The Impact of Implicit-Bias-Oriented Diversity Training on Police Officers' Beliefs, Motivations, and Actions.

U.S. police departments have attempted to address racial inequities in policing with diversity training. However, little research has evaluated whether these trainings are effective at changing officers' beliefs, motivations, and actions. To examine their efficacy, we tested a day-long implicit-bias-oriented diversity training designed to increase U.S. police officers' knowledge of biases, concerns about bias, and use of evidence-based strategies to mitigate bias (total N = 3,764). The training was immediately effective at increasing knowledge about bias, concerns about bias, and intentions to address bias, relative to baseline. However, the effects were fleeting. Although the training was linked to higher knowledge for at least 1 month, it was ineffective at durably increasing concerns or strategy use. These findings suggest that diversity trainings as they are currently practiced are unlikely to change police behavior. We conclude with theorizing about what organizations and training programs could do for greater impact.

Racial Demographics Explain the Link Between Racial Disparities in Traffic Stops and County-Level Racial Attitudes.

Disparities in the treatment of Black and White Americans in police stops are pernicious and widespread. We examined racial disparities in police traffic stops by leveraging data on hundreds of U.S. counties from the Stanford Open Policing Project and corresponding county-level data on implicit and explicit racial attitudes from the Project Implicit research website. We found that Black-White traffic-stop disparities are associated with county-level implicit and explicit racial attitudes and that this association is attributable to racial demographics: Counties with a higher proportion of White residents had larger racial disparities in police traffic stops. We also examined racial disparities in several poststop outcomes (e.g., arrest rates) and found that they were not systematically related to racial attitudes, despite evidence of disparities. These findings indicate that racial disparities in counties' traffic stops are reliably linked to counties' racial attitudes and demographic compositions.

Best research practices for using the Implicit Association Test.

Interest in unintended discrimination that can result from implicit attitudes and stereotypes (implicit biases) has stimulated many research investigations. Much of this research has used the Implicit Association Test (IAT) to measure association strengths that are presumed to underlie implicit biases. It had been more than a decade since the last published treatment of recommended best practices for research using IAT measures. After an initial draft by the first author, and continuing through three subsequent drafts, the 22 authors and 14 commenters contributed extensively to refining the selection and description of recommendation-worthy research practices. Individual judgments of agreement or disagreement were provided by 29 of the 36 authors and commenters. Of the 21 recommended practices for conducting research with IAT measures presented in this article, all but two were endorsed by 90% or more of those who felt knowledgeable enough to express agreement or disagreement; only 4% of the totality of judgments expressed disagreement. For two practices that were retained despite more than two judgments of disagreement (four for one, five for the other), the bases for those disagreements are described in presenting the recommendations. The article additionally provides recommendations for how to report procedures of IAT measures in empirical articles.

Phosphorogenic Iridium(III) bis-Tetrazine Complexes for Bioorthogonal Peptide Stapling, Bioimaging, Photocytotoxic Applications, and the Construction of Nanosized Hydrogels.

The dual functionality of 1,2,4,5-tetrazine as a bioorthogonal reactive unit and a luminescence quencher has shaped tetrazine-based probes as attractive candidates for luminogenic labeling of biomolecules in living systems. In this work, three cyclometalated iridium(III) complexes featuring two tetrazine units were synthesized and characterized. Upon photoexcitation, the complexes were non-emissive but displayed up to 3900-fold emission enhancement upon the inverse electron-demand Diels-Alder (IEDDA) [4+2] cycloaddition with (1R,8S,9s)-bicyclo[6.1.0]non-4-yne (BCN) substrates. The rapid reaction kinetics (k2 up to 1.47×104  M-1 s-1 ) of the complexes toward BCN substrates allowed effective peptide labeling. The complexes were also applied as live cell bioimaging reagents and photocytotoxic agents. One of the complexes was utilized in the preparation of luminescent nanosized hydrogels that exhibited interesting cargo delivery properties.

Implicit Social Cognition.

In the last 20 years, research on implicit social cognition has established that social judgments and behavior are guided by attitudes and stereotypes of which the actor may lack awareness. Research using the methods of implicit social cognition has produced the concept of implicit bias, which has generated wide attention not only in social, clinical, and developmental psychology, but also in disciplines outside of psychology, including business, law, criminal justice, medicine, education, and political science. Although this rapidly growing body of research offers prospects of useful societal applications, the theory needed to confidently guide those applications remains insufficiently developed. This article describes the methods that have been developed, the findings that have been obtained, and the theoretical questions that remain to be answered.

Continued low uptake of treatment for hepatitis C virus infection in a large community-based cohort of inner city residents.

BACKGROUND & AIMS: Despite advances in HCV treatment, recent data on treatment uptake is sparse. HCV treatment uptake and associated factors were evaluated in a community-based cohort in Vancouver, Canada. METHODS: The CHASE study is a cohort of inner city residents recruited from January 2003-June 2004. HCV status and treatment were retrospectively and prospectively determined through data linkages with provincial virology and pharmacy databases. Logistic regression analyses were used to identify factors associated with HCV treatment uptake. RESULTS: Among 2913, HCV antibody testing was performed in 2405, 64% were HCV antibody-positive (n = 1533). Individuals with spontaneous clearance (18%, n = 276) were excluded. Among the remaining 1257 HCV antibody-positive participants (mean age 42, 71% male), 29% were Aboriginal. At enrolment, the majority reported recent injecting (60%) and non-injecting drug use (87%). Between January 1998 and March 2010, 6% (77 of 1257) initiated HCV treatment. In adjusted analyses, Aboriginal ethnicity [adjusted odds ratio (AOR) 0.23; 95% CI 0.10, 0.51] and crack cocaine use (AOR 0.61; 95% CI 0.37, 0.99) were associated with a decreased odds of receiving HCV treatment, while methamphetamine injecting (AOR 0.16; 95% CI 0.02, 1.18) trended towards a lower odds of receiving treatment. HCV treatment uptake ranged from 0.2 (95% CI 0.0, 0.7) per 100 person-years (PYs) in 2003 to 1.6 (95% CI 0.9, 2.6) per 100 PYs in 2009. CONCLUSION: HCV treatment uptake remains low in this large community-based cohort of inner city residents with a high HCV prevalence and access to universal healthcare.

Moral elevation reduces prejudice against gay men.

Disgust is linked to social evaluation. People with higher disgust sensitivity exhibit more sexual prejudice, and inducing disgust increases sexual prejudice. We tested whether inducing moral elevation, the theoretical opposite of disgust, would reduce sexual prejudice. In four studies (N = 3622), we induced elevation with inspiring videos and then measured sexual prejudice with implicit and explicit measures. Compared to control videos that elicited no particular affective state, we found that elevation reduced implicit and explicit sexual prejudice, albeit very slightly. No effect was observed when the target of social evaluation was changed to race (Black-White). Inducing amusement, another positive emotion, did not significantly affect sexual prejudice. We conclude that elevation weakly but reliably reduces prejudice towards gay men.

America's racial framework of superiority and Americanness embedded in natural language.

America's racial framework can be summarized using two distinct dimensions: superiority/inferiority and Americanness/foreignness. We investigated America's racial framework in a corpus of spoken and written language using word embeddings. Word embeddings place words on a low-dimensional space where words with similar meanings are proximate, allowing researchers to test whether the positions of group and attribute words in a semantic space reflect stereotypes. We trained a word embedding model on the Corpus of Contemporary American English-a corpus of 1 billion words that span 30 years and 8 text categories-and compared the positions of racial/ethnic groups with respect to superiority and Americanness. We found that America's racial framework is embedded in American English. We also captured an additional nuance: Asian people were stereotyped as more American than Hispanic people. These results are empirical evidence that America's racial framework is embedded in American English.

Individual Differences in Implicit Bias Can Be Measured Reliably by Administering the Same Implicit Association Test Multiple Times.

The use of the Implicit Association Test (IAT) as a measure of individual differences is stymied by insufficient test-retest reliability for assessing trait-level constructs. We assess the degree to which the IAT measures individual differences and test a method to improve its validity as a "trait" measure: aggregating across IATs. Across three studies, participants (total n = 960) completed multiple IATs in the same session or across multiple sessions. Using latent-variable models, we found that half of the variance in IAT scores reflects individual differences. Aggregating across multiple IATs approximately doubled the variance explained with explicit measures compared with a single IAT D-score. These findings show that IAT scores contain considerable noise and that a single IAT is inadequate to estimate trait bias. However, aggregation across multiple administrations can correct this and better estimate individual differences in implicit attitudes.

Endonasal Acoustic Doppler Sonography in Predicting the Survival of Nasoseptal Flap Following Previous Irradiation.

OBJECTIVE: Blood supply to the nasoseptal flap may be compromised in patients who had previous irradiation to the head and neck region, hence, affecting its viability. Here, we evaluate the role of an endonasal acoustic Doppler sonography in predicting the survival of the nasoseptal flap in this group of patients. STUDY DESIGN: Retrospective cohort. METHODS: Retrospective review of patients with previous irradiation to the head and neck region who had undergone endoscopic endonasal surgeries requiring nasoseptal flap as reconstruction. Survival rates of nasoseptal flap were compared between groups where endonasal Doppler was used. RESULTS: A total of 28 patients were identified with previous irradiation to the head and neck region who had undergone endoscopic endonasal surgeries requiring nasoseptal flap as reconstruction. The overall survival rate of nasoseptal flap is 67.8% (19 out of 28). Endonasal acoustic Doppler was used in 17 of these patients, of which 13 patients had a positive signal. The flap survival rate in the Doppler-positive group compared to the non-Doppler group was significantly better at 100% vs 45.4% (P = .003). Among those where the endonasal Doppler was used, the flap survival rate with a negative doppler signal was significantly worse at 25%, compared with 100% flap survival in those with positive doppler signal (P = .006). The positive predictive value of a positive endonasal Doppler signal with flap survival is 100%. CONCLUSION: The use of endonasal acoustic Doppler may be useful in predicting the viability of nasoseptal flap in postirradiated patients who need a local mucosal flap coverage. LEVEL OF EVIDENCE: 3 Laryngoscope, 133:244-247, 2023.

Intracranial nasofrontal dermoid cyst and a hair in the nose tip without a sinus tract identified with single-staged combined approach excision done.

This is the first reported case of intracranial nasofrontal dermoid without sinus tract, with complete excision done in single-staged combined approach frontal craniotomy and open rhinoplasty, and satisfactory nasal reconstruction.

Combining Transoral Nasopharyngeal Brush and Plasma Epstein-Barr Virus DNA in Detecting Locally Recurrent Nasopharyngeal Carcinoma.

OBJECTIVE: To evaluate the sensitivities and specificities of Epstein-Barr virus (EBV) DNA in the detection of locally recurrent or persistent nasopharyngeal carcinoma (NPC) through nasopharyngeal (NP) brush biopsy and plasma, respectively, and whether a combination of both would be superior to the individual tests. STUDY DESIGN: A case-control study was conducted from September 2016 to June 2022. SETTING: A multicentre study at 3 tertiary referral centers in Hong Kong was conducted by the Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong. METHODS: Twenty-seven patients with biopsy-confirmed locally recurrent NPC were recruited as study subjects. Magnetic resonance imaging was performed to rule out regional recurrence. The control group consisted of 58 patients with a prior history of NPC who were now disease-free based on endoscopic and imaging findings. Patients underwent both the transoral NP brush (NP Screen®) and blood for plasma Epstein-Barr DNA levels. RESULTS: The sensitivity and specificity of the combined modalities were 84.62% and 85.19%, respectively. The positive predictive value was 73.33% and the negative predictive value was 92.0%. CONCLUSION: The combination of NP brush biopsy and plasma EBV DNA is potentially an additional surveillance modality in detecting the local recurrence of NPC. Further study with a larger sample size would be required to validate the cutoff values.

Ready access to illicit drugs among youth and adult users.

BACKGROUND: Current drug-control strategies in Canada focus funding and resources predominantly on drug law enforcement, often at the expense of preventive, treatment, and harm reduction efforts. This study aimed to examine the availability of the most commonly used substances in Vancouver, Canada after the implementation of such strategies. METHODS: Using data from two large cohorts of drug-using youth and adults in Vancouver from the calendar year 2007, we assessed perceived availability of heroin, crack, cocaine, crystal methamphetamine, and marijuana. RESULTS: Compared to youth (n= 330), a greater proportion of adults (n= 1,160) reported immediate access (ie, within 10 minutes) to heroin (81.0% vs. 55.9%, p < .001), crack (90.4% vs. 69.3%, p < .001), and cocaine (83.7% vs. 61.1%, p < .001). Conversely, larger proportions of youth reported immediate access to crystal methamphetamine (62.8% vs. 39.4%, p < .001) and marijuana (88.4% vs. 73.2%, p < .001) compared to adult users. CONCLUSIONS: Regardless of differences in illicit drug availability by age, all drugs are readily accessed in Vancouver despite drug law enforcement efforts. This includes drugs that are frequently injected and place users at risk of human immunodeficiency virus (HIV) infection and transmission of other blood-borne disease.

The validity of reporting willingness to use a supervised injecting facility on subsequent program use among people who use injection drugs.

BACKGROUND: Innovative health programs for injection drug users (IDUs), such as supervised injecting facilities (SIFs), are often preceded by evaluations of IDUs' willingness to use the service. The validity of these surveys has not been fully evaluated. We sought to determine whether measures of willingness collected prior to the opening of a Canadian SIF accurately predicted subsequent use of the program. METHODS: Data were derived from a prospective cohort of IDUs. The sample size for this study was 640 IDUs. Using multivariate logistic regression, it was assessed if a history of reporting willingness to use the program, were it available, was associated with subsequent use. In sub-analysis restricted to individuals who had a history of reported willingness, we used multivariate longitudinal analysis to identify factors associated with not attending the SIF. RESULTS: Among 442 IDUs, 72% of those who reported initial willingness to use a SIF later attended the program, and a prior willingness to use a SIF significantly predicted later attendance (adjusted odds ratio = 1.67). In sub-analyses restricted to those who had a history of reporting willingness to use the SIF, not using the program was predicted by not frequenting the neighborhood where the SIF was located. CONCLUSION: Our findings indicate that reported willingness measures collected from IDUs regarding potential SIF program participation prior to its opening independently predicted later attendance even when variables that were likely determinants of willingness were adjusted for. These data suggest that willingness measures are reasonably valid tools for planning the delivery of health services among IDU populations.

Emergency department utilization among a cohort of HIV-positive injecting drug users in a Canadian setting.

BACKGROUND: Human immunodeficiency virus (HIV)-positive injection drug users (IDUs) are known to be at risk for multiple medical problems that may necessitate emergency department (ED) use; however, the relative contribution of HIV disease vs. injection-related complications has not been well described. OBJECTIVES: We examined factors associated with ED use among a prospective cohort of HIV-positive IDUs in a Canadian setting. METHODS: We enrolled HIV-positive IDUs into a community-recruited prospective cohort study. We modeled factors associated with the time to first ED visit using Cox regression to determine factors independently associated with ED use. In sub-analyses, we examined ED diagnoses and subsequent hospital admission rates. RESULTS: Between December 5, 2005 and April 30, 2008, 428 HIV-positive IDUs were enrolled, among whom the cumulative incidence of ED use was 63.7% (95% confidence interval [CI] 59.1-68.3%) at 12 months after enrollment. Factors independently associated with time to first ED visit included: unstable housing (hazard ratio [HR] 1.5; 95% CI 1.1-2.0) and reporting being unable to obtain needed health care services (HR 2.2; 95% CI 1.2-4.1), whereas CD4 count and viral load were non-significant. Skin and soft tissue infections accounted for the greatest proportion of ED visits (17%). Of the 2461 visits to the ED, 419 (17%) were admitted to the hospital. CONCLUSIONS: High rates of ED use were observed among HIV-positive IDUs, a behavior that was predicted by unstable housing and limited access to primary care. Factors other than HIV infection seem to be driving ED use among this population in the post-highly active antiretroviral therapy era.

Subjective Identity Concealability and the Consequences of Fearing Identity-Based Judgment.

In intergroup contexts, people may fear being judged negatively because of an identity they hold. For some, the prospect of concealment offers an opportunity to attenuate this fear. Therefore, believing an identity is concealable may minimize people's fears of identity-based judgment. Here, we explore the construct of subjective identity concealability: the belief that an identity one holds is concealable from others. Across four pre-registered studies and a set of internal meta-analyses, we develop and validate a scale to measure individual differences in subjective identity concealability and provide evidence that it is associated with lower levels of the psychological costs of fearing judgment in intergroup contexts. Open materials, data, and code for all studies, pre-registrations for Studies 1-4, and online supplementary materials can be found at the following link: https://osf.io/pzcf9/.

School Mental Health Professionals' Knowledge of Stereotypes and Implicit Bias Toward Black and Latinx Youths.

Clinician bias is a contributor to health care inequities, but research on racial-ethnic bias among mental health professionals, especially toward minoritized youths, is limited. This column describes two studies involving mental health clinicians in schools, where most youths access mental health services. Study 1 used a mixed-methods approach to identify stereotypes about Black and Latinx youths salient to clinicians (e.g., academic failure; anger and aggression). In study 2, the authors developed four Implicit Association Tests to assess clinicians' implicit prejudice and stereotyping of Black and Latinx youths and found pro-White and anti-Black/Latinx bias at levels similar to those of other health care providers and the general population.

A Brief Online Implicit Bias Intervention for School Mental Health Clinicians.

Clinician bias has been identified as a potential contributor to persistent healthcare disparities across many medical specialties and service settings. Few studies have examined strategies to reduce clinician bias, especially in mental healthcare, despite decades of research evidencing service and outcome disparities in adult and pediatric populations. This manuscript describes an intervention development study and a pilot feasibility trial of the Virtual Implicit Bias Reduction and Neutralization Training (VIBRANT) for mental health clinicians in schools-where most youth in the U.S. access mental healthcare. Clinicians (N = 12) in the feasibility study-a non-randomized open trial-rated VIBRANT as highly usable, appropriate, acceptable, and feasible for their school-based practice. Preliminarily, clinicians appeared to demonstrate improvements in implicit bias knowledge, use of bias-management strategies, and implicit biases (as measured by the Implicit Association Test [IAT]) post-training. Moreover, putative mediators (e.g., clinicians' VIBRANT strategies use, IAT D scores) and outcome variables (e.g., clinician-rated quality of rapport) generally demonstrated correlations in the expected directions. These pilot results suggest that brief and highly scalable online interventions such as VIBRANT are feasible and promising for addressing implicit bias among healthcare providers (e.g., mental health clinicians) and can have potential downstream impacts on minoritized youth's care experience.

A Diffusion Model Approach for Understanding the Impact of 17 Interventions on the Race Implicit Association Test.

Performance on implicit measures reflects construct-specific and nonconstruct-specific processes. This creates an interpretive issue for understanding interventions to change implicit measures: Change in performance could reflect changes in the constructs of interest or changes in other mental processes. We reanalyzed data from six studies (N = 23,342) to examine the process-level effects of 17 interventions and one sham intervention to change race implicit association test (IAT) performance. Diffusion models decompose overall IAT performance (D-scores) into construct-specific (ease of decision-making) and nonconstruct-specific processes (speed-accuracy trade-offs, non-decision-related processes like motor execution). Interventions that effectively reduced D-scores changed ease of decision-making on compatible and incompatible trials. They also eliminated differences in speed-accuracy trade-offs between compatible and incompatible trials. Non-decision-related processes were affected by two interventions only. There was little evidence that interventions had any long-term effects. These findings highlight the value of diffusion modeling for understanding the mechanisms by which interventions affect implicit measure performance.

Reducing implicit racial preferences: III. A process-level examination of changes in implicit preferences.

Implicit bias change was initially assumed to reflect changes in associations, but subsequent research demonstrated that implicit bias change can also reflect changes in control-oriented processes that constrain the expression of associations. The present research examines the process-level effects of 17 different implicit bias-reduction interventions and one sham intervention by analyzing data from more than 20,000 participants who completed an intervention condition or a baseline control condition followed by a race Implicit Association Test (IAT). To identify the processes influenced by each intervention, we applied the Quadruple process model to participants' IAT responses then meta-analyzed parameter estimates according to a taxonomy of interventions based on shared features. Interventions that relied on counterstereotypic exemplars or strategies to override biases influenced both associations and control-oriented processes, whereas interventions that relied on evaluative conditioning influenced only control-oriented processes. In contrast, interventions that focused on egalitarian values, perspective taking, or emotion had no reliable influence on any of the processes examined. When interventions did change associations, they were much more likely to reduce positive White associations than negative Black associations. The present research extends upon traditional dual-process perspectives by identifying robust intervention effects on response biases. These findings connect features of interventions with changes in the processes underlying implicit bias. (PsycInfo Database Record (c) 2021 APA, all rights reserved).