https://orcid.org/0000-0002-7734-4958
Figures
Abstract
Background
Despite decades of calls for increased diversity in the health research workforce, disparities exist for many populations, including Black, Indigenous, and People of Color individuals, those from low-income families, and first-generation college students. To increase representation of historically marginalized populations, there is a critical need to develop programs that strengthen their path toward health research careers. High school is a critically important time to catalyze interest and rebuild engagement among youth who may have previously felt excluded from science, technology, engineering, and mathematics (STEM) and health research careers.
Methods
The overall objective of the MYHealth program is to engage high school students in a community-based participatory research program focused on adolescent health. Investigators will work alongside community partners to recruit 9th through 12th graders who self-identify as a member of a group underrepresented in STEM or health research careers (e.g., based on race and ethnicity, socioeconomic status, first generation college student, disability, etc.). MYHealth students are trained to be co-researchers who work alongside academic researchers, which will help them to envision themselves as scientists capable of positively impacting their communities through research. Implemented in three phases, the MYHealth program aims to foster a continuing interest in health research careers by developing: 1) researcher identities, 2) scientific literacy, 3) scientific self-efficacy, and 4) teamwork and leadership self-efficacy. In each phase, students will build knowledge and skills in research, ethics, data collection, data analysis, and dissemination. Students will directly collaborate with and be mentored by a team that includes investigators, community advisors, scientific advisors, and youth peers.
Citation: Chuisano SA, Rafferty J, Allen A, Chang T, Diemer M, Harris K, et al. (2023) Increasing representation and diversity in health research: A protocol of the MYHealth research training program for high school students. PLoS ONE 18(9): e0281790. https://doi.org/10.1371/journal.pone.0281790
Editor: Sally Mohammed Farghaly, Alexandria University Faculty of Nursing, EGYPT
Received: January 30, 2023; Accepted: September 13, 2023; Published: September 28, 2023
Copyright: © 2023 Chuisano et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: No datasets were generated or analysed during the current study. All relevant data from this study will be made available upon study completion.
Funding: The research is supported by the National Institute of General Medical Sciences of the National Institutes of Health under award number R25GM137361, awarded to author MD. There was no additional external funding received for this study. The funders had and will not have a role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Introduction
Despite decades of calls for increased diversity in the research workforce, several groups continue to be excluded and thereby underrepresented in Science, Technology, Engineering, and Math (STEM) careers in the United States [1]. In 2019, Black, Indigenous, and People of Color (BIPOC) individuals were awarded only 11.7% of STEM research doctorates, despite making up about a third of the U.S. population and the workforce [1]. Likewise, while women comprised 47% of the workforce, they received only 42.2% of STEM doctorates [1]. Parental education is also associated with postsecondary enrollment, which is an important step on the trajectory toward many STEM professions. College enrollment directly after high school is lower among children whose parents did not graduate high school (50%), attend college (57%), or graduate college (67%), compared to those whose parents have completed a bachelor’s degree (84%) [2]. Low-income youth also continue to graduate high school and enroll in college at lower rates (65% vs. 83%) than their middle- and high-income peers [3]. While these figures have improved slightly in the last decade, significant work is still needed to address these inequities [4,5].
An initial and persistent interest in science is driven largely by social and environmental factors, making those from historically excluded groups more vulnerable to barriers such as family factors (e.g., attitudes toward science careers, parent interest in scientific activities), pedagogical factors (e.g., teaching culture, classroom culture), extracurricular activities (e.g., science clubs, out-of-school experiences), and social factors (e.g., models of science interest, peer culture), which in turn impact one’s expectations and beliefs that they can succeed in science [6,7]. High school and adolescence are critical windows to intervene in developing an interest in STEM. This period of the life course is centered on identity development and is when youth begin to understand their skills, interests, and values and begin to make career decisions [7]. When youth are encouraged to practice science and strengthen their beliefs about their efficacy, they are more likely to express interest, achieve, and persist in science. However, this is not the most likely experience for youth from historically excluded groups, who may experience school practices that do not nurture science interests and capacities [8,9] and have access to fewer out-of-school science experiences, mentorship, and science role models [10].
Despite school requirements for science curricula, some high school students still lack meaningful and relevant opportunities to engage in science and research [8,9]. Research suggests that teens from historically excluded groups often view school science as “hard” and “discouraging” and do not see science as relevant to their everyday lives [6,9–11]. Moreover, students may not know any science professionals in their daily lives, making science and research seem abstract. When paired with a lack of advocates, mentors, and support systems, this leaves students from historically excluded groups with more negative experiences of science [10]. On the other hand, when students experience success with science, receive support from parents and other adults, and develop self-efficacy in science, they are more likely to have positive attitudes toward science [8]. Out-of-school experiences, including summer research experiences and after-school programs can help students develop an interest in science, improve science self-efficacy, increase their science knowledge and skills, and build commitment and persistence in high school that may improve enrollment and retention in undergraduate and graduate school programs in the future [12–14]. Critical to the success and effectiveness of programs is exposure to developmentally- and personally-relevant research opportunities, mentorship and social support, and experiences that encourage empowerment, agency, and a sense of purpose [9].
Increasing the participation and success of researchers from historically excluded groups is essential for strengthening innovation and global leadership in health research [15]. Diverse and inclusive scientific teams not only generate novel research questions and methods, but by bringing their life experiences and perspectives, they also offer new problem-solving approaches to persistent issues in research [16]. Furthermore, tackling the innumerable health disparities faced by historically excluded groups requires the support of diverse scientific teams. Thus, the need for a diverse health research workforce serves as a comprehensive theoretical and empirical foundation for the Michigan Youth Health (MYHealth) program [7,10,12,17]. The overall goal of the MYHealth research training program is to address the persistent problem of underrepresentation of historically excluded groups in health research careers. This project combines an innovative, youth-centered research program with a community-based participatory research (CBPR) approach to partner with high school students as co-researchers. The training program aims to help youth build persistence toward health research careers by developing: 1) researcher identities, 2) scientific literacy, 3) scientific self-efficacy, and 4) teamwork and leadership self-efficacy. Engaging high school students in a research training program is advantageous because postsecondary decisions and occupational interests are often crystallized and plans formulated during adolescence [7].
Conceptual overview
Because students from excluded groups are more likely to encounter external barriers (e.g., fewer STEM role models, less access to rigorous STEM coursework) that are associated with dropping out of the STEM and health research pipeline, it is imperative to understand how to support their persistence toward science careers effectively [18–20]. Based on an ethnically diverse sample, Chemers and colleagues demonstrated that researcher identity, science self-efficacy, and leadership and teamwork self-efficacy mediated the relationship between science support experiences and persistence in science and health research careers [18]. Extrapolating from these findings, researchers have validated the effectiveness of interventions that incorporate a range of out-of-school programs that provide opportunities for research experiences, mentoring, and community involvement [12–14]. Building on Chemers’ framework for understanding persistence in science, MYHealth integrates social cognitive theory, expectancy-value theory of achievement motivation, and CBPR. The MYHealth framework (based on one created by Chemers and colleagues, 2011) is outlined in Fig 1. Blue sections of Fig 1 indicate program constructs that have been added or modified for the MYHealth program.
Social cognitive theory (SCT).
SCT seeks to explain human learning and motivation and has been applied to domain-specific learning (e.g., science learning) across fields [21–25]. SCT identifies three components that interact to influence learning: personal characteristics (e.g., self-efficacy), environmental characteristics (e.g., school, support, community), and behavior (e.g., pursuit of opportunities). These dynamics have been extensively studied in relation to science interest, achievement, and career choice [18,26,27], and among historically excluded youth [28,29]. Research demonstrates that students from historically excluded groups have fewer opportunities to have their science self-efficacy beliefs (the beliefs that they can do science) nurtured; these dynamics, in turn, suppress motivation and science self-efficacy beliefs and ultimately contribute to fewer youth pursuing science degrees and research careers [30–32]. In the context of MYHealth, we hope to help students build self-efficacy throughout the three phases of the program, helping them to see their own ability to do science independently and as part of a team. In addition, the program aims to build their ability to see themselves as a researcher or a scientist, guiding them on the pathway to a science or research job or career in the future.
Expectancy-value theory of achievement motivation.
Linked to SCT, the core of the expectancy-value theory of achievement motivation is that students’ achievement and decisions related to achievement are determined by expectancies for success in that domain and the perceived value of that domain in their lives [33,34]. According to this theory, achieving and maintaining an interest in science results from students’ beliefs about their likelihood of success in science and the value they assign to science. Applied to MYHealth, expectancy-value theory posits that students from excluded groups can be supported to view science and research careers as attainable and important through opportunities that: 1) increase positive perceptions related to their science and research skills, characteristics, and competencies and 2) increase positive perceptions related to their personal values and goals. Taken together, science- and research-related SCT and expectancy-value theory help us to understand the processes that contribute to persistence in science and research and associated careers, particularly among historically excluded students.
Community-based participatory research (CBPR).
CBPR is built on core principles that support partnership, capacity building, co-learning, and action toward equity and social justice [26,35,36] and has decades of research demonstrating its effectiveness in creating partnerships and enhancing the quality and rigor of research [37–39]. CBPR follows the research cycle and includes building a research team (with nontraditional research partners, like youth), identifying the needs and priorities of a community, asking questions, gathering data, interpreting data from the lens of the community, and implementing action strategies toward health and social justice.
Using CBPR as a model for engaging youth as co-researchers benefits youth directly (e.g., research training, communication skills, problem-solving and critical thinking skills, leadership, preparedness for college), their communities (e.g., community literacy, improved programs and services, improved policy), and research quality and rigor (e.g., improved recruitment, retention, sustainability) [40,41] by building capacity and incorporating the lived experiences of individuals in a focal population. Given its overall inclusive and equitable approach, CBPR is a compelling and effective methodology for engaging students from marginalized groups and supporting their long-term interest in science.
The MYHealth curriculum is aligned with CBPR principles that values health equity and social justice. These pricinciples are woven throughout the fabric of the program through the lens of what research is, how it is done well, and what a researcher looks like. For example, health services research training includes research ethics and discussions of treating research participants with respect and autonomy. The program curriculum also includes reflections on historical examples and traditional research practices that might perpetuate systematic mistreatement or exclusion of certain groups. We anticipate that MYHealth team members (faculty, staff, and graduate and undergraduate research assistants) and guest speakers will have diverse life experiences and backgrounds, similar to and different from those of our MYHealth students. In learning about health services research, students will also be exposed to the life stories of influential health researchers throughout history. Our intent is to provide repeated exposure to equitable and inclusive research practices and diverse research teams, both in the curriculum and in the MYHealth program experience.
In summary, the MYHealth program builds on the theoretical underpinnings of SCT, expectancy-value theory of achievement motivation, and a CBPR approach to create an out-of-school research experience for youth that includes experiences with an applied adolescent health research project, instrumental and socioemotional mentoring from academic researchers and a community of learners, and community involvement through research projects that impact youth and their communities. Through these program components, we will impact four primary psychological and cognitive processes: researcher identity, science self-efficacy, leadership and teamwork self-efficacy, and scientific literacy. By using MYHealth to develop these domains among youth co-researchers, we will achieve our long-term goal of increasing persistence toward health research careers.
Overview of the MYHealth program
The MYHealth program is a research training program with the long-term goal of increasing the representation of groups traditionally excluded from biomedical, behavioral, and clinical research, including individuals from low-income backgrounds, first-generation college students, and racial and ethnic minority youth. The MYHealth program plans to enroll 4 successive 12-month cohorts of high school students who primarily self-identify as underrepresented in STEM. The MYHealth program hopes to achieve its overall aim via multiple phases each year, as outlined in Fig 2. The Summer Launch, Impact Projects, and Peer Leadership phases each have specific goals, activities, outputs, and outcomes that are summarized in Table 1 and detailed in the sections that follow.
The program curriculum was developed through an iterative process of piloting and feedback from high school students from the local population. Students in the pilot program were recruited from the same high schools as students who will be recruited later in MYHealth to ensure representativeness of our target population. A condensed 12-week curriculum was presented to a pilot cohort of four high school students from Southeast Michigan. The 12-week curriculum covered both Summer Launch and Impact Projects topics, allowing students to build knowledge about research and design and implement their own research project. Students who completed the pilot program were invited to serve as Peer Leaders in the first full year of the program. The refined curriculum developed through this pilot is detailed below. Each year, the research team plans to make modifications made based on our formative evaluation.
Summer Launch.
The Summer Launch will be a 10-day training in CBPR and health research methodologies for up to 70 students each year. Based on initial interest and engagement, we expect the number of enrolled students to be closer to 30–40. The overall goal is to train high school students to be co-researchers who can work alongside academic researchers on studies of adolescent health to develop their interest in STEM and incubate researcher identities. A sample of Summer Launch curriculum topics and program constructs are outlined in Table 2. The Summer Launch is designed to take place in person on the University of Michigan campus to build excitement and energy related to research, create community among students from different communities in Southeast Michigan, and introduce youth to college campuses. The Summer Launch will be adapted and conducted virtually when meeting in person is not possible due to COVID-19 restrictions. MYHealth Summer Launch will facilitated by program faculty (academic researchers and staff) as well as undergraduate and graduate-level research assistants. Activities will be completed in small groups of 3–10 depending on student enrollement and faculty capacity, and will be facilitated by at minimum 1–2 program faculty and/or research assistants.
Throughout Summer Launch, students will learn about research methods, CBPR, and various adolescent health studies (Table 2). We will create applied learning experiences using MyVoice, a national text message poll of 14-24-year-olds to understand adolescents’ views on a range of health-related topics [42]. For all discussions, MyVoice will serve as a specific data source to illustrate research elements in the context of a real-world project. For example, when learning about data collection, youth will review existing MyVoice question sets and participate in a MyVoice pilot, receiving SMS messages like MyVoice participants. Consistent with our CBPR approach that trains youth to be co-researchers, the Summer Launch agenda and activities will align with equity, inclusion, and social justice principles. Each topic will consider the importance of ethical and responsible conduct of research—from designing a study with the well-being and needs of participants in mind, to obtaining consent, to fairly representing data and disseminating it to all relevant stakeholders.
Impact projects.
At the end of the Summer Launch, all students are invited to apply to participate in the Impact Projects phase, a nine-month program that aims to build on the overall momentum, skills, and interests developed in the previous phase. Impact Projects are guided by several key principles, including equitable partnership as co-researchers, positioning youth as experts of their own experiences, studying a relevant and meaningful topic to youth, and sharing findings with diverse audiences. By engaging in these collaborative activities, the students will develop their researcher identities, enhance their sense of scientific self-efficacy, and hone their scientific literacy.
When applying, students will indicate their interest in continuing to build their research skills and specify their interest in various adolescent health topics to help guide the direction of the Impact Projects. Due to loss of eligibility (graduating from high school), loss of interest in the program, schedule conflicts, and other challenges, we anticipate there will be a natural reduction in the number of students interested in participating in Impact Projects. Based on our funding and team size, we have the capacity for up to 30 high school students to complete Impact Projects each year. In the event that more than 30 students are interested in continuing into Impact Projects, those who are nearing loss of eligibility (high school juniors and seniors) will be given priority, as well as those who show an interest in completing a youth-focused research project (the focus of Impact Projects). Students interested in further pursuing research or health-related programs will be connected with community partners in our network that also focus on this age group (including those that help with recruitment for this program).
During Impact Projects, MYHealth students continue to leverage MyVoice (the national text message poll of youth) and build off the CBPR principles that are taught in the summer. Rather than partnering with a specific community in Southeast Michigan, the community of interest during Impact Projects will be other youth across the United States. Impact Project students will become co-researchers on MyVoice (the national text message poll of youth described under Summer Launch), allowing them to conduct research on 14–24 year olds across the country. Program staff regularly work with youth or individuals between the ages of 14 and 24 (both in MYHealth and in other settings) and, as such, are well suited to support MYHealth students in their research of this population. Impact Project students are not only trained as co-researchers but serve as experts in their own life experience as a young person living in the United States. Each Impact Project team develops a core research question relating to youth perspectives or experiences with a health or health policy topic, and carries out an original study using MyVoice for primary data collection. Students complete literature reviews and additional training, led by facilitators and research assistants, to build additional expertise in the area of their research topic, just as career researchers would. At the end of the year, research findings will be shared with academic and/or community audiences to practice scientific communication and dissemination.
Students will meet virtually, approximately twice per month, in two to three teams that include up to 15 Impact Project students, at least one faculty mentor, up to four undergraduate and/or graduate student research assistants, and Peer Leaders who are MYHealth alumni. Teams will work in smaller groups of 3–8 students, facilitated by faculty and research assistants, as well as one large team to complete activities related to completing their research project. In the first offering of the program, high school students who have completed the pilot MYHealth program will be eligible to serve as Peer Leaders. Projects are conducted virtually to broaden access to MYHealth for high school students across schools and communities. To effectively engage high school students, meetings will be highly interactive, including group processes and applied exercises. See Table 3 for a sample of the Impact Projects agenda. Activities will mimic the research process, including three key phases: 1) Study Design; 2) Data Collection and Analysis; and 3) Dissemination. These phases will include ongoing training in CBPR, health research methods, and the responsible conduct of research. Though most of the training and activities will occur in small groups, each team will also share their progress with other Impact Project teams and program faculty to receive feedback and practice research communication.
Peer leaders.
The overall aim of the Peer Leaders phase is to provide ongoing social and academic support, increase motivation, and improve self-efficacy for students from historically excluded groups pursuing STEM and health research careers [28,43]. All students who have completed the Impact Projects program will have the opportunity to apply to join the Peer Leaders phase. Peer Leaders will most likely be high school students or early college students who recently completed Impact Projects. Due to loss of interest in the program, schedule conflicts and other challenges, we anticipate there will be a natural reduction in the number of students interested in participating in Peer Leaders compared to Impact Projects. Based on our funding and team size, we have the capacity for approximately 10 students to serve as Peer Leaders each year. In the event that more than 10 students are interested in continuing into Peer Leaders, those who show an interest in building teamwork and mentorship skills will be prioritized (the focus of the Peer Leaders phase). As with Impact Projects, other interested students will be encouraged to apply to other programs offered to high school students in our area.
Peer Leaders will receive additional coaching and support from program faculty, including additional training in CBPR and health research methodologies. Peer Leaders will interact closely with MYHealth high school students and program faculty during the Summer Launch and Impact Projects. Peer Leaders will be part of Impact Project teams and will provide coaching and guidance to their team members, work alongside faculty mentors, and maintain logs of research activities and progress for the program evaluation. Peer Leaders will be encouraged to contribute to dissemination efforts, including 1) contributing to manuscripts and presentations to share evaluation findings; 2) supporting resource-sharing efforts through in-person presentations to local STEM programs; 3) supporting resource-sharing efforts through the website and social media strategies.
Methods
A longitudinal mixed methods approach will be used to collect multiple quantitative and qualitative measures of implementation and outcomes over four years to evaluate the impact of the MYHealth program on participants’ interest in and persistence in STEM research. The Institutional Review Board at the University of Michigan approved the evaluation study of the MYHealth program (HUM00213914, HUM00214694, HUM00214949). All MYHealth participants will consent or assent to participate in the research and parental consent will be collected for minors. Participants will be assigned a random identifier at the start of the program to protect their anonymity and confidentiality throughout data analysis. Because survey questions are focused on attitudes and beliefs about science and research and are not sensitive in nature, there is minimal risk to the participants throughout the course of the study. All study participants (in Summer Launch, Impact Projects, and Peer Leaders) receive monetary incentives for participating in the MYHealth program as well as one-time payments for completing surveys and post-program interviews. For program completion, incentives are paid at the end of the program (for Summer Launch) or monthly and are calculated as the number of hours of the program that has been completed. With each additional year of participation, the hourly rate earned increases.
Setting
The MYHealth program focuses on recruiting high school students based in Southeast Michigan including, but not limited to, the Detroit, Southfield, Flint, Ypsilanti, and the surrounding areas. These communities in Southeastern Michigan will be well-suited for recruitment of high school students from historically excluded groups and have a clear need for additional science training that is more engaging, relevant, and impactful than traditional classroom science. During the 2016–2017 school year, science proficiency rates in these communities lagged behind other schools in Southeastern Michigan and the state of Michigan. For example, several focal communities had science proficiency rates of 11th grade high school students between 9% and 11%. When looking at economically disadvantaged districts, these numbers dropped below 8%. While state proficiency assessments are not the sole determinant of science interest, enrollment in science courses in college, or future STEM careers [44], high school science achievement can alter youth’s perceptions of their capacity to engage in science [7,18,45].
Recruitment
High school students will be recruited through ongoing partnerships with community partners who have established networks of schools, teachers, and communities and will connect eligible students and families to the MYHealth program. Community partnerships will be developed and maintained with organizations that also prioritize increasing access to resources for students who are part of groups that have historically been excluded or underrepresented in STEM and health research careers. These partners include university centers that serve students and schools, local school districts, and an academic support program. Our community partners will distribute recruitment materials directly (e.g., information sheets, flyers, emails) through their networks. Interested students and their families will be directed to complete an online application form or contact our research team via email or telephone. The application form (administered via the Qualtrics secure platform) asks interested high school students and their families to provide contact information, state their interest in MYHealth, and explain why they think they would be a good fit for the program. Based on our funding and team size, we have the capacity for up to 70 high school students to complete the Summer Launch program each year. In the event that more than 70 students apply to the Summer Launch program in a given year, priority will be given to strong applicants. A strong applicant is considered one that expresses an interest in learning more about health, community engagement, research, or the capacity to work in teams. Prior knowledge of or interest in these topics is not a requirement to be eligible for MYHealth.
Upon enrollment, MYHealth participants can elect to receive a laptop computer to use for the duration of the study. Details about computer availability are provided on recruitment flyers and in signup emails to encourage uptake. In addition, the study team is available to provide technical assistance (i.e, help troubleshooting internet, microphone or camera issues, etc.), as needed, to ensure that all students have access to the MYHealth program.
Data collection and outcome measures
Numerous scales that have been previously validated with youth will be used to measure youth experiences with STEM and research [8], researcher identity [46,47], interest in and persistence in STEM careers [24], scientific literacy [48,49], and leadership, and teamwork-self-efficacy [18]. Measures were tested during a pilot phase and then revisions were incorporated. Table 4 presents an overview of the key measures and the critical time points at which they are collected.
Surveys.
An online survey will be administered via Qualtrics at multiple timepoints during each program phase, including pre- and post- Summer Launch, pre-, mid-, and post- Impact Projects, pre- and post- Peer Leadership, and one year after completing all program activities (Table 4). The one-year follow-up survey will track youths’ continued interest and persistence in STEM research careers, knowledge and skills related to STEM research, and how the program has influenced their engagement in other research activities. Survey items and question wording may be modified during the four-year program to improve survey completion, reduce survey fatigue, and improve data collection. Surveys will be distributed during online meetings in hopes of increasing response rates. Those not in attendance will be sent the survey via email. In addition, participants receive a monetary incentive for completing surveys during the program.
Engagement and participation.
Each year students’ opinions on successes and challenges of the MYHealth program will be collected using open-ended survey questions and semi-structured interviews (see below) to make ongoing course improvements. In addition, we will design Peer Leader and research assistant logs to facilitate reflections about what worked in each meeting and what could be improved before the next session for both the Summer Launch and the Impact Project programs.
A research assistant will track program hours and attendance to gauge dosage [53] in the Impact Projects. Logs will be used to track the implementation of CBPR processes at monthly meetings. The logs will consist of a Research Process Checklist [55] to understand progress in the research design process (e.g., stated research problem, defined variables, and specified procedures to analyze data). Finally, the research assistant will complete an observational rating scale, Youth Participatory Action Research Process Template [54], to track CBPR processes demonstrated by the Peer Leader and Impact Project students in each small group, including training and practice of research skills, promoting strategic thinking, group work, networking, communication skills, and power sharing. In addition, evaluators will work with the research assistants to complete the Critical Thinking Rubric for PBL [51] at three points during the academic year. In the spring of each year, Impact Project students will disseminate research findings. The research assistant will use the Presentation Rubric for PBL to capture how students are communicating research processes and findings with youth, community, policy, and academic audiences [52].
Semi-structured interviews and/or focus groups.
Each year at the end of the Summer Launch, all students will be invited to complete a semi-structured interview or focus group [56]. In the post-Summer Launch survey, there will be a yes/no question “Are you interested in completing a post-program interview?” to gauge students’ interest. A purposive sampling strategy will be used to create a sample of students who 1) are from different grades, 2) may or may not be interested in continuing to be part of MYHealth, 3) who were highly, moderately, or minimally engaged with the program based on attendance and completion of activities, and 4) who may or may not wish to continue learning about research. We will use a semi-structured interview guide that explores student experiences during the Summer Launch including perceptions of research and STEM careers, experiences with diversity, equity, and inclusion during MYHealth, and possible barriers to participation and continued engagement. Sample questions include 1) What was it like to participate in MYHealth? 2) What do you think it means to be a researcher? 3) Would you recommend MYHealth to someone you know? Why or why not? Interview questions may be modified slightly for each participant to glean additional insights into their specific program experiences and post-program survey respones. Each year, we will aim to complete at least 10 interviews. All interviews will be recorded and transcribed.
Similarly, at the end of the Impact Project each year, a sample of students will be asked to participate in semi-structured interviews or a focus group to understand processes that occurred during implementation with each cohort. Questions will probe topics such as students’ perceptions of STEM and health research careers, their experiences with diversity, equity, and inclusion on the Impact Projects, and possible barriers to participation and continued engagement. All interviews will be recorded and transcribed for analysis.
Analyses.
Overall, there are parallel strategies to evaluate all three program components: the Summer Launch, Impact Projects, and Peer Leadership. A Repeated Measures Analysis of Variance will be conducted to analyze the quantitative items in the pre-, post-, and follow-up surveys. Small-scale analyses will be performed on each program phase, and a longer-term evaluation will be conducted on longitudinal data. Over time, between-subjects factors may be added to account for differences between cohorts, or disaggregate data by demographic factors (e.g., gender, ethnicity). The final reporting will utilize appropriate statistical significance and associated effect sizes.
Interview data will be analyzed with an inductive thematic analysis approach [57], focusing on individual and group impacts that mattered most to participants, and describing program elements that led to these outcomes. Codes will be applied to all interview transcripts and then synthesized into related themes and conclusions. Findings will be used to inform future years of the MYHealth program.
Results
We anticipate that up to 280 total high school students from historically excluded groups will be enrolled in MYHealth across four years: up to 280 will have completed the Summer Launch, a subset of up to 120 will have completed the Impact Projects, and a smaller subset of up to 40 will have become Peer Leaders. Primary quantitative outcomes for this evaluation are Researcher Identity and STEM research career interest. Our power analyses indicate that we need 90 students each in the Summer Launch and Impact Projects to detect a minimum effect size of 0.3 which is considered small by conventional interpretations [58]. This assumes 80% power at 5% Type 1 error (two-tailed t-test). Given our anticipated sample, we will have sufficient students to make conclusions about changes in Researcher Identity and STEM career interest even with attrition.
For the qualitative components of the program evaluation, we will use purposive sampling to guide participant selection and ensure variation in participant experiences with the program. We will continue to invite additional students participate as needed to achieve a sufficient sample size to achieve thematic saturation. In qualitative approaches, thematic saturation refers to the point at which there is adequate evidence to develop themes and no new insights are gathered with continued data collection. For interview studies, thematic saturation is often estimated to be achieved between 6–20 interviews [59,60]. To further encourage participation, monetary incentives will be provided for completing semi-structured interviews in all three phases.
Discussion
MYHealth is limited by our small cohort size and geography. The cohort size for each phase is limited to ensure that students receive adequate time with faculty mentors and support for their small group projects. Over the four years of the project, we will be able to understand the impact of the research training program. Currently, only students from Southeast Michigan can participate. If successful, future iterations of MYHealth could leverage our virtual program to extend to another setting outside of Southeast Michigan.
The first complete year of the MYHealth program began in the Summer of 2022, and will re-open annually for the following three years. We anticipate data will become available through peer-reviewed publications beginning in the first two years and on several more instances throughout the course of the project.
Conclusion
The MYHealth program capitalizes on Social Cognitive Theory, Expectancy Value Theory, and a CBPR approach to design and implement a program that aims to address the continuing lack of diversity within the STEM workforce. The program assesses the role and intersection of personal characteristics (e.g., researcher identity, self-efficacy), social and environmental factors, and behavioral influences to spark and maintain interest in STEM careers.
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