Unconscious Bias among Health Professionals: A Scoping Review.

BACKGROUND: Unconscious biases are one of the causes of health disparities. Health professionals have prejudices against patients due to their race, gender, or other factors without their conscious knowledge. This review aimed to provide an overview of research on unconscious bias among health professionals and to investigate the biases that exist in different regions of the world, the health professions that are considered, and the research gaps that still exist. METHODS: We conducted a scoping review by systematically searching PubMed/MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and AMED. All records were double-screened and included if they were published between 2011 and 2021. RESULTS: A total of 5186 records were found. After removing duplicates (n = 300), screening titles and abstracts (n = 4210), and full-text screening (n = 695), 87 articles from 81 studies remained. Studies originated from North America (n = 60), Europe (n = 13), and the rest of the world (n = 6), and two studies were of global scope. Racial bias was investigated most frequently (n = 46), followed by gender bias (n = 11), weight bias (n = 10), socio-economic status bias (n = 9), and mental illness bias (n = 7). Most of the studies were conducted by physicians (n = 51) and nurses (n = 20). Other health care professionals were rarely included in these studies. CONCLUSIONS: Most studies show that health professionals have an implicit bias. Racial biases among physicians and nurses in the USA are well confirmed. Research is missing on other biases from other regions and other health professions.

A Literature Review to Identify Effective Web- and App-Based mHealth Interventions for Stress Management at Work.

BACKGROUND: Persistent job-related stress can be harmful to physical and mental health and has a sizable financial burden on society. Face-to-face interventions are effective in reducing stress but have the disadvantage of high costs and time requirements. mHealth solutions may be an effective alternative to provide stress management interventions at work. Occupational health professionals need information on which mHealth apps are effective for employees to manage job-related stress. The aim of this review is to provide an overview of effective web- and app-based interventions for reduction of job-related stress and stress-related symptoms. METHOD: A literature review was conducted in the databases PubMed, PsycINFO, CINAHL Complete, and IEEEXplore. FINDINGS: A total of 24 articles describing 19 products were found. All products showed effectiveness in trials in improving mental and/or physical health and reducing stress. Most products have a course-like structure with a duration from 1 to 8 weeks. The products use various methods such as psychoeducation and education on stress, cognitive restructuring, emotional regulation, problem-solving, goal setting, gratitude, breathing, or mindfulness techniques. Most products use more than one method and most mixed material such as text on web pages, text messages, videos, reading and audio material, and games. CONCLUSION/APPLICATION TO PRACTICE: Overall, effective mHealth products were identified for the intervention of acute and chronic stress. Occupational health practitioners can use these 19 evidence-based mHealth products when advising organizations on health promotion of employees to reduce stress symptoms and promote health and well-being.

Effects of an Exergame Software for Older Adults on Fitness, Activities of Daily Living Performance, and Quality of Life.

BACKGROUND: As people become older, the biological process of aging leads to a decline in functional capabilities, which entails difficulties in the performance of daily tasks. Within the "Active and Assisted Living Joint Programme" a consortium from Spain, Germany, and Switzerland developed an interactive Exergame software for older adults to maintain their physical abilities and independence within the daily tasks. SUBJECTS AND METHODS: An interventional study was conducted to validate the software. For 3 months, Swiss and Spanish seniors used the system at least three times a week for minimum half an hour in their homes. The physical condition in terms of maintaining or increasing strength, balance, safety, and mobility of the seniors was assessed by using the Berg Balance Scale and the Senior Fitness Test. In addition, the effect on independence within the activities of daily living was assessed by using the Canadian Occupational Performance Measure, the Performance Quality Rating Scale, and the Iconographical Falls Efficacy Scale. We used the EQ 5D to evaluate the "quality of life." RESULTS: Twenty-nine participants (male; n = 14; female; n = 15) completed the study. Scores of endurance (2 minutes step test; P = 0.01, η2 = 0.3) increased significantly. Moderate effect sizes in quality of life (r = 0.3), lower body strength (η2 = 0.08), and large effect sizes in endurance (η2 = 0.3) were detected. A small effect was evaluated within the gait speed (r = 0.2), mobility in the lower body (r = 0.2), and the balance capabilities (r = 0.2). CONCLUSION: The results of this study lead us to the conclusion that physical training with activity-focused exergames that are related to the everyday tasks of older adults could help to maintain and improve the individual fitness status.

A study of measuring participation according to the International Classification of Functioning, Disability and Health with the Revised Role Checklist.

OBJECTIVE:: To empirically test the hypothesis that the 10 roles on the Revised Role Checklist are represented in the International Classification of Functioning, Disability and Health participation areas. DESIGN:: Cross-sectional survey. SUBJECTS:: Investigators from Japan, Norway, Sweden, Switzerland, the United Kingdom and the United States recruited a total of 295 adults from the general population. There were 103 (34.9%) male and 191 (64.7%) female participants with one participant not indicating gender. The age distribution of participants was from <25 ( n = 68) to 75+ with a mode of 25-34 years. MAIN MEASURE:: The Revised Role Checklist Part 1 was used to assess perceived incumbency in 10 roles. In addition, subjects were asked to provide role examples. RESULTS:: Of the 7087 examples provided by participants, 6578 (92.8%) fit the original hypothesis that the roles in the Revised Role Checklist were covered in participation areas. Fit was determined when the role example was either named in the associated International Classification of Functioning, Disability and Health participation area or when the criteria of: "does this example conceivably fit in the respective area as 'a person's involvement in life situations' fit relative to each role." Slight modification of the scope of three roles of the original hypothesis resulted in a 97.6% match. CONCLUSION:: The roles in the Revised Role Checklist are well represented in the International Classification of Functioning, Disability and Health categories of participation.

Child sexual abuse revisited: a population-based cross-sectional study among Swiss adolescents.

PURPOSE: Child sexual abuse (CSA) is one of the most serious public health problems among children and adolescents, owing to its widespread prevalence and serious health consequences. The present study aimed to assess the prevalence of, and characteristics and circumstances associated with, CSA. METHODS: An epidemiological survey was conducted on a nationally representative sample of 6,787 ninth-grade students (15.5 ± .66 years of age) in Switzerland. Self-reported computer-assisted questionnaires were administered between September 2009 and May 2010. Various forms of sexual victimization were assessed using the newly developed Child Sexual Abuse Questionnaire. RESULTS: Overall, 40.2% and 17.2% of girls and boys, respectively, reported having experienced at least one type of CSA event. Lifetime prevalence rates were 35.1% and 14.9%, respectively, for CSA without physical contact, 14.9% and 4.8% for CSA with physical contact without penetration, and 2.5% and .6% for CSA with penetration among girls and boys. The most frequently experienced event was sexual harassment via the Internet. More than half of female victims and more than 70% of male victims reported having been abused by juvenile perpetrators. Depending on the specific event, only 44.4%-58.4% of female victims and 5.8%-38% of male victims disclosed CSA, mostly to peers. CONCLUSIONS: The present study confirms the widespread prevalence of CSA. The high prevalence of CSA via the Internet and the frequent reports of juvenile perpetrators suggest emerging trends in CSA. Low disclosure rates, especially among male victims, and reluctance to disclose events to family members and officials may impede timely intervention.

Stages of parental engagement in a universal parent training program.

This paper reports findings on parental engagement in a community-based parent training intervention. As part of a randomized trial, 821 parents were offered group-based Triple P as a parenting skills prevention program. Program implementation was conducted by practitioners. The intervention was implemented between Waves 1 and 2 of a longitudinal study, with a participation rate of 69% and a retention rate of 96%. The study finds that a practitioner-led dissemination can achieve recruitment and completion rates that are similar to those reported in researcher-led trials. Second, the study found that different factors are associated with the various stages of the parental engagement process. Family-related organizational and timing obstacles to participation primarily influence the initial stages of parental involvement. The strength of neighborhood networks plays a considerable role at the participation and completion stages of parental engagement. The general course climate and the intensity of program exposure predict the utilization of the program several months after the delivery.