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1. Lived Experiences of African American Engineering Students at a PWI Through the Lens of Navigational Capital

   Damas, S. ; Benson, L. ( February 2022 , 2022 CoNECD (Collaborative Network for Engineering & Computing Diversity))

   There are significant disparities between the conferring of science, technology, engineering, and mathematics (STEM) bachelor’s degrees to minoritized groups and the number of STEM faculty that represent minoritized groups at four-year predominantly White institutions (PWIs). Studies show that as of 2019, African American faculty at PWIs have increased by only 2.3% in the last 20 years. This study explores the ways in which this imbalance affects minoritized students in engineering majors. Our research objective is to describe the ways in which African American students navigate their way to success in an engineering program at a PWI where the minoritized faculty representation is less than 10%. In this study, we define success as completion of an undergraduate degree and matriculation into a Ph.D. program. Research shows that African American students struggle with feeling like the “outsider within” in graduate programs and that the engineering culture can permeate from undergraduate to graduate programs. We address our research objective by conducting interviews using navigational capital as our theoretical framework, which can be defined as resilience, academic invulnerability, and skills. These three concepts come together to denote the journey of an individual as they achieve success in an environment not created with them in mind. Navigational capital has been applied in education contexts to study minoritized groups, and specifically in engineering education to study the persistence of students of color. Research on navigational capital often focuses on how participants acquire resources from others. There is a limited focus on the experience of the student as the individual agent exercising their own navigational capital. Drawing from and adapting the framework of navigational capital, this study provides rich descriptions of the lived experiences of African American students in an engineering program at a PWI as they navigated their way to academic success in a system that was not designed with them in mind. This pilot study took place at a research-intensive, land grant PWI in the southeastern United States. We recruited two students who identify as African American and are in the first year of their Ph.D. program in an engineering major. Our interview protocol was adapted from a related study about student motivation, identity, and sense of belonging in engineering. After transcribing interviews with these participants, we began our qualitative analysis with a priori coding, drawing from the framework of navigational capital, to identify the experiences, connections, involvement, and resources the participants tapped into as they maneuvered their way to success in an undergraduate engineering program at a PWI. To identify other aspects of the participants’ experiences that were not reflected in that framework, we also used open coding. The results showed that the participants tapped into their navigational capital when they used experiences, connections, involvement, and resources to be resilient, academically invulnerable, and skillful. They learned from experiences (theirs or others’), capitalized on their connections, positioned themselves through involvement, and used their resources to achieve success in their engineering program. The participants identified their experiences, connections, and involvement. For example, one participant who came from a blended family (African American and White) drew from the experiences she had with her blended family. Her experiences helped her to understand the cultures of Black and White people. She was able to turn that into a skill to connect with others at her PWI. The point at which she took her familial experiences to use as a skill to maneuver her way to success at a PWI was an example of her navigational capital. Another participant capitalized on his connections to develop academic invulnerability. He was able to build his connections by making meaningful relationships with his classmates. He knew the importance of having reliable people to be there for him when he encountered a topic he did not understand. He cultivated an environment through relationships with classmates that set him up to achieve academic invulnerability in his classes. The participants spoke least about how they used their resources. The few mentions of resources were not distinct enough to make any substantial connection to the factors that denote navigational capital. The participants spoke explicitly about the PWI culture in their engineering department. From open coding, we identified the theme that participants did not expect to have role models in their major that looked like them and went into their undergraduate experience with the understanding that they will be the distinct minority in their classes. They did not make notable mention of how a lack of minority faculty affected their success. Upon acceptance, they took on the challenge of being a racial minority in exchange for a well-recognized degree they felt would have more value compared to engineering programs at other universities. They identified ways they maneuvered around their expectation that they would not have representative role models through their use of navigational capital. Integrating knowledge from the framework of navigational capital and its existing applications in engineering and education allows us the opportunity to learn from African American students that have succeeded in engineering programs with low minority faculty representation. The future directions of this work are to outline strategies that could enhance the path of minoritized engineering students towards success and to lay a foundation for understanding the use of navigational capital by minoritized students in engineering at PWIs. Students at PWIs can benefit from understanding their own navigational capital to help them identify ways to successfully navigate educational institutions. Students’ awareness of their capacity to maintain high levels of achievement, their connections to networks that facilitate navigation, and their ability to draw from experiences to enhance resilience provide them with the agency to unleash the invisible factors of their potential to be innovators in their collegiate and work environments. 

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2. Advance Planning for Technology Use in Dementia Care: Development, Design, and Feasibility of a Novel Self-administered Decision-Making Tool

   https://doi.org/10.2196/39335  

   Berridge, Clara ; Turner, Natalie R ; Liu, Liu ; Karras, Sierramatice W ; Chen, Amy ; Fredriksen-Goldsen, Karen ; Demiris, George ( January 2022 , JMIR Aging)

   Monitoring technologies are used to collect a range of information, such as one’s location out of the home or movement within the home, and transmit that information to caregivers to support aging in place. Their surveilling nature, however, poses ethical dilemmas and can be experienced as intrusive to people living with Alzheimer disease (AD) and AD-related dementias. These challenges are compounded when older adults are not engaged in decision-making about how they are monitored. Dissemination of these technologies is outpacing our understanding of how to communicate their functions, risks, and benefits to families and older adults. To date, there are no tools to help families understand the functions of monitoring technologies or guide them in balancing their perceived need for ongoing surveillance and the older adult’s dignity and wishes.

   We designed, developed, and piloted a communication and education tool in the form of a web application called Let’s Talk Tech to support family decision-making about diverse technologies used in dementia home care. The knowledge base about how to design online interventions for people living with mild dementia is still in development, and dyadic interventions used in dementia care remain rare. We describe the intervention’s motivation and development process, and the feasibility of using this self-administered web application intervention in a pilot sample of people living with mild AD and their family care partners.

   We surveyed 29 mild AD dementia care dyads living together before and after they completed the web application intervention and interviewed each dyad about their experiences with it. We report postintervention measures of feasibility (recruitment, enrollment, and retention) and acceptability (satisfaction, quality, and usability). Descriptive statistics were calculated for survey items, and thematic analysis was used with interview transcripts to illuminate participants’ experiences and recommendations to improve the intervention.

   The study enrolled 33 people living with AD and their care partners, and 29 (88%) dyads completed the study (all but one were spousal dyads). Participants were asked to complete 4 technology modules, and all completed them. The majority of participants rated the tool as having the right length (>90%), having the right amount of information (>84%), being very clearly worded (>74%), and presenting information in a balanced way (>90%). Most felt the tool was easy to use and helpful, and would likely recommend it to others.

   This study demonstrated that our intervention to educate and facilitate conversation and documentation of preferences is preliminarily feasible and acceptable to mild AD care dyads. Effectively involving older adults in these decisions and informing care partners of their preferences could enable families to avoid conflicts or risks associated with uninformed or disempowered use and to personalize use so both members of the dyad can experience benefits.

    

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3. Smarthealth technology study protocol to improve relationships between older adults with dementia and family caregivers

   https://doi.org/10.1111/jan.14714  

   Rose, Karen M. ; Coop Gordon, Kristina ; Schlegel, Emma C. ; Mccall, Matthew ; Gao, Ye ; Ma, Meiyi ; Lenger, Katherine A. ; Ko, Eunjung ; Wright, Kathy D. ; Wang, Hongning ; et al ( February 2021 , Journal of Advanced Nursing)

   The aim of this study is to develop a Smarthealth system of monitoring, modelling, and interactive recommendation solutions (for caregivers) for in‐home dementia patient care that focuses on caregiver–patient relationships.

   This descriptive study employs a single‐group, non‐randomized trial to examine functionality, effectiveness, feasibility, and acceptability of the novel Smarthealth system.

   Thirty persons with Alzheimer's Disease or related dementia and their family caregivers (N = 30 dyads) will receive and install Smarthealth technology in their home. There will be a 1‐month observation phase for collecting baseline mood states and a 2‐month implementation phase when caregivers will receive stress management techniques for each detected, negative mood state. Caregivers will report technique implementation and usefulness, sent via Ecological Momentary Assessment system to the study‐provided smartphone. Caregivers will provide daily, self‐reported mood and health ratings. Instruments measuring caregiver assessment of disruptive behaviours and their effect on caregivers; caregiver depressive symptoms, anxiety and stress; caregiver strain; and family functioning will be completed at baseline and 3 months. The study received funding in 2018 and ethics board approval in 2019.

   This study will develop and test novel in‐home technology to improve family caregiving relationships. Results from this study will help develop and improve the Smarthealth recommendation system and determine its usefulness, feasibility, and acceptability for persons with dementia and their family caregiver.

   The Smarthealth technology discussed will provide in‐home stress reduction resources at a time when older adults may be experiencing increasingly high rates of isolation and anxiety and caregiver dyads may be experiencing high levels of relationship strain.

   This study was registered with Clinical Trials.gov (Identifier NCT04536701).

    

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4. Reducing the Price of Naïveté in return‐to‐play from sports‐related concussion

   https://doi.org/10.1111/poms.14024  

   Garcia, Gian‐Gabriel P. ; Lavieri, Mariel S. ; McAllister, Thomas W. ; McCrea, Michael A. ; Broglio, Steven P. ; CARE Consortium Investigators ( June 2023 , Production and Operations Management)

   Patient‐reported outcomes (PROs) play an increasingly important role in medical decision making. Yet, patients whose objectives differ from their physician's may strategically report symptoms to alter treatment decisions. For example, athletes may underreport symptoms to expedite return‐to‐play (RTP) from sports‐related concussion (SRC). Thus, clinicians must implement treatment policies that mitigate thePrice of Naïveté, that is, the reduction in health outcomes due to naïvely believing strategically reported symptoms. In this study, we analyze dynamic treatment cessation decisions with strategic patients. Specifically, we formulate the Behavior‐Aware Partially Observable Markov Decision Process (BA‐POMDP), which optimizes the timing of treatment cessation decisions while accounting for known symptom‐reporting behaviors. We then analytically characterize the BA‐POMDP's optimal policy, leading to several practical insights. Next, we formulate the Behavior‐Learning Partially Observable Markov Decision Process (BL‐POMDP), which extends the BA‐POMDP by learning a patient's symptom‐reporting behavior over time. We show that the BL‐POMDP is decomposable into several BA‐POMDPs, allowing us to leverage the BA‐POMDP's structural properties for solving the BL‐POMDP. Then, we apply the BL‐POMDP to RTP from SRC using data from 29 institutions across the United States. We estimate the Price of Naïveté by comparing the BL‐POMDP to naïve benchmark policies. Accordingly, the BL‐POMDP reduces premature RTP by over 44% and provides up to 3.63 additional health‐adjusted athletic exposures per athlete compared to current practice. Overall, changing the interpretation of reported symptoms can better reduce the Price of Naïveté over adjusting treatment cessation thresholds. Therefore, to improve patients' health outcomes, clinicians must understand how strategic behavior manifests in PROs.

    

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5. Impact of physical and social settings on parent engagement in learning through making

   Letourneau, S.M. ; McMillan Culp, K. ; Wells, D. ( April 2019 , American Educational Research Association)

   Previous research has documented the benefits of making for young learners, but few studies have examined how parents engage in maker activities during family visits to museums, both as facilitators of their children’s learning and as makers in their own right. In this study, we asked how caregivers participate in making and tinkering programs, how parents describe the benefits of making (for their children and themselves), and what aspects of the physical and social setting influence parents’ engagement. Data included observations of 88 family groups participating in various making and tinkering activities at a science center (including woodworking, fashion design, virtual reality drawing, circuit blocks, etc) and exit interviews with a subset of 66 caregivers. Qualitative data analysis connected observed qualities of the physical and social setting with caregivers’ observed and reported engagement. Through this analysis, we identified specific aspects of the physical environment, tools/materials, and facilitation strategies that invited family participation in general and that were associated with specific caregiver roles, including observing children’s learning, facilitation of children’s learning, and engagement as a maker alongside children. The implications of the findings for the design and facilitation of maker programs are discussed. 

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