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Women (compared to men) and individuals from minority ethnic groups (compared to the majority group) face unfavourable labour market outcomes in many economies 1,2 , but the extent to which discrimination is responsible for these effects, and the channels through which they occur, remain unclear 3,4 . Although correspondence tests 5 -in which researchers send fictitious CVs that are identical except for the randomized minority trait to be tested (for example, names that are deemed to sound 'Black' versus those deemed to sound 'white')-are an increasingly popular method to quantify discrimination in hiring practices 6,7 , they can usually consider only a few applicant characteristics in select occupations at a particular point in time. To overcome these limitations, here we develop an approach to investigate hiring discrimination that combines tracking of the search behaviour of recruiters on employment websites and supervised machine learning to control for all relevant jobseeker characteristics that are visible to recruiters. We apply this methodology to the online recruitment platform of the Swiss public employment service and find that rates of contact by recruiters are 4-19% lower for individuals from immigrant and minority ethnic groups, depending on their country of origin, than for citizens from the majority group. Women experience a penalty of 7% in professions that are dominated by men, and the opposite pattern emerges for men in professions that are dominated by women. We find no evidence that recruiters spend less time evaluating the profiles of individuals from minority ethnic groups. Our methodology provides a widely applicable, non-intrusive and cost-efficient tool that researchers and policy-makers can use to continuously monitor hiring discrimination, to identify some of the drivers of discrimination and to inform approaches to counter it.

Background: Responses to anticipateddiscrimination are common among mental health service users and can have adetrimental impact on their recovery. Since 2009, the Time to Change (TTC)anti-stigma program in England has aimed to improve service users' empowerment,reducing public stigma and discrimination. In this paper, we aim to evaluatewhether service users' awareness of TTC is associated with fewer responses toanticipated discrimination., Methods: We used data collected for the evaluation of TTC from samples of mental health service users interviewed by telephone in annual surveys 2009-2014., Results: Five thousand and nine hundredand twenty-three participants completed the survey, mainly suffering from mooddisorders (depression, 28.4%, n = 1,681) and schizophrenia related disorders(15.4%, n = 915).In 23.2% of cases,participants were aware of any aspects of the TTC program, while participationin TTC was reported by 2.6%. Being aware of the TTC program was notsignificantly associated with responses to anticipated discrimination, exceptfor those participating in the TTC campaign in 2013. Stopping oneself fromapplying for work was significantly associated with experienced discriminationin both finding (p < 0.001) and keeping (p < 0.001) a job.Concealing mental health problems was associated with a general experience ofbeing shunned (p < 0.001)., Conclusions: Awareness of a nationalanti-stigma program may not be sufficient to encourage people to seek work/educationor to be open about their illness in situations in which they currentlyanticipate discrimination. There is the need to identify new multi-levelstrategies for challenging anticipated discrimination, even focusing ondifferent target groups.

Introduction: The presence of discrimination, bullying, sexual harassment, and harassment (DBSH) in the healthcare workplace negatively affects the health and well-being of providers and is associated with poor mental health, low self-esteem, high levels of absenteeism, and low levels of productivity., Methods: The American Academy of Orthopaedic Surgeons (AAOS) developed and distributed a survey to a subset of AAOS members to assess the climate of workplace safety and overall workplace culture. Women and underrepresented minority (URM) AAOS members and an equal number of randomly selected non-URM men were invited to participate in the survey., Results: Nine hundred twenty-seven of 5,638 (16.4%) members responded to the survey. Sixty-six percent of respondents reported experiencing DBSH behavior with specific exposures to DBSH of 79%, 55%, 47%, and 40%, respectively. Women (81%) were more likely than men (35%) to have experienced these behaviors. Fifty-eight percent of respondents reported that their workplaces were equipped to deal effectively with DBSH behaviors., Discussion: DBSH behaviors occur in the orthopaedic workplace. More attention to these issues is necessary to ensure that all orthopaedic surgeons in training and in practice have a safe work environment that is inclusive, equitable, and health-promoting., Level of Evidence: N/A.

Purpose: Students perceive bias in learning environments. Curricula targeting implicit bias recognition and management increase student awareness and achieve strategy identification, but fall short of actual skill development to address bias. In light of this gap, the authors developed and evaluated a skills-based elective to recognize and manage implicit bias in the learning environment., Method: Nine 1.5-hour sessions were delivered to 15 first-year medical students from 2017 to 2019. An evidence-based conceptual framework and transformative learning theory informed the instructional design; it incorporated active learning exercises. Skills assessment occurred through direct observation of student performances in role-play exercises. Using thematic analysis, the authors conducted a program evaluation based on focus groups with students and data from notes taken by the investigative team., Results: Students engaged with all aspects of instruction, including role-plays. Authors identified 3 themes from the program evaluation: (1) Student engagement can be enhanced, (2) Instruction is empowering, and (3) It (addressing bias in one's own and witnessed encounters) can be done! Analysis additionally highlighted opportunities for improvement and lessons learned., Conclusions: This innovative course achieved skill development and practice for medical students in implicit bias recognition and management as it pertains to 3 facets of clinical care present at every stage of a health professional's career. These include interpersonal encounters, advocating for patients when bias is perceived in witnessed encounters with peers and supervisors, and addressing comments made by others within the learning environment. Outcomes could inform novel, skills-based curricula across the spectrum of health professions training and practice.

Competing Interests: Competing interests: Simone Vigod reports receiving royalties for authorship of materials related to depression and pregnancy, from UpToDate, Inc. No other competing interests were declared.

Some patients engage in behavior or use language that demeans clinicians on the basis of their social identity traits, such as race, ethnicity, sex, disability, gender presentation, and sexual orientation, and some patients even request reassignment of involved clinicians. Despite the importance and prevalence of this problem, many medical centers lack an organizational approach for addressing patient conduct. Policy development can be daunting because organizations may encounter various barriers, including reluctance of staff to have difficult conversations about race or other identity traits; uncertainty about what constitutes an appropriate response to the spectrum of demeaning behaviors and who should make this determination; what, if any, support should be offered to targeted clinicians; whether these incidents should be reported and to whom; and whether the medical center's response should differ depending on whether nurses, trainees, or other clinicians are involved. These determinations have important implications for patients' informed consent rights, clinicians' employment rights, and medical centers' obligations to protect patients' health while adhering to workplace antidiscrimination laws and institutional commitments to diversity, equality, and inclusion. This article addresses these considerations and offers guidance to organizations on devising effective policies that meet the needs of medical centers, patients, and health care workers across services and roles, including physicians, nurses, and trainees.

Recent events encompassing social injustices, healthcare disparities, and police brutality against Black citizens highlight the continued need to strive toward unbiased and inclusive practices in all realms of the world. Our voices as cell biologists are powerful tools that can be used to combat inequities in the scientific landscape. In this inaugural Voices essay, we discuss how exclusion and inclusion events have contributed to our scientific journeys and how scientists can work to create an inclusive environment for our trainees and colleagues. As underrepresented minority scientists in the early and late stages of our scientific training, we frame the trainee experience to provide insight from unique perspectives. This essay also provides actionable items that the cell biology community can implement to promote inclusivity. We anticipate that initiating an open dialogue focused on diversity and inclusion will promote growth in the field of cell biology and enable scientists to assess and assume their role in creating welcoming environments. We believe that scientists at all stages in their careers can make meaningful and habitual contributions to supporting inclusivity in cell biology, thereby creating a future where diversity, equity, and inclusion are expected, not requested.

Although there is evidence that peer-led HIV treatment interventions are effective in improving health outcomes of people living with HIV (PLWH), few studies have assessed the health and psychosocial benefits of being a peer living with HIV. Qualitative interviews were conducted with nine PLWH who were peers of an HIV self-management intervention, to examine how this experience was perceived to impact their health behaviors, social support, and professional development. Peers reported improved HIV self-management and reduced health risk behaviors, which were attributed to increased self-efficacy and the desire to be a role model for participants. Peers described the experience as an opportunity to expand social networks and develop professional skills that could be leveraged for future employment. Our findings suggested that the benefits of being a peer could be enhanced in trainings and supervision by linking the importance of health-promoting behaviors to being a role model for other PLWH.

Background and Objectives: Individuals with high anxiety sensitivity (AS) display negative interpretive biases in response to uncomfortable but nondangerous physical sensations. Research suggests that modifying interpretation biases associated with AS leads to changes in AS. The present study sought to replicate and extend this research by addressing limitations of previous studies, increasing the amount of training and adding a follow-up period., Method: Participants high in AS were randomly assigned to four sessions of computerized interpretation bias modification (CBM-I) training or four sessions of computerized "sham" training (control condition) over a 2-week period. The outcomes were AS, interpretive biases, and reactions to induced physical sensations. Assessments occurred at baseline, during training, immediately after the final training session, and 2 weeks after the final training; number of re-assessments varied by outcome., Results: The CBM-I condition did not outperform the control condition. At the end of the training period, the CBM-I condition displayed limited reductions in AS and interpretation biases. There were no changes in reactions to induced physical sensations. Similar results were found in the control condition for all outcomes., Limitations: The control task and the dose of training may have obscured potential effects of CBM-I., Conclusions: When considered within the context of previous research, the experimental effects and therapeutic potential of CBM-I for high AS appear to be minimal. However, methodological questions need to be resolved before such a conclusion can be considered definitive., Competing Interests: Declaration of competing interest The authors do not have any conflicts of interest., (Copyright © 2019. Published by Elsevier Ltd.)

Annually, the National Association of School Nurses (NASN) sets advocacy goals. The goals include legislative and policy priorities. This article sets forth current NASN legislative priorities and results of advocacy that benefit students. The NASN Board of Directors are instrumental in moving policy priorities forward. In addition, this article shares NASN advocacy during the COVID-19 pandemic.

Contact-based interventions are commonly regarded as best practice in stigma reduction. In this Open Forum, the author used the findings from eight systematic reviews to critically evaluate the quality of the evidence for the effectiveness of such interventions. He found that trials of contact-based interventions lacked methodological rigor, reporting was biased toward positive results, the trials were subject to demand characteristics, no dose effects were observed, effects did not last, and no evidence supported behavior change. Standards for future trials are proposed and implications for reducing stigma and discrimination are discussed.

In an ideal world, there are equal opportunities for women to enter and progress in all scientific disciplines without bias or prejudice. Here, we share our experiences in building communities of women parasitology and offer easy-to-implement guidelines for scientists and institutions to overcome unconscious bias and create environments with better gender equality and diversity., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Stigma associated with gambling disorder is complex, and is a key obstacle that prevents sufferers from seeking early help for their condition. However, little research has addressed how best to reduce gambling stigma. This study explored the effectiveness of video intervention styles, that have been used to reduce public stigma for conditions such as mental illness and substance use disorders. This was done to determine which would be most suitable, considering the unique characteristics of gambling disorder. An online survey of 164 people living in Australia was conducted which examined attitudes toward gamblers experiencing problems before and after an intervention. Participants were randomly allocated to one of three interventions (contact, education, advocacy) or a control video. The study found that each intervention was associated with changes to different components of stigma. Importantly, the education intervention increased labelling, but reduced stereotype endorsement and anger. Advocacy also reduced anger, attributions of character flaws, and anticipated discrimination and recoverability. While these interventions were generally effective at reducing stigma, the contact intervention was mixed, effectively intervening for some aspects of stigma, but increasing stigma on others. No single intervention reduced all aspects of stigma, suggesting that a complementary approach utilising specific elements of each intervention style could be used to deliver relevant information and effectively reduce stigma. Taken together, this suggests that research should be conducted into comprehensive, combined interventions, that include aspects of all three intervention styles, in an attempt to reduce more aspects of stigma simultaneously.

Purpose/objective: Health care providers' attitudes of marginalized groups can be key factors that contribute to health care access and outcome disparities because of their influence on patient encounters as well as clinical decision-making. Despite a growing body of knowledge linking disparate health outcomes to providers' clinical decision making, less research has focused on providers' attitudes about disability. The aim of this study was to examine providers' explicit and implicit disability attitudes, interactions between their attitudes, and correlates of explicit and implicit bias. Research Method/Design: We analyzed secondary data from 25,006 health care providers about their disability attitudes. In addition to analyzing people's explicit and implicit attitudes (Disability Attitudes Implicit Association Test), we used Son Hing, Chung-Yan, Hamilton, & Zanna's (2008) model of two-dimensional prejudice to compare provider's explicit and implicit attitudes. Finally, we used linear regression models to examine correlates of providers' explicit and implicit attitudes., Results: While on average, provider's explicit attitudes ( M = 4.41) indicated little prejudice, their implicit attitudes ( M = 0.54) revealed they moderately preferred nondisabled people-they were aversive ableists. Correlates of providers' explicit and implicit attitudes also included age, gender, political orientation, and having relationships with disability (friends, family, and being a person with disability)., Conclusions/implications: This study revealed that despite a majority of providers self-reporting not being biased against people with disabilities, implicitly, the overwhelming majority were biased. This study's findings can be used to better understand how provider disability bias can contribute to inequitable health care access and health outcomes for people with disabilities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Although scholars have long studied circumstances that shape prejudice, inquiry into factors associated with long-term prejudice reduction has been more limited. Using a 6-year longitudinal study of non-Black physicians in training ( N = 3,134), we examined the effect of three medical-school factors-interracial contact, medical-school environment, and diversity training-on explicit and implicit racial bias measured during medical residency. When accounting for all three factors, previous contact, and baseline bias, we found that quality of contact continued to predict lower explicit and implicit bias, although the effects were very small. Racial climate, modeling of bias, and hours of diversity training in medical school were not consistently related to less explicit or implicit bias during residency. These results highlight the benefits of interracial contact during an impactful experience such as medical school. Ultimately, professional institutions can play a role in reducing anti-Black bias by encouraging more frequent, and especially more favorable, interracial contact.

Purpose: Digital storytelling (DST), broadly speaking, is a storytelling method that is interwoven with digital media. It is commonly used in educational settings or human services to support various sorts of social advocacy. While many of these DST practices have devised methods to engage marginalized groups to express their voices, they lack parallel initiatives to enable audiences to understand those voices. This study examined a story-retelling workshop model called  StoryAd , which utilizes productions from DST activities to facilitate face-to-face contact. The workshop itself is also a lite version of DST activity., Method: A pilot study was conducted in Hong Kong in 2019. Participants enrolled online, met offline, and their advertisement ideas might go online and contribute back to the stories. The workshop model was evaluated using a one-group pretest-posttest design. The participants were 45 Hong Kong Chinese, aged 18-60., Results: Participants' critical thinking disposition, self-esteem, perspective-taking, and curiosity toward new information increased, while their need for cognitive-closure decreased., Discussion and Conclusion: This study has proved the feasibility and acceptability of the workshop model. It also opens the discussion about extending DST pedagogy to engage and influence story-readers.

Purpose of Review: Although the business world has long recognized the benefits of diversity and inclusion and the effects of unconscious bias, the discourse is just now gaining traction in the medical field. In addition, many businesses have developed key initiatives to address unconscious bias in the workplace., Recent Findings: In the medical field, diversity leads to improved health outcomes, increased access to healthcare by the underserved and more innovation. However, unconscious bias may inadvertently propagate health disparities, affect trainee evaluations, hinder faculty satisfaction and exclude populations from meaningful research., Summary: In this review, we discuss diversity, inclusion and unconscious bias in obstetrics and gynaecology, as it relates to patient care, health outcomes, medical faculty and trainees. We also discuss potential interventions that mitigate these issues.

Issue Addressed: Social inclusion is important for mental health, and schools are important settings for creating positive attitudes against prejudice. Capoeira is a Brazilian traditional culture that is a mixture of dance, martial arts and games, and has many educational possibilities. Since it arose from and helped people rise above black oppression, the purpose of the project was introducing the content of capoeira to primary school students with the aim of promoting of mental health and preventing prejudice behaviours using an intercultural perspective in a school where nearly half the students are Aboriginal., Methods: Five capoeira classes were conducted in a primary school located in a regional city in Western Australia, with two Year 5-6 classes and boys and girls aged 11-12 years old. Activities were meant to create an environment of dialogue, joy and empathy towards a different culture. Feedback from 31 of 34 students were collected and analysed, dealing with their impressions, positive and negative aspects., Results: The results were positive, with aspects of movement, joy, dance and music identified as important experiences. Empathy towards the new culture was written and drawn by many of the students. Joint work with teachers improved engagement and feedback from students., Conclusion: Capoeira can be an inspiring vehicle in intercultural education, promoting mental health and empathy for different cultures. SO WHAT?: Broad intercultural education which embraces positive cultural experiences and stories from elsewhere, delivered in schools can contribute to children's intercultural competence. Longer interventions with follow-up to measure changes in students' attitudes are required., (© 2018 Australian Health Promotion Association.)

Background: Lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals experience higher rates of health disparities. These disparities may be driven, in part, by biases of medical providers encountered in health care settings. Little is known about how medical, nursing, or dental students are trained to identify and reduce the effects of their own biases toward LGBTQ individuals. Therefore, a systematic review was conducted to determine the effectiveness of programs to reduce health care student or provider bias towards these LGBTQ patients., Methods: The authors performed searches of online databases (MEDLINE/PubMed, PsycINFO, Web of Science, Scopus, Ingenta, Science Direct, and Google Scholar) for original articles, published in English, between March 2005 and February 2017, describing intervention studies focused on reducing health care student or provider bias towards LGBTQ individuals. Data extracted included sample characteristics (i.e., medical, nursing, or dental students or providers), study design (i.e., pre-post intervention tests, qualitative), program format, program target (i.e., knowledge, comfort level, attitudes, implicit bias), and relevant outcomes. Study quality was assessed using a five-point scale., Results: The search identified 639 abstracts addressing bias among medical, nursing, and dental students or providers; from these abstracts, 60 articles were identified as medical education programs to reduce bias; of these articles, 13 described programs to reduce bias towards LGBTQ patients. Bias-focused educational interventions were effective at increasing knowledge of LGBTQ health care issues. Experiential learning interventions were effective at increasing comfort levels working with LGBTQ patients. Intergroup contact was effective at promoting more tolerant attitudes toward LGBTQ patients. Despite promising support for bias education in increasing knowledge and comfort levels among medical, nursing, and dental students or providers towards LGBTQ persons, this systematic review did not identify any interventions that assessed changes in implicit bias among students or providers., Conclusions: Strategies for assessing and mitigating implicit bias towards LGBTQ patients are discussed and recommendations for medical, nursing, and dental school curricula are presented.

Unconscious (or implicit) biases are learned stereotypes that are automatic, unintentional, deeply engrained, universal, and able to influence behavior. Several studies have documented the effects of provider biases on patient care and outcomes. This article provides a framework for exploring the implications for unconscious bias in surgical education and highlights best practices toward minimizing its impact. Presented is the background related to some of the more common unconscious biases and effects on medical students, resident trainees, and academic faculty. Finally, targeted strategies are highlighted for individuals and institutions for identification of biases and the means to address them., (Published by Elsevier Inc.)

Background: Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness., Methods: We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-reviewed studies conducted on adults between May 2005 and April 2015, testing interventions designed to reduce implicit bias, with results measured using the Implicit Association Test (IAT) or sufficiently similar methods., Results: 30 articles were identified as eligible. Some techniques, such as engaging with others' perspective, appear unfruitful, at least in short term implicit bias reduction, while other techniques, such as exposure to counterstereotypical exemplars, are more promising. Robust data is lacking for many of these interventions., Conclusions: Caution is thus advised when it comes to programs aiming at reducing biases. This does not weaken the case for implementing widespread structural and institutional changes that are multiply justified.

Purpose: This article describes the work of the South African Truth and Reconciliation Commission (TRC) in examining the role of the health sector in human rights violations in the protracted conflicts during apartheid., Organizing Construct: The enabling legislation contained in the Promotion of National Healing and Reconciliation Act of 1995 allowed for in-depth examination of violations and complicity in human rights abuses. We provide an overview of the process of the public hearings, soliciting submissions, examining evidence of abuse, personal testimony of conflict in situations of dual accountability, and ultimately the recommendations made by the TRC. The article also outlines the responses of various health professional training institutions to the TRC's recommendations, the implementation of university health and human rights courses, and some current challenges post-TRC., Conclusions: The health sector hearings of the TRC provided a window into the structural unequal access, racial discrimination, prejudice, and abuse in the health services under the apartheid regime. Examination of past violations perpetrated by an abusive regime and by those such as health workers operating in such a system is imperative to ensure that these abuses are not repeated in the future., Clinical Relevance: In delivering comprehensive, compassionate, and ethical care, healthcare professionals have accountability to respect and promote the human rights of their patients. Training in human rights and its relationship to health should be incorporated into all health professional programs., (© 2018 Sigma Theta Tau International.)

Purpose: To inform the field of rehabilitation psychology about the sociocultural implications of the term "disability," and explain the rationale behind the #SaytheWord movement, a social media call to embrace disability identity., Method: Review of the literature on disability terminology, the history of language use, and the relationship between attitudes toward disability and language. We reflect on the role of disability within the field of psychology and within the American Psychological Association (APA), including the underrepresentation of disabled psychologists and trainees with disabilities and the lack of mentorship opportunities available in the field., Implications: The authors argue that erasure of the word "disability" can have unintended and adverse consequences. We describe how erasure of disability identity in the context of current sociopolitical efforts to reduce and eliminate public services and supports for people with disabilities is especially threatening to members of the disability community. To move forward, the authors postulate that the disability movement must reconcile its own history of exclusion and adopt a disability justice framework., Conclusion: The field of psychology has a rich tradition of appreciation of cultural diversity and individual difference; yet, disability has largely been left out of these efforts. The disability movement is moving toward the status of a diverse cultural group with a social justice agenda parallel to those of other marginalized communities. The authors posit that psychology must play a stronger role in advancing the human rights of people with disabilities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

We investigated whether encouraging young children to discuss the mental states of an immigrant group would elicit more prosocial behaviour towards them and impact on their perception of a group member's emotional experience. Five- and 6-year-old children were either prompted to talk about the thoughts and feelings of this social group or to talk about their actions. Across two studies, we found that this manipulation increased the extent to which children shared with a novel member of the immigrant group who was the victim of a minor transgression. The manipulation did not lead to greater sharing towards a victim from the children's own culture and did not influence their perception of a victim's negative emotions. These results may ultimately have implications for interventions aimed at fostering positive intergroup relations within the context of immigration., (© 2018 John Wiley & Sons Ltd.)

Rehabilitation psychology uniquely incorporates a holistic, psychosocial perspective encompassing all aspects of disability, with a particular focus on the connection between disabled people and the social environment. This article introduces a special issue of Rehabilitation Psychology on diversity and social justice in disability research. The 13 articles in this special issue coalesce around the 3 themes of (a) critical disability identity theory, (b) discrimination and prejudice, and (c) health disparities in the context of disability. This article introduces each of these articles and draws upon the work contained in this special issue to highlight important future directions for research on diversity and social justice in disability across the following areas: (a) nondisabled privilege, (b) rehabilitation versus cure versus adjustment, (c) diverse modes of knowing, and (d) a priori diversity and strength-based measures. This special issue helps rehabilitation psychologists consider how they can best fulfill their social justice, human rights, and advocacy missions in order to advance access and inclusion with and for diverse groups of disabled people. (PsycINFO Database Record (c) 2019 APA, all rights reserved).