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The social media platforms of the twenty-first century have an enormous role in regulating speech in the USA and worldwide1. However, there has been little research on platform-wide interventions on speech2,3. Here we evaluate the effect of the decision by Twitter to suddenly deplatform 70,000 misinformation traffickers in response to the violence at the US Capitol on 6 January 2021 (a series of events commonly known as and referred to here as 'January 6th'). Using a panel of more than 500,000 active Twitter users4,5 and natural experimental designs6,7, we evaluate the effects of this intervention on the circulation of misinformation on Twitter. We show that the intervention reduced circulation of misinformation by the deplatformed users as well as by those who followed the deplatformed users, though we cannot identify the magnitude of the causal estimates owing to the co-occurrence of the deplatforming intervention with the events surrounding January 6th. We also find that many of the misinformation traffickers who were not deplatformed left Twitter following the intervention. The results inform the historical record surrounding the insurrection, a momentous event in US history, and indicate the capacity of social media platforms to control the circulation of misinformation, and more generally to regulate public discourse.
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Desinformación , Gobierno Federal , Medios de Comunicación Sociales , Violencia , Humanos , Medios de Comunicación Sociales/ética , Medios de Comunicación Sociales/normas , Medios de Comunicación Sociales/estadística & datos numéricos , Medios de Comunicación Sociales/tendencias , Estados Unidos , Violencia/psicologíaRESUMEN
If popular online platforms systematically expose their users to partisan and unreliable news, they could potentially contribute to societal issues such as rising political polarization1,2. This concern is central to the 'echo chamber'3-5 and 'filter bubble'6,7 debates, which critique the roles that user choice and algorithmic curation play in guiding users to different online information sources8-10. These roles can be measured as exposure, defined as the URLs shown to users by online platforms, and engagement, defined as the URLs selected by users. However, owing to the challenges of obtaining ecologically valid exposure data-what real users were shown during their typical platform use-research in this vein typically relies on engagement data4,8,11-16 or estimates of hypothetical exposure17-23. Studies involving ecological exposure have therefore been rare, and largely limited to social media platforms7,24, leaving open questions about web search engines. To address these gaps, we conducted a two-wave study pairing surveys with ecologically valid measures of both exposure and engagement on Google Search during the 2018 and 2020 US elections. In both waves, we found more identity-congruent and unreliable news sources in participants' engagement choices, both within Google Search and overall, than they were exposed to in their Google Search results. These results indicate that exposure to and engagement with partisan or unreliable news on Google Search are driven not primarily by algorithmic curation but by users' own choices.
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Conducta de Elección , Fuentes de Información , Política , Prejuicio , Motor de Búsqueda , Humanos , Fuentes de Información/estadística & datos numéricos , Fuentes de Información/provisión & distribución , Prejuicio/psicología , Reproducibilidad de los Resultados , Motor de Búsqueda/métodos , Motor de Búsqueda/normas , Encuestas y Cuestionarios , Estados Unidos , AlgoritmosRESUMEN
Many critics raise concerns about the prevalence of 'echo chambers' on social media and their potential role in increasing political polarization. However, the lack of available data and the challenges of conducting large-scale field experiments have made it difficult to assess the scope of the problem1,2. Here we present data from 2020 for the entire population of active adult Facebook users in the USA showing that content from 'like-minded' sources constitutes the majority of what people see on the platform, although political information and news represent only a small fraction of these exposures. To evaluate a potential response to concerns about the effects of echo chambers, we conducted a multi-wave field experiment on Facebook among 23,377 users for whom we reduced exposure to content from like-minded sources during the 2020 US presidential election by about one-third. We found that the intervention increased their exposure to content from cross-cutting sources and decreased exposure to uncivil language, but had no measurable effects on eight preregistered attitudinal measures such as affective polarization, ideological extremity, candidate evaluations and belief in false claims. These precisely estimated results suggest that although exposure to content from like-minded sources on social media is common, reducing its prevalence during the 2020 US presidential election did not correspondingly reduce polarization in beliefs or attitudes.
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Actitud , Política , Medios de Comunicación Sociales , Adulto , Humanos , Emociones , Lenguaje , Estados Unidos , DesinformaciónRESUMEN
Science rarely proceeds beyond what scientists can observe and measure, and sometimes what can be observed proceeds far ahead of scientific understanding. The twenty-first century offers such a moment in the study of human societies. A vastly larger share of behaviours is observed today than would have been imaginable at the close of the twentieth century. Our interpersonal communication, our movements and many of our everyday actions, are all potentially accessible for scientific research; sometimes through purposive instrumentation for scientific objectives (for example, satellite imagery), but far more often these objectives are, literally, an afterthought (for example, Twitter data streams). Here we evaluate the potential of this massive instrumentation-the creation of techniques for the structured representation and quantification-of human behaviour through the lens of scientific measurement and its principles. In particular, we focus on the question of how we extract scientific meaning from data that often were not created for such purposes. These data present conceptual, computational and ethical challenges that require a rejuvenation of our scientific theories to keep up with the rapidly changing social realities and our capacities to capture them. We require, in other words, new approaches to manage, use and analyse data.
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Cambio Social , Condiciones Sociales/estadística & datos numéricos , Ciencias Sociales/métodos , Conjuntos de Datos como Asunto , Historia del Siglo XXI , Humanos , Ciencias Sociales/éticaRESUMEN
We study the effect of Facebook and Instagram access on political beliefs, attitudes, and behavior by randomizing a subset of 19,857 Facebook users and 15,585 Instagram users to deactivate their accounts for 6 wk before the 2020 U.S. election. We report four key findings. First, both Facebook and Instagram deactivation reduced an index of political participation (driven mainly by reduced participation online). Second, Facebook deactivation had no significant effect on an index of knowledge, but secondary analyses suggest that it reduced knowledge of general news while possibly also decreasing belief in misinformation circulating online. Third, Facebook deactivation may have reduced self-reported net votes for Trump, though this effect does not meet our preregistered significance threshold. Finally, the effects of both Facebook and Instagram deactivation on affective and issue polarization, perceived legitimacy of the election, candidate favorability, and voter turnout were all precisely estimated and close to zero.
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Política , Medios de Comunicación Sociales , Humanos , Estados Unidos , Actitud , Masculino , FemeninoRESUMEN
Machines powered by artificial intelligence increasingly mediate our social, cultural, economic and political interactions. Understanding the behaviour of artificial intelligence systems is essential to our ability to control their actions, reap their benefits and minimize their harms. Here we argue that this necessitates a broad scientific research agenda to study machine behaviour that incorporates and expands upon the discipline of computer science and includes insights from across the sciences. We first outline a set of questions that are fundamental to this emerging field and then explore the technical, legal and institutional constraints on the study of machine behaviour.
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Inteligencia Artificial , Inteligencia Artificial/legislación & jurisprudencia , Inteligencia Artificial/tendencias , Humanos , Motivación , RobóticaRESUMEN
Following the 2020 general election, Republican elected officials, including then-President Donald Trump, promoted conspiracy theories claiming that Joe Biden's close victory in Georgia was fraudulent. Such conspiratorial claims could implicate participation in the Georgia Senate runoff election in different ways-signaling that voting doesn't matter, distracting from ongoing campaigns, stoking political anger at out-partisans, or providing rationalizations for (lack of) enthusiasm for voting during a transfer of power. Here, we evaluate the possibility of any on-average relationship with turnout by combining behavioral measures of engagement with election conspiracies online and administrative data on voter turnout for 40,000 Twitter users registered to vote in Georgia. We find small, limited associations. Liking or sharing messages opposed to conspiracy theories was associated with higher turnout than expected in the runoff election, and those who liked or shared tweets promoting fraud-related conspiracy theories were slightly less likely to vote.
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Comunicación , Fraude , Política , Georgia , Humanos , Estudios LongitudinalesRESUMEN
The public often turns to science for accurate health information, which, in an ideal world, would be error free. However, limitations of scientific institutions and scientific processes can sometimes amplify misinformation and disinformation. The current review examines four mechanisms through which this occurs: (1) predatory journals that accept publications for monetary gain but do not engage in rigorous peer review; (2) pseudoscientists who provide scientific-sounding information but whose advice is inaccurate, unfalsifiable, or inconsistent with the scientific method; (3) occasions when legitimate scientists spread misinformation or disinformation; and (4) miscommunication of science by the media and other communicators. We characterize this article as a "call to arms," given the urgent need for the scientific information ecosystem to improve. Improvements are necessary to maintain the public's trust in science, foster robust discourse, and encourage a well-educated citizenry.
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INTRODUCTION: The major stressors associated with the COVID-19 pandemic provide an opportunity to understand the extent to which protective factors against depression may exhibit gender-specificity. METHOD: This study examined responses from multiple waves of a 50 states non-probability internet survey conducted between May 2020 and January 2021. Participants completed the PHQ-9 as a measure of depression, as well as items characterizing social supports. We used logistic regression models with population reweighting to examine association between absence of even mild depressive symptoms and sociodemographic features and social supports, with interaction terms and stratification used to investigate sex-specificity. RESULTS: Among 73,917 survey respondents, 31,199 (42.2%) reported absence of mild or greater depression-11,011/23,682 males (46.5%) and 20,188/50,235 (40.2%) females. In a regression model, features associated with greater likelihood of depression-resistance included at least weekly attendance of religious services (odds ratio [OR]: 1.10, 95% confidence interval [CI]: 1.04-1.16) and greater trust in others (OR: 1.04 for a 2-unit increase, 95% CI: 1.02-1.06), along with level of social support measured as number of social ties available who could provide care (OR: 1.05, 95% CI: 1.02-1.07), talk to them (OR: 1.10, 95% CI: 1.07-1.12), and help with employment (OR: 1.06, 95% CI: 1.04-1.08). The first two features showed significant interaction with gender (p < .0001), with markedly greater protective effects among women. CONCLUSION: Aspects of social support are associated with diminished risk of major depressive symptoms, with greater effects of religious service attendance and trust in others observed among women than men.
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COVID-19 , Trastorno Depresivo Mayor , Estudios Transversales , Depresión , Trastorno Depresivo Mayor/epidemiología , Femenino , Humanos , Masculino , Pandemias , SARS-CoV-2RESUMEN
People influence each other when they interact to solve problems. Such social influence introduces both benefits (higher average solution quality due to exploitation of existing answers through social learning) and costs (lower maximum solution quality due to a reduction in individual exploration for novel answers) relative to independent problem solving. In contrast to prior work, which has focused on how the presence and network structure of social influence affect performance, here we investigate the effects of time. We show that when social influence is intermittent it provides the benefits of constant social influence without the costs. Human subjects solved the canonical traveling salesperson problem in groups of three, randomized into treatments with constant social influence, intermittent social influence, or no social influence. Groups in the intermittent social-influence treatment found the optimum solution frequently (like groups without influence) but had a high mean performance (like groups with constant influence); they learned from each other, while maintaining a high level of exploration. Solutions improved most on rounds with social influence after a period of separation. We also show that storing subjects' best solutions so that they could be reloaded and possibly modified in subsequent rounds-a ubiquitous feature of personal productivity software-is similar to constant social influence: It increases mean performance but decreases exploration.
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Conducta Cooperativa , Inteligencia , Solución de Problemas , Adulto , Femenino , Humanos , MasculinoRESUMEN
The internet has become a popular resource to learn about health and to investigate one's own health condition. However, given the large amount of inaccurate information online, people can easily become misinformed. Individuals have always obtained information from outside the formal health care system, so how has the internet changed people's engagement with health information? This review explores how individuals interact with health misinformation online, whether it be through search, user-generated content, or mobile apps. We discuss whether personal access to information is helping or hindering health outcomes and how the perceived trustworthiness of the institutions communicating health has changed over time. To conclude, we propose several constructive strategies for improving the online information ecosystem. Misinformation concerning health has particularly severe consequences with regard to people's quality of life and even their risk of mortality; therefore, understanding it within today's modern context is an extremely important task.
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Comunicación , Exactitud de los Datos , Difusión de la Información , Alfabetización Informacional , Internet/estadística & datos numéricos , Salud Pública/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Medios de Comunicación Sociales , Atención , Actitud , Humanos , Internet , Federación de Rusia , Estados UnidosRESUMEN
Do leaders persuade? Social scientists have long studied the relationship between elite behavior and mass opinion. However, there is surprisingly little evidence regarding direct persuasion by leaders. Here we show that political leaders can persuade their constituents directly on three dimensions: substantive attitudes regarding policy issues, attributions regarding the leaders' qualities, and subsequent voting behavior. We ran two randomized controlled field experiments testing the causal effects of directly interacting with a sitting politician. Our experiments consist of 20 online town hall meetings with members of Congress conducted in 2006 and 2008. Study 1 examined 19 small meetings with members of the House of Representatives (average 20 participants per town hall). Study 2 examined a large (175 participants) town hall with a senator. In both experiments we find that participating has significant and substantively important causal effects on all three dimensions of persuasion but no such effects on issues that were not discussed extensively in the sessions. Further, persuasion was not driven solely by changes in copartisans' attitudes; the effects were consistent across groups.
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Comunicación Persuasiva , Política , Adulto , Actitud , Conducta , Emigración e Inmigración , Femenino , Humanos , Internet , Masculino , Persona de Mediana Edad , Política Pública , Distribución Aleatoria , Medio Social , Percepción Social , Encuestas y Cuestionarios , Estados UnidosRESUMEN
Importance: The frequent occurrence of cognitive symptoms in post-COVID-19 condition has been described, but the nature of these symptoms and their demographic and functional factors are not well characterized in generalizable populations. Objective: To investigate the prevalence of self-reported cognitive symptoms in post-COVID-19 condition, in comparison with individuals with prior acute SARS-CoV-2 infection who did not develop post-COVID-19 condition, and their association with other individual features, including depressive symptoms and functional status. Design, Setting, and Participants: Two waves of a 50-state nonprobability population-based internet survey conducted between December 22, 2022, and May 5, 2023. Participants included survey respondents aged 18 years and older. Exposure: Post-COVID-19 condition, defined as self-report of symptoms attributed to COVID-19 beyond 2 months after the initial month of illness. Main Outcomes and Measures: Seven items from the Neuro-QoL cognition battery assessing the frequency of cognitive symptoms in the past week and patient Health Questionnaire-9. Results: The 14â¯767 individuals reporting test-confirmed COVID-19 illness at least 2 months before the survey had a mean (SD) age of 44.6 (16.3) years; 568 (3.8%) were Asian, 1484 (10.0%) were Black, 1408 (9.5%) were Hispanic, and 10â¯811 (73.2%) were White. A total of 10 037 respondents (68.0%) were women and 4730 (32.0%) were men. Of the 1683 individuals reporting post-COVID-19 condition, 955 (56.7%) reported at least 1 cognitive symptom experienced daily, compared with 3552 of 13 084 (27.1%) of those who did not report post-COVID-19 condition. More daily cognitive symptoms were associated with a greater likelihood of reporting at least moderate interference with functioning (unadjusted odds ratio [OR], 1.31 [95% CI, 1.25-1.36]; adjusted [AOR], 1.30 [95% CI, 1.25-1.36]), lesser likelihood of full-time employment (unadjusted OR, 0.95 [95% CI, 0.91-0.99]; AOR, 0.92 [95% CI, 0.88-0.96]) and greater severity of depressive symptoms (unadjusted coefficient, 1.40 [95% CI, 1.29-1.51]; adjusted coefficient 1.27 [95% CI, 1.17-1.38). After including depressive symptoms in regression models, associations were also found between cognitive symptoms and at least moderate interference with everyday functioning (AOR, 1.27 [95% CI, 1.21-1.33]) and between cognitive symptoms and lower odds of full-time employment (AOR, 0.92 [95% CI, 0.88-0.97]). Conclusions and Relevance: The findings of this survey study of US adults suggest that cognitive symptoms are common among individuals with post-COVID-19 condition and associated with greater self-reported functional impairment, lesser likelihood of full-time employment, and greater depressive symptom severity. Screening for and addressing cognitive symptoms is an important component of the public health response to post-COVID-19 condition.
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COVID-19 , Adulto , Masculino , Femenino , Humanos , COVID-19/complicaciones , COVID-19/epidemiología , Calidad de Vida , SARS-CoV-2 , Síndrome Post Agudo de COVID-19 , Enfermedad Crónica , Autoinforme , CogniciónRESUMEN
Importance: Trust in physicians and hospitals has been associated with achieving public health goals, but the increasing politicization of public health policies during the COVID-19 pandemic may have adversely affected such trust. Objective: To characterize changes in US adults' trust in physicians and hospitals over the course of the COVID-19 pandemic and the association between this trust and health-related behaviors. Design, Setting, and Participants: This survey study uses data from 24 waves of a nonprobability internet survey conducted between April 1, 2020, and January 31, 2024, among 443â¯455 unique respondents aged 18 years or older residing in the US, with state-level representative quotas for race and ethnicity, age, and gender. Main Outcome and Measure: Self-report of trust in physicians and hospitals; self-report of SARS-CoV-2 and influenza vaccination and booster status. Survey-weighted regression models were applied to examine associations between sociodemographic features and trust and between trust and health behaviors. Results: The combined data included 582â¯634 responses across 24 survey waves, reflecting 443â¯455 unique respondents. The unweighted mean (SD) age was 43.3 (16.6) years; 288â¯186 respondents (65.0%) reported female gender; 21â¯957 (5.0%) identified as Asian American, 49â¯428 (11.1%) as Black, 38â¯423 (8.7%) as Hispanic, 3138 (0.7%) as Native American, 5598 (1.3%) as Pacific Islander, 315â¯278 (71.1%) as White, and 9633 (2.2%) as other race and ethnicity (those who selected "Other" from a checklist). Overall, the proportion of adults reporting a lot of trust for physicians and hospitals decreased from 71.5% (95% CI, 70.7%-72.2%) in April 2020 to 40.1% (95% CI, 39.4%-40.7%) in January 2024. In regression models, features associated with lower trust as of spring and summer 2023 included being 25 to 64 years of age, female gender, lower educational level, lower income, Black race, and living in a rural setting. These associations persisted even after controlling for partisanship. In turn, greater trust was associated with greater likelihood of vaccination for SARS-CoV-2 (adjusted odds ratio [OR], 4.94; 95 CI, 4.21-5.80) or influenza (adjusted OR, 5.09; 95 CI, 3.93-6.59) and receiving a SARS-CoV-2 booster (adjusted OR, 3.62; 95 CI, 2.99-4.38). Conclusions and Relevance: This survey study of US adults suggests that trust in physicians and hospitals decreased during the COVID-19 pandemic. As lower levels of trust were associated with lesser likelihood of pursuing vaccination, restoring trust may represent a public health imperative.
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COVID-19 , SARS-CoV-2 , Confianza , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Adulto , Masculino , Femenino , Estados Unidos/epidemiología , Persona de Mediana Edad , Encuestas y Cuestionarios , Hospitales/estadística & datos numéricos , Pandemias , Anciano , Médicos/psicología , Médicos/estadística & datos numéricos , Adulto Joven , Conductas Relacionadas con la Salud , AdolescenteRESUMEN
The COVID-19 pandemic offers an unprecedented natural experiment providing insights into the emergence of collective behavioral changes of both exogenous (government mandated) and endogenous (spontaneous reaction to infection risks) origin. Here, we characterize collective physical distancing-mobility reductions, minimization of contacts, shortening of contact duration-in response to the COVID-19 pandemic in the pre-vaccine era by analyzing de-identified, privacy-preserving location data for a panel of over 5.5 million anonymized, opted-in U.S. devices. We define five indicators of users' mobility and proximity to investigate how the emerging collective behavior deviates from typical pre-pandemic patterns during the first nine months of the COVID-19 pandemic. We analyze both the dramatic changes due to the government mandated mitigation policies and the more spontaneous societal adaptation into a new (physically distanced) normal in the fall 2020. Using the indicators here defined we show that: a) during the COVID-19 pandemic, collective physical distancing displayed different phases and was heterogeneous across geographies, b) metropolitan areas displayed stronger reductions in mobility and contacts than rural areas; c) stronger reductions in commuting patterns are observed in geographical areas with a higher share of teleworkable jobs; d) commuting volumes during and after the lockdown period negatively correlate with unemployment rates; and e) increases in contact indicators correlate with future values of new deaths at a lag consistent with epidemiological parameters and surveillance reporting delays. In conclusion, this study demonstrates that the framework and indicators here presented can be used to analyze large-scale social distancing phenomena, paving the way for their use in future pandemics to analyze and monitor the effects of pandemic mitigation plans at the national and international levels.
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Importance: Post-COVID-19 condition (PCC), or long COVID, has become prevalent. The course of this syndrome, and likelihood of remission, has not been characterized. Objective: To quantify the rates of remission of PCC, and the sociodemographic features associated with remission. Design: 16 waves of a 50-state U.S. non-probability internet survey conducted between August 2020 and November 2022. Setting: Population-based. Participants: Survey respondents age 18 and older. Main Outcome and Measure: PCC remission, defined as reporting full recovery from COVID-19 symptoms among individuals who on a prior survey wave reported experiencing continued COVID-19 symptoms beyond 2 months after the initial month of symptoms. Results: Among 423 survey respondents reporting continued symptoms more than 2 months after acute test-confirmed COVID-19 illness, who then completed at least 1 subsequent survey, mean age was 53.7 (SD 13.6) years; 293 (69%) identified as women, and 130 (31%) as men; 9 (2%) identified as Asian, 29 (7%) as Black, 13 (3%) as Hispanic, 15 (4%) as another category including Native American or Pacific Islander, and the remaining 357 (84%) as White. Overall, 131/423 (31%) of those who completed a subsequent survey reported no longer being symptomatic. In Cox regression models, male gender, younger age, lesser impact of PCC symptoms at initial visit, and infection when the Omicron strain predominated were all statistically significantly associated with greater likelihood of remission; presence of 'brain fog' or shortness of breath were associated with lesser likelihood of remission. Conclusions and Relevance: A minority of individuals reported remission of PCC symptoms, highlighting the importance of efforts to identify treatments for this syndrome or means of preventing it.
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It is critical to understand how algorithms structure the information people see and how those algorithms support or undermine society's core values. We offer a normative framework for the assessment of the information curation algorithms that determine much of what people see on the internet. The framework presents two levels of assessment: one for individual-level effects and another for systemic effects. With regard to individual-level effects we discuss whether (a) the information is aligned with the user's interests, (b) the information is accurate, and (c) the information is so appealing that it is difficult for a person's self-regulatory resources to ignore ("agency hacking"). At the systemic level we discuss whether (a) there are adverse civic-level effects on a system-level variable, such as political polarization; (b) there are negative distributional or discriminatory effects; and (c) there are anticompetitive effects, with the information providing an advantage to the platform. The objective of this framework is both to inform the direction of future scholarship as well as to offer tools for intervention for policymakers.
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Importance: Little is known about the functional correlates of post-COVID-19 condition (PCC), also known as long COVID, particularly the relevance of neurocognitive symptoms. Objective: To characterize prevalence of unemployment among individuals who did, or did not, develop PCC after acute infection. Design, Setting, and Participants: This survey study used data from 8 waves of a 50-state US nonprobability internet population-based survey of respondents aged 18 to 69 years conducted between February 2021 and July 2022. Main Outcomes and Measures: The primary outcomes were self-reported current employment status and the presence of PCC, defined as report of continued symptoms at least 2 months beyond initial month of symptoms confirmed by a positive COVID-19 test. Results: The cohort included 15â¯308 survey respondents with test-confirmed COVID-19 at least 2 months prior, of whom 2236 (14.6%) reported PCC symptoms, including 1027 of 2236 (45.9%) reporting either brain fog or impaired memory. The mean (SD) age was 38.8 (13.5) years; 9679 respondents (63.2%) identified as women and 10â¯720 (70.0%) were White. Overall, 1418 of 15â¯308 respondents (9.3%) reported being unemployed, including 276 of 2236 (12.3%) of those with PCC and 1142 of 13â¯071 (8.7%) of those without PCC; 8229 respondents (53.8%) worked full-time, including 1017 (45.5%) of those with PCC and 7212 (55.2%) without PCC. In survey-weighted regression models excluding retired respondents, the presence of PCC was associated with a lower likelihood of working full-time (odds ratio [OR], 0.71 [95% CI, 0.63-0.80]; adjusted OR, 0.84 [95% CI, 0.74-0.96]) and with a higher likelihood of being unemployed (OR, 1.45 [95% CI, 1.22-1.73]; adjusted OR, 1.23 [95% CI, 1.02-1.48]). The presence of any cognitive symptom was associated with lower likelihood of working full time (OR, 0.70 [95% CI, 0.56-0.88]; adjusted OR, 0.75 [95% CI, 0.59-0.84]). Conclusions and Relevance: PCC was associated with a greater likelihood of unemployment and lesser likelihood of working full time in adjusted models. The presence of cognitive symptoms was associated with diminished likelihood of working full time. These results underscore the importance of developing strategies to treat and manage PCC symptoms.