National Panel Research Articles

Accurate and inaccurate beliefs about cancer risk factors among Spanish-preferring adults in the United States

ObjectiveTo characterize inaccurate and accurate beliefs about cancer risk factors held among Spanish-preferring adults in the United States. MethodsFrom a national probability panel, we surveyed 196 Hispanic adults who prefer completing questionnaires in Spanish. We also used data from a representative sample of 1200 adults in the US to compare belief acceptance. ResultsMany less accepted accurate beliefs about cancer risk factors related to topics like fruit/vegetable consumption, weight loss, and alcohol use. Several inaccurate beliefs were widely held, with some being more accepted in the Spanish-preferring sample than the general US adult sample. Higher levels of self-reported media literacy and information scanning associated with more acceptance of both accurate and inaccurate beliefs. Access to the internet at home associated with discernment between accurate and inaccurate beliefs about cancer risk factors. ConclusionAcceptance of accurate beliefs and rejection of inaccurate beliefs varied across potential cancer risk factors. Future Spanish-language public health messaging should address these belief inconsistencies when providing up-to-date cancer-related recommendations or correcting inaccurate information in the public communication environment. InnovationOur study provides comprehensive information about cancer beliefs among Spanish-preferring adults in the United States, which was not previously available, and find that media literacy is a concept likely to be important to consider when putting together intervention tools to combat misinformation.

Association Between Parental Problematic Internet Use and Adolescent Depression.

We examined the association between parental problematic internet use (PIU) and adolescent depression and whether this association varied based on internet-related rules. We recruited adolescents ages 13-18 and their parent using national Qualtrics panels (N = 4592 dyads). Measures included the Problematic and Risky Internet Use Screening Scale (PRIUSS-3), the Patient Health Questionnaire (PHQ-9), and the internet specific parenting practice scale (ISPPS). Parental PIU was associated with symptoms of adolescent depression, including suicidal ideation, even when controlling for adolescent PIU (β = 0.35, 95% CI [0.32, 0.38]). Time-related rules moderated this association in a non-linear way where the association was strongest when time-related rules were unclear / mid-range. The moderation effect was linear for content-related rules, where stricter rules were associated with a weaker association between parent PIU and adolescent depression. Results support clinicians assessing parent PIU when treating depressed adolescents and engaging parents in monitoring their adolescents' internet use content.

Local nature-based recreation as a pathway to environmental citizenship

Local parks and protected areas (PPAs) offer important settings for nature exposure proximate to home that may encourage local environmental citizenship (LEC); however, there has been limited investigation of this relationship and how it may be impacted by individual characteristics. This national panel study of U.S. adults examined relationships between frequency of visitation to local nature-based recreation settings and LEC, with assessment of differences by race/ethnicity and associations with age and political orientation (N = 556). Results indicate that more frequent visitation to local nature-based recreation settings is associated with significantly greater environmental advocacy and activism, volunteering, literacy, and political ecological citizenship. Age was negatively related to environmental advocacy and activism, volunteering, and literacy, and liberalism was associated with greater participation in all types of LEC, especially political ecological citizenship. Most LEC types did not vary by race/ethnicity, although there were small differences in environmental advocacy and activism, which was higher among Black/African American and Hispanic/Latino populations compared to Asian respondents. Findings indicate that frequency of visitation to local nature-based recreation settings is associated with LEC regardless of one's age, political orientation, or race/ethnicity, and thus increasing equitable access to local nature-based recreation, especially among those who have been historically underserved, has the potential to encourage PPA stewardship through LEC, while also contributing to the advancement of procedural environmental justice. Management implications•Environmental stewardship and volunteer organizations should focus on supporting land managers in advancing equity in local parks and protected areas (PPAs) as well as engaging users in these spaces through programs which leverage people's connection with nature at the local scale and provide opportunities for accessible involvement in environmental citizenship activities.•Interpretation and education can be used to increase individual's environmental knowledge, while contextualizing such information to places they care about.•Enhanced promotion of local opportunities for stewardship among local PPA visitors may be warranted, especially events or programs with few barriers to entry that might encourage greater future participation.

A cost-benefit analysis of the life-prolonging effect of nonsteroidal anti-inflammatory drugs for persons with dementia and pain

ABSTRACT Persons with dementia are more susceptible to pain. If they take Nonsteroidal Anti-Inflammatory Drugs (NSAID) as pain relievers, the policy question is whether these medicines will be socially worthwhile. In this paper, a Cost-Benefit Analysis (CBA) was undertaken of the NSAID to see whether their benefits outweigh the costs for elderly persons with dementia. To construct the benefits, a Quality Adjusted Life Year was used as the intervention output, which was then converted into monetary terms using the Value of a Statistical Life Year. Using estimates based on a large, US national panel data set, the CBA found that the NSAID generated positive net-benefits. It was possible to re-evaluate all the prior dementia interventions that were based on the same data set, using the same methods as for the NSAID CBA. By comparing the NSAID results with those from the other alternative dementia interventions one can establish public funding priorities.

Health Care Expenditure in United States Adults With Heart Failure With and Without Diabetes

The health costs for heart failure (HF) among individuals with and without diabetes can help understand the conjoint burden of diabetes and HF. Using the 2008–2019 US national Medical Expenditure Panel Survey data including 2,019 adults with HF and a 2-part adjusted model, we estimated mean and adjusted incremental direct medical expenditures related to diabetes. The total direct expenditures for individuals with HF increased by 27%: $24,725 (95% confidence interval [CI]: $20,457-$28,993) in 2008-2009 to $31,426 (95% CI: $25,705-$37,147) in 2018-2019. The expenditures rose by 34% among those with diabetes. Inpatient costs represented the highest fraction of costs ∼ 43.3 % and were 8% higher among those with diabetes vs. those without diabetes. The drug costs accounted for 24% of all costs, increased by 44%, and were 86% higher among HF patients with diabetes vs. those without diabetes. The adjusted excess costs among individuals with HF and diabetes vs. HF without diabetes was $6,818 (95% CI: 2,241-11,395); the corresponding excess costs for drugs and medical costs other than drugs were $3,297 (95% CI: 2,168-4,426) and $3,554 (95% CI: -777-7,886). Among US adults with HF, the estimated adjusted total direct excess costs were $5.2 billion per year higher among individuals with diabetes vs. those without diabetes. In conclusion, diabetes is associated with substantially increased health care costs among patients with HF, suggesting the need for an integrated management of diabetes and HF.

Identifying cost-based quality and performance indicators for home care: a modified delphi method study

BackgroundThis study, part of a multi-study program, aimed to identify a core set of cost-based quality and performance indicators using a modified Delphi research approach. Conceptually, this core set of cost-based indicators is intended for use within a broader health system performance framework for evaluating home care programming in Canada.MethodsThis study used findings from a recently published scoping review identifying 34 cost-focused home care program PQIs. A purposive and snowball technique was employed to recruit a national panel of system-level operational and content experts in home care. We collected data through progressive surveys and engagement sessions. In the first round of surveying, the panel scored each indicator on Importance, Actionable, and Interpretable criteria. The panel set the second round of ranking the remaining indicators’ consensus criteria. The panel ranked by importance their top five indicators from operational and system perspectives. Indicators selected by over 50% of the panel were accepted as consensus.ResultsWe identified 13 panellists. 12 completed the first round which identified that 30 met the predetermined inclusion criteria. Eight completed the ranking exercise, with one of the eight completing one of two components. The second round resulted in three PQIs meeting the consensus criteria: one operational and two systems-policy-focused. The PQIs: “Average cost per day per home care client,” “Home care service cost (mean) per home care client 1y, 3y and 7y per health authority and provincially and nationally”, and “Home care funding as a percent of overall health care expenditures.”ConclusionsThe findings from this study offer a crucial foundation for assessing operational and health system outcomes. Notably, this research pioneers identifying key cost-based PQIs through a national expert panel and modified Delphi methodology. This study contributes to the literature on PQIs for home care and provides a basis for future research and practice. These selected PQIs should be applied to future research to test their applicability and validity within home care programming and outcomes. Researchers should apply these selected PQIs in future studies to evaluate their applicability and validity within home care programming and outcomes.

Reported Increase in Substance Use Following Mass Terrorism and the Role of Psychosocial Factors

Research has shown evidence of increased substance use (ISU) in populations affected by mass terrorism; however, less is known regarding how psychosocial factors interact to estimate ISU following such events. To examine which factors are associated with reporting ISU, test whether psychological distress (PD) mediated the association between exposure to trauma and reporting ISU, and whether the mediation effect differed among those with prior mental health (MH) difficulties and those without. A partially representative cross-sectional survey of the adult Jewish population in Israel (aged 18-70 years) was conducted 4 weeks after October 7, 2023 (October 31 to November 5, 2023). A national Web panel using quotas based on national distributions was used. Randomly chosen adult Jewish members were invited to participate until a predetermined sample size was reached. The study measures included reporting ISU (outcome), PD (mediator), exposure to terror events and sociodemographic characteristics (variables), and prior MH difficulties (moderator). Hypotheses regarding outcome and variables were formulated before data collection. A total of 7000 invitations were distributed, 2679 individuals consented, 1432 were excluded owing to quota limits, 74 failed attention tests, and 205 opted out, resulting in 968 participants (490 women [50.6%]; mean [SD] age, 41.5 [14.6] years). Hierarchical regression analysis revealed that participants were significantly more likely to report ISU if they had experienced direct exposure (odds ratio [OR], 5.75; 95% CI, 2.53 to 13.05), indirect exposure (OR, 1.84; 95% CI, 1.27 to 2.67), media exposure (OR, 1.22; 95% CI, 1.09 to 1.36), PD (OR, 1.80; 95% CI, 1.44 to 2.25), or previous MH difficulties (OR, 2.76; 95% CI, 1.86 to 4.09). PD partially mediated the association between indirect exposure (b = 0.20; 95% CI, 0.11 to 0.31) and media exposure (b = 0.14; 95% CI, 0.10 to 0.19) and reporting ISU. No evidence was found to support previous MH difficulties as a moderator of these indirect effects (indirect exposure, b = -0.003; 95% CI, -0.28 to 0.28; media exposure, b = 0.01; 95% CI, -0.06 to 0.08). This study contributes to the research on the association of mass terrorism with ISU while shedding important light on the role it may play in the self-medication of PD following exposure, even in those who might have no previous MH difficulties. These insights are crucial for planning essential health services and preventive measures.

Restoring Trust in US Elections through Effective Election Administrator Messaging

Abstract During the 2020 election cycle, numerous national, state, and local organizations mounted campaigns designed to counter mis- and disinformation about election activities and to foster public trust in election processes. Local and state election offices focused intently on creating and disseminating accurate messages about when, where, and how to vote. Despite these efforts, trust in the 2020 election remained confoundingly low. This research analyzes this disconnect between messages from election offices and public trust by testing messages collected from election officials around the country using focus groups and a national panel survey experiment. We find that in focus groups, neutral messages that evoke local connections tested better than other types of messages. Further, messenger characteristics influenced whether participants trusted the messages. Using messages based on these findings, we fielded a survey experiment during the 2022 midterm election cycle, finding that the interaction between baseline trust, racial identification, and identification with the messenger moves trust.

Health Belief Model Predicts Likelihood of Eating Nutrient-Rich Foods among U.S. Adults.

Despite decades of messaging, most Americans still consume excess fats and sugars, but inadequate fiber, potassium, and calcium. Nutrient-rich foods (NRFs) have a high density of favorable nutrients related to calories. Choosing NRFs could lower risk of nutrition-related chronic diseases and aid in their control. We hypothesized that having greater knowledge of NRFs, the presence of a nutrition-related chronic disease or risk factor, and positive Health Belief Model (HBM) views would be predictive of the likelihood of eating NRFs. Through a national online survey panel, 976 adults aged 18-80 completed demographic, health, NRF knowledge, attitudes, and HBM construct questions. Participants were 77% White, 52% women, and 55% had a nutrition-related disease or risk factor. Multivariable HBM scales were generated by theory, principal components, and reliability analysis. NRF knowledge was significantly higher for women, Whites, households without children, and persons without a nutrition-related disease (all p ≤ 0.015). 'Likelihood of eating NRFs' was significantly higher for persons with a nutrition-related disease, Whites, married participants, main food shoppers, and households with children (all p ≤ 0.022). Regressing demographic and HBM constructs on the 'likelihood of eating NRFs' resulted in R2 of 0.435. Nutrition-related disease and HBM constructs of self-efficacy, perceived benefits, and cues to action were predictive of the likelihood of eating NRFs, but higher NRF knowledge was negatively associated.

Delphi Consensus Statement on the Role of Probiotics in the Treatment of Atopic Dermatitis.

Background Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intense itching and recurrent eczematous lesions.Important factors in the etiopathogenesis of AD include genetic predisposition, epidermal barrier dysfunction, immune dysregulation, and gut and skin dysbiosis. Probiotics could be a potential preventive strategy for allergies including AD through immune system modulation as well as enhancement of the epithelial barrier integrity. To further understand the role of probiotics in the management of AD, a Knowledge, Attitude, and Practices (KAP) survey was conducted. Materials and methods A steering committee comprising nine experts formulated consensus recommendations on the role of probiotics in the management of AD and associated flare-ups through the use of the Knowledge, Attitude, and Practices questionnaire while analyzing literature reviews and responses from a national panel consisting of 175 members. The evidence strength and quality were evaluated based on the Agency for Healthcare Research and Quality (AHRQ) criteria. The acceptance of expert opinions as recommendations was considered upon receiving an endorsement from ≥70% of the panelists, as indicated by a Likert scale. Results The national panel emphasized that the improvement in nutritional status, immunomodulatory properties, and beneficial effects on the gastrointestinal (GI) tract and skin support the use of probiotics in AD. The panel agreed that probiotics should be a part of the complementary therapy in the management of AD and associated flare-ups. Mostly, a probiotics supplementation duration of eight to 12 weeks is preferred by dermatologists. Probiotics, when used as an adjuvant therapy, may serve as a strategy to reduce steroid usage or maintenance therapy in high-risk cases with flares. Conclusion A Delphi-mediated KAP response provides a real-life approach to the use of probiotics in the management of AD. It suggests that probiotics could be useful as an adjuvant therapy in the management of AD and associated flare-ups when used along with traditional treatment.

Trends in direct health care costs among US adults with atherosclerotic cardiovascular disease with and without diabetes

ObjectivePopulation-based national data on the trends in expenditures related to coexisting atherosclerotic cardiovascular diseases (ASCVD) and diabetes is scarce. We assessed the trends in direct health care expenditures for ASCVD among individuals with and without diabetes, which can help to better define the burden of the co-occurrence of diabetes and ASCVD.MethodsWe used 12-year data (2008–2019) from the US national Medical Expenditure Panel Survey including 28,144 U.S individuals aged ≥ 18 years. Using a two-part model (adjusting for demographics, comorbidities and time), we estimated mean and adjusted incremental medical expenditures by diabetes status among individuals with ASCVD. The costs were direct total health care expenditures (out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources) from various sources (office-based visits, hospital outpatient, emergency room, inpatient hospital, pharmacy, home health care, and other medical expenditures).ResultsThe total direct expenditures for individuals with ASCVD increased continuously by 30% from $14,713 (95% confidence interval (CI): $13,808–$15,619) in 2008–2009 to $19,145 (95% CI: $17,988–$20,301) in 2008–2019. Individuals with diabetes had a 1.5-fold higher mean expenditure that those without diabetes. A key driver of the observed increase in direct costs was prescription drug costs, which increased by 37% among all individuals with ASCVD. The increase in prescription drug costs was more pronounced among individuals with ASCVD and diabetes, in whom a 45% increase in costs was observed, from $5184 (95% CI: $4721–$5646) in 2008–2009 to $7501 (95% CI: $6678–$8325) in 2018–2019. Individuals with ASCVD and diabetes had $5563 (95% CI: $4643–$6483) higher direct incremental expenditures compared with those without diabetes, after adjusting for demographics and comorbidities. Among US adults with ASCVD, the estimated adjusted total direct excess medical expenditures were $42 billion per year among those with diabetes vs. those without diabetes.ConclusionsIn the setting of ASCVD, diabetes is associated with significantly increased health care costs, an increase that was driven by marked increase in medication costs.

External Quality Assessment Program for SARS-COV-2 Molecular Detection in Pakistan.

Amid coronavirus disease 2019 (COVID-19) pandemic, accurate detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical for diagnosis management and breaking down transmission chains. We designed a national external quality assessment panel (EQAP) for SARS-CoV-2 molecular detection comprising working laboratories nationwide. A molecular diagnostic EQA panel that consists of five samples for SARS CoV-2 testing was distributed to 141 public and private sector laboratories across country. These samples contain different concentrations of SARS-CoV-2 to evaluate the sensitivity of commercial kits available. Sensitivity among public and private sector laboratories was variable, particularly lower SARS-CoV-2 concentrations significantly increased the risk of false-negative tests, whereas Ct values of accurately tested SARS-CoV-2 specimens increased as concentration decreased. These findings highlighted that performance of used commercial kits was not significantly correlated to various extraction or PCR methods. This study highlights the need for a national external quality assessment panel (EQAP) in the country to improve the quality of the healthcare system while ensuring the accuracy and reliability of results. Furthermore, EQAPs can help laboratories meet accreditation and regulatory requirements. However, continued participation in EQAP is recommended for quality enhancement of laboratories.

Women’s Experiences of Sexual Harassment and Reductions in Well-Being and System Justification

This study examines the impact of personally experiencing sexual harassment on women’s subjective well-being and perceptions of gender relations and society. We draw upon large-scale national probability panel data and utilize propensity score matching to identify (1) women who reported sexual harassment in the past year and (2) a matched control group of women who were comparable in outcome and demographic variables in the previous year but did not report sexual harassment (Nmatched pairs = 609). We then compare pre- and post-event levels of well-being and system justification across groups, including the perceived fairness of gender relations and society in general. Women who reported sexual harassment experienced significant pre-to-post declines in well-being (lower life satisfaction, higher psychological distress) and reductions in perceptions that gender relations, and broader society, are fair. Critically, these changes were significantly different than matched controls who did not show the same pre-post changes in well-being or system justification. These results provide robust evidence that sexual harassment has detrimental effects on well-being and document the previously unexamined effect of sexual harassment on women’s reduced support for the (gendered) status quo, which has important implications for social change.

Understanding cooperative contact tracing: Factors explored through privacy management theories

This study investigates the factors influencing the comfort level of the general public when disclosing personal information for the coronavirus disease 2019 contact tracing. This is a secondary analysis of the American Trends Panel, a national probability-based online panel of American adults, with data collected by the Pew Research Center between July 13 and 19, 2020. Grounded in privacy management theories, ordered logistic regression analyses examined three types of information disclosure: places visited, names of contacts, and location data from cell phones. Key independent variables measured trust in the stakeholders' ability to protect data and perceived risks to health and finances. The findings suggest that higher levels of trust in entities' data security capabilities can predict individuals’ comfort levels when disclosing personal data. Additionally, the participants were more comfortable with noncommercial data use, especially when it was used by researchers and state and local officials. However, financial threats showed variations in sharing certain types of data. Individuals were less likely to feel at ease sharing contact tracing data as concerns about personal finances increased. Similarly, when individuals perceived threats to the U.S. economy, they were less likely to feel comfortable sharing their location data from cell phones, which might have been perceived as intrusive. Public health outreach efforts should account for individual differences and the nature of the information requested in commercial and noncommercial contexts. Future studies can enhance the explanatory capacity of data disclosure models by incorporating additional relevant contextual and environmental variables.

Individual, social and area level factors associated with older people's walking: Analysis of an UK household panel study (Understanding Society)

BackgroundAmong older people, walking is a popular and prevalent activity. Walking is key to increasing physical activity levels and resulting physical and mental health. In the context of rapidly ageing populations, it is important to better understand what factors are associated with walking among older people, based on the socioecological model of health. MethodsWe used data from Understanding Society (n:6450), a national panel survey of UK adults aged 65 years and over living in Great Britain. Slope Indices of Inequality (SII) were calculated for weekly walking hours for older people according to individual, social and area characteristics. These include health, loneliness and social isolation, previous walking and sporting activity, residential self-selection, contact with neighbours, number of close friends and social activity. Spatial area-level data described local area crime, walkability, and proximity to retail, greenspace, and public transport amenities. ResultsMultivariable models indicated that poor health, particularly requiring help with walking, was the strongest predictor of weekly walking hours (SII (95% CI) comparing those needing help vs. no help: −3.58 (−4.30, −2.87)). However, both prior sporting activity (most vs. least active: 2.30 (1.75, 2.88)) and walking for pleasure (yes vs. no: 1.92 (1.32, 2.53)) were strongly associated with increased walking several years later. Similarly having close friends (most vs. fewest, 1.18 (0.72, 1.77)) and local retail destinations (any vs. none: 0.93 (0.00, 1.86)) were associated with more weekly walking. ConclusionsPast engagement in physical activity and walking for pleasure are strong predictors of walking behaviour in older people, underscoring the importance of implementing and sustaining walking interventions across the lifespan to ensure continued engagement in later years and the associated health benefits. However, poor health significantly impedes walking in this demographic, emphasising the need for interventions that offer both physical assistance and social support to promote this activity.

Impacts of Long COVID on workers: A longitudinal study of employment exit, work hours and mental health in the UK.

The COVID-19 pandemic has had enormous implications for the world of work. However, there has been relatively little focus on the employment and workforce challenges of the virus in relation to workforce health, beyond the immediate management of the spread of the disease. There is an important gap in understanding the ongoing workforce issues created by the significant incidence of Long COVID in the population. This paper examines the effects of Long COVID on employment and workers' mental health to contribute to understanding of work-limiting health conditions and to offer policy implications for COVID-19 and similar health conditions on employment and the workforce. A large national panel study for the UK is used to estimate the likelihood of exiting employment as well as on changes in working hours and general mental health and happiness of those who remain in work. The sample includes individuals 16 years and older who were in employment in January/February 2020 and followed during the pandemic 2020-2021. Long COVID is self-reported in the data. Informed by conceptual consideration of employment protection in the UK, two groups of individuals with Long COVID are defined based on the duration of symptoms. Group 1 has Long COVID 5-28 weeks after an infection with COVID-19, which is up to the maximum length of Statutory Sick Pay in the UK. Group 2 has symptoms for 29+ weeks, which is beyond the statutory entitlement to sickness pay. Panel regression models are fitted both with fixed-effects and random-effects. Individual and job characteristics are used as controls Those with no COVID-19 symptoms are the reference group. In between-person comparison, Group 2 is at higher risk of exiting employment compared to those with no COVID-19 symptoms. Between-person estimates of mental health and well-being show negative effects of Long COVID for both groups but these are greatest in Group 2. Within-person estimates suggest that factors associated with earnings mediate the negative Long COVID effects on mental health in Group 1 and that Group 2 adapts to working with Long COVID. Group 1 is at risk of working zero hours (i.e. being on sick leave) but neither Group 1 nor Group 2 have a higher probability of working fewer hours compared to those with no COVID-19 symptoms. The negative impact of Long COVID on working hours stems primarily from working zero hours (sickness leave) rather than working fewer hours, suggesting a lack of accommodation by employers of Long COVID at work. The extension of Statutory Sickness Pay and greater flexibility to manage partial (returns to) work would help preserve employment and mental health. Those with Long COVID for 12 months are likely to meet the definition of disability and so have a right to receive reasonable workplace adjustments.

Income Distribution Effects of the Belt and Road Initiative

The Belt and Road Initiative (BRI) adheres to the principles of inclusive development, shared business interests, and collaborative construction. This paper empirically investigates the impact of the BRI on domestic income inequality in participating countries using national panel data from 2008 to 2023 and employing a difference-in-differences methodology. The findings indicate that the BRI significantly reduces domestic income inequality in participating countries. This effect is consistent across different geographic locations but is more pronounced in countries with lower levels of economic development. The economic channel analysis reveals that the BRI facilitates trade, which, in turn, reduces income inequality by promoting the industrial upgrading and optimizing the comparative advantages of the host countries. The political channel analysis shows that the BRI enhances governance capacities in participating countries, further contributing to the reduction in income disparity. Extended analyses suggest that the BRI significantly boosts the economic development levels of participating countries, and this positive effect is uniformly distributed across various economies. These findings provide empirical support for the mutually beneficial industrial relationships and inclusive development fostered by the BRI between China and its participating countries.

Impact of China's carbon emissions trading scheme on firm-level pollution abatement and employment: Evidence from a national panel dataset

As an emerging economy, China has implemented market-oriented carbon emissions trading schemes in response to growing environmental challenges. Yet, concerns persist regarding the potential hindrance of these policies on socio-economic progress due to increased costs and possible declines in employment rates. Using a novel rich panel dataset of small-medium enterprises from 2011 to 2015, this study employs time-varying difference-in-differences methods to provide robust empirical evidence on the effect of these carbon trading policies. The findings reveal that the trial programs notably decreased sulfur dioxide emissions at the firm level by 2–3%, concurrently fostering a 6–7% increase in employment, indicating the realization of a ‘double dividend.’ An analysis of variations demonstrates that non-state enterprises, foreign-owned companies, and industries with substantial pollution levels experienced the most significant benefits, particularly with heightened positive impacts on employment observed in Western regions. Upon delving into the mechanisms involved, it becomes evident that initial job losses were offset by the emergence of new positions due to the expansion in output and the effects of substituting factors resulting from green investments catalyzed through the carbon trading initiative. These compelling findings strongly advocate for the widespread implementation of market-based tools on a national scale, providing robust support for concurrently addressing environmental concerns and promoting livelihood objectives within the specific context of China.

Feeling blue? Arts attendance as a moderator of the effect of neuroticism on subjective well-being: evidence from two national panel studies

Neuroticism has long been known as a risk factor for reduced happiness and impaired health. And yet, despite the growing evidence linking arts engagement to happiness, the question remains: Do people high in neuroticism benefit from arts engagement? Using data from two nationally representative panel studies from Germany (N = 874) and Switzerland (N = 6,336) we examined whether arts attendance moderates the relation between neuroticism and subjective well-being. Results showed that popular arts attendance moderated the effect of neuroticism on life satisfaction and positive affect in the German sample. Quite similar results were observed in the Swiss sample, where arts attendance acted as a protective factor but only for life satisfaction. Arts attendance, however, did not serve as a moderator of the relation between neuroticism and negative affect in both samples. Even so, taken together, these findings further confirm the contribution of arts engagement to subjective well-being and illustrate the importance of its promotion among people scoring high in neuroticism.

Beliefs about COVID-19 testing and treatment: A national survey of Black and White adults

ObjectivesKnowledge, access, and use of testing and antiviral treatments is critical to managing and mitigating the continuing burden of the novel Corona Virus (COVID-19) in the United States. This study measured knowledge, attitude, behaviors, and self-reported barriers towards COVID-19 testing and outpatient anti-viral medications (OPA) treatments among Black and older individuals who face greater hospitalization and mortality from the disease. Study designCross-sectional structured survey. MethodsRespondents were randomly selected from an opt-in national panel in December 2022. Equal numbers of Black and White US adults over the age of 40 (n = 1037) completed the 42 item online survey. The main measures were key sociodemographic variables of respondents, race, age, political affiliation and COVID-19 attitudes, beliefs, testing behaviors, and knowledge and barriers to OPA access. ResultsOverall, awareness and knowledge of COVID-19 outpatient treatments was low. Black respondents were more likely to test for COVID-19 than White respondents but less likely to know about OPA treatments. Insurance coverage was a significant factor in use of home tests. Knowledge of OPA treatments was low across groups. White respondents were more likely than Black respondents to be aware of OPA treatments (1.75, 95 % CI [1.31–2.33]) as were higher income respondents (1.13, 95 % CI [1.08–1.17]) and self-identified Liberals (1.79, 95 % CI [1.29–2.49]). ConclusionsClinicians should know large numbers of patients may not be testing for COVID-19, nor are they aware of outpatient treatment options and may hold inaccurate beliefs about them. Developing culturally specific patient education materials are warranted to increase testing, utilization of vaccinations and OPAs.