Two Minds Blog

  This week, the White House announced that the United States will not  meet the target of vaccinating 70% of American adults by July 4th. Back in April, many people here in Denver were driving a hundred miles to get their vaccine doses in rural areas the minute they became available. What gives? As usual , human behavior rather than medical expertise is the limiting factor in addressing health challenges. A recent national survey identified four main reasons that people weren't yet vaccinated. Together they add up to around 35% of adults, or about the number who haven't yet gotten a COVID-19 vaccine. 1. Watchful Waiting (about 8%) - these people aren't yet convinced that the vaccines are efficacious or safe. An often-cited argument that might tell you someone is in this group is the fact that the vaccine hasn't yet been FDA-approved, but is still in an "emergency authorization" phase. That's of course true. Normally, the FDA approval process involves mu...

In several previous studies on HIV prevention and HIV medication adherence , I used a model in which various Intuitive-level experiences have their effect on behavior by way of a mediating variable called "motivation." The title of one of my previous papers, " motivation as a mechanism ," explains the way that I was thinking about this relationship between Intuitive-level variables 4 or 5 years ago. A student recently asked me whether I meant intrinsic or extrinsic motivation when I included the variable in my model. That question got me thinking again about the whole concept of motivation, and whether it really plays a role in determining people's behavior. Motivation can be defined as "reasons for acting in a particular way," as a "desire to do something," or as "willingness to do something." My own use of the term has been most similar to the last of these definitions, "willingness," because I understand "reasons...

One of my teaching roles involves reviewing clinical quality improvement (QI) projects led by students in our Doctor of Nursing Practice (DNP) program. The classic QI method involves looking at regular reports from a clinic or hospital unit, graphing the data either monthly or weekly, and making changes with the hope of seeing a sharp improvement on the graph right around the time that the interventions were put into place. For example, a student might measure the percentage of hospitalized patients who have a fall after surgery (generally considered to be a preventable adverse event) on a weekly basis. If the rate is generally stable, but it goes down after the student initiates some provider training and a new procedure to screen patients for fall risk, and then the rate stabilizes at the new lower level going forward, it’s reasonable to assume that the student’s QI project caused the improvement. Regular measurement is the key: In the words of management consultant Peter Drucker (i...

In a study last year , colleagues and I found that people with HIV experienced high levels of fatigue and that their fatigue was predicted by everyday factors like sleep, stress, and mood. These findings showed interesting differences between people’s conscious (Narrative mind) experiences of fatigue and the daily non-conscious factors (Intuitive mind) that actually predicted their day-to-day levels of fatigue.  Knowing this, I wondered whether we could help people to reduce their fatigue by giving them more information about predictors of fatigue that are normally outside of their awareness. I was able to conduct a preliminary test of this idea (pre-COVID) in a single case study where I met with an additional participant who would have qualified for the study, but who enrolled after the main data collection phase was completed and analyses had already begun. This serendipitous timing allowed me to provide the participant with information compiled from all of the other people in th...

With Dr. Scott Harpin Scholarly writing is one of the great challenges of academic life, often summarized as “publish or perish.” Yet many of us in this business feel that we are perishing. Despite writing’s importance, the typical faculty feeling about it is something like this: “Writing is a backburner thing: I simply do not have enough time to make it happen.” Writing is a behavior that’s hard to change despite the existence of real-world consequences. In the worst-case scenario failure to write means that a faculty members don’t get tenure and lose their jobs, but the less-severe consequences include bad annual reviews, lack of recognition for their work, and a personal sense of shame or failure. Even those who are  successful  at writing by objective measures (publication counts, citation indices) almost always go through periods of writers’ block, anxiety about writing, and self-recrimination for failing to write. Writing is a key to success in academia. Why is it so h...

After a year of living in pandemic conditions, many people have experienced at least some level of traumatic events . These can include things like isolation and disruption of social support networks; unemployment and financial strains; living with continual threats to health and safety; negotiating differing levels of risk tolerance with others in a highly politicized environment; witnessing the illness or actual death of people in your social network including family members; and being unable to respond in typical ways or participate in typical grieving rituals because of the pandemic. Additional stressors include frequently changing health policy and community rules, the desire to maintain aspects of "normal" life (e.g., holidays, vacations) despite pandemic-related changes, the additional cost or difficulty associated with doing so, and the indefinite and uncertain nature of the changes that have occurred in everyday living. Layered on all of these things is a climate of ...

My youngest child moves up from elementary school to middle school this year, which means that I’m ending my 7-year tenure as a PTA parent coordinator for her school’s science fair. People love to hate the science fair. Some of the most common critiques are that: (a) the events are unnecessarily competitive and therefore a source of stress for children, (b) that the assignment highlights resource gaps because affluent families can provide more support to their children’s projects at home, or worse buy their kids a high-quality project (!), and (c) that many of the experiments are cookie-cutter projects taken from books and aren’t actually all that interesting. Many aspects of these are true, and in fact the same critiques could be leveled at the last professional poster session that I attended: there’s competition that can make junior scientists feel bad about their work, the rich schools have better projects and more of them, and a lot of the scientific findings are pretty predictab...