Geographic and Specialty Access Disparities in US Pediatric Leukodystrophy Diagnosis.

OBJECTIVE: To examine disparities in the diagnosis of leukodystrophies including geographic factors and access to specialty centers. STUDY DESIGN: Retrospective cohort study of pediatric patients admitted to Pediatric Health Information System hospitals. Patients with leukodystrophy were identified with International Classification of Diseases, Tenth Revision, Clinical Modification diagnostic codes for any of 4 leukodystrophies (X-linked adrenoleukodystrophy, Hurler disease, Krabbe disease, and metachromatic leukodystrophy). We used 3-level hierarchical generalized logistic modeling to predict diagnosis of a leukodystrophy based on distance traveled for hospital, neighborhood composition, urban/rural context, and access to specialty center. RESULTS: We identified 501 patients with leukodystrophy. Patients seen at a leukodystrophy center of excellence hospital were 1.73 times more likely to be diagnosed than patients at non-center of excellence hospitals. Patients who traveled farther were more likely to be diagnosed than those who traveled shorter. Patients living in a Health Professionals Shortage Area zip code were 0.86 times less likely to be diagnosed than those living in a non-Health Professionals Shortage Area zip code. CONCLUSIONS: Geographic factors affect the diagnosis of leukodystrophies in pediatric patients, particularly in regard to access to a center with expertise in leukodystrophies. Our findings suggest a need for improving access to pediatric specialists and possibly deploying specialists or diagnostic testing more broadly.

The Role of Parents' Nativity in Shaping Differential Risks of Food Insecurity Among US First Graders.

Objectives Food insecurity remains a problem in the US, especially for children in immigrant families. We developed a novel measure of parental nativity and incorporated school effects to advance knowledge from prior studies. Methods Using hierarchical logistic models and data from the Early Childhood Longitudinal Study-2011 Kindergarten Cohort, we examined how parental nativity and race/ethnicity, and school characteristics influence household food insecurity among a nationally representative sample of US first-graders in 2012. Results After adjusting for potential confounders, children without any US-born parents had a higher likelihood of household food insecurity than children with two US-born parents or one foreign-born/one US-born parent. Attending a Title 1 school was associated with food insecurity independent of household socioeconomic status. Conclusions for Practice Results suggest that providers should take special care to screen for food insecurity among children with only immigrant parents and that Title 1 schools have a potentially important role to play in reducing food insecurity.

Hispanic/Latinx STEM Majors Applying to Graduate School: The Role of Family, Peers, and Undergraduate Research Programs in Facilitating Community Cultural Wealth.

This paper examines the critical transition from undergraduate to graduate biomedical education and focuses on Hispanic/Latinx students who participated in a biomedical undergraduate research program at a Hispanic-Serving Institution located on the US-Mexico border. We use the community cultural wealth (CCW) framework (Yosso, 2005) to analyze 13 qualitative interviews about students' experiences applying to graduate school in biomedical fields and how different program activities allowed students to navigate the graduate school application process. Our findings suggest that different programmatic activities (research experiences, research mentorship, workshops, family involvement, and advising) facilitated students' graduate school application process by enhancing different types of cultural capital: aspirational, familial, social, navigational, and resistant.

Student mental health during Summer 2022 research experiences for undergraduates (REUs): Mentorship, remote engagement, and COVID-19.

Objective: We examined how mentorship, remote participation, and COVID-19 challenges were associated with the mental health of college students participating in summer research programs. Participants: Participants were students participating in 78 National Science Foundation (NSF) Research Experiences for Undergraduate (REU) Sites during Summer 2022 (n = 516 students). Methods: We used multivariable generalized estimating equations that account for clustering by REU Site. Results: Students with more competent mentors had reduced depression severity. Students who spent ≥25% of their time doing remote research or ≥25% of their time in remote meetings and workshops had greater depression severity. Remote research was also associated with anxiety severity. Having a COVID-19 challenge that impacted students' research experience was associated with increases in depression and anxiety severity. Conclusions: Results suggest potential interventions: implement strategies to boost mentor competency and scaffold a support system into summer research programs to enhance student wellbeing. Additional research on remote engagement is needed.

Modifying Summer Undergraduate Research Programs during COVID-19 Increased Graduate School Intentions but Exacerbated Anxieties.

COVID-19 created unprecedented challenges for college students, highlighting the need to provide educational contexts that foster well-being. Summer undergraduate research experiences (SUREs) constitute a high-impact practice, yet little systematic knowledge exists about how the first surge of COVID-19 influenced undergraduate researchers' well-being. This knowledge is important for preparing for future disruptions. This study applies the student well-being model (SWBM) to examine how SURE status (e.g., modification vs. cancellation) impacted students' mental health and graduate school intentions using primary survey data collected from U.S. undergraduate researchers in science, technology, engineering, and mathematics (STEM) fields in Summer 2020 (n = 408, from 131 institutions). Just under half had their SURE canceled, and the others engaged in modified SUREs. Students whose SUREs were canceled had reduced anxiety severity (p < 0.05), but greater concerns about graduate school matriculation (p < 0.001), compared with students with modified SUREs. Results suggest that modified SUREs are a reasonable path forward under conditions where in-person contact is untenable. Results point toward potential improvements in higher education practices that may enhance student well-being following disruptive events. Program directors can address potential causes of anxiety in modified SUREs, advocate for student-centered adjustments to graduate admission processes, and use experiences during COVID-19 as a springboard to broaden participation in undergraduate research.

Academic Achievement of Latino/a Students Who Began College before Age 18 at a Hispanic-Serving Institution.

There has been growth in Early College High Schools, and other similar programs, to improve racial/ethnic minority and first-generation students' access to higher education. As a result, there has been an increase in nontraditionally aged students (e.g., students under 18) in higher education. Despite increases in students under 18 attending universities, little is known about these students' academic achievement and experiences. This mixed method study addresses that limitation by using institutional and interview data from one Hispanic Serving Institution to examine the academic achievement and college experiences of young Latino/a student's (i.e., beginning college before the age of 18). Generalized estimating equations were used to compare the academic performance of Latino/as <18 to Latino/a students ages 18-24, and interviews were conducted with a subset of the students to understand the results. Quantitative results indicate that young students outperformed students who are 18-24 years of age in terms of GPA over three semesters in college. Interviews showed that participating in high school programs designed for college bound students; an openness to seek help; and avoidance of high-risk behaviors were possible explanations behind the academic success of young Latino/as.

Advancing understanding of discordant mentoring relationships in STEMM: A method and framework.

Having a diverse workforce in STEMM (science, technology, engineering, mathematics, and medicine) fields is essential for the United States to remain competitive in the global economy and to create a more just society. Faculty-mentored undergraduate research experiences have been identified as a high-impact practice for encouraging students from diverse backgrounds to pursue STEMM education and careers. Despite extensive research examining factors influencing the effectiveness of mentor-mentee relationships, there is still limited understanding of how differences or similarities in the social identities of mentors and mentees, which we term mentor-mentee discordance, impact undergraduates' research experiences and outcomes. In this perspective, we propose that mentor-mentee discordance should be conceptualized as a multidimensional, continuous construct and suggest a global index to measure varying degrees of discordance in mentoring relationships. We also offer a conceptual model that incorporates the Discordance Index to systematize the understanding of the effects of discordant mentoring relationships on student development across social contexts and over time. Finally, we provide recommendations for future researchers, STEMM educators, and program directors who are interested in using the Discordance Index.

"Your Family is Always With You": Perceptions of Parental Relationships Among Hispanic/Latinx Young Adults Pursuing STEM Careers.

Hispanic/Latinx young adults remain significantly underrepresented in science, technology, engineering, and mathematics (STEM) fields, yet the role families play in these young adults' trajectories in STEM is still underexamined. The purpose of this study was to examine the relational supports and constraints that Hispanic/Latinx college students in STEM majors experienced with their parents as they moved through college and transitioned into their first year of graduate school or full-time employment. Two rounds of interviews were conducted with 18 Hispanic/Latinx young adults who were part of an undergraduate STEM program at a Hispanic-majority university. Most of the study participants reported benefiting from immense emotional support from their parents; however, this emotional support was often simultaneously coupled with home-school value conflicts and a dynamic we call "conversational constraints." Results from this study point to important interventions involving family that might improve the rates of participation of Hispanic/Latinx students from a range of socioeconomic backgrounds in STEM fields.

Undergraduate researchers' graduate school intentions during COVID-19.

There is emerging literature on the disruptive effects of the COVID-19 pandemic on college students, but little is known about the impacts on undergraduate researchers (UGRs). On the basis of survey data collected in Summer 2020, this paper examines how less competent mentorship and COVID-19-related difficulties shaped UGRs' graduate school intentions. Results suggest that the pandemic strengthened UGRs' graduate school intentions when UGRs experienced fewer COVID-19-related difficulties. The pandemic weakened URG's graduate school intentions when they had a less competent faculty mentor. Having a more competent postgraduate mentor had a positive effect on UGRs' graduate school intentions in response to the pandemic. Those findings indicate that higher quality postgraduate mentorship may serve as an effective surrogate for lower quality faculty mentorship. Findings suggest that immediate strategies are needed to bolster graduate school aspirations among specific groups of UGRs in response to the pandemic. UGRs of particular concern include those who were highly impacted by COVID-19 with less competent mentors, were first-generation college students, had less prior research experience, had their Summer 2020 research experiences canceled, and were social/behavioral sciences majors.

A US National Study of Barriers to Science Training Experienced by Undergraduate Students during COVID-19.

Undergraduate research is a high-impact practice on college campuses. How the COVID-19 pandemic has affected undergraduate researchers' progress is poorly understood. We examine how demographics, academic characteristics, research disruptions and faculty mentorship are associated with four barriers to research progress. Data are drawn from a survey of over 1000 undergraduate student researchers across the US. We examine students who actively continued to conduct faculty-mentored research during mid-March/April 2020 (n = 485). Using generalized estimating equations that control clustering by institution, we found economic hardship, discomfort teleconferencing, lower quality mentors, sexual minority status and higher grade point averages were associated with motivation problems. Economic hardship, serious illness, Internet connection issues, a lack of face-to-face meetings and lower a frequency of mentor-mentee communication were associated with a time crunch with regard to conducting research. Discomfort teleconferencing, Internet connection issues, a lack of face-to-face meetings and decrease in research workload were associated with task uncertainty. Economic hardship, serious illness and being an engineering major were associated with lacking needed tools for the research. In sum, economic hardship was an important correlate of research barriers, as were communication challenges and sexual minority status. Results can inform practical actions by research program directors and faculty undergraduate research mentors.

Effects of mentor-mentee discordance on Latinx undergraduates' intent to pursue graduate school and research productivity.

Owing to an undergraduate demographic transition in STEM, Latinx students are likely to work with faculty from different backgrounds when participating in undergraduate research experiences (UREs). However, the effects of mentor-mentee demographic discordance on student STEM development are unclear. This paper examines how mentoring discordance affects Latinx students' intentions to pursue graduate school and research productivity. We collected data from participants in a multiyear, multi-institutional URE program (n = 171 dyads), which we analyzed using multivariable generalized estimating equations. Results indicate that compared with gender concordance, gender discordance was associated with a 17% increase in intent to pursue graduate school for Latina students. Compared with racial/ethnic concordance, racial/ethnic discordance was associated with a 38% increase in intent to pursue graduate school for Latino students. When paired with gender discordant mentors, Latina students were 70% less likely to present their URE projects at a professional conference. When faculty mentors were culturally competent and interacted with mentees frequently, Latinx students became more interested in pursuing graduate school. Because mentors from different demographic backgrounds contribute to the development of Latinx STEM students in varied ways, URE program directors should integrate opportunities for multiple mentorships.

The Emerging STEM Paths and Science Identities of Hispanic/Latinx College Students: Examining the Impact of Multiple Undergraduate Research Experiences.

This study reports findings from 19 interviews with Hispanic/Latinx students participating in a university-wide, multiyear program designed to retain students from underrepresented backgrounds in science, technology, engineering, and mathematics (STEM) at a Hispanic-serving institution. We focus on the impact that having multiple opportunities to engage in faculty-mentored, cocurricular undergraduate research experiences (UREs) had on students' STEM paths in college and the cultivation of their science identities. In addition to professional and psychosocial benefits, our findings suggest that having the opportunity to spend multiple summers in UREs at partnering institutions away from home helped to strengthen Hispanic/Latinx students' comfort levels with being away from their families and helped them recognize the broad range of opportunities available to them for graduate school.

Anxiety and depression among US college students engaging in undergraduate research during the COVID-19 pandemic.

OBJECTIVE: The objective was to examine mental health of undergraduate researchers (UGRs) during the COVID-19 pandemic. PARTICIPANTS: We surveyed 962 UGRs who were conducting research in Spring 2020 at over 100 US universities. METHODS: We conducted an online survey in July 2020. We analyzed data using descriptive statistics and multivariable generalized estimating equations. RESULTS: 63% reported at least mild anxiety and 73% reported at least mild depression based on GAD-7 and PHQ-9 scores; 15.2% reported severe anxiety (score ≥ 15) and 23.4% reported severe depression (score ≥ 15). More COVID-19-related adverse event experiences were associated with more severe anxiety and depression, as were first-generation status, woman gender, and LGBQ status. Greater social support was protective, and significantly more so for men (vs. women) and continuing generation (vs. first generation) students. CONCLUSION: Faculty have an important role in the mental health of their mentees. Additional interventions are needed to better support women and first-generation students.Supplemental data for this article can be accessed online at.

BUILD Peer Mentor Training Model: Developing a Structured Peer-to-Peer Mentoring Training for Biomedical Undergraduate Researchers.

One of the key challenges many peer-to-peer mentoring programs face is the lack of high-quality mentor training. In order to address this issue, the BUILDing SCHOLARS (BUILD) program at The University of Texas at El Paso (UTEP) implements a structured peer mentor training and provides the training to BUILD fellows at UTEP for four academic years. This paper focuses on introducing the BUILD Peer Mentor Training (BPMT) model and investigates its impacts on students using program evaluation data. Our results reveal that BUILD peer mentors were satisfied with the BPMT and their relationships with the mentees. They also reported that the training greatly improved their problem solving and action planning skills, and slightly improved their communication skills and ability to assess a mentee's understanding. Finally, four practical recommendations are provided for institutions and programs that might be interested in implementing a similar peer mentor training.

Ancestry-based intracategorical injustices in carcinogenic air pollution exposures in the United States.

Previous studies of US environmental inequalities have focused on racial/ethnic differences in air pollutant exposure. Few have applied an intracategorical framework, which enables the identification of within-group differences through the examination of subgroups. We applied this framework to examine exposure disparities between 26 ancestry/ethnic origin groups within five US racial/ethnic categories. Data come from the US Census, American Community Survey, and National Air Toxics Assessment. We calculated national population-weighted lifetime cancer risk (LCR) scores from residential exposure to hazardous air pollutants. Results showed that Americans of Dominican, Ethiopian, and Somalian descent have the highest total LCR scores at 53.1, 49.2, and 48.3 estimated excess cases of cancer per one million people, respectively. Use of the intracategorical framework enabled characterization of disparate risks that would be overlooked based on the conventional assumption that racial/ethnic environmental inequalities conform to broad, homogenous categories. Intracategorical studies can inform interventions by identifying environmentally-disadvantaged socio-demographic groups.

Racial/Ethnic and Insurance Status Disparities in Distance Traveled to Access Children's Hospital Care for Severe Illness: the Case of Children with Leukodystrophies.

Families of children with special health care needs may travel substantial distances to access specialized health care. However, it is not known how race/ethnicity, insurance status, and access to disease-specific specialty care affect travel distances. This analysis examines patients aged 18 years or younger who were discharged from a Pediatric Health Information System (PHIS) children's hospital (n = 52) with a diagnosis of an inherited leukodystrophy between October 1, 2015, and September 30, 2018 (n = 950 patients). Leukodystrophies are rare but very serious neurological illnesses, with elevated mortality and morbidity rates. Bivariate and hierarchical generalized linear models reveal that white children, privately insured children, and children visiting leukodystrophy specialist centers travel farther for children's hospital care. These findings indicate that socially privileged families travel greater distances to obtain specialized health care, which could affect clinical outcomes.

Baseline Characteristics of the 2015-2019 First Year Student Cohorts of the NIH Building Infrastructure Leading to Diversity (BUILD) Program.

Objective: The biomedical/behavioral sciences lag in the recruitment and advancement of students from historically underrepresented backgrounds. In 2014 the NIH created the Diversity Program Consortium (DPC), a prospective, multi-site study comprising 10 Building Infrastructure Leading to Diversity (BUILD) institutional grantees, the National Research Mentoring Network (NRMN) and a Coordination and Evaluation Center (CEC). This article describes baseline characteristics of four incoming, first-year student cohorts at the primary BUILD institutions who completed the Higher Education Research Institute, The Freshmen Survey between 2015-2019. These freshmen are the primary student cohorts for longitudinal analyses comparing outcomes of BUILD program participants and non-participants. Design: Baseline description of first-year students entering college at BUILD institutions during 2015-2019. Setting: Ten colleges/universities that each received <$7.5mil/yr in NIH Research Project Grants and have high proportions of low-income students. Participants: First-year undergraduate students who participated in BUILD-sponsored activities and a sample of non-BUILD students at the same BUILD institutions. A total of 32,963 first-year students were enrolled in the project; 64% were female, 18% Hispanic/Latinx, 19% African American/Black, 2% American Indian/Alaska Native and Native Hawaiian/Pacific Islander, 17% Asian, and 29% White. Twenty-seven percent were from families with an income <$30,000/yr and 25% were their family's first generation in college. Planned Outcomes: Primary student outcomes to be evaluated over time include undergraduate biomedical degree completion, entry into/completion of a graduate biomedical degree program, and evidence of excelling in biomedical research and scholarship. Conclusions: The DPC national evaluation has identified a large, longitudinal cohort of students with many from groups historically underrepresented in the biomedical sciences that will inform institutional/national policy level initiatives to help diversify the biomedical workforce.

School bullying, body size, and gender: an intersectionality approach to understanding US children's bullying victimization.

We examine separate and combined effects of children's body size and gender on school bullying victimization in the US. Second-grade data from the 2012-2013 school year from the US Early Childhood Longitudinal Study, Kindergarten Class of 2011 were analyzed, hierarchical generalized logistic modeling was used, and three forms of school bullying were studied. Girls were less likely than boys to be verbally or physically bullied and obese children were more likely to be verbally and relationally bullied than non-obese children. The protective effect of gender extends to obese girls when obesity is not a risk factor (physical bullying). When obesity is a risk factor, gender is not protective (verbal bullying) or is a risk factor (relational bullying) for girls. These findings suggest an intersectional body size-gender lens is crucial to understanding how inequality is produced through school bullying. Future interventions should incorporate an intersectional understanding of school bullying.

Race/Ethnicity, Obesity, and the Risk of Being Verbally Bullied: a National Multilevel Study.

OBJECTIVE: To examine the effects of obese/overweight status and race/ethnicity on the risk for being verbally bullied among second grade children, and to investigate if the relationship between weight status and verbal bullying varies based on race/ethnicity. DESIGN: Data on second graders from the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (Children = 18,130; Schools = 2419) were analyzed. Hierarchical generalized logistic modeling was used to address the objectives. RESULTS: Independent of the child's sex, age, academic performance, family socioeconomic status, and school characteristics, obese/overweight children (relative to non-obese/overweight children) and Black children (relative to White children) were more likely to be verbally bullied. Hispanic and Asian children were less likely to be verbally bullied relative to White children. Hispanic obese/overweight children experienced less verbal bullying than White obese/overweight children. CONCLUSIONS: This study documented disproportionate risks of being verbally bullied for obese/overweight US second graders. The risk of being verbally bullied was significantly greater for obese/overweight White children vs. obese/overweight Hispanic children. IMPLICATIONS: Findings can inform the development of strategies to reduce verbal bullying of obese/overweight children in US elementary schools.