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A 2-year follow-up of a randomized field experiment previously reported in Science is presented. A subtle intervention to lessen minority students' psychological threat related to being negatively stereotyped in school was tested in an experiment conducted three times with three independent cohorts (N = 133, 149, and 134). The intervention, a series of brief but structured writing assignments focusing students on a self-affirming value, reduced the racial achievement gap. Over 2 years, the grade point average (GPA) of African Americans was, on average, raised by 0.24 grade points. Low-achieving African Americans were particularly benefited. Their GPA improved, on average, 0.41 points, and their rate of remediation or grade repetition was less (5% versus 18%). Additionally, treated students' self-perceptions showed long-term benefits. Findings suggest that because initial psychological states and performance determine later outcomes by providing a baseline and initial trajectory for a recursive process, apparently small but early alterations in trajectory can have long-term effects. Implications for psychological theory and educational practice are discussed.

BackgroundEthnic minority women are at increased risk of cervical cancer. Self-sampling for high-risk human papillomavirus (HPV) is a promising approach to increase cervical screening among hard-to-reach populations.ObjectiveTo compare a community health worker (CHW)-led HPV self-sampling intervention with standard cervical cancer screening approaches.DesignA 26-week single-blind randomized pragmatic clinical trial.ParticipantsFrom October 6, 2011 to July 7, 2014, a total of 601 Black, Haitian, and Hispanic women aged 30–65 years in need of cervical cancer screening were recruited, 479 of whom completed study follow-up.InterventionsParticipants were randomized into three groups: (1) outreach by CHWs and provision of culturally tailored cervical cancer screening information (outreach), (2) individualized CHW-led education and navigation to local health care facilities for Pap smear (navigation), or (3) individualized CHW-led education with a choice of HPV self-sampling or CHW-facilitated navigation to Pap smear (self-swab option).Main MeasuresThe proportion of women in each group whom self-reported completion of cervical cancer screening. Women lost to follow-up were considered as not having been screened.Key ResultsOf the 601 women enrolled, 355 (59%) were Hispanic, 210 (35%) were Haitian, and 36 (6%) were non-Haitian Black. In intent-to-treat analyses, 160 of 207 (77%) of women in the self-swab option group completed cervical cancer screening versus 57 of 182 (31%) in the outreach group (aOR 95% CI, p < 0.01) and 90 of 212 (43%) in the navigation group (aOR CI, p = 0.02).ConclusionsAs compared to more traditional approaches, CHW-facilitated HPV self-sampling led to increased cervical cancer screening among ethnic minority women in South Florida.Trial RegistrationClinical Trials.gov Identifier: NCT02121548

The 2020 American Heart Association Impact Goal aims to improve cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular disease and stroke by 20%. A large step toward this goal would be to better understand and take advantage of the significant intersection between behavior and biology across the entire life-span. In the proposed FAMILIA studies, we aim to directly address this major knowledge and clinical health gap by implementing an integrated family-centric health promotion intervention and focusing on the intersection of environment and behavior, while understanding the genetic and biologic basis of cardiovascular disease. We plan to recruit 600 preschool children and their 600 parents or caregivers from 12-15 Head Start schools in Harlem, NY, and perform a 2:1 (2 intervention/1 control) cluster randomization of the schools. The preschool children will receive our intensive 37-hour educational program as the intervention for 4 months. For the adults, those in the “intervention” group will be randomly assigned to 1 of 2 intervention programs: an “individual-focused” or “peer-to-peer based.” The primary outcome in children will be a composite score of knowledge (K), attitudes (A), habits (H), related to body mass index Z score (B), exercise (E), and alimentation (A) (KAH-BEA), using questionnaires and anthropometric measurements. For adults, the primary outcome will be a composite score for behaviors/outcomes related to blood pressure, exercise, weight, alimentation (diet) and tobacco (smoking; Fuster-BEWAT score). Saliva will be collected from the children for SNP genotyping, and blood will be collected from adults for RNA sequencing to identify network models and predictors of primary prevention outcomes. The FAMILIA studies seek to demonstrate that targeting a younger age group (3-5 years) and using a family-based approach may be a critical strategy in promoting cardiovascular health across the life-span.

A randomized prevention study for ethnic minority mothers assessed the intervention effects of Parent Management Training—Oregon Model (PMTO) on maternal parent practices and child behavior. Ninety-six mothers from Somalia and Pakistan and their children aged 3 to 9 years were randomized to PMTO or a wait-list condition (WLC). Assessments were carried out at the baseline and post-intervention, using standardized measures and a multi-agent approach. All analyses were based on the intention-to-treat principle. Analysis of covariance (ANCOVA) showed that PMTO was effective in enhancing parent practices, with a decrease in harsh discipline and an increase in positive parenting. Moreover, PMTO produced reductions in motherreported child conduct problems. The largest effect sizes were found among mothers who attended more than 50 % of the PMTO group sessions. Teacher reports showed, however, that there were no significant intervention effects on conduct problems and social competence in kindergarten or school. The results emphasize the importance and feasibility of offering PMTO to ethnic minority families.

Background Stroke is a leading cause of adult disability and mortality. Intravenous thrombolysis can minimize disability when patients present to the emergency department for treatment within the 3 − 4½ h of symptom onset. Blacks and Hispanics are more likely to die and suffer disability from stroke than whites, due in part to delayed hospital arrival and ineligibility for intravenous thrombolysis for acute stroke. Low stroke literacy (poor knowledge of stroke symptoms and when to call 911) among Blacks and Hispanics compared to whites may contribute to disparities in acute stroke treatment and outcomes. Improving stroke literacy may be a critical step along the pathway to reducing stroke disparities. The aim of the current study is to test a novel intervention to increase stroke literacy in minority populations in New York City. Design and Methods In a two-arm cluster randomized trial, we will evaluate the effectiveness of two culturally tailored stroke education films – one in English and one in Spanish – on changing behavioral intent to call 911 for suspected stroke, compared to usual care. These films will target knowledge of stroke symptoms, the range of severity of symptoms and the therapeutic benefit of calling 911, as well as address barriers to timely presentation to the hospital. Given the success of previous church-based programs targeting behavior change in minority populations, this trial will be conducted with 250 congregants across 14 churches (125 intervention; 125 control). Our proposed outcomes are (1) recognition of stroke symptoms and (2) behavioral intent to call 911 for suspected stroke, measured using the Stroke Action Test at the 6-month and 1-year follow-up. Discussion This is the first randomized trial of a church-placed narrative intervention to improve stroke outcomes in urban Black and Hispanic populations. A film intervention has the potential to make a significant public health impact, as film is a highly scalable and disseminable medium. Since there is at least one church in almost every neighborhood in the USA, churches have the ability and reach to play an important role in the dissemination and translation of stroke prevention programs in minority communities. Trial registration NCT01909271 ; July 22, 2013

Prior work finds a diversity paradox: Diversity breeds innovation, yet underrepresented groups that diversify organizations have less successful careers within them. Does the diversity paradox hold for scientists as well? We study this by utilizing a near-complete population of ∼1.2 million US doctoral recipients from 1977 to 2015 and following their careers into publishing and faculty positions. We use text analysis and machine learning to answer a series of questions: How do we detect scientific innovations? Are underrepresented groups more likely to generate scientific innovations? And are the innovations of underrepresented groups adopted and rewarded? Our analyses show that underrepresented groups produce higher rates of scientific novelty. However, their novel contributions are devalued and discounted: For example, novel contributions by gender and racial minorities are taken up by other scholars at lower rates than novel contributions by gender and racial majorities, and equally impactful contributions of gender and racial minorities are less likely to result in successful scientific careers than for majority groups. These results suggest there may be unwarranted reproduction of stratification in academic careers that discounts diversity’s role in innovation and partly explains the underrepresentation of some groups in academia.

Objective: No model of self-management education or peer support has yet achieved widespread reach and acceptability with minority ethnic groups. We sought to refine and test a new complex intervention in diabetes education: informal story-sharing groups facilitated by bilingual health advocates. Methods: Pilot randomized trial with in-depth process evaluation in a socioeconomically deprived area. 157 people referred for diabetes education were randomized by concealed allocation to an intervention (story-sharing group in their own language) or control ('usual care' self-management education, through an interpreter if necessary) arm. Story-sharing groups were held in five ethnic languages and English (for African Caribbeans), and ran fortnightly for six months. Primary outcome was UKPDS (UK Prospective Diabetes Study) risk score. Secondary outcomes included attendance, HbA1c, well-being and enablement. Process measures included ethnographic observation, and qualitative interviews with staff and patients. Results: Some follow-up data were obtained on 87% of participants. There was no significant difference between intervention and control arms in biomedical outcomes. Attendance was 79% in the story-sharing arm and 35% in the control arm (p < 0.0001), and patient enablement scores were significantly higher (8.3 compared to 5.9, p < 0.005). The model was very popular with clinicians, managers and patients, which helped overcome numerous challenges to its successful embedding in a busy public sector diabetes service. Conclusion: People from minority ethnic groups in a socioeconomically deprived area were keen to attend informal story-sharing groups and felt empowered by them, but clinical outcomes were no better than with conventional education. Further research is needed to maximize the potential and evaluate the place of this appealing service model before it is introduced as a part of mainstream diabetes services.

Sexually transmitted diseases, including the acquired immunodeficiency syndrome (AIDS), are a global problem that causes immense suffering and costs billions of dollars annually. 1 – 3 Women and children have the most severe symptoms and sequelae. 1 – 4 Women are twice as likely as men to become infected with the pathogens causing gonorrhea, chlamydial disease, hepatitis B, and chancroid after a single exposure. 5 The efficiency of male-to-female transmission of the human immunodeficiency virus (HIV) is about four times as high as that of female-to-male transmission. 6 Rates of heterosexually acquired HIV infection among women have been increasing in the United States. 7 , 8 In 1995, . . .

A systemic problem requiring openness and strong leadership

The creation of a large and diverse STEM workforce is a national imperative in the U.S. Despite significant efforts to improve equitable STEM educational and hiring practices, disparate employment in STEM fields across racial and ethnic demographics persists. Educational researchers and practitioners have increasingly focused on out-of-school time STEM programs as a potential avenue for boosting high school students’ interest in pursuing STEM careers. However, many studies on the efficacy of such programs rely on data from single programs with small sample sizes. The present work uses our nationally representative sample of 14,176 U.S. college students to investigate the relationship between out-of-school time STEM program attendance and students’ reported STEM career interests. Our analysis shows that students who, during their high school years, attended an out-of-school time STEM program designed specifically for underrepresented minority students had 2.4 times the odds of reporting an interest in a STEM career at the end of high school, compared to those who did not attend any out-of-school time STEM program ( p < 0 . 001 ) . By contrast, students who attended a general population STEM program (not specifically designed for underrepresented minority students) had only 1.3 times the odds of expressing an interest in a STEM career at the end of high school, compared to those who did not attend any out-of-school time STEM program ( p < 0 . 001 ) . Additionally, those who attended an underrepresented minority STEM program had 1.9 times the odds of aspiring to a STEM career, compared to those who attended a general population program ( p < 0 . 001 ) . This is the first study to use nationally representative data to compare underrepresented minority focused and general out-of-school time STEM programs. Given these promising results, this work encourages further development and funding of out-of-school time STEM programs designed for underrepresented minorities to foster a diverse and equitable STEM workforce.