Determining Associations Among Health Orientation, Fitness Orientation, and Attitudes Toward Fatness in Physiotherapists and Physiotherapy Students Using Structural Equation Modeling.

Purpose: Research suggests physiotherapists hold negative attitudes and beliefs toward fatness and fat people. Physiotherapists are also health-conscious, and invested in healthy lifestyle behaviours including physical activity. Our purpose was to describe relationships between health orientation, fitness orientation, and fat attitudes. Methods: Physiotherapists (n = 187) and physiotherapy students (n = 34) completed an online survey (Health Orientation Scale, Multidimensional Body-Self Relations Questionnaire, Fat Attitudes Assessment Toolkit). Structural equation modeling estimated associations between fat attitudes (dependent variable) and health and fitness orientation (independent variables). Results: Participants scored high in orientation toward fitness and health. We found strong positive associations between fitness orientation and health orientation (p < 0.001). Health orientation was not significantly associated with fat attitudes (p = 0.075), whereas increased age was associated with more positive fat attitudes (p < 0.01). Although most participants acknowledged that factors outside an individual's control contribute to body weight, many also agreed with normative negative perspectives. Conclusions: Physiotherapists are highly oriented toward fitness and health. This may underlie beliefs in the controllability of body weight and contribute to negative attitudes toward fatness and fat people. Further research, with greater sample sizes is necessary to further investigate associations between health orientation and fat attitudes.

Objectif: selon les recherches, les physiothérapeutes ont des attitudes et croyances négatives à l'égard de l'obésité et des personnes obèses. Ils sont également soucieux de la santé et investis dans des comportements sains, y compris l'activité physique. Les chercheurs visaient à décrire la relation entre l'orientation vers la santé, l'orientation vers la forme physique et les attitudes vers l'obésité. Méthodologie: les physiothérapeutes (n = 187) et les étudiants en physiothérapie (n = 34) ont rempli un sondage en ligne (échelle d'orientation vers la santé, questionnaire multidimensionnel des relations entre le corps et soi, outil d'évaluation des attitudes envers l'obésité). Les chercheurs ont utilisé la modélisation des équations structurelles pour estimer les associations entre les attitudes envers l'obésité (variables dépendantes) et l'orientation vers la santé et la forme physique (variables indépendantes). Résultats: les participants ont obtenu un résultat élevé à l'égard de l'orientation vers la forme physique et vers la santé. Les chercheurs ont trouvé des associations positives vigoureuses entre l'orientation vers la forme physique et l'orientation vers la santé (p < 0,001). L'orientation vers la santé n'était pas associée de manière significative aux attitudes envers l'obésité (p = 0,075), mais un âge plus avancé était associé à des attitudes plus positives envers l'obésité (p < 0,01). Même si la plupart des participants reconnaissent que des facteurs hors du contrôle individuel contribuent au poids, bon nombre conviennent également avoir des points de vue négatifs normatifs. Conclusions: les physiothérapeutes sont fortement orientés vers la forme physique et la santé, ce qui peut sous-tendre des croyances à l'égard de la contrôlabilité du poids et contribuer à des attitudes négatives envers l'obésité et les personnes obèses. Il faudra réaliser des recherches plus approfondies auprès d'échantillons plus importants pour étudier les associations entre l'orientation vers la santé et les attitudes envers l'obésité de manière plus approfondie.

Us, them and we: How national and human identifications influence adolescents' ethnic prejudice.

Although there have been numerous studies on the relations between group identification and ethnic prejudice, it is less clear whether their associations reflect stable individual tendencies or rather situational or temporal fluctuations. This longitudinal multilevel study aimed to fill this gap by examining the between- and within-person associations of identification with the national and superordinate human groups and levels of prejudice against multiple ethnic minorities. A total of 883 Italian majority adolescents (Mage = 15.66, SD = 1.15 at T1, 49.7% females) completed questionnaires at four time points over the course of 1 year. Results showed that national identification was related to more prejudice at the between-person level but to decreases in prejudice at the within-person level. Additionally, human identification contributed to lower levels of and steeper decreases in prejudice at both the between- and within-person levels. Common and unique associations also emerged across different ethnic minority targets, but only for between-person effects. Overall, this study highlights the importance of distinguishing stable individual levels and momentary fluctuations of both ingroup identifications and ethnic prejudice in order to orient future interventions aimed at improving the quality of intergroup relationships.

Measuring persistent somatic symptom related stigmatisation: Development of the Persistent Somatic Symptom Stigma scale for Healthcare Professionals (PSSS-HCP).

OBJECTIVE: Persistent somatic symptoms (PSS) describe recurrent or continuously occurring symptoms such as fatigue, dizziness, or pain that have persisted for at least several months. These include single symptoms such as chronic pain, combinations of symptoms, or functional disorders such as fibromyalgia or irritable bowel syndrome. While stigmatisation by healthcare professionals is regularly reported, there are limited measurement instruments demonstrating content validity. This study develops a new instrument to measure stigmatisation by healthcare professionals, the Persistent Somatic Symptom Stigma scale for Healthcare Professionals (PSSS-HCP). METHODS: Development was an iterative process consisting of research team review, item generation and cognitive interviewing. We generated a longlist of 60 items from previous reviews and qualitative research. We conducted 18 cognitive interviews with healthcare professionals in the United Kingdom (UK). We analysed the relevance, comprehensibility and comprehensiveness of items, including the potential for social desirability bias. RESULTS: After research team consensus and initial feedback, we retained 40 items for cognitive interviewing. After our first round of interviews (n = 11), we removed 20 items, added three items and amended five items. After our second round of interviews (n = 7), we removed four items and amended three items. No major problems with relevance, comprehensibility, comprehensiveness or social desirability were found in remaining items. CONCLUSIONS: The provisional version of the PSSS-HCP contains 19 items across three domains (stereotypes, prejudice, discrimination), demonstrating sufficient content validity. Our next step will be to perform a validation study to finalise item selection and explore the structure of the PSSS-HCP.

Gender Essentialism Predicts Prejudice against Gender Nonconformity in Two Cultural Contexts.

Gender-nonconforming children face a substantial amount of prejudice, making it important to investigate potential contributing factors. In a correlational study of 253 U.S. Midwestern and Pacific Northwestern 6- to 10-year-old gender-conforming children (Age M = 7.95, SD = 1.43; 54% girl, 46% boy; 77% White), we examined how gender essentialism (beliefs that gender is biological, discrete, informative, and immutable) and gender identity essentialism (beliefs that gender identity is immutable) relate to prejudice against gender-nonconforming children. We also examined whether these associations varied by the child's cultural context (rural, non-diverse, conservative vs. urban, more diverse, liberal). We found a positive correlation between gender essentialism and prejudice, in both cultural contexts. Additionally, children from the more rural context endorsed more essentialism and expressed more prejudice than did their counterparts from the more urban context. However, we found no differences in children's gender identity essentialism by cultural context and no association with prejudice.

Understanding stigma of dementia during COVID-19: a scoping review.

Introduction: Stigma of dementia is one of the greatest challenges for people living with dementia. However, there is little research on the different types of stigma of dementia in the COVID-19 pandemic. The purpose of this scoping review is to synthesize the existing literature on dementia-related stigma (self, public, and structural stigma), during the pandemic. Methods: Guided by Arksey and O'Malley's scoping review framework and PRISMA guidelines, CINAHL, EMBASE, Google Scholar, Medline, PsycINFO, and Web of Science were searched for English language literature from January 2020 to June 2023. Inclusion criteria consisted of peer-reviewed, original research articles addressing stigma of dementia during the COVID-19 pandemic. Thematic analysis was used to analyze the data and steps were taken to ensure rigor. Results: Fifteen articles met our inclusion criteria. Four primary themes were identified including: 1) COVID-19 stereotypes and assumptions of dementia; 2) human rights issues and deprived dignity; 3) disparate access to health services and supports; and 4) cultural inequities and distrust. Discussion: The COVID-19 pandemic has contributed to the stigmatization of people living with dementia. Further research is needed to develop, implement, and evaluate interventions targeted towards the different types of dementia-related stigma (including self, public, and structural stigma). Moreover, our findings highlight the need for more collaborative research that prioritizes the lived experience and input of diverse people living with dementia. Research partnerships with diverse people living with dementia are vital to improving future pandemic planning. Only through evidence-informed research and lived experience can we begin to fully address the different types of dementia-related stigma and enhance the quality of life of people living with dementia.

Testing the Moderating Effect of Anti-Prejudice Motivation and Peer Attitudes on the Effectiveness of a School-Based Vicarious Contact Intervention.

Vicarious contact has often been used for studying prejudice-reduction in school contexts due to its relatively accessible application through written or audiovisual portrayals of positive intergroup contact. However, these interventions may sometimes prove ineffective, thus restricting their ecological validity and independent use in education. To contribute to the understanding of factors that might facilitate or mitigate the efficacy of vicarious contact in reducing ethnic prejudice among adolescents, the present study tested for the moderating effect of anti-prejudice motivation and friends' outgroup attitudes. Participants were Finnish secondary school students (N = 334; M = 13.38 years, SD = 0.53; 48% female; 19% ethnic minority) allocated into cluster-randomized intervention (N = 149) and control (N = 185) groups. Participants in the intervention group took part in 4 × 45-min teacher-led intervention sessions. A pretest-posttest design was employed to assess the outgroup attitudes three weeks before the intervention and the follow-up two weeks after. The results showed that adolescents' intrinsic, but not extrinsic, anti-prejudice motivation and the pre-intervention attitudes of their reciprocal classroom friends positively predicted post-intervention attitudes towards people from different ethnic and cultural groups. However, only extrinsic motivation moderated the intervention effect as the results indicated the intervention to have a detrimental effect on outgroup attitudes among adolescents with less motivation to be non-prejudiced in order to gain social acceptance. This attitudinal backlash among adolescents less susceptible to the social influence of others implies that motivational aspects should not be overlooked when developing school-based intervention programs, especially when social norms are used as a mechanism of attitude change.

Gender-Ambiguous Voices and Social Disfluency.

Recently, gender-ambiguous (nonbinary) voices have been added to voice assistants to combat gender stereotypes and foster inclusion. However, if people react negatively to such voices, these laudable efforts may be counterproductive. In five preregistered studies (N = 3,684 adult participants) we found that people do react negatively, rating products described by narrators with gender-ambiguous voices less favorably than when they are described by clearly male or female narrators. The voices create a feeling of unease, or social disfluency, that affects evaluations of the products being described. These effects are best explained by low familiarity with voices that sound ambiguous. Thus, initial negative reactions can be overcome with more exposure.

The Effect of Minority Stress Processes on Smoking for Lesbian, Gay, Bisexual, Transgender, and Queer Individuals: A Systematic Review.

Purpose: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are more likely to smoke than non-LGBTQ individuals. Smoking has been posited as a coping mechanism for LGBTQ individuals facing minority stress. However, the exact relationship between minority stress and smoking behaviors among LGBTQ individuals is unclear. Therefore, the purpose of this systematic review was to examine how minority stress processes are associated with smoking behaviors for LGBTQ individuals. Methods: Searches of the PubMed and PsycINFO databases were conducted for smoking-, LGBTQ-, and minority stress-related terms. No date, geographic, or language limits were used. For inclusion, the study must have (1) been written in English, (2) had an LGBTQ group as the study population or a component of the study population, (3) assessed the cigarette smoking status of patients, and (4) assessed at least one minority stress-related process (internalized stigma, perceived stigma, or prejudice events). Results: The final review included 44 articles. Aside from two outlier studies, all of the reviewed studies exhibited that increased levels of minority stress processes (internalized queerphobia, perceived stigma, and prejudice events) were associated with increased probability of cigarette use in LGBTQ individuals. Increased minority stress was also associated with greater psychological distress/mental health decline. Conclusion: The findings of this review suggest that minority stress processes represent a contributing factor to smoking health disparities in LGBTQ populations. These results highlight the need for smoking cessation and prevention programs to address minority stress and improve smoking disparities in these populations.

Comfort with LGB people and attitudes toward same-sex parenting in Continental American Hispanic Nations.

Negative attitudes toward Lesbian, Gay, and Bisexual (LGB) individuals leads to a perceived inability of LGB individuals to foster 'appropriate' family relationships, inciting negative attitudes specifically toward same-sex parenting. Intergroup and interpersonal relationships play a critical role in fostering attitudes toward others wherein type of contact, frequency, degree of closeness in the relationship, and the positivity/negativity of interactions are potential mediator of these relations, Moreover, the mechanism behind co-constructing positive relationships with sexual and gender minorities is comfort with contact with LGB individuals. The present study explored the effects of interpersonal contact and the mediator role of comfort with LGB people in explaining attitudes toward same-sex parenting in Spanish-speaking countries in North, Central, and South America. These countries are of particular interest given the dearth of research in the region on attitudes toward same-sex parenting as well as the varying degrees of acceptance of and protections for same-sex parented families. A non-probabilistic sample of 1955 heterosexual cisgender participants from 14 countries was asked to complete a series of sociodemographic questions, a questionnaire about their interpersonal contact/comfort experiences with LGB people, and the Attitudes Toward Gay and Lesbian Parenting Scale. Results showed that comfort was vital in fostering accepting attitudes toward Same-Sex Parenting across countries. Findings also suggested that comfort with LGB people has a particularly powerful influence in regions with less legal and cultural acceptance of LGB individuals. Policies are not enough to instill widespread change: we must encourage, facilitate, and supervise the formation of relationships with LGB people.

Integrating gender expertise into the Canadian Armed Forces: challenges for change agents and culture change.

Introduction: Gender Advisors (GENADs) have played a key role in the efforts of military organizations worldwide to integrate gender perspectives, and culture change, within the defence and security context. Military organizations, however, continue to face challenges in regard to diversity and inclusion, including limited representation of women and other diverse groups who do not fit the white male, masculine stereotype, and subtle and overt expressions of prejudice and stigma towards under-represented and marginalized groups. In such an organizational context, the integration of gender perspectives has faced challenges, and transformative culture change has remained elusive. In particular, the experience of GENADs suggests that there may be unique challenges to serving as "gender experts" within military organizations. This paper, therefore, examines the lived experience of GENADs within the context of military organizations, as illustrated by GENADs in the Canadian Armed Forces. Methods: We consider two qualitative studies on the lived experience of GENADs and focus on the shared theme of legitimacy of gender expertise at both individual and systemic levels. Results: This analysis highlights challenges that gendered power relations may pose for GENADs as individual change agents, and for systemic, transformative culture change, within existing military organizations, while reaffirming the importance of understanding the lived experience of GENADs in their pursuit of more equitable institutional and operational outcomes. Conclusion: Using social-psychological theories of tokenism, we consider more broadly what it means to be the gender person within masculinized military organizations and conclude with reflections on the potential contours of transformative culture change within the military context.

Teacher's social desirability bias and Migrant students: A study on explicit and implicit prejudices with a list experiment.

Scholarly research has consistently shown that teachers present negative assessments of and attitudes toward migrant students. However, previous studies have not clearly addressed the distinction between implicit and explicit prejudices, or identified their underlying sources. This study identifies the explicit and implicit prejudices held by elementary and middle school teachers regarding the learning abilities of an ethnic minority group: Haitian students within the Chilean educational system. We use a list experiment to assess how social desirability and intergroup attitudes toward minority students influence teachers' prejudices. The findings reveal that teachers harbor implicit prejudices towards Haitian students and are truthful in reporting their attitudes, thereby contradicting the desirability bias hypothesis. We suggest that teachers rely on stereotypes associated with the students' nationality when assessing Haitian students' learning abilities. The implications of these results are discussed in relation to theories grounded in stereotypes and intergroup attitudes.

Why step in? Shifting justifications for bystander behaviors through interventions with youth in the Middle East.

Research shows positive bystander intervention effectively mitigates bullying experiences. Yet, more evidence regarding bystander responses to bias-based social exclusion (BSE) is needed in intergroup contexts, especially in the majority world and in areas of intractable conflict. This study assessed the effectiveness of skills and skills + contact-based interventions for BSE among 148 Palestinian Citizens of Israel (Mage = 10.55) and 154 Jewish-Israeli (Mage = 10.54) early adolescents (Girls = 52.32%) in Tel Aviv-Yafo. Bystander responses were assessed by participants' reactions to hypothetical BSE scenarios over three time points. Repeated measures ANOVAs revealed both interventions significantly increased positive and decreased negative bystander responses, with changes maintained at the follow-up. The opposite result pattern emerged for the control group. Findings suggest that both interventions can effectively encourage youth to publicly challenge BSE, even amidst intractable conflict.

Association between discrimination and subsequent psychotic experiences in patients with COVID-19: A cohort study.

Although cross-sectional studies have suggested that discrimination has a negative impact on the mental health of patients with COVID-19, no cohort studies with longitudinal data have established a causal relationship. Therefore, this study aimed to investigate the association between COVID-19-related discrimination and subsequent psychotic experiences in individuals who had contracted the disease. Secondary outcomes were PTSD symptoms, psychological distress, and suicidal ideation. We utilized inverse probability weighting and marginal structural models with robust standard errors to analyze the association, accounting for confounders and loss to follow-up. In a sensitivity analysis, we evaluated the robustness of the estimates to potential unmeasured confounding by analyzing E-values. Of 7760 participants who had contracted COVID-19, 5971 were included after excluding those with missing sociodemographic data. Of these, 1736 (29.1 %) reported experiencing COVID-19-related discrimination. Of the 2559 participants who completed the study, 253 (9.9 %) reported having at least one psychotic experience. Participants who reported experiencing any COVID-19-related discrimination showed a higher risk of subsequent psychotic experiences compared with participants without such discrimination (risk difference 6.6 %, 95 % CI 4.0 %-9.9 %; risk ratio 1.82, 95 % CI 1.42-2.47). A negative impact was also found in suicidal ideation, PTSD symptoms, and psychological distress. E-values demonstrated the robustness of some of the observed associations to unmeasured confounding. The study found that COVID-19-related discrimination was associated with subsequent psychotic experiences and other mental health outcomes in individuals who had contracted the disease. A study focusing on prevention strategies, such as an anti-discrimination campaign, is warranted.

Psychological Distress and Behavioral Vigilance in Response to Minority Stress and Threat among Members of the Asian American and Pacific Islander Community during the COVID-19 Pandemic.

Stigmatization, hostility, and violence towards the Asian American and Pacific Islander (AAPI) community have increased sharply during the COVID-19 pandemic. It is important to conduct research to promote understanding of the effects of such stigmatization on the AAPI community. Accordingly, the present study used a combined minority stress and integrated threat framework to examine whether factors related to AAPI identity would moderate the relationship between stigmatization/threat associated with AAPI identity and increased psychological distress and behavioral vigilance. AAPI individuals were recruited online from both Turk Prime and Reddit and completed measures of perceived stigmatization; integrated threat; depression, anxiety, and stress; and behavioral vigilance. Perceptions of stigmatization and threat predicted relevant outcomes both as individual predictors and in multivariate analyses. However, factors relating to the strength of AAPI identification did not moderate the effects of stigmatization and threat on psychological distress and behavioral vigilance, which is a result that failed to support this aspect of the broader conceptual model on which this project was based. Instead, these proposed moderators were themselves predicted by stigmatization and threat variables. The implications of these findings for effective interventions to alleviate the negative consequences of anti-Asian stigmatization are discussed.

Social media and anti-immigrant prejudice: a multi-method analysis of the role of social media use, threat perceptions, and cognitive ability.

Introduction: The discourse on immigration and immigrants is central to contemporary political and public discussions. Analyzing online conversations about immigrants provides valuable insights into public opinion, complemented by data from questionnaires on how attitudes are formed. Methods: The research includes two studies examining the expressive and informational use of social media. Study 1 conducted a computational text analysis of comments on Singaporean Facebook pages and forums, focusing on how social media is used to discuss immigrants. Study 2 utilized survey data to examine the use of social media at the individual level, testing the relationships between cognitive ability, perceptions of threat, negative emotions towards immigrants, and social media usage within the Integrated Threat Theory framework. Results: Study 1 found that discussions about immigrants on social media often involved negative emotions and concerns about economic impact, such as competition for jobs and crime. Complementing these findings about perceived economic threats, Study 2 showed that individuals with higher social media usage and greater perceptions of threat were more likely to have negative emotions towards immigrants. These relationships were mediated by perceptions of threat and were stronger in individuals with lower cognitive abilities. Discussion: The findings from both studies demonstrate the role of social media in shaping public attitudes towards immigrants, highlighting how perceived threats influence these attitudes. This research suggests the importance of considering how digital platforms contribute to public opinion on immigration, with implications for understanding the dynamics of attitude formation in the digital age.

Classical and Modern Prejudice toward Individuals with Intellectual Disabilities: The Role of Experienced Contact, Beliefs in a Just World and Social Dominance Orientation.

This study investigates the impact of experienced contact on prejudiced attitudes towards individuals with intellectual disabilities (IDs), examining beliefs in a just world (BJW) and social dominance orientation (SDO) as potential serial mediators. Data were collected from 224 university students (M = 23.02, SD = 2.48). Path analysis modelling assessed the structural relationships between the study variables. The findings revealed that experienced contact was negatively and significantly associated with BJW and SDO. Additionally, BJW and SDO fully mediated the relationship between experienced contact and overt prejudice. These findings underscore the influence of individual differences on attitudes towards individuals with ID, establishing a crucial foundation for future research and the development of interventions aimed at reducing prejudice and discrimination.

Sexism and Feminist Conspiracy Beliefs: Hostile Sexism Moderates the Link Between Feminist Conspiracy Beliefs and Rape Myth Acceptance.

This research examined the effect of belief in feminist conspiracy theories and sexist ideology on endorsing rape myths. Study 1 (N = 201) uncovered that the relationship between feminist conspiracy beliefs and rape myth acceptance was conditional on higher levels of hostile sexism. Study 2 (N = 552) demonstrated that for those with higher hostile sexism, exposure to feminist conspiracy theories (vs. control) increased feminist conspiracy beliefs, which were then associated with rape myths. The current research suggests that the link between feminist conspiracy beliefs and rape myths could result from such beliefs upholding a hostile sexist view of women.

Investigating How High Perceived Economic Inequality Exacerbates Intergroup Competition, Zero-Sum Beliefs, and Perceived Intergroup Prejudice.

Rising economic inequality is associated with more prejudice. Little empirical data, however, investigate how inequality affects individuals' psychological processing and, in turn, exacerbates perceptions of prejudice in people's geographic area. We hypothesized that higher perceived economic inequality triggers beliefs that unequal economies are zero-sum and leads to beliefs that people are in competition for limited resources, which may ultimately exacerbate perceived prejudice. Through nine experiments (Studies 1-5 in the manuscript and three additional studies in the Supplement), we provide evidence that higher perceived inequality increases perceived prejudice against a wide range of outgroups. Furthermore, zero-sum beliefs and perceived competition serially mediate this relationship (Studies 2 and 3). In Study 4, we investigate nuance in this hypothesized model by testing whether higher perceived economic inequality exacerbates perceived racial/ethnic prejudice among a large, diverse sample and find a similar pattern of results. Finally (Study 5), we demonstrate that assuaging competition beliefs mitigates perceived prejudice.

Exploring the healthcare access challenges faced by visually impaired young women in Nepal: Navigating sexual harassment and stigma within healthcare settings.

Introduction: Despite global progress in gender equality, still not every woman has access to safe and the highest quality health care. Visually impaired young adult women represent one of the most vulnerable groups with a poorer ability to access necessary healthcare services. This study aims to explore and comprehend the experiences of visually impaired young adult women in accessing healthcare services in Nepal. Methods: A descriptive phenomenological study was conducted among 16 visually impaired women aged 20 to 35 years who had utilized healthcare services within the past 12 months. Face-to-face, in-depth interviews were conducted for data collection, and thematic analysis was conducted for data analysis. Results: Our study revealed a range of challenges faced by visually impaired young women that impeded their healthcare-seeking. These challenges included sexual harassment by male healthcare providers, disability-related stigma, financial difficulties, limited autonomy in decision-making, and a lack of disability-friendly healthcare facilities and services. Particularly, experiencing sexual harassment from male healthcare providers, coupled with underlying disability-related stigma, profoundly influenced the avoidance of healthcare. To navigate these challenges, some women sought support by having family members or friends accompany them or by requesting to be seen by a female healthcare provider. Nevertheless, financial dependence on families and women lacking employment and income led to a feeling of burden on the family, contributing to a reluctance among women to seek expensive healthcare. Social organization-based, collaborative efforts and peer support networks played a significant role in breaking down barriers and improving overall healthcare experiences. Conclusions: While integrating disability-friendly healthcare services and infrastructure is essential, fostering attitudinal and behavioral change-particularly among male healthcare providers-is more important to ensure safety for young women in healthcare settings. The implementation of anti-sexual harassment policies is imperative to ensure a safe and respectful environment. Community mobilizing and peer group-based programs can be tested for increasing visually impaired women's utilization of relevant healthcare services.

Implicit and Explicit Weight Bias among Midwives: Variations Across Demographic Characteristics.

INTRODUCTION: Weight bias toward individuals with higher body weights is present in health care settings. However, there has been limited quantitative exploration into weight bias among perinatal care providers and its potential variations based on demographic characteristics. The aim of this study was to examine if the direction and extent of weight bias among midwives certified by the American Midwifery Certification Board (AMCB) varied across age, years since certification, body mass index (BMI), race, ethnicity, and US geographic region. METHODS: Through direct email listservs, postcard distribution, social media accounts, and professional networks, midwives were invited to complete an online survey of their implicit weight bias (using the Implicit Association Test) and their explicit weight bias using the Anti-Fat Attitudes Questionnaire (AFA), Fat Phobia Scale (FPS), and Preference for Thin People (PTP) measure. RESULTS: A total of 2106 midwives who identified as Black or White and resided in one of 4 US geographic regions participated in the survey. Midwives with a lower BMI expressed higher levels of implicit (P <.01) and explicit (P ≤.01) weight bias across all 4 measures except for the AFA Fear of Fat Subscale. Implicit weight bias levels also varied by age (P <.001) and years since certification (P <.001), with lower levels among younger midwives (vs older) and those with fewer years (vs more) since certification. Only age and BMI remained significant (P <.001) after adjusting for other demographic characteristics. Lower explicit weight bias levels were found among midwives who identified as Black (vs White) on 2 measures (FPS: adjusted ß = -0.07, P = .004; PTP: P = .01). DISCUSSION: This was the first quantitative study of how weight bias varies across demographic characteristics among a national sample of midwives. Further exploration is needed in more diverse samples. In addition, research to determine whether weight bias influences clinical decision-making and quality of care is warranted.