Intentional Invisibility: Professional Women and the Navigation of Workplace Constraints

Drawing on an in-depth case study at a large nonprofit organization, we find, in line with previous scholarship, that women professionals continue to face biased expectations at work and at home. We leverage data from interviews and participant observation to identify a new strategy that women use to navigate professional constraints created by the second shift and workplace double binds: “intentional invisibility.” Intentional invisibility refers to a set of risk-averse, conflict-avoidant strategies that women professionals in our study employ to feel authentic, manage competing expectations in the office, and balance work and familial responsibilities. We find women across the organization reporting intentionally remaining behind the scenes in attempts to avoid backlash and maintain a professional status quo. While intentional invisibility allows women to successfully navigate gender unequal professional and personal landscapes, it could simultaneously present an additional challenge to career advancement

Integration of Tobacco Treatment Services into Cancer Care at Stanford.

As part of a National Cancer Institute Moonshot P30 Supplement, the Stanford Cancer Center piloted and integrated tobacco treatment into cancer care. This quality improvement (QI) project reports on the process from initial pilot to adoption within 14 clinics. The Head and Neck Oncology Clinic was engaged first in January 2019 as a pilot site given staff receptivity, elevated smoking prevalence, and a high tobacco screening rate (95%) yet low levels of tobacco cessation treatment referrals (<10%) and patient engagement (<1% of smokers treated). To improve referrals and engagement, system changes included an automated "opt-out" referral process and provision of tobacco cessation treatment as a covered benefit with flexible delivery options that included phone and telemedicine. Screening rates increased to 99%, referrals to 100%, 74% of patients were reached by counselors, and 33% of those reached engaged in treatment. Patient-reported abstinence from all tobacco products at 6-month follow-up is 20%. In July 2019, two additional oncology clinics were added. In December 2019, less than one year from initiating the QI pilot, with demonstrated feasibility, acceptability, and efficacy, the tobacco treatment services were integrated into 14 clinics at Stanford Cancer Center

Intentional Invisibility: Professional Women and the Navigation of Workplace Constraints

Drawing on an in-depth case study at a large nonprofit organization, we find, in line with previous scholarship, that women professionals continue to face biased expectations at work and at home. We leverage data from interviews and participant observation to identify a new strategy that women use to navigate professional constraints created by the second shift and workplace double binds: “intentional invisibility.” Intentional invisibility refers to a set of risk-averse, conflict-avoidant strategies that women professionals in our study employ to feel authentic, manage competing expectations in the office, and balance work and familial responsibilities. We find women across the organization reporting intentionally remaining behind the scenes in attempts to avoid backlash and maintain a professional status quo. While intentional invisibility allows women to successfully navigate gender unequal professional and personal landscapes, it could simultaneously present an additional challenge to career advancement

Tobacco Product Promotions Remain Ubiquitous and Are Associated with Use and Susceptibility to Use Among Adolescents.

IntroductionThe decline in tobacco smoking among US adolescents has been exceeded by the exponential rise in nicotine vaping with an overall net gain in youth tobacco product use. While cigarette companies are restricted from advertising on television/radio, vaping promotions have been largely unrestricted. This study examined exposure to tobacco product promotions in a US sample of 1003 adolescents and its associations with product use and susceptibility to use.Aims and methodsAdolescents (13-17) were recruited online and anonymously surveyed in 2019 about their ever and current (past 30 days) tobacco smoking (cigarette and cigar) and nicotine vaping behaviors, and among never-users, susceptibility to vaping. Multivariate models tested associations with past-month exposure to tobacco product promotions controlling for demographic features, harm perceptions, and family and peer influences.ResultsTobacco product use was 34% ever-use and 20% current-use. Most had seen cigarette (91%) and nicotine vaping (80%) product promotions in the past 30 days. A majority reported exposure at point-of-sale and on major (television and cinema) and social media. In adjusted multivariate models, greater exposure to tobacco product promotions was significantly associated with ever and current smoking and vaping; and among never-users, susceptibility to vaping (all p < .01, effect sizes 1.03-1.05). Family/peer use and attitudes also were significant correlates.ConclusionsTobacco product promotions remain ubiquitous and are significantly associated with adolescents' tobacco product use and susceptibility to vape. Peers and family are important social influences and may reflect indirect channels of tobacco marketing. Stricter regulatory restrictions on tobacco marketing to young people are warranted.ImplicationsThis study adds to mounting evidence showing that tobacco marketing remains pervasive and is associated with tobacco use and susceptibility to use. Most youth report seeing cigarette and nicotine vaping product promotions, with notable differences by channel: traditional media predominate for cigarettes and social media/email for e-cigarettes. Greater exposure to tobacco promotions is significantly associated with ever and current smoking and vaping, and among never-users, susceptibility to vaping. The accumulating findings support stricter regulatory restrictions on marketing of tobacco products in media channels accessed by youth

E-Cigarettes: Harmful or Harm-Reducing? Evaluation of a Novel Online CME Program for Health Care Providers.

AimPatients are asking health care providers about e-cigarettes, vaping, and other electronic nicotine delivery systems (ENDS). Provider advice on ENDS has varied greatly, suggesting a need for evidence-based continuing medical education (CME).SettingA novel free online CME course was developed on ENDS risks and benefits, product types (e.g., vape pens, pods), and screening and counseling best practices for adults, adolescents, and different smoker profiles (e.g., daily, social).ParticipantsFrom January 2017 through June 2018, 1061 individuals accessed the course: 46% physicians, 7% physician assistants, 7% nurse practitioners, 15% nurses, 4% pharmacists, and 28% allied health/student/other; 41% were international.Program descriptionThe course was built from observed online patient-provider interactions. Through video role-plays, expert interviews, and interactive activities, the course engaged learners in the evidence on ENDS. Completers earned 1.5 CME units.Program evaluationA total of 555 health care providers earned 832.5 CME units. Pre- to post-test scores significantly increased from 57 to 90%; 76% rated the course as above average (41%) or outstanding (35%); 99% indicated the course was free of commercial bias.DiscussionAddressing the growing need for balanced provider education on ENDS, this interactive online CME engaged learners and increased knowledge on devices and evidence-based cessation approaches