Utilization of a "Diversity Index" to Assess Racial Diversity of US School of Pharmacy Graduates.

OBJECTIVE: Diversity in the training environment for health professionals is associated with improved abilities for graduates to care for diverse populations. Thus, a goal for health professional training programs, including pharmacy schools, should be to pursue representation among graduates that mirrors that of their communities. METHODS: We evaluate racial and ethnic diversity among graduates of Doctor of Pharmacy (PharmD) programs across the United States (US) over time. Using a "Diversity Index", we quantify the relative racial and ethnic representation of each program's graduates compared with that of college-age graduates nationally and within the geographic region of the respective pharmacy school. RESULTS: Over the past decade, the number of US PharmD graduates increased by 24%. During this time, the number of Black and Hispanic PharmD graduates significantly increased. Still, representation of minoritized populations among graduates continues to be significantly lower compared with US benchmark populations. Only 16% of PharmD programs had a Diversity Index that matched or exceeded their benchmark comparator Black or Hispanic populations. CONCLUSION: These findings highlight the significant opportunity that exists to increase the diversity of graduates of US PharmD programs to better reflect the diversity of the US population.

News Media Coverage of Childcare: How U.S. Local TV News Framed the Problem Before and During the Early Stage of the COVID-19 Pandemic.

Early care and education (ECE), or the care young children receive before entering formal schooling, can take multiple forms and is delivered in different settings, such as a center, church, or public school. Federal and state governments regularly fund ECE programs and policies through the Child Care and Development Block Grant Act (CCDBG). Many families, however, face significant challenges in access, cost, and quality of ECE programs, and ECE professionals report substantial challenges in the workplace (e.g., inadequate training) and beyond (e.g., low wages). Policies addressing issues related to ECE were proposed in 2021, but stalled on the U.S. federal policy agenda. In this study, we examine the ECE content of local television news coverage both for its representations of and for its potential influences on ECE policy agendas. We use data from local stations affiliated with the major networks (ABC, NBC, CBS, and FOX) in media markets across the U.S., airing before and during the pandemic. We analyze elements of coverage that could affect public recognition of ECE-related issues, including how problems were framed (e.g., news coverage highlighting scandals or adverse events at ECE facilities) and solutions identified (e.g., public policy). We find that during 2018 and 2019, more coverage highlighted scandalous activity than public policy. The reverse was true, however, during the early period of the pandemic (from mid-March through June of 2020). Researchers and health professionals were seldom included in stories in either sample, and very few stories offered context about the benefits of ECE for health and well-being. These coverage patterns have implications for the public's understanding of ECE policy and the perceived need for reform. Policymakers, advocates, and researchers looking to advance support for ECE should consider ways to use local television news to present health and policy-relevant information to broad segments of the public.

Television airings of U.S. federal COVID-19 public service announcements in 2020 were associated with market-level political orientation, not COVID-19 rates.

Televised public service announcements were one of the ways that the U.S. federal government distributed health information about the COVID-19 pandemic to Americans in 2020. However, little is known about the reach of these campaigns or the populations who might have been exposed to the information these ads conveyed. We conducted a descriptive analysis of federally-affiliated public service announcement airings to assess where they were aired and the market-level social and demographic characteristics associated with the airings. We found no correspondence between airings and COVID-19 incidence rates from March to December 2020, but we found a positive association between airings and the Democratic vote share of the market, adjusting for other market demographic characteristics. Our results suggest that PSAs may have contributed to divergent exposure to health information among the U.S. public during the first year of the COVID-19 pandemic.

Association of the COVID-19 Pandemic With Medical School Diversity Pathway Programs.

Importance: Medical school pathway programs are a strategy to increase the diversity of the physician workforce. The COVID-19 pandemic may have negatively affected pathway programs, further challenging efforts to increase diversity. Objectives: To describe the changes in medical school pathway programs during the COVID-19 pandemic and identify methods for sustaining and supporting these programs during and after the pandemic. Design, Setting, and Participants: A survey study using an exploratory sequential mixed-method design was conducted from January 4 to August 3, 2021. Semistructured interviews with a sample of medical school pathway program administrators and academic leaders of US allopathic and osteopathic medical school diversity pathway programs identified themes and patterns of change to pathway programs since the onset of the pandemic compared with previous years. These themes were used to develop a survey that was sent to medical schools to assess the association between COVID-19 and their programs. Main Outcomes and Measures: The association between the COVID-19 pandemic and medical school diversity pathway programs was explored using interview and survey data assessing respondent characteristics; changes in the scope, size, and funding of programs in 2020 compared with previous years; and respondents' perceptions of future needs for pathway programs. Results: Twelve program administrators and academic leaders were interviewed. Interviews revealed challenges and benefits of virtual programming in engaging and reaching students and speakers, the value of community partnerships to sustaining programming, and the importance of psychosocial support to mediating students' mental health challenges due to COVID-19 and remote learning. Of 198 schools surveyed in the quantitative phase, 112 responded (56.6%), 106 (94.6%) of which had been sponsoring or assisting with pathway programs during the COVID-19 pandemic. Forty-two respondents (39.6%) had reduced pathway programs since the onset of the COVID-19 pandemic compared with the previous year. Program cancellations were more likely to be noted in elementary school-aged (50.0% decrease in programming; P = .01) and middle school-aged (32.6%; P = .02) students compared with older groups. Conclusions and Relevance: In this survey study, schools indicated that pathway programs were disrupted by COVID-19. Ongoing and flexible supports may be needed to sustain these programs. These findings are timely given recent investments in equity-focused programs to diversify the health workforce.

Analysis of Social Mission Commitment at Dental, Medical, and Nursing Schools in the US.

Importance: The COVID-19 pandemic and calls for racial justice have highlighted the need for schools to promote social mission. Measuring social mission engagement and performance in health professions education may encourage institutional efforts to advance health equity and social justice commitments. Objective: To describe the current state of social mission commitment within dental, medical, and nursing schools in the US and to examine how social mission performance compares across school types. Design, Setting, and Participants: This cross-sectional survey study invited all US dental and medical schools and a subset of baccalaureate- and master's degree-conferring nursing schools to participate in a self-assessment to measure their school's social mission commitment from January 29 through October 9, 2019. The survey measured 79 indicators (with indicators defined as responses to specific scored questions that indicated the state or level of social mission commitment) across 18 areas in 6 domains of school functioning (educational program, community engagement, governance, diversity and inclusion, institutional culture and climate, and research) that have potential to enhance social mission engagement and performance. Individual health professions schools were the unit of analysis, and 689 dental, medical, and nursing schools were invited to participate. School deans and program directors were the primary target respondents because of their broad insight into their school's programs and policies and their ability to request data from various internal sources. Demographic information from respondents was not collected because multiple respondents from an institution could complete different sections of the survey. Main Outcomes and Measures: Survey responses were analyzed to create indicator scores, standardized area scores, and an overall social mission score for each school. Using descriptive analyses, frequency and contingency tables of specific indicators within each area were created, and schools were compared based on ownership status (private or public), Carnegie Classification of Institutions of Higher Education research classification group (doctoral university with very high research activity [R1], doctoral university with high [R2] or moderate [R3] research activity, baccalaureate or master's nursing college or university, or special focus institution), and discipline group (dental school, medical school granting doctor of osteopathic medicine [DO] degrees, medical school granting doctor of medicine [MD] degrees, nursing school granting baccalaureate-level degrees, or nursing school granting master's-level degrees). Results: Among 689 invited schools, 242 schools (35.1%) completed the self-assessment survey. Of those, 133 (55.0%) were nursing schools, 83 (34.3%) were medical schools, and 26 (10.7%) were dental schools. Response rates ranged from 133 of 420 invited nursing schools (31.7%) to 83 of 203 invited medical schools (40.9%). Most schools included social determinants of health in their curriculum in either required courses (233 of 242 schools [96.3%]) or elective courses (4 of 242 schools [1.7%]), but only 116 of 235 schools (49.4%) integrated social determinants of health across all years of study. Most schools also included health disparities in either their required courses (232 of 242 [95.9%]) or elective courses (6 of 242 [2.5%]); however, only 118 of 235 schools (50.2%) integrated health disparities across all years of study. In several areas of social mission, public schools performed better than private schools (eg, curriculum: mean [SE] standardized area score, 0.13 [0.07] points vs -0.14 [0.09] points, respectively), and R1 doctoral universities and special focus institutions performed better than R2 and R3 doctoral universities and baccalaureate and master's nursing colleges and universities (eg, extracurricular activities: mean [SE] standardized area score, 0.25 [0.09] points for R1 doctoral universities and 0.20 [0.12] points for special focus institutions vs -0.05 [0.12] points for R2 and R3 doctoral universities and - 0.30 [0.12] points for baccalaureate and master's nursing colleges and universities. Different areas of strength emerged for dental, medical, and nursing schools. For example, in the curriculum area, MD-granting medical schools had a mean (SE) standardized area score of 0.38 (0.08) points, which was significantly higher than the standardized area scores of dental schools (mean [SE], -0.21 [0.14] points), DO-granting medical schools (mean [SE], -0.22 [0.13] points), graduate nursing schools (mean [SE], -0.21 [0.19] points), and undergraduate nursing schools (mean [SE], -0.05 [0.10] points). Conclusions and Relevance: In this study, there was widespread interest from health professions educational leaders in understanding and enhancing social mission commitment. Future work may focus on identifying and promoting best practices using the framework described, providing schools with continued opportunities for self-assessment, and further validating the self-assessment survey.

Paid family leave on local television news in the United States: Setting the agenda for policy reform.

Access to paid family and medical leave ("paid leave") has bipartisan support among lawmakers in the United States, but the issue remains stalled on the public policy agenda. The U.S. does not currently have a federal paid leave policy, and unpaid leave-guaranteed by the Family and Medical Leave Act of 1993-is all that is available to the majority of workers. In this study, we examine the content of local television news as representations of, and potential influence on, paid leave policy agendas. To do so, we analyze the extent to which local television news coverage describes the problem of lack of employment leave, and whether coverage highlights public policy as a solution. We use data from local television stations affiliated with the four major networks (ABC, NBC, CBS, and FOX) in all 210 media markets in the U.S. during a period pre-pandemic, from October 2018 until July 2019. We find that 64% of local television news coverage related to paid leave discussed the issue in the context of public policy. Coverage more often cited early-stage policy actions such as a policy idea - reflected in 40% of stories discussing stages of public policymaking - or the introduction of a bill - detailed in 22% of these stories. This coverage aligns with actual policy activity at the state-level during the same time period. News coverage infrequently included elements that could shape public understanding of paid leave as a population health issue, such as including health-related sources of providers or researchers. Policymakers, advocates, and researchers looking to advance public support for paid leave should consider efforts to use local television news as a vehicle to present health and policy-relevant information to broad segments of the public and set the agenda for policy reform.