Primary care professionals' perspectives on tailoring buprenorphine training for rural practice.

PURPOSE: Buprenorphine is a highly effective medication for opioid use disorder (OUD) that remains substantially underutilized by primary care professionals (PCPs). This is particularly true in rural communities, which have fewer prescribers and significant access disparities. The Drug Enforcement Administration removed the X-waiver requirement in December 2022, yet many rural clinicians still report barriers to prescribing buprenorphine. In this study, we examined rural PCPs' experiences with buprenorphine to identify tailored training strategies for rural practice. METHODS: Physicians, nurse practitioners, and physician associates practicing in rural Ohio counties were recruited through contacts at statewide health associations and health professions training programs. Twenty-three PCPs were interviewed about their perspectives on prescribing buprenorphine, including their training history. FINDINGS: PCPs self-reported being motivated to respond to OUD. However, they also reported that current training efforts failed to equip them with the knowledge and resources needed to prescribe effectively, and that urban-focused training often alienated rural clinicians. Participants suggested tailoring training content to rural settings, using rural trainers, and bolstering confidence in navigating rural-specific barriers, such as resource deficits and acute opioid fatigue. CONCLUSION: Our study found that current training on buprenorphine prescribing is inadequate for meeting the needs of rural PCPs. Tailored buprenorphine training is needed to improve accessibility and acceptability, and to better support the clinical workforce in communities disproportionately impacted by the opioid epidemic.

Buprenorphine misinformation and willingness to treat patients with opioid use disorder among primary care-aligned health care professionals.

BACKGROUND: Buprenorphine is a highly effective medication for opioid use disorder that is underused by health care professionals (HCPs). Medications for opioid use disorder (MOUD) misinformation may be an important barrier to buprenorphine access, but most implementation strategies have aimed to reduce negative attitudes towards patients with opioid use disorder (OUD) rather than misinformation specific to buprenorphine use. In this study, we assessed the degree to which HCPs endorsed misinformation related to buprenorphine, and whether this is associated with willingness to provide care to patients with OUD. METHODS: In September-December of 2022, we surveyed HCPs practicing in Ohio (n = 409). Our primary outcomes included a previously validated 5-item measure of HCP willingness to treat patients with OUD, and three other measures of willingness. Our key independent variable was a study-developed 5-item measure of endorsement of misinformation related to buprenorphine, which assessed beliefs in buprenorphine's efficacy in managing withdrawal symptoms and reducing overdose deaths as well as beliefs about the role of buprenorphine in achieving remission. We computed descriptive and bivariable statistics and fit regression models predicting each outcome of interest. RESULTS: On average, HCPs scored 2.34 out of 5.00 (SD = 0.80) on the composite measure of buprenorphine misinformation. 48.41% of participants endorsed at least one piece of misinformation. The most endorsed items were that buprenorphine is ineffective at reducing overdose deaths (M = 2.75, SD =0 .98), and that its use substitutes one drug for another (M = 2.41, SD = 1.25). HCP endorsement of buprenorphine misinformation significantly and negatively predicted willingness to work with patients with OUD (b = - 0.34; 95% CI - 0.46, - 0.21); intentions to increase time spent with this patient population (b = - 0.36; 95% CI - 5.86, - 1.28); receipt of an X-waiver (OR = 0.54, 95% CI 0.38, 0.77); and intention to get an X-waiver (OR: 0.56; 95% CI: 0.33-0.94). CONCLUSIONS: Misinformation is common among HCPs and associated with lower willingness to treat patients with OUD. Implementation strategies to increase MOUD use among HCPs should specifically counter misinformation related to buprenorphine. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov, NCT05505227. Registered 17 August 2022, https://clinicaltrials.gov/ct2/show/NCT05505227.

Differences in buprenorphine prescribing readiness among primary care professionals with and without X-waiver training in the US.

BACKGROUND: Medications for opioid use disorder (OUD) are effective at preventing overdose and infectious disease but are vastly under-prescribed in the US. For decades, prescribers faced additional training and regulation to prescribe buprenorphine which stigmatized the medication and lessened support for a harm reduction approach to treating opioid use disorder. The Drug Enforcement Administration removed the X-waiver requirement for prescribing buprenorphine in late 2022, which removed stigma and lessened important barriers to prescribing but also left training at the discretion of individual organizations. Our study aimed to assess differences in knowledge, confidence, and stigma regarding buprenorphine between those who went through the X-waiver training and those who did not, among practicing primary care providers (PCPs). METHODS: We assessed buprenorphine prescribing readiness among primary care aligned outpatient providers in Ohio, USA. Using survey data, we conducted bivariate and regression analyses predicting primary prescribing outcomes. Primary outcomes measured knowledge of and confidence in buprenorphine, as well as perceived adequacy of one's training. Secondary outcomes were attitudes toward patients with OUD, including bias toward OUD patients, stress when working with them, and empathy toward them. Participants (n = 403) included physicians, nurse practitioners, and physician assistants practicing in primary care aligned disciplines. RESULTS: Survey data showed that PCPs who received X-waiver training were more likely to understand and have confidence in the mechanism of buprenorphine, and consider their training on treating OUD to be adequate. PCPs with an X-waiver showed more empathy, less negative bias, and experienced less stress when working with patients with OUD. CONCLUSION: Removing restrictive policies for prescribing buprenorphine is an important step to expanding access and reducing the stigma associated with opioid use disorder treatment. Yet, our findings suggest that the training received alongside regulation may be important for improving prescribing confidence and reducing stigma. Strategies to increase buprenorphine prescribing are unlikely to be effective without also expanding access to prescribing support for primary care providers across the career course.

Have You Heard the News? The Effects of Exposure to News About Recent Transgender Legislation on Transgender Youth and Young Adults.

Introduction: Over the last 3 years, there has been a proliferation of legislation aimed at restricting the rights of transgender Americans, including their access to gender-affirming health care. While the health implications of not having access to gender-affirming care are well documented, there may be additional indirect harms associated with proposing this type of legislation, such as those associated with being exposed to negative messages about transgender people or having to contend with friends and family who support the legislation. Methods: This study was conducted between September and November 2021 and used a mixed-methods design to examine the implications of consuming news related to the recently proposed legislation as well as perceiving that people in one's social network support such legislation on the health and well-being of transgender youth and young adults (n = 113). Results: Results showed that news consumption was associated with increased rumination and physical health symptoms and that perceived support for the legislation was associated with greater rumination, depressive symptoms, physical health symptoms, and fear of disclosing one's identity. Themes from the open-ended questions further underscored that the current legislation has impacted transgender youth and young adults' access to general health care; increased experiences of discrimination and other maltreatment; and resulted in some respondents engaging in unhealthy coping responses. Conclusions and Policy Implications: Policy makers should consider these adverse consequences when responding to current, and crafting future, legislation directed at transgender Americans.

The Burden of Hate: How Nonwork Discrimination Experienced During the COVID-19 Pandemic Impacts Asian American Employees.

The COVID-19 pandemic has been accompanied by a sharp increase in prejudice and discrimination targeting Asian Americans in the USA. Thus, in addition to the public health risks associated with the virus, exposure to discrimination poses a unique threat to the health and well-being of Asian Americans. Indeed, empirical evidence has documented the linkage between experiencing anti-Asian discrimination during the pandemic and health decrements among Asian Americans. The goal of this study was to expand that research to also consider the ways experiencing discrimination in a nonwork context may spill over to affect the general and job-related well-being of Asian American employees as well as the potential mitigating role of coworker compassion. Results from a sample of 311 Asian American employees demonstrated that experiencing nonwork discrimination was associated with decrements in physical health and increased depression and job-related exhaustion. Further, there were significant interactions between nonwork discrimination and coworker compassion for engagement, emotional exhaustion, and depressive symptoms such that nonwork discrimination was more strongly related to each outcome when coworker compassion was low. The findings from the current study suggest that experiences of racial derogation, even those that occur outside the workplace environment, are detrimental to the well-being of employees and that coworker compassion is a positive resource that may foster healthier and more inclusive work environments. Supplementary Information: The online version contains supplementary material available at 10.1007/s10869-022-09848-6.

Positive contact and empathy as predictors of primary care providers' willingness to prescribe medications for opioid use disorder.

Introduction: Patients with opioid use disorder (OUD) have a heightened need for quality health care, including access to evidence-based medications to reduce cravings and prevent overdose. However, primary care providers (PCPs) are reluctant to work with patients with OUD and implement medication prescribing into primary care practice. Previous studies have sought to identify potential ways to overcome these barriers, but often utilize interventions that facilitate both positive contact with as well as empathy for patients with OUD. In this study, we jointly assess positive contact and empathy to determine their unique impact on treatment attitudes and behaviors among PCPs, after controlling for other known predictors. Methods: We surveyed 409 PCPs currently practicing in Ohio in 2022. Our primary dependent variables were willingness to work with patients with OUD, receipt of an X-waiver to prescribe buprenorphine, and interest in receiving an X-waiver. Our primary independent variables were positive contact and empathy toward patients with OUD. We computed bivariate correlations and multivariable linear regression (for continuous dependent variables) and logistic regression (for binary dependent variables) to understand the relationship between positive contact, empathy, and our outcome variables while accounting for other known predictors and relevant participant demographics. Results: Positive contact was positively correlated with willingness to work with patients with OUD, receipt of the X-waiver, an interest in receiving the X-waiver, more frequent checking with patients about the need for naloxone, and higher odds of naloxone prescribing. These relationships held after accounting for PCP demographics, explicit bias toward patients with OUD, and overall levels of contact with patients with OUD. Empathy, conversely, was not a significant predictor of any treatment outcomes in the fully adjusted models. Conclusion: Interventions and medical education programs aimed at improving treatment outcomes for patients with OUD should facilitate positive contact between PCPs and patients with OUD.

Experiencing, anticipating, and witnessing discrimination during the COVID-19 pandemic: Implications for health and wellbeing among Asian Americans.

The onset of the COVID-19 pandemic spurred increased racial animus toward Asians and Asian Americans (A/AA) who have since been contending with increased racism and violence. While some of the harm associated with this increased prejudice may derive from personally experienced discrimination, the COVID-19 pandemic has also been marked by an increase in vicarious exposure to discrimination as well as increased anticipation of discrimination, both of which may be taxing for the mental and physical health of A/AA. The goal of this study, accordingly, was to examine the effects of personal experiences of discrimination, vicarious exposure to discrimination, and anticipated discrimination on depressive symptoms, physical health symptoms, sleep quality, and sleep disturbances among A/AA. Results from our two-wave field survey demonstrated that experiencing and anticipating discrimination were associated with mental and physical health symptoms as well as sleep disturbances. Further, personal experiences of discrimination interacted with vicarious discrimination to determine physical health symptoms such that greater vicarious exposure weakened the relationship between experienced discrimination and physical health symptoms. These findings demonstrate the need to mobilize resources to combat the multipronged, negative implications of the recent rise in anti-Asian prejudice during the COVID-19 pandemic.

An experimental study of the effects of messaging strategies on vaccine acceptance and hesitancy among Black Americans.

Black Americans have been disproportionately affected by COVID-19 but have comparatively low vaccination rates, creating a need for vaccine messaging strategies that are tailored to this population. We conducted an experimental study to examine the effects of three messaging strategies on Black Americans' reported willingness to receive the vaccine and vaccine hesitancy. We also recruited White and Hispanic Americans to assess any potential backfire effects of the tailored strategies for non-Black participants. A total of 739 participants completed the study. Results from 4x2 ANCOVAs indicate that, among Black participants, messaging that acknowledged past unethical treatment of Black Americans in medical research and emphasized current safeguards to prevent medical mistreatment was associated with significantly less vaccine hesitancy than the control condition. The same effects were not observed for messaging strategies that provided general safety information about the vaccine or that emphasized the role of the vaccine in reducing racial inequities. There were no significant differences across conditions for participants of other races. Results demonstrate that public health messages tailored to address specific vaccine concerns may aid future vaccination campaigns.

Barriers to Working with Patients Who Misuse Opioids and Physician Burnout: Implications for Medical Education.

BACKGROUND: Physicians are on the front lines of the U.S. opioid epidemic, providing care in multiple treatment settings. Very little is known, however, about whether this experience has contributed to physician burnout. This information is critical for guiding efforts to expand the relatively low level of training on opioid misuse currently available in medical education. METHODS: We surveyed 408 board-certified physicians practicing in Ohio about their experiences working with patients who misuse opioids. We also collected quantitative measures of physicians' burnout and their level of contact with this patient population. We coded and analyzed open-ended responses and calculated a partial correlation between contact and burnout, controlling for relevant factors. RESULTS: Physicians experienced three primary barriers when working with patients who misuse opioids: inadequate knowledge and training, limited external resources and partnerships in their communities, and an incomplete context for understanding problematic patient behaviors. 70% of physicians experienced negative emotions when working with this patient population and 19% mentioned experiencing burnout specifically. Contact with patients who misuse opioids was significantly and positively associated with burnout scores. CONCLUSIONS: Our findings underscore the need for medical educators to take a proactive approach to equipping physicians with the knowledge, skills, and resources needed to effectively work with patients who misuse opioids.

Shift happens: The gender composition in clinical neuropsychology over five decades.

OBJECTIVE: The current study utilizes five decades of data to demonstrate cohort differences in gender representation in governance, speaking at conferences, serving on editorial boards, and in scholarly productivity in clinical neuropsychology. Broadly examining gender disparities across domains of professional attainment helps illuminate the areas in which inequity in clinical neuropsychology is most pronounced and in need of ameliorative resources. METHODS: Data from 1967 to 2017 were coded from publicly available information from the four major professional associations for clinical neuropsychology in the U.S. (i.e. INS, AACN, NAN, & SCN). Gender differences were examined in (1) speaking at a national conference, (2) holding an office in a professional organization, (3) serving on the editorial team for a journal affiliated with a professional organization, and (4) scholarly activity as coded from Google Scholar. RESULTS: The percentage of men in the field significantly declined across time, whereas the percentage of women significantly increased; the number of women exceeded the number of men in approximately 1992. Gender differences in conference speakers, editorial board members, and research citations were greater in the earlier than in more recent cohorts of clinical neuropsychologists but gender inequity in conference speaking and editorial activities is evident in the most recent cohorts. DISCUSSION: Gender differences in conference speakers, editorial board members, and in earning research citations have diminished over time, but early career women still face disadvantages in speaking at conferences and serving on editorial boards. We provide strategies to increase and sustain women's participation in leadership in neuropsychology.

Revisiting the relationship between contact and physician attitudes toward patients with opioid use disorder.

INTRODUCTION: Prior research suggests that some physicians hold negative attitudes toward patients who misuse opioids and that this serves as a barrier which limits the availability and effectiveness of health care services. Interventions which improve physicians' attitudes have thus garnered attention, many of which have focused on increasing contact between physicians and patients who misuse opioids. However, drawing on recent literature on intergroup contact, the current paper argues that contact may not have uniformly positive effects on prejudice. METHODS: We surveyed 408 board-certified physicians in the state of Ohio where many opioid overdose deaths have been concentrated. We used regression to test for interactions between contact and three focal variables, bias, burnout, and stress, on physician willingness to work with patients who misuse opioids. RESULTS: The negative relationships between bias, physician burnout, and stress induced by working with patients who misuse opioids and physicians' willingness to work with this patient population are each exacerbated when contact with patients who misuse opioids is high. CONCLUSIONS: Although intervention studies have shown promise for the role that increased contact may have in reducing stigma toward patients who misuse opioids, these interventions may not be appropriate for physicians who are experiencing strain or who hold preexisting negative attitudes toward this patient population. Future interventions may need to target bias, burnout, and stress, in addition to facilitating contact, to increase physician willingness to work with these patients.

Physician blame and vulnerability: novel predictors of physician willingness to work with patients who misuse opioids.

BACKGROUND: Successfully combating the opioid crisis requires patients who misuse opioids to have access to affirming and effective health care. However, there is a shortage of physicians who are willing to work with these patients. We investigated novel predictors of what might be contributing to physicians' unwillingness to engage with this patient population to better identify and direct interventions to improve physician attitudes. METHODS: 333 physicians who were board certified in the state of Ohio completed a survey about their willingness to work with patients who misuse opioids. The hypothesized relationships between the proposed predictors and willingness to work with this patient population were tested using multivariate regression, supplemented with qualitative analysis of open-text responses to questions about the causes of addiction. RESULTS: Perceptions of personal invulnerability to opioid misuse and addiction, opioid misuse and addiction controllability, and health care provider blame for the opioid crisis were negatively associated with physician willingness to work with patients who misuse opioids after controlling for known predictors of physician bias toward patients with substance use disorders. Physicians working in family and internal medicine, addiction medicine, and emergency medicine were also more willing to work with this patient population. CONCLUSIONS: Distancing oneself and health care professionals from opioid misuse and placing blame on those who misuse are negatively associated with treatment willingness. Interventions to improve physician willingness to work with patients who misuse opioids can target these beliefs as a way to improve physician attitudes and provide patients with needed health care resources.

Interpreting moderated multiple regression: A comment on Van Iddekinge, Aguinis, Mackey, and DeOrtentiis (2018).

When data contradict theory, data usually win. Yet, the conclusion of Van Iddekinge, Aguinis, Mackey, and DeOrtentiis (2018) that performance is an additive rather than multiplicative function of ability and motivation may not be valid, despite applying a meta-analytic lens to the issue. We argue that the conclusion was likely reached because of a common error in the interpretation of moderated multiple-regression results. A Monte Carlo study is presented to illustrate the issue, which is that moderated multiple regression is useful for detecting the presence of moderation but typically cannot be used to determine whether or to what degree the constructs have independent or nonjoint (i.e., additive) effects beyond the joint (i.e., multiplicative) effect. Moreover, we argue that the practice of interpreting the incremental contribution of the interaction term when added to the first-order terms as an effect size is inappropriate, unless the interaction is perfectly symmetrical (i.e., X-shaped), because of the partialing procedure that moderated multiple regression uses. We discuss the importance of correctly specifying models of performance as well as methods that might facilitate drawing valid conclusions about theories with hypothesized multiplicative functions. We conclude with a recommendation to fit the entire moderated multiple-regression model in a single rather than separate steps to avoid the interpretation error highlighted in this article. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Beyond political affiliation: an examination of the relationships between social factors and perceptions of and responses to COVID-19.

A significant challenge in the United States' response to COVID-19 continues to be wide variation in the extent to which individuals believe the virus is a credible health threat and are willing to undertake measures to protect personal and public health. In this study, data were collected from a national sample of 1141 participants from the United States to examine how beliefs and behavioral responses to COVID-19 have been shaped by sociopolitical characteristics. The relationships between social predictors; perceived severity, knowledge, and fear of the virus; and health behaviors were tested using path analysis. Social characteristics significantly predicted perceived severity, knowledge, and fear, as well as health behaviors, even after controlling for an objective indicator of the risk of contracting the virus. Our findings suggest that perceptions and knowledge of the virus, especially believing that the virus poses a serious threat to one's individual health, are important determinants of behavior, but also that perceptions and knowledge are strongly driven by social and cultural factors above and beyond political affiliation.

Attitudes toward and experiences working with patients who misuse opioids among board certified physicians in Ohio.

Background: The United States has experienced substantial consequences associated with the opioid epidemic. One such consequence has been an increased need for patients who misuse opioids to interface with health care professionals. As such, it is important to understand physician attitudes toward and experiences with this patient population. The goal of this paper is to assess the extent to which physicians hold negative attitudes toward patients who misuse opioids and whether this patient population receives differential treatment. Methods: Using a mixed methods design, we surveyed board-certified physicians in Ohio regarding their attitudes toward patients who misuse opioids as well as their observations of bias toward these patients in health care settings. Results: Our findings suggest that negative attitudes toward patients who misuse opioids are common among physicians as were personal experiences of bias toward this patient population. We also found that physicians rationalized treating these patients differently and perceived barriers to achieving more equitable treatment. Finally, some physicians expressed a desire for additional training and resources to reduce bias. Conclusions: Negative attitudes toward patients who misuse opioids may serve as a critical barrier to patients accessing care in areas heavily affected by the U.S. opioid epidemic.

Rural-Urban Differences in Physician Bias Toward Patients With Opioid Use Disorder.

OBJECTIVE: Effective treatments for opioid use disorder exist, but rural areas of the United States have a shortage of services offering such treatments. Physician bias toward patients with opioid use disorder can also limit care access, but no studies have assessed whether physician bias is a more acute barrier in rural compared with urban communities. METHODS: In total, 408 board-certified physicians in Ohio, a state with a high rate of opioid overdoses, completed an online survey examining perspectives on clinical care for patients who misuse opioids. Respondents with missing county-level data were excluded, leaving a total sample of 274. The authors used t tests to determine rural-urban differences in bias, key predictors of bias, and availability of opioid services. Multivariable regression modeling was used to estimate rural-urban differences in bias independent of key bias predictors. RESULTS: Physicians in rural areas (N=37) reported higher levels of bias toward patients with opioid use disorder than did their urban counterparts (N=237). This difference remained statistically significant even after accounting for known bias predictors and physician specialty. Physicians specializing in addiction medicine reported lower bias than did physicians not working in this specialty. CONCLUSIONS: Given existing disparities in harm reduction and addiction treatment services in rural areas, increased physician bias in counties lacking these services suggests that rural patients with opioid use disorder face numerous challenges to finding effective treatment. Bias reduction interventions should target health care professionals in rural communities where such efforts may have the most pronounced impact on improving health care access.

Why public health framing matters: An experimental study of the effects of COVID-19 framing on prejudice and xenophobia in the United States.

The COVID-19 pandemic has triggered a notable increase in the expression of prejudicial and xenophobic attitudes that threaten the wellbeing of minority groups and contribute to the overall public health toll of the virus. However, while there is evidence documenting the growth in discrimination and xenophobia, little is known about how the COVID-19 outbreak is activating the expression of such negative attitudes. The goal of the current paper therefore was to investigate what aspects of the COVID-19 pandemic may be contributing to this rise in expressions of prejudice and xenophobia. More specifically, this study used an experimental design to assess the effects of using stigmatized language to describe the virus as well as the threat to physical health and economic wellbeing posed by the virus on COVID-19 prejudice. Data were collected from a national sample of 1451 adults residing within the United States. Results from 2 × 2 x 2 between-subjects analyses of covariance demonstrated that emphasizing the connection between China and COVID-19, rather than framing the virus neutrally, increased negative attitudes toward Asian Americans, beliefs that resources should be prioritized for Americans rather than immigrants, and general xenophobia. Emphasizing the severity of the economic impact of the virus also increased beliefs that Asian Americans are a threat to resources and general xenophobia. In contrast, messages which emphasized the serious health risks of COVID-19 did not increase bias toward Asian Americans or xenophobia. Our findings suggest that specific types of public health messaging related to infectious diseases, especially framing the virus in terms of its country of origin or its likely economic impact, may elicit prejudice and xenophobia. Public health campaigns that emphasize the severity of the virus, however, are not likely to trigger the same negative attitudes. Implications for public health responses to health crises are discussed.

The Role of News Consumption and Trust in Public Health Leadership in Shaping COVID-19 Knowledge and Prejudice.

The novelty of COVID-19 has created unique challenges to successful public health efforts because it has required the public to quickly learn and formulate knowledge and attitudes about the virus as information becomes available. The need to stay apprised of new information has also created a critical role for mass media and public institutions in shaping the public's knowledge of, attitudes about, and responses to the unfolding pandemic. In this study, we examine how media consumption and reliance on specific institutions for information shapes three critical outcomes associated with public health epidemics: the accumulation of knowledge and the endorsement of misinformation about COVID-19, and prejudicial responses to the virus. We surveyed 1,141 adults residing across the United States in March 2020. Using multivariate regression and t-tests, we found that participants had greater knowledge, were less likely to endorse misinformation, and reported less bias toward Asian Americans when they had higher trust in the CDC and lower trust in President Trump. Reliance on certain news formats and sources was also associated with knowledge, misinformation, and prejudice. Our findings suggest that trust and news consumption can pose critical barriers to health literacy and foster negative prejudicial responses that further undermine public health efforts surrounding the COVID-19 pandemic.

Unexpected public health consequences of the COVID-19 pandemic: a national survey examining anti-Asian attitudes in the USA.

OBJECTIVES: This paper empirically examines whether and how COVID-19 may be activating bias and discrimination toward individuals of Asian descent. METHODS: In March 2020, we used a national online survey to collect data from 1141 US residents. Using descriptive statistics and multivariate regression, we estimated the prevalence and COVID-19-related predictors of bias toward people of Asian descent. RESULTS: We found over 40% of our sample reported they would engage in at least one discriminatory behavior toward people of Asian descent. Respondents who were fearful of COVID-19 (b = .09, p < 0.001) and had less accurate knowledge about the virus (b = - .07, p < 0.001) reported more negative attitudes toward Asians as did respondents with less trust in science (b = - .06, p < 0.001) and more trust in President Trump (b = .04, p < 0.001). CONCLUSIONS: Public health leaders must confront fear of the virus, improve knowledge, and bolster trust in science as these factors may evoke negative attitudes toward Asians and increase prejudice and discrimination. Specifically, our findings warrant the adoption of public health campaigns that provide health information and build trust in scientific knowledge.

A meta-analysis of sex and race differences in perceived workplace mistreatment.

Despite the growing number of meta-analyses published on the subject of workplace mistreatment and the expectation that women and racial minorities are mistreated more frequently than men and Whites, the degree of subgroup differences in perceived workplace mistreatment is unknown. To address this gap in the literature, we meta-analyzed the magnitude of sex and race differences in perceptions of workplace mistreatment (e.g., harassment, discrimination, bullying, incivility). Results indicate that women perceive more sex-based mistreatment (i.e., mistreatment that explicitly targets a person's sex) in the workplace than men (δ = .46; k = 43), whereas women and men report comparable perceptions of all other forms of mistreatment (δ = .02; k = 300). Similarly, although racial minorities perceive more race-based mistreatment (i.e., mistreatment that explicitly targets a person's race) in the workplace than Whites (δ = .71; k = 18), results indicate smaller race differences in all other forms of workplace mistreatment (δ = .10; k = 61). Results also indicate that sex and race differences have mostly decreased over time, although for some forms of mistreatment, subgroup differences have increased over time. We conclude by offering explanations for the observed subgroup differences in workplace mistreatment and outline directions for future research. (PsycINFO Database Record