The sleep loss insult of Spring Daylight Savings in the US is observable in Twitter activity

AbstractSleep loss has been linked to heart disease, diabetes, cancer, and an increase in accidents, all of which are among the leading causes of death in the United States. Population-scale sleep studies have the potential to advance public health by helping to identify at-risk populations, changes in collective sleep patterns, and to inform policy change. Prior research suggests other kinds of health indicators such as depression and obesity can be estimated using social media activity. However, the inability to effectively measure collective sleep with publicly available data has limited large-scale academic studies. Here, we investigate the passive estimation of sleep loss through a proxy analysis of Twitter activity profiles. We use “Spring Forward” events, which occur at the beginning of Daylight Savings Time in the United States, as a natural experimental condition to estimate spatial differences in sleep loss across the United States. On average, peak Twitter activity occurs 15 to 30 min later on the Sunday following Spring Forward. By Monday morning however, activity curves are realigned with the week before, suggesting that the window of sleep opportunity is compressed in Twitter data, revealing Spring Forward behavioral change.

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The Sleep Loss Insult of Spring Daylight Savings in the US Is Observable in Twitter Activity

10.21203/rs.3.rs-198809/v1 ◽

2021 ◽

Author(s):

Kelsey Linnell ◽

Michael Arnold ◽

Thayer Alshaabi ◽

Thomas McAndrew ◽

Jeanie Lim ◽

...

Keyword(s):

United States ◽

Large Scale ◽

Health Indicators ◽

The United States ◽

Sleep Loss ◽

Monday Morning ◽

The Us ◽

Spatial Differences ◽

At Risk Populations ◽

Twitter Activity

Abstract Sleep loss has been linked to heart disease, diabetes, cancer, and an increase in accidents, all of which are among the leading causes of death in the United States. Population-scale sleep studies have the potential to advance public health by helping to identify at-risk populations, changes in collective sleep patterns, and to inform policy change. Prior research suggests other kinds of health indicators such as depression and obesity can be estimated using social media activity. However, the inability to effectively measure collective sleep with publicly available data has limited large-scale academic studies. Here, we investigate the passive estimation of sleep loss through a proxy analysis of Twitter activity profiles. We use \Spring Forward" events, which occur at the beginning of Daylight Savings Time in the United States, as a natural experimental condition to estimate spatial differences in sleep loss across the United States. On average, peak Twitter activity occurs 15 to 30 minutes later on the Sunday following Spring Forward. By Monday morning however, activity curves are realigned with the week before, suggesting that the window of sleep opportunity is compressed in Twitter data, revealing Spring Forward behavioral change.

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Introduction

Sharing the Burden ◽

10.1093/oso/9780190618605.003.0001 ◽

2019 ◽

pp. 1-15

Author(s):

Charlie Laderman

Keyword(s):

United States ◽

Twentieth Century ◽

Large Scale ◽

The United States ◽

Great Powers ◽

Great Power ◽

World Power ◽

The Us ◽

Eastern Question

This introductory chapter outlines why the American response to the destruction of the Ottoman Armenians offers such critical insights into the US rise to world power, its evolving relationship with Britain, and the development of ideas on humanitarian intervention and global order at the turn of the twentieth century. It introduces the Armenian question, setting it within the larger Eastern question, and explains why the Ottoman Empire became a target for outside intervention by the European great powers in the nineteenth century. It explains why the United States, which had traditionally avoided political entanglement in the Near East even while its missionaries established an exceptional role there, began to take a greater interest in the region as its emergence as a great power coincided with the first large-scale Armenian massacres.

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Crisis Standards of Care Implementation at the State Level in the United States

Prehospital and Disaster Medicine ◽

10.1017/s1049023x20001089 ◽

2020 ◽

Vol 35 (6) ◽

pp. 599-603 ◽

Cited By ~ 1

Author(s):

Colton Margus ◽

Ritu R. Sarin ◽

Michael Molloy ◽

Gregory R. Ciottone

Keyword(s):

United States ◽

Large Scale ◽

State Level ◽

The United States ◽

The State ◽

Pediatric Care ◽

Standards Of Care ◽

Institute Of Medicine ◽

Full Spectrum ◽

The Us

AbstractIntroduction:In 2009, the Institute of Medicine published guidelines for implementation of Crisis Standards of Care (CSC) at the state level in the United States (US). Based in part on the then concern for H1N1 pandemic, there was a recognized need for additional planning at the state level to maintain health system preparedness and conventional care standards when available resources become scarce. Despite the availability of this framework, in the years since and despite repeated large-scale domestic events, implementation remains mixed.Problem:Coronavirus disease 2019 (COVID-19) rejuvenates concern for how health systems can maintain quality care when faced with unrelenting burden. This study seeks to outline which states in the US have developed CSC and which areas of care have thus far been addressed.Methods:An online search was conducted for all 50 states in 2015 and again in 2020. For states without CSC plans online, state officials were contacted by email and phone. Public protocols were reviewed to assess for operational implementation capabilities, specifically highlighting guidance on ventilator use, burn management, sequential organ failure assessment (SOFA) score, pediatric standards, and reliance on influenza planning.Results:Thirty-six states in the US were actively developing (17) or had already developed (19) official CSC guidance. Fourteen states had no publicly acknowledged effort. Eleven of the 17 public plans had updated within five years, with a majority addressing ventilator usage (16/17), influenza planning (14/17), and pediatric care (15/17), but substantially fewer addressing care for burn patients (9/17).Conclusion:Many states lacked publicly available guidance on maintaining standards of care during disasters, and many states with specific care guidelines had not sufficiently addressed the full spectrum of hazard to which their health care systems remain vulnerable.

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The 2,000 Mile Wall in Search of a Purpose: Since 2007 Visa Overstays have Outnumbered Undocumented Border Crossers by a Half Million

Journal on Migration and Human Security ◽

10.14240/jmhs.v5i1.77 ◽

2017 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Robert Warren ◽

Donald Kerwin

Keyword(s):

United States ◽

Homeland Security ◽

Large Scale ◽

The United States ◽

Immigration Enforcement ◽

Border Patrol ◽

The Us ◽

Mexico Border ◽

Border Crossers ◽

Us Mexico Border

The Trump administration has made the construction of an “impregnable” 2,000-mile wall across the length of the US-Mexico border a centerpiece of its executive orders on immigration and its broader immigration enforcement strategy. This initiative has been broadly criticized based on: Escalating cost projections: an internal Department of Homeland Security (DHS) study recently set the cost at $21.6 billion over three and a half years; Its necessity given the many other enforcement tools — video surveillance, drones, ground sensors, and radar technologies — and Border Patrol personnel, that cover the US-Mexico border: former DHS Secretary Michael Chertoff and other experts have argued that a wall does not add enforcement value except in heavy crossing areas near towns, highways, or other “vanishing points” (Kerwin 2016); Its cost-effectiveness given diminished Border Patrol apprehensions (to roughly one-fourth the level of historic highs) and reduced illegal entries (to roughly one-tenth the 2005 level according to an internal DHS study) (Martinez 2016); Its efficacy as an enforcement tool: between FY 2010 and FY 2015, the current 654-mile pedestrian wall was breached 9,287 times (GAO 2017, 22); Its inability to meet the administration’s goal of securing “operational control” of the border, defined as “the prevention of all unlawful entries to the United States” (White House 2017); Its deleterious impact on bi-national border communities, the environment, and property rights (Heyman 2013); and Opportunity costs in the form of foregone investments in addressing the conditions that drive large-scale migration, as well as in more effective national security and immigration enforcement strategies. The Center for Migration Studies (CMS) has reported on the dramatic decline in the US undocumented population between 2008 and 2014 (Warren 2016). In addition, a growing percentage of border crossers in recent years have originated in the Northern Triangle states of Central America (CBP 2016). These migrants are fleeing pervasive violence, persecution, and poverty, and a large number do not seek to evade arrest, but present themselves to border officials and request political asylum. Many are de facto refugees, not illegal border crossers. This report speaks to another reason to question the necessity and value of a 2,000-mile wall: It does not reflect the reality of how the large majority of persons now become undocumented. It finds that two-thirds of those who arrived in 2014 did not illegally cross a border, but were admitted (after screening) on non-immigrant (temporary) visas, and then overstayed their period of admission or otherwise violated the terms of their visas. Moreover, this trend in increasing percentages of visa overstays will likely continue into the foreseeable future. The report presents information about the mode of arrival of the undocumented population that resided in the United States in 2014. To simplify the presentation, it divides the 2014 population into two groups: overstays and entries without inspection (EWIs). The term overstay, as used in this paper, refers to undocumented residents who entered the United States with valid temporary visas and subsequently established residence without authorization. The term EWI refers to undocumented residents who entered without proper immigration documents across the southern border. The estimates are based primarily on detailed estimates of the undocumented population in 2014 compiled by CMS and estimates of overstays for 2015 derived by DHS. Major findings include the following: In 2014, about 4.5 million US residents, or 42 percent of the total undocumented population, were overstays. Overstays accounted for about two-thirds (66 percent) of those who arrived (i.e., joined the undocumented population) in 2014. Overstays have exceeded EWIs every year since 2007, and 600,000 more overstays than EWIs have arrived since 2007. Mexico is the leading country for both overstays and EWIs; about one- third of undocumented arrivals from Mexico in 2014 were overstays. California has the largest number of overstays (890,000), followed by New York (520,000), Texas (475,000), and Florida (435,000). Two states had 47 percent of the 6.4 million EWIs in 2014: California (1.7 million) and Texas (1.3 million). The percentage of overstays varies widely by state: more than two-thirds of the undocumented who live in Hawaii, Massachusetts, Connecticut, and Pennsylvania are overstays. By contrast, the undocumented population in Kansas, Arkansas, and New Mexico consists of fewer than 25 percent overstays.

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The Development of the US National Missile Defense and its Impact on the International Security

MGIMO Review of International Relations ◽

10.24833/2071-8160-2015-1-40-43-48 ◽

2015 ◽

pp. 43-48

Author(s):

J. Yu. Parshkova

Keyword(s):

United States ◽

Former Soviet Union ◽

Large Scale ◽

International Security ◽

The United States ◽

Ballistic Missile ◽

Missile Defense ◽

Ballistic Missiles ◽

The Us ◽

National Missile Defense

The article reflects the US officials' point of view on the development of its national missile defense. The major threat to international security is the proliferation of ballistic missiles and weapons of mass destruction. The United States and the former Soviet Union made huge efforts to reduce and limit offensive arms. However, presently the proliferation of ballistic missiles spreads all over the world, especially in the Middle East, because of the ballistic missile technology falling into the hands of hostile non-state groups. Missile defenses can provide a permanent presence in a region and discourage adversaries from believing they can use ballistic missiles to coerce or intimidate the U.S. or its allies. With the possible attack regional missile defense systems will be promptly mobilized to enhance an effective deterrent. The ultimate goal of such large-scale missile defense deployment is to convince the adversaries that the use of ballistic missiles is useless in military terms and that any attack on the United States and its allies is doomed to failure. The United States has missile defense cooperative programs with a number of allies, including United Kingdom, Japan, Australia, Israel, Denmark, Germany, Netherlands, Czech Republic, Poland, Italy and many others. The Missile Defense Agency also actively participates in NATO activities to maximize opportunities to develop an integrated NATO ballistic missile defense capability. The initiative of the development of US BMD naturally belongs to the United States. That country has enormous technological, financial, economic, military and institutional capabilities, exceeding by far those of the other NATO members combined.

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The 2,000 Mile Wall in Search of a Purpose: Since 2007 Visa Overstays have Outnumbered Undocumented Border Crossers by a Half Million

Journal on Migration and Human Security ◽

10.1177/233150241700500107 ◽

2017 ◽

Vol 5 (1) ◽

pp. 124-136 ◽

Cited By ~ 13

Author(s):

Robert Warren ◽

Donald Kerwin

Keyword(s):

United States ◽

Homeland Security ◽

Large Scale ◽

The United States ◽

Immigration Enforcement ◽

Border Patrol ◽

The Us ◽

Mexico Border ◽

Border Crossers ◽

Us Mexico Border

The Trump administration has made the construction of an “impregnable” 2,000-mile wall across the length of the US-Mexico border a centerpiece of its executive orders on immigration and its broader immigration enforcement strategy. This initiative has been broadly criticized based on: • Escalating cost projections: an internal Department of Homeland Security (DHS) study recently set the cost at $21.6 billion over three and a half years; • Its necessity given the many other enforcement tools — video surveillance, drones, ground sensors, and radar technologies — and Border Patrol personnel, that cover the US-Mexico border: former DHS Secretary Michael Chertoff and other experts have argued that a wall does not add enforcement value except in heavy crossing areas near towns, highways, or other “vanishing points” (Kerwin 2016); • Its cost-effectiveness given diminished Border Patrol apprehensions (to roughly one-fourth the level of historic highs) and reduced illegal entries (to roughly one-tenth the 2005 level according to an internal DHS study) (Martinez 2016); • Its efficacy as an enforcement tool: between FY 2010 and FY 2015, the current 654-mile pedestrian wall was breached 9,287 times (GAO 2017, 22); • Its inability to meet the administration's goal of securing “operational control” of the border, defined as “the prevention of all unlawful entries to the United States” (White House 2017); • Its deleterious impact on bi-national border communities, the environment, and property rights (Heyman 2013); and • Opportunity costs in the form of foregone investments in addressing the conditions that drive large-scale migration, as well as in more effective national security and immigration enforcement strategies. The Center for Migration Studies (CMS) has reported on the dramatic decline in the US undocumented population between 2008 and 2014 (Warren 2016). In addition, a growing percentage of border crossers in recent years have originated in the Northern Triangle states of Central America (CBP 2016). These migrants are fleeing pervasive violence, persecution, and poverty, and a large number do not seek to evade arrest, but present themselves to border officials and request political asylum. Many are de facto refugees, not illegal border crossers. This report speaks to another reason to question the necessity and value of a 2,000-mile wall: It does not reflect the reality of how the large majority of persons now become undocumented. It finds that two-thirds of those who arrived in 2014 did not illegally cross a border, but were admitted (after screening) on non-immigrant (temporary) visas, and then overstayed their period of admission or otherwise violated the terms of their visas. Moreover, this trend in increasing percentages of visa overstays will likely continue into the foreseeable future. The report presents information about the mode of arrival of the undocumented population that resided in the United States in 2014. To simplify the presentation, it divides the 2014 population into two groups: overstays and entries without inspection (EWIs). The term overstay, as used in this paper, refers to undocumented residents who entered the United States with valid temporary visas and subsequently established residence without authorization. The term EWI refers to undocumented residents who entered without proper immigration documents across the southern border. The estimates are based primarily on detailed estimates of the undocumented population in 2014 compiled by CMS and estimates of overstays for 2015 derived by DHS. Major findings include the following: • In 2014, about 4.5 million US residents, or 42 percent of the total undocumented population, were overstays. • Overstays accounted for about two-thirds (66 percent) of those who arrived (i.e., joined the undocumented population) in 2014. • Overstays have exceeded EWIs every year since 2007, and 600,000 more overstays than EWIs have arrived since 2007. • Mexico is the leading country for both overstays and EWIs; about one-third of undocumented arrivals from Mexico in 2014 were overstays. • California has the largest number of overstays (890,000), followed by New York (520,000), Texas (475,000), and Florida (435,000). • Two states had 47 percent of the 6.4 million EWIs in 2014: California (1.7 million) and Texas (1.3 million). • The percentage of overstays varies widely by state: more than two-thirds of the undocumented who live in Hawaii, Massachusetts, Connecticut, and Pennsylvania are overstays. By contrast, the undocumented population in Kansas, Arkansas, and New Mexico consists of fewer than 25 percent overstays.

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In Search of Covariates of HIV-1 Subtype B Spread in the United States—A Cautionary Tale of Large-Scale Bayesian Phylogeography

Viruses ◽

10.3390/v12020182 ◽

2020 ◽

Vol 12 (2) ◽

pp. 182 ◽

Cited By ~ 3

Author(s):

Samuel L. Hong ◽

Simon Dellicour ◽

Bram Vrancken ◽

Marc A. Suchard ◽

Michael T. Pyne ◽

...

Keyword(s):

United States ◽

New York ◽

Large Scale ◽

The United States ◽

Resistance Testing ◽

Western World ◽

Phylogenetic Structure ◽

Subtype B ◽

The Us ◽

Hiv 1

Infections with HIV-1 group M subtype B viruses account for the majority of the HIV epidemic in the Western world. Phylogeographic studies have placed the introduction of subtype B in the United States in New York around 1970, where it grew into a major source of spread. Currently, it is estimated that over one million people are living with HIV in the US and that most are infected with subtype B variants. Here, we aim to identify the drivers of HIV-1 subtype B dispersal in the United States by analyzing a collection of 23,588 pol sequences, collected for drug resistance testing from 45 states during 2004–2011. To this end, we introduce a workflow to reduce this large collection of data to more computationally-manageable sample sizes and apply the BEAST framework to test which covariates associate with the spread of HIV-1 across state borders. Our results show that we are able to consistently identify certain predictors of spread under reasonable run times across datasets of up to 10,000 sequences. However, the general lack of phylogenetic structure and the high uncertainty associated with HIV trees make it difficult to interpret the epidemiological relevance of the drivers of spread we are able to identify. While the workflow we present here could be applied to other virus datasets of a similar scale, the characteristic star-like shape of HIV-1 phylogenies poses a serious obstacle to reconstructing a detailed evolutionary and spatial history for HIV-1 subtype B in the US.

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How Rare Is Rare? Carrier Frequencies for Fanconi Anemia In the United States and Israel

Blood ◽

10.1182/blood.v116.21.2229.2229 ◽

2010 ◽

Vol 116 (21) ◽

pp. 2229-2229

Author(s):

Philip S Rosenberg ◽

Hannah Tamary ◽

Blanche P. Alter

Keyword(s):

United States ◽

Fanconi Anemia ◽

Carrier Frequency ◽

Large Scale ◽

Conflicts Of Interest ◽

Demographic Data ◽

New York State ◽

The United States ◽

Ashkenazi Jews ◽

The Us

Abstract Abstract 2229 Background: Although carrier frequencies for Fanconi anemia (FA) have been estimated for several founder populations, carrier frequencies in different countries remain unclear. One exception is Israel. In Jewish populations, founder mutations have been identified, e.g. the FANCC IVS+4 A>T mutation in Ashkenazi Jews, and the FANCA 2172–2173insG mutation in Moroccan Jews. The ability to test for specific mutations has enabled screening studies: the carrier frequency in Israeli Ashkenazi Jews is around 1:85; limited available data suggest that carrier frequencies in other Israeli Jewish subgroups may be similar (Tamary et al. BJH 2000). FA also occurs in Israeli Arab populations but carrier frequencies have not been determined. In contrast, there are much less data for the United States (US). Swift (Nature 1971) estimated the US FA carrier frequency as 1:300, but this estimate was based on surprisingly limited data - in total, the 12 persons with FA born in New York State from 1956 until 1967 who were known to the author among the corresponding total of 4.2 million live births. Nonetheless, this figure remains widely cited and has not been updated even after 40 years. We sought to update this estimate given the biological importance of the FA pathway. Methods: We applied Swift's approach (knowledge of the number of FA cases born during a given period with a known overall birth rate) to contemporary data for the United States and Israel. Specifically, we used the Hardy-Weinberg Law and demographic data from the Fanconi Anemia Research Fund (FARF, 488 FA) and the Israeli Fanconi Anemia Registry (ISFAR, 66 FA). Results: On average during the 1990s, 15 persons with FA were born each year in the US who eventually became known to the FARF, amongst the 4.0 million persons born each year in the US during that period. The corresponding Hardy-Weinberg carrier frequency is 1:257 (95% Confidence Interval: 1:240 – 1:277). This range describes a lower bound because ascertainment in FARF must be less than 100%. Even so, the lower confidence limit is significantly greater that 1:300. The true ascertainment in FARF is unknown. We propose that values between 40% – 60% are plausible. Using this range to adjust the observed birth incidence upwards, we obtained a plausible range for the carrier frequency of 1:156 – 1:209 [midpoint 1:182]. We applied the same approach to the ISFAR where 2.6 births per year were observed. We assumed 50% – 100% ascertainment by ISFAR since cases were identified through a country-wide hospital network. For the entire country of Israel (Jews and non-Jews combined), we obtained a plausible range for the carrier frequency of 1:66 – 1:128 [midpoint 1:93]. Hence, the range for Israel derived using Swift's indirect approach (estimated from birth rates) is broadly consistent with direct surveys. Conclusions: The FA carrier frequency in the US may be higher than previously thought, around 1:200 or perhaps even higher. From the perspective of population genetics, our results suggest there is less difference between the average carrier frequency in the US and higher carrier frequencies of around 1:100 reported for a number of ethnic groups including Ashkenazi Jews. This is consistent with the facts that the general US population is heterogeneous mixture of descendents of many ancestral groups, and FA is found world-wide. Our results also suggest that some European populations may have higher carrier frequencies than currently recognized. Our findings are sensitive to a number of assumptions. Going forwards, large scale re-sequencing studies could more precisely determine how many persons in the general population carry causative alleles for FA and other rare recessive syndromes. Disclosures: No relevant conflicts of interest to declare.

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Zero Undocumented Population Growth Is Here to Stay and Immigration Reform Would Preserve and Extend These Gains

Journal on Migration and Human Security ◽

10.14240/jmhs.v5i2.95 ◽

2017 ◽

Vol 5 (2) ◽

Author(s):

Robert Warren

Keyword(s):

United States ◽

Population Growth ◽

Homeland Security ◽

Large Scale ◽

Population Change ◽

The United States ◽

The Us ◽

Southern Border ◽

Zero Population Growth ◽

Legal Immigration

This report demonstrates that a broad and sustained reduction in undocumented immigration to the United States occurred in the 2008 to 2015 period. First, the report shows that, contrary to conventional wisdom, the Great Recession had little, if any, role in the transformation to zero population growth. The population stopped growing because of increased scrutiny of air travel after 9/11, a decade and a half of accelerating efforts to reduce illegal entries across the southern border, long-term increases in the numbers leaving the population each year, and improved economic and demographic conditions in Mexico. These conditions are likely to continue for the foreseeable future. It is time to recognize that the era of large-scale undocumented population growth has ended, and that there is a need to reform the US legal immigration system to preserve and extend these gains (Kerwin and Warren 2017, 319-21). Major findings of the report include: The recession did not reduce arrivals or accelerate departures from the undocumented population; it essentially had very little impact on population change.[1]Population growth was lower in 2008 to 2015 than in 2000 to 2008 for all major sending areas and for 13 of the top 15 countries of origin.[2]Population growth was lower in 2008 to 2015 than in 2000 to 2008 in all of the top 15 states. In 10 of the 15 top states, growth changed to decline.Nearly twice as many left[3] the undocumented population from Mexico than arrived in the 2008 to 2015 period — 1.7 million left the population and 900,000 arrived.Almost twice as many overstays as persons who entered without inspection (EWIs) “arrived” (joined the undocumented population) from 2008 to 2015 — 2.0 million overstays compared to 1.1 million EWIs.Overstays leave the undocumented population at higher rates than EWIs: about 1.9 million, or 40 percent, of overstays that lived in the United States in 2008 had left the undocumented population by 2015, compared to 1.6 million, or 24 percent, of EWIs.The rate of overstays (65% of the newly undocumented), compared to EWIs, is more dramatic than the numbers indicate since estimates of the undocumented count Central American asylum seekers that cross the US southern border as EWIs.[1] The term “population” in this paper refers to the undocumented population, both persons who have stayed in the United States beyond the period of their temporary admission (“overstays”) and those who entered without inspection (EWIs).[2] In this paper, the terms “2000 to 2008 period” and “2008 to 2015 period” are not overlapping; they are used for ease of presentation. Estimates for the two time periods are based on data for 2000, 2008, and 2015. Technically, the earlier period is for 2000 through 2007 (eight years), and the latter period is for 2008 through 2014 (seven years).[3] Undocumented residents can leave the population in four ways: emigrate voluntarily, adjust to lawful status, be removed by the Department of Homeland Security (DHS), or (a relatively small number) die.

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Racial bias confrontation in the United States: What (if anything) has changed in the COVID-19 era, and where do we go from here?

Group Processes & Intergroup Relations ◽

10.1177/1368430220981417 ◽

2021 ◽

Vol 24 (2) ◽

pp. 260-269

Author(s):

Christopher K. Marshburn ◽

Abigail M. Folberg ◽

Chelsea Crittle ◽

Keith B. Maddox

Keyword(s):

United States ◽

Large Scale ◽

Racial Bias ◽

The United States ◽

White Americans ◽

Direct Impact ◽

The Us ◽

Current Article

Contemporary racial inequities rooted in historically biased systems (e.g., policing) have largely been confronted by those directly affected. We argue, however, that the US response to the COVID-19 pandemic created a context that led many White Americans to recognize the direct impact that systems and structures have on individuals – particularly in the case of systemic anti-Black racism. This recognition was accompanied by large-scale confrontation actions (in the form of mass protests) throughout the US. The current article uses the Confronting Prejudiced Responses (CPR) model to outline conditions that fostered White Americans’ shift in awareness surrounding racial inequity and the consequences of this perception change. Furthermore, we describe how reactions to confrontation efforts may depend on the messenger, message, modality and audience. Finally, we provide recommendations for individuals and organizations to support confrontation efforts aimed at reducing biased behavior and policies.

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