no research has measured this construct of unwantedness nor examined its potential role in avoidance behavior. Further, although past work examines links between individual factors and avoidance, it generally fails to consider how these factors may work in tandem to predict avoidance. The present work proposes and defines a novel construct which can summarize multiple factors that contribute to health information avoidance: unwantedness of information, or the extent to which one does not desire information.In Study 1, participants completed a disease risk calculator, faced a decision to learn or forego their disease-risk feedback, and completed three measures of unwantedness. The results revealed that a brief 2-item measure of unwantedness accounted for as much variance in avoidance as more extended measures. Further, unwantedness of disease-risk feedback was associated with a greater likelihood of avoiding disease-risk feedback. In Study 2, participants completed a disease risk calculator, the 2-item measure of unwantedness, and then faced a decision to learn or forego their disease-risk feedback. The results revealed that the 2-item measure of unwantedness demonstrated convergent and discriminant validity. Moreover, disutility of learning information and lack of resources for learning information were both associated with greater unwantedness of information which, in turn, was associated with a greater likelihood of information avoidance. In Study 3, participants were assigned to a behavioral obligation manipulation, a manipulation emphasizing lack of treatment, or a control condition before completing a risk calculator for TAA deficiency (a fictitious disease). Next, they completed the 2-item measure of unwantedness and faced a decision to learn or forego their disease-risk feedback. The results suggested that the behavioral obligation manipulation increased unwantedness of disease-risk feedback and, in turn, avoidance. Collectively, these findings support the role of unwantedness of information in decisions to avoid health information and suggest that unwantedness is a promising target for future research aimed at reducing avoidance of health information.

Avoiding information about one’s risk for disease can have long-term implications for health. Past research suggests that people avoid health information when they perceive that they lack control and coping resources. We theorized that these two relationships implicate a broader underlying mechanism in health information avoidance—coping self-efficacy. Two studies examined the relationship between coping self-efficacy and avoidance of personal disease risk. Study 1 revealed that coping self-efficacy, but not general self-efficacy, was associated with information avoidance, such that participants who reported greater coping self-efficacy were less likely to avoid their risk. Study 2 established a causal relationship between coping self-efficacy and avoidance. Participants who reflected on their past positive coping strategies were less likely to avoid learning their risk as compared to those who did not reflect on their coping strategies. These findings suggest that coping self-efficacy is likely a good target for reducing health information avoidance.

Food is an ever-present part of the environment, nevertheless, no research has attempted to broadly examine the phenomenon of avoiding information about food. This literature has predominately focused on avoiding calorie information, avoiding information about animals, and information about environmental impact. In the present work, I investigated what types of information people will avoid learning about their food and the individual differences associated with the desire to avoid food information. Using a mixed-methods approach, in three studies, this project explores what information people want to avoid learning about their food, the extent to which people want to avoid specific undesirable food information, and what individual differences relate to food-related information avoidance. In Study 1, participants provided free responses to questions about food information they would like to avoid. The results revealed that participants most often cited a desire to avoid information about food preparation followed by information about the content/ingredients in the food. In Study 2, participants were assigned to one of four conditions representing food contexts that had different levels of personal control and social obligation and were asked to rate their degree of desire to avoid pieces of food information. Results suggested on average participants most preferred to avoid information surrounding others. This included information such as being judged by others and the burden it took for others to make them their meal. Moreover, participants were more likely to avoid food information in a food context where they experience low personal control. In Study 3, participants rated their degree of desire to avoid food information, along with several individual difference measure. Results revealed that eating identity centrality, food-related disgust, environmental concern, and perception of current physical health were all significant predictors of food-related information avoidance. These findings are an important initial step in identifying the information people are most inclined to avoid and suggest that reports of what people immediately consider when recalling what they do not want to know about their food might not fully portray the information they most want to avoid. Furthermore, they provide an initial base for understanding of the what and the who of information avoidance in the context of food.

Across 4 studies, we examined whether information avoidance—the deliberate decision to remain ignorant of available information—serves a self-protective function that is interchangeable with other mechanisms of self-protection. We tested this idea by examining the relationship between information avoidance and defensive derogation of feedback. In Studies 1a and 1b, we examine whether people with a prior disposition to avoid would be more likely to derogate health information they received. We then replicated these findings in a large, confirmatory sample (Study 2). Study 3 experimentally ruled out two potential alternative explanations for the relationship established in Studies 1 and 2 by manipulating whether participants have an opportunity to avoid feedback (eliminating self-selection bias), and by presenting everyone with identical feedback (eliminating variance in the feedback received). Finally, Study 4 experimentally tested whether situations that should influence defensiveness—induction of self-(un)certainty—would increase (certainty) or decrease (uncertainty) both proactive avoidance and reactive defensiveness (Study 4). Taken together, results suggest that information avoidance is likely part of a broader self-protective system, and that people will substitute other mechanisms of self-protection for avoidance.