Examining Linguistic Differences in Electronic Health Records for Diverse Patients With Diabetes: Natural Language Processing Analysis.

Background: Individuals from minoritized racial and ethnic backgrounds experience pernicious and pervasive health disparities that have emerged, in part, from clinician bias. Objective: We used a natural language processing approach to examine whether linguistic markers in electronic health record (EHR) notes differ based on the race and ethnicity of the patient. To validate this methodological approach, we also assessed the extent to which clinicians perceive linguistic markers to be indicative of bias. Methods: In this cross-sectional study, we extracted EHR notes for patients who were aged 18 years or older; had more than 5 years of diabetes diagnosis codes; and received care between 2006 and 2014 from family physicians, general internists, or endocrinologists practicing in an urban, academic network of clinics. The race and ethnicity of patients were defined as White non-Hispanic, Black non-Hispanic, or Hispanic or Latino. We hypothesized that Sentiment Analysis and Social Cognition Engine (SEANCE) components (ie, negative adjectives, positive adjectives, joy words, fear and disgust words, politics words, respect words, trust verbs, and well-being words) and mean word count would be indicators of bias if racial differences emerged. We performed linear mixed effects analyses to examine the relationship between the outcomes of interest (the SEANCE components and word count) and patient race and ethnicity, controlling for patient age. To validate this approach, we asked clinicians to indicate the extent to which they thought variation in the use of SEANCE language domains for different racial and ethnic groups was reflective of bias in EHR notes. Results: We examined EHR notes (n=12,905) of Black non-Hispanic, White non-Hispanic, and Hispanic or Latino patients (n=1562), who were seen by 281 physicians. A total of 27 clinicians participated in the validation study. In terms of bias, participants rated negative adjectives as 8.63 (SD 2.06), fear and disgust words as 8.11 (SD 2.15), and positive adjectives as 7.93 (SD 2.46) on a scale of 1 to 10, with 10 being extremely indicative of bias. Notes for Black non-Hispanic patients contained significantly more negative adjectives (coefficient 0.07, SE 0.02) and significantly more fear and disgust words (coefficient 0.007, SE 0.002) than those for White non-Hispanic patients. The notes for Hispanic or Latino patients included significantly fewer positive adjectives (coefficient -0.02, SE 0.007), trust verbs (coefficient -0.009, SE 0.004), and joy words (coefficient -0.03, SE 0.01) than those for White non-Hispanic patients. Conclusions: This approach may enable physicians and researchers to identify and mitigate bias in medical interactions, with the goal of reducing health disparities stemming from bias.

Social inattentional blindness to idea stealing in meetings.

Using a virtual reality social experiment, participants (N = 154) experienced being at the table during a decision-making meeting and identified the best solutions generated. During the meeting, one meeting participant repeated another participant's idea, presenting it as his own. Although this idea stealing was clearly visible and audible, only 30% of participants correctly identified who shared the idea first. Subsequent analyses suggest that the social environment affected this novel form of inattentional blindness. Although there was no experimental effect of team diversity on noticing, there was correlational evidence of an indirect effect of perceived team status on noticing via attentional engagement. In sum, this paper extends the inattentional blindness phenomenon to a realistic professional interaction and demonstrates how features of the social environment can reduce social inattention.

The Dobbs Decision and the Future of Occupational Health in the US.

Access to abortion care has a profound impact on women's ability to participate in the workforce. In the US, restrictions on abortion care have waxed and waned over the years, including periods when abortion was broadly permitted across the nation for most pregnant people for a substantial proportion of pregnancy and times when restrictions varied across states, including states where abortion is banned for nearly all reasons. Additionally, access to abortion care has always been a reproductive justice issue, with some people more able to access this care than others even when it is structurally available. In June 2022, the US Supreme Court handed down the Dobbs v. Jackson Women's Health Organization, returning to states the ability to determine restrictions on abortion, including near-total bans on abortion. In this anthology, ten experts share their perspectives on what the Dobbs decision means for the future, how it will exacerbate existing, well-researched issues, and likely also create new challenges needing investigation. Some contributions are focused on research directions, some focus on implications for organizations, and most include both. All contributions share relevant occupational health literature and describe the effects of the Dobbs decision in context.

Managing One's Age in Age-Dissimilar Mentoring Relationships.

The aging of the workforce creates opportunities for experienced employees to share expertise with newer employees, via mentoring relationships. Age-dissimilar interactions, however, like those between mentor and protégé, can engender challenging interpersonal dynamics such as concern about how others view and respond to them. The current study examines the unique challenges and opportunities of age-dissimilar mentoring relationships, using a sample of doctor and lawyer protégés. Findings suggest that age dissimilarity does not play as large of a role in mentoring relationship outcomes as age-related behaviors. How one manages their age seems to be more important, such that managing one's age in a positive way by redefining age-related stereotypes rather than switching attention away from stereotypes is better for mentoring relationship outcomes no matter the age difference between mentor and protégé. Implications, inferences, and limitations are discussed.

Worrying About Finances During COVID-19: Resiliency Enhances the Effect of Worrying on Both Proactive Behavior and Stress.

Amidst the COVID-19 pandemic and resulting economic instability, many people are contending with financial insecurity. Guided by Conservation of Resources Theory (Hobfoll, American Psychologist 44:513-524, 1989; Hobfoll et al., Annual Review of Organizational Psychology and Organizational Behavior 5:103-128, 2018), the current research explores the consequences of experiencing financial insecurity during a pandemic, with a focus on individuals who report relatively higher rates of financial insecurity, performance challenges, and stress during such experiences: working parents (American Psychological Association, 2022). This research also examines the role that personal resources, in the form of trait resiliency, play in the relationships between financial insecurity and behavioral and psychological outcomes including worrying, proactive behaviors, and stress. In a study of 636 working parents and their children, we find that financial insecurity heightens worrying, underscoring the threatening nature of the loss or anticipated loss of material resources. Worrying, in turn, promotes proactive behaviors at work-an effect that is more pronounced among high-resiliency individuals. However, worrying is also associated with elevated stress among high-resiliency individuals, providing support for a trait activation perspective (rather than buffering hypotheses) on ongoing, uncontrollable adversities. Taken together, our results help to (1) illuminate the impact of financial insecurity on work and well-being, (2) reveal a mechanism (i.e., worrying) that helps explain the links between financial insecurity and work and personal outcomes, and (3) expand our knowledge of the implications trait resiliency has for both psychological and behavioral reactions to ongoing crises.

Beyond the Baby Bump: Subtle Discrimination Against Working Mothers In the Hiring Process.

Despite a large proportion of working mothers in the American workforce, research suggests that negative stereotypes and discrimination against working mothers continue to exist. In a set of two experimental studies, the current paper examined subtle discrimination against non-pregnant, working mothers in different hiring settings. In Study 1, using a between-subject field experiment and applying for geographically dispersed jobs with manipulated resumes, we found evidence for subtle discrimination, such that mothers received more negativity in callback messages than women without children, men without children, and fathers. They were also rejected more quickly than women without children and fathers. In Study 2, using a more controlled experimental paradigm, we tested our hypothesis in a hypothetical interview evaluation setting. We found that mothers faced more interpersonal hostility across different job types as compared to women without children. Together, these studies highlight the presence of subtle discrimination against working mothers at different stages of the hiring process.

The role of fairness perceptions in patient and employee health: A multilevel, multisource investigation.

This research extends the group engagement model (GEM) to examine how fairness judgments implicate both organizational-level and individual-level outcomes, including patient health and satisfaction (i.e., patient health outcomes) and employee health. Based on the social identity arguments of the GEM, we argue that fair career advancement procedures at the organizational level and experiences of discrimination at the individual level are indicators of identity-based evaluations of fairness. Utilizing annual staff survey data from the National Health Service (NHS) in the U.K. (n = 147 hospitals with n = 60,602 employees), we observe that organizational fairness of career advancement procedures significantly relates to patient health through the hospital-level mediator, employee voice. Individual fairness of an employee's personal experience with discrimination significantly relates to employee health through the individual-level mediator, psychological safety. Results support the three-stage indirect effect from organizational-level fairness to employee health via individual-level fairness and individual-level psychological safety. In supplemental studies, measurement limitations are addressed through multitrait multimethod matrix and content validation approaches. These results indicate that the archival NHS measures sufficiently operationalize the constructs of interest providing further support for the hypothesized model. The theoretical and practical implications of this work for multilevel conceptualizations of fairness and healthcare organizations are presented. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Work-family strategies during COVID-19: Examining gender dynamics among dual-earner couples with young children.

There are several existing typologies of dual-earner couples focused on how they dually manage work and family; however, these all assume that couples can outsource childcare during normal work hours and that work is largely conducted outside of the home. Early attempts to control COVID-19 altered these assumptions with daycares/schools closing and the heavy shift to remote work. This calls into question whether couples tended to fall back on familiar gendered patterns to manage work and family, or if they adopted new strategies for the unique pandemic situation. We addressed this question using a sample of 274 dual-earner couples with young children. We content coded couples' qualitative responses about their plans for managing childcare and work commitments and used these codes in a latent class analysis to identify subgroups. Seven classes were identified, with 36.6% of the sample using strategies where women did most or all childcare, 18.9% of the sample using strategies that were not clearly gendered or egalitarian, and 44.5% of the sample using unique egalitarian strategies. We also obtained data from 133 of these couples approximately 7 weeks later regarding their well-being and job performance. Results suggested that women in the Remote Wife Does It All class had the lowest well-being and performance. There were nuanced differences between the egalitarian strategies in their relationships with outcomes, with the Alternating Days egalitarian category emerging as the overall strategy that best preserved wives' and husbands' well-being while allowing both to maintain adequate job performance. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

How do aggression source, employee characteristics and organisational response impact the relationship between workplace aggression and work and health outcomes in healthcare employees? A cross-sectional analysis of the National Health Service staff survey in England.

OBJECTIVES: To examine the prevalence of aggression in healthcare and its association with employees' turnover intentions, health and engagement, as well as how these effects differ based on aggression source (patients vs colleagues), employee characteristics (race, gender and occupation) and organisational response to the aggression. DESIGN: Multilevel moderated regression analysis of 2010 National Health Service (NHS) survey. SETTING: 147 acute NHS trusts in England. PARTICIPANTS: 36 850 participants across three occupational groups (14% medical/dental, 61% nursing/midwifery, 25% allied health professionals or scientific and technical staff). MAIN OUTCOME MEASURES: Employee turnover intentions, health and work engagement. RESULTS: Both forms of aggression (from patients and colleagues) have significant and substantial effects on turnover intentions, health and work engagement; however, for all three outcome variables, the effect of aggression from colleagues is more than twice the size of the effect of aggression from patients. Organisational response was found to buffer the negative effects of aggression from patients for turnover intentions and the negative effects of aggression from patients and colleagues for employee health. The results also demonstrated that nurses/midwives, women and Black employees are more likely to experience aggression; however, no clear patterns emerged on how aggression differentially impacts employees of different races, genders and occupations with respect to the outcome variables. CONCLUSIONS: Although aggression from patients and colleagues both have negative effects on healthcare employees' turnover intentions, health and work engagement, these negative effects are worse when it is aggression from colleagues. Having an effective organisational response can help ameliorate the negative effects of aggression on employees' health; however, it may not always buffer negative effects on turnover intentions and work engagement. Future research should examine other approaches, as well as how organisational responses and resources may need to differ based on aggression source.

The Benefits of Identity Integration across Life Domains.

A significant portion of Americans identify as lesbian, gay, or bisexual (LGB). Troubling then is the fact that many of these individuals lack federal protections, with two-thirds reporting that they experience discrimination. This creates a difficult disclosure dilemma for LGB individuals. On one hand, self-verification theory and the work of Dr. Gregory Herek indicate that there are psychological benefits to being open about one's identity in the workplace and social situations. In contrast, disclosing may open these individuals up to discriminatory experiences. To analyze the benefits and consequences of disclosure decisions across life domains, we collected survey data from 184 LGB individuals working at least 30 hours per week in the United States of America. Regression analyses showed that life satisfaction was maximized when disclosure was high and concordant across life domains. In other words, LGB individuals experienced the highest levels of life satisfaction when they were able to be open about their identity in work and non-work situations (i.e., identity integration). Notably, the most negative outcomes (e.g., worsened life satisfaction) were observed when identity disconnects (e.g., high disclosure at work, low disclosure in non-work domains) or identity denial (i.e., low disclosure in both domains) were present, confirming seminal theories of disclosure decisions across life domains. Our findings indicate that we should strive to create disclosure-supportive environments in work and non-work domains, with supportive organizational policies and active allies playing a crucial role in this process.

Affective antecedents and consequences of revealing and concealing a lesbian, gay, or bisexual identity.

This study examined affect as it relates to the identity management (IM) experiences of lesbian, gay, and bisexual (LGB) workers. We integrate IM theories and evidence (Chaudoir & Fisher, 2010; Pachankis, 2007) within the framework of affective events theory (Weiss & Cropanzano, 1996) to predict relationships among mood, identity management, and emotion at work. LGB participants rated aspects of positive and negative affect each work morning and immediately following IM situations at work over 3 weeks, making it possible to examine within-person changes and next-day consequences of IM. Our results provided little support for the notion that LGB workers' IM behaviors are driven by affect. However, there do appear to be affective consequences of IM behaviors. After concealment, participants experienced diminished positive affect and increased negative affect; in contrast, revealing was associated with increased positive affect and diminished negative affect. Additionally, these immediate affective consequences of identity management continued into the following day for some facets of affect. We examine these findings as they relate to the identity management and affect literatures, thereby building new insights into their intersections. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Investigating why and for whom management ethnic representativeness influences interpersonal mistreatment in the workplace.

Preliminary research suggests that employees use the demographic makeup of their organization to make sense of diversity-related incidents at work. The authors build on this work by examining the impact of management ethnic representativeness-the degree to which the ethnic composition of managers in an organization mirrors or is misaligned with the ethnic composition of employees in that organization. To do so, they integrate signaling theory and a sense-making perspective into a relational demography framework to investigate why and for whom management ethnic representativeness may have an impact on interpersonal mistreatment at work. Specifically, in three complementary studies, the authors examine the relationship between management ethnic representativeness and interpersonal mistreatment. First, they analyze the relationship between management ethnic representativeness and perceptions of harassment, bullying, and abuse the next year, as moderated by individuals' ethnic similarity to others in their organizations in a sample of 60,602 employees of Britain's National Health Service. Second, a constructive replication investigates perceived behavioral integrity as an explanatory mechanism that can account for the effects of representativeness using data from a nationally representative survey of working adults in the United States. Third and finally, online survey data collected at two time points replicated these patterns and further integrated the effects of representativeness and dissimilarity when they are measured using both objective and subjective strategies. Results support the authors' proposed moderated mediation model in which management ethnic representation is negatively related to interpersonal mistreatment through the mediator of perceived behavioral integrity, with effects being stronger for ethnically dissimilar employees. (PsycINFO Database Record

One hundred years of discrimination research in the Journal of Applied Psychology: A sobering synopsis.

Employment discrimination-a legal, social, moral, and practical problem-has been a persistent focus of narrow scholarship in the Journal of Applied Psychology since its inception. Indeed, this article identifies the environmental characteristics, conceptual underpinnings, dominant methodologies, research questions and findings across 508 articles published on discrimination in the journal over the last 100 years. Emergent themes document signs of stability and change in 3 eras: an era wherein discrimination research was itself discriminatory (1917-1969), the heyday of discrimination research (1970-1989), and an era of unsteady progress (1990-2014). This synthesis suggests that, although increasingly sophisticated methodological approaches have been applied to this topic, the targets of focus and theories driving research have largely been static. Additionally, research published on discrimination in the Journal of Applied Psychology has often trailed too far behind the times. Specific recommendations for advancing the psychological study of employment discrimination in applied contexts are provided. (PsycINFO Database Record

A field experiment: reducing interpersonal discrimination toward pregnant job applicants.

The current research targets 4 potential stereotypes driving hostile attitudes and discriminatory behaviors toward pregnant women: incompetence, lack of commitment, inflexibility, and need for accommodation. We tested the relative efficacy of reducing concerns related to each of the stereotypes in a field experiment in which female confederates who sometimes wore pregnancy prostheses applied for jobs in a retail setting. As expected, ratings from 3 perspectives (applicants, observers, and independent coders) converged to show that pregnant applicants received more interpersonal hostility than did nonpregnant applicants. However, when hiring managers received (vs. did not receive) counterstereotypic information about certain pregnancy-related stereotypes (particularly lack of commitment and inflexibility), managers displayed significantly less interpersonal discrimination. Explicit comparisons of counterstereotypic information shed light on the fact that certain information may be more effective in reducing discrimination than others. We conclude by discussing how the current research makes novel theoretical contributions and describe some practical organizational implications for understanding and improving the experiences of pregnant workers.

Bringing social identity to work: the influence of manifestation and suppression on perceived discrimination, job satisfaction, and turnover intentions.

In the current article, we explored whether manifesting or suppressing an identity (race/ethnicity, gender, age, religion, sexual orientation, or disability) at work is related to perceived discrimination, job satisfaction, and turnover intentions. Participants included 211 working adults who completed an online survey. The results showed that efforts to suppress a group identity were positively (and behavioral manifestations of group identity negatively) related to perceived discrimination, which predicted job satisfaction and turnover intentions. These results suggest that diverse employees actively manage their nonwork identities while at work and that these identity management strategies have important consequences.

Effects of manifest ethnic identification on employment discrimination.

Evidence from recent laboratory experiments suggests that ethnic identification can lead to negative evaluations of ethnic minorities (Kaiser & Pratt-Hyatt, 2009). The current research considers the generalizability of these findings to face-to-face interactions in contexts wherein impression management concerns are salient: the workplace hiring process. In a field experiment, Black, Hispanic, and Irish individuals applied for retail jobs with or without visible display of their ethnic identification. Analysis of indicators of formal (e.g., application offering, interview scheduling) and interpersonal discrimination (e.g., interaction length, nonverbal negativity) suggest store personnel interacting with other-race applicants exhibited greater positivity and longer interactions when applicants displayed ethnic identification than when they did not. The findings suggest that psychologists need to understand not only attitudes or intentions expressed in the lab, but also the behavioral consequences of manifest group identity as they unfold in natural environments.

Moral credentialing by association: the importance of choice and relationship closeness.

People express more prejudice if they have established their "moral credentials." Five studies explored the acquisition of moral credentials through associations with racial minorities, particularly close relationships that are personally chosen. Participants choosing to write about a positive experience with a Black person (Study 1) or Hispanic person (Study 2) subsequently expressed more preference for Whites and tolerance of prejudice than did other participants. In Study 3, the credentialing effect of choice was diminished when participants were given an incentive for that choice. Participants in Study 4 who wrote about a Black friend were more credentialed than those who wrote about a Black acquaintance, regardless of whether the experience was positive or negative. Study 5 suggested that participants strategically referred to close associations with minorities when warned of a future situation in which they might appear prejudiced.

Assessment of weight stigma.

The purpose of this review article is to familiarize readers with the common methodologies used to assess weight stigma. This article explores the most frequent ways weight stigma is assessed, offers relevant empirical examples of each methodology, examines the strengths and weaknesses of each approach, and offers recommendations for strengthening research assessment of weight stigma for the future. Furthermore, this article highlights 4 dimensions that are important to consider when assessing weight stigma, regardless of the research methodology used.

Hostile and benevolent reactions toward pregnant women: complementary interpersonal punishments and rewards that maintain traditional roles.

A naturalistic field study investigated behavior toward pregnant (vs. nonpregnant) women in nontraditional (job applicant) and traditional (store customer) roles. Female confederates, who sometimes wore a pregnancy prosthesis, posed as job applicants or customers at retail stores. Store employees exhibited more hostile behavior (e.g., rudeness) toward pregnant (vs. nonpregnant) applicants and more benevolent behavior (e.g., touching, overfriendliness) toward pregnant (vs. nonpregnant) customers. A second experiment revealed that pregnant women are especially likely to encounter hostility (from both men and women) when applying for masculine as compared with feminine jobs. The combination of benevolence toward pregnant women in traditional roles and hostility toward those who seek nontraditional roles suggests a system of complementary interpersonal rewards and punishments that may discourage pregnant women from pursuing work that violates gender norms.