Mental models of women with breast implants: local complications.

Twenty-five women with breast implants participated in semistructured interviews designed to reveal their "mental models" of the processes potentially causing local (i.e., nonsystemic) problems. The authors analyzed their responses in terms of an "expert model," circumscribing scientifically relevant information. Most of the women interviewed had something to say about most elements in the expert model. Nonetheless, gaps in their mental models undermined decision making about their implants. One woman misunderstood the terms used by the medical community to describe implant failure (e.g., rupture, leak, and bleed). Another exaggerated the implants' vulnerability to direct impacts, such as car accidents. Participants also overestimated their ability to detect localized problems and to select medical remedies. Although they were generally satisfied with their own implants, many participants were dissatisfied with the decision-making processes that lead to their choice. Their interviews are interpreted by the form and content of communications that women with implants need to help them manage their health decisions better.

The effect of question format on measured HIV/AIDS knowledge: detention center teens, high school students, and adults.

This study examines the effect of question format on HIV/AIDS knowledge assessed in teens in a detention center, public high school students, and adults. Multiple-choice items were taken from a Red Cross questionnaire and were transformed into open-ended and true/false/don't know formats. Each respondent received an open-ended and a structured version of the test (consisting of multiple-choice and true/false/don't know items). Format effects varied by group and order of presentation: High school students and adults performed better on the open-ended questions if they had answered the structured versions first-suggesting that the structured questions provided these respondents with unintended cues. Detention center youths did not benefit from having answered the structured items, and scored especially low on the open-ended questions. However, they did almost as well as the other groups with the true/false/don't know format. Implications are discussed for measuring HIV/AIDS knowledge and evaluating educational programs for different target audiences.