Enrollment Decisions Research Articles

Student enrollment decisions and academic success: evaluating the impact of classroom space design

Student enrollment decisions and academic success: evaluating the impact of classroom space design

The role of psychosocial factors in the decision to enroll in physical education courses at the state college level

Objective: Physical education (PE) courses may provide young adults with opportunities to become active, however, enrollment in college PE courses remains low. Participants: This study examined psychosocial factors related to PE enrollment in a sample of 177 college students (29.4% completed a PE course). Methods: Participants completed an online survey that inquired about demographic information, college PE enrollment, exercise self-efficacy, and several open-ended questions regarding their enrollment decisions. Results: There were no differences in self-efficacy scores between PE completers and non-completers. PE completers had more positive previous experiences with PE (43.7% vs 19.3%, p < .01) while non-completers had more negative PE experiences (33% vs 12.5%, p = .03). PE completers felt that self-improvement (51.5% vs 21.3%, p < .01) was most important regarding decisions to enroll in a PE course, while non-completers were concerned with PE courses counting toward their degree (29.2% vs 9.1%, p = .02). Conclusions: These findings can help inform those involved in teaching and administration of PE courses at the state college level. Future research should further investigate how past PE experiences shape students’ feelings toward PE.

Parent clinical trial priorities for fragile X syndrome: a best-worst scaling.

An expansion in the availability of clinical drug trials for genetic neurodevelopmental conditions is underway. Delineating patient priorities is key to the success of drug development and clinical trial design. There is a lack of evidence about parent decision-making in the context of clinical drug trials for genetic neurodevelopmental conditions. We assessed parents' priorities when making a decision whether to enroll their child with fragile X syndrome (FXS) in a clinical drug trial. An online survey included a best-worst scaling method for parents to prioritize motivating and discouraging factors for child enrollment. Parents were recruited through the National Fragile X Foundation and FRAXA. Sequential best-worst with conditional logit analysis was used to determine how parents prioritize motivating and discouraging factors about trial enrollment decisions. Respondents (N = 354) were largely biological mothers (83%) of an individual with FXS who ranged in age from under 5 to over 21 years. The highest motivating factor was a trial to test a drug targeting the underlying FXS mechanism (coeff = 3.28, p < 0.001), followed by the potential of the drug to help many people (coeff = 3.03, p < 0.001). Respondents rated requirement of blood draws (coeff = -3.09, p < 0.001), loss of access to the drug post trial (coeff = -3.01, p < 0.001), and drug side effects (coeff = -2.96, p < 0.001) as most discouraging. The priorities defined by parents can be incorporated into evidence-based trial design and execution to enhance the enrollment process.

Factors impacting enrollment on NCI-COG Pediatric MATCH trial treatment protocols.

10007 Background: The NCI-Children’s Oncology Group (COG) Pediatric Molecular Analysis for Therapy Choice (MATCH) trial assigns patients age 1 to 21 years with relapsed or refractory solid tumors, lymphomas, and histiocytic disorders to phase 2 treatment arms of molecularly-targeted therapies based on the genetic alterations detected in their tumor. Treatment arm assignments and enrollment decisions have now been made for 1000 study participants: we report here match and enrollment data and factors affecting treatment protocol enrollment. Methods: Patients enrolled in the Pediatric MATCH screening protocol were assigned to an open treatment protocol if an actionable mutation (aMOI) was detected by tumor DNA and RNA-based cancer gene panel sequencing. After a match, treatment protocol enrollment must occur within 8-12 weeks. Patient demographic data, reasons for not enrolling on treatment protocol (if applicable), and prior history of molecular testing were reported by study sites. The Fisher exact test was used to compare protocol enrollment rates between groups. Results: Results were analyzed for the first 1000 patients with testing completed (enrolled between July 2017 and October 2020). At least one tumor aMOI was detected in 310 (31%) patients and treatment protocol slots were available for 284 patients (28%). A total of 131 patients (46% of those matched) enrolled on a treatment arm. No difference in treatment protocol match or enrollment rate was observed for gender, race, or ethnicity. Both treatment protocol match rate (105/275, 38% vs 86/394, 22%) and enrollment rate (56/275, 20% vs 33/394, 8%) were significantly more frequent in patients with a reported history of prior molecular testing (p&lt;0.0001). The most common reasons provided for not enrolling on a treatment protocol were: patient receiving other treatment (32% of responses), poor clinical status (16%), lack of measurable disease (11%), or ineligible diagnosis for that treatment arm (10%). Ineligibility due to history of excluded prior targeted therapy (6%) or inability to swallow capsules (4%) was less frequent. Conclusions: The rate of Pediatric MATCH treatment protocol enrollment has exceeded pre-study projections, due to more frequent actionable mutation detection and treatment assignment than anticipated (28% observed, 10% projected). This may in part reflect an increased number of targetable events in recurrent or refractory pediatric cancers. Correlative studies analyzing pre-treatment tumors from MATCH study patients are underway and will address this hypothesis. Prior history of molecular testing was associated with higher match and enrollment rate and poor clinical status was a common reason for not enrolling on a treatment protocol, suggesting that early molecular screening of children with solid malignancies may facilitate enrollment to biomarker-selected trials of targeted therapies. Clinical trial information: NCT03155620.

Bereaved Informal Caregivers Rarely Recall a Relationship Between Transfusions and Hospice in Acute Myeloid Leukemia.

The inability to prescribe blood transfusions is a potential barrier to timely hospice enrollment for patients with blood cancers. The benefits and harms of transfusions near the end of life (EOL), however, are poorly characterized and patients' preferences are unknown. We sought to characterize the recollections of bereaved caregivers about the relationships between transfusions and hospice enrollment decisions. We recruited 18 bereaved caregivers of 15 decedents who died within 6-18 months of the interview. Interviews focused on caregivers' recollections of transfusion and hospice enrollment decisions. Transcripts were analyzed for themes. We identified 2 themes. First, caregivers described that transfusions were necessary and the decisions to receive transfusions or not were deferred to the clinicians. Second, only 1 caregiver recalled transfusions as relevant to hospice decisions. In that instance there was a delay. Caregivers identified difficulties recognizing death was imminent, hope for miracles, and the necessity of accepting life was ending as more relevant barriers. The results indicate clinicians' beliefs in transfusion at EOL may be a more relevant barrier to hospice enrollment than patients' preferences. Strategies to evaluate accurately and discuss the actual benefits and harms of transfusions at the EOL are necessary to advise patients and integrate their preferences into decisions.

Using behavioral outreach to counteract administrative burden and encourage take-up of simplified disability payment rules

Take-up of employment programs among people with disabilities can be limited by the administrative burdens of decision-making, which must factor in the complexities of how work affects disability cash assistance payments. This study presents evidence on using outreach motivated by behavioral research to encourage enrollment in a pilot initiative with the Social Security Administration that simplified Social Security Disability Insurance payment rules. Because enrolling would leave some beneficiaries worse off, informed enrollment decisions required understanding both the complexities of current rules and potential effects of the new demonstration rules. We sought to counteract bottlenecks stemming from decision-making burdens through increased outreach with tailored messaging. A randomized controlled trial was used to test two features of a reminder postcard. First, we compared fold-over postcards containing information about the demonstration to open postcards with more generic information, finding that fold-over postcards increased enrollment by around 25 percent (or 0.12 percentage points). Second, we compared an urgent message framing with no stated enrollment end-date to a deadline framing with an explicit enrollment cutoff date. Although the final enrollment rate was similar across timeline framing options, the urgent framing appears to have resulted in faster enrollment.

Enrolment patterns in federal universities based on three criteria (2010-2031): A time series approach

Introduction: There is a general agreement among previous studies that gender, merit and catchment area criteria allows for access to university education, but the pattern of these variables over the years has not been proven in these studies. Purpose: This study used a times series approach to evaluate the enrolment patterns in federally owned universities in South-South Zone, Nigeria, based on the gender, merit and catchment area criteria. Methodology: The descriptive survey design was adopted for this study. A purposive sampling technique was adopted to choose three universities based on the generation of their establishment. The evaluation covered from 2010 to 2019 using stationary time-bound data collected from the academic planning units of the institutions through a checklist. Future enrolment forecasts were made to 2031 using the moving average forecasting technique. Results: A gender-based difference in enrolment, in favour of males was recorded between 2010 and 2019; there were notable fluctuations in the enrolment pattern based on the merit criterion from 2010 to 2019; the enrolment pattern in terms of the catchment area criterion was consistent from 2010 – 2019. In terms of the projection, it was predicted that enrolment at the aggregate level would rise continuously across federal universities, but not at the institutional level. more women than men are expected to be enrolled in academic programmes at federal institutions, while at the institutional level, gender-based enrolment can fluctuate. Recommendations/Classroom Implications: Based on these findings, implications are discussed for future enrolment decisions at both the institutional and national levels.

The Role of College-Bound Friends in College Enrollment Decisions by Race, Ethnicity, and Gender

This study examines the association between college-bound friends and college enrollment using restricted transcript data from the High School Longitudinal Study. Propensity score matching and school fixed effects models suggest that having close college-bound friends is positively associated with enrolling in college. However, Black and Latino male students are much less likely to benefit from having college-bound friends than others, suggesting that structural and cultural factors that are tied to race, ethnicity, and gender may limit the beneficial potential of friends, especially for these male Black and Latino students. Implications for addressing racial and ethnic disparities in college enrollment and for the role of friends in college enrollment decisions are discussed.

A Qualitative Analysis of Factors Influencing Critical Care Trial Enrollment Among Surrogates.

We sought to identify factors that influence surrogate decision makers' decisions to enroll patients into a critical care randomized controlled trial. We conducted a qualitative study embedded within a randomized controlled trial testing the effect of a behavioral nudge intervention for surrogate decision makers on enrollment rate in a sham ventilatory weaning trial among patients with acute respiratory failure. Participants were adult surrogate decision makers of patients receiving mechanical ventilation for acute respiratory failure. The study was conducted in 10 ICUs across 2 urban hospitals within an academic medical center in Philadelphia, Pennsylvanaia, United States. Immediately following their trial enrollment decision, surrogate decision makers were asked to enter free-text responses about the factors that influenced their decision. Responses were analyzed using content analysis. Of the 90 (49%) participants who provided free-text responses, the mean age was 54.9 years (SD 14.3), 69 (79%) were Caucasian, and 48 (53%) were the spouse of the eligible patient. We identified 5 themes influencing enrollment decisions: (i) trial characteristics, (ii) patient clinical condition, (iii) decision making processes, (iv) altruism, and (v) enrollment attempt. Among surrogates who enrolled the patient in the trial (n = 40), the most commonly cited factors were helping future patients (n = 24, 60%) and following the patient's wishes (n = 11, 28%). In contrast, those who declined enrollment (n = 50) most commonly reported that the patient was too sick (n = 27, 54%) and that they feared complicating the patient's condition (n = 11, 22%). Surrogates who enroll patients into trials most often cite altruistic motivations, while those who decline enrollment are most often concerned with the severity of the patients' condition.

Do household perceptions influence enrolment decisions into community-based health insurance schemes in Tanzania?

BackgroundSeveral countries including Tanzania, have established voluntary non-profit insurance schemes, commonly known as community-based health insurance schemes (CBHIs), that typically target rural populations and the informal sector. This paper considers the importance of household perceptions towards CBHIs in Tanzania and their role in explaining the enrolment decision of households.MethodsThis was a cross-sectional household survey that involved 722 households located in Bahi and Chamwino districts in the Dodoma region. A three-stage sampling procedure was used, and the data were analyzed using both factor analysis (FA) and principal component analysis (PCA). Statistical tests such as Bartlett’s test of sphericity, Kaiser-Meyer-Olkin (KMO) for sampling adequacy, and Cronbach’s alpha test for internal consistency and scale reliability were performed to examine the suitability of the data for PCA and FA. Finally, multivariate logistic regressions were run to determine the associations between the identified factors and the insurance enrolment status.ResultsThe PCA identified seven perception factors while FA identified four factors. The quality of healthcare services, preferences (social beliefs), and accessibility to insurance scheme administration (convenience) were the most important factors identified by the two methods. Multivariate logistic regressions showed that the factors identified from the two methods differed somewhat in importance when considered as independent predictors of the enrollment status. The most important perception factors in terms of strength of association (odds ratio) and statistical significance were accessibility to insurance scheme administration (convenience), preferences (beliefs), and the quality of health care services. However, age and income were the only socio-demographic characteristics that were statistically significant.ConclusionHousehold perceptions were found to influence households’ decisions to enroll in CBHIs. Policymakers should recognize and consider these perceptions when designing policies and programs that aim to increase the enrolment into CBHIs.

Continuing Social Constraints in Education Agency: The School Choices and Experiences of Middle- Class African American Families in Albany, NY

This paper explores the experiences of middle-class African American parents who have enrolled their children in a central-city public school district and the factors that inform and contribute to their school enrollment decisions. Data come from nineteen in-depth interviews with middle-class African American parents in Albany, New York. The paper uses the conceptual framework of empowerment and agency to explore and analyze the findings. Findings suggest that middle-class African American parents possess some measure of empowerment based on their human capital and positive childhood experiences in public schools. The latter denotes the salience of emotions in intergenerational education transmission. Parents’ empowerment, however, does not fully extend to agency. Most parents’ school choices have been structured and narrowed by racial segregation in residence and by the real and perceived racial exclusion in private school settings. Therefore, even for highly-educated, middle-income African Americans, anxieties over racial exclusion act as a strong social constraint on parents’ community and school choices.

The effects of releasing early results from ongoing clinical trials

Most trials do not release interim summaries on efficacy and toxicity of the experimental treatments being tested, with this information only released to the public after the trial has ended. While early release of clinical trial data to physicians and patients can inform enrollment decision making, it may also affect key operating characteristics of the trial, statistical validity and trial duration. We investigate the public release of early efficacy and toxicity results, during ongoing clinical studies, to better inform patients about their enrollment options. We use simulation models of phase II glioblastoma (GBM) clinical trials in which early efficacy and toxicity estimates are periodically released accordingly to a pre-specified protocol. Patients can use the reported interim efficacy and toxicity information, with the support of physicians, to decide which trial to enroll in. We describe potential effects on various operating characteristics, including the study duration, selection bias and power.

Parental Factors Associated With the Decision to Participate in a Neonatal Clinical Trial

It remains poorly understood how parents decide whether to enroll a child in a neonatal clinical trial. This is particularly true for parents from racial or ethnic minority populations. Understanding factors associated with enrollment decisions may improve recruitment processes for families, increase enrollment rates, and decrease disparities in research participation. To assess differences in parental factors between parents who enrolled their infant and those who declined enrollment for a neonatal randomized clinical trial. This survey study conducted from July 2017 to October 2019 in 12 US level 3 and 4 neonatal intensive care units included parents of infants who enrolled in the High-dose Erythropoietin for Asphyxia and Encephalopathy (HEAL) trial or who were eligible but declined enrollment. Data were analyzed October 2019 through July 2020. Parental choice of enrollment in neonatal clinical trial. Percentages and odds ratios (ORs) of parent participation as categorized by demographic characteristics, self-assessment of child's medical condition, study comprehension, and trust in medical researchers. Survey questions were based on the hypothesis that parents who enrolled their infant in HEAL differ from those who declined enrollment across 4 categories: (1) infant characteristics and parental demographic characteristics, (2) perception of infant's illness, (3) study comprehension, and (4) trust in clinicians and researchers. Of a total 387 eligible parents, 269 (69.5%) completed the survey and were included in analysis. This included 183 of 242 (75.6%) of HEAL-enrolled and 86 of 145 (59.3%) of HEAL-declined parents. Parents who enrolled their infant had lower rates of Medicaid participation (74 [41.1%] vs 47 [55.3%]; P = .04) and higher rates of annual income greater than $55 000 (94 [52.8%] vs 30 [37.5%]; P = .03) compared with those who declined. Black parents had lower enrollment rates compared with White parents (OR, 0.35; 95% CI, 0.17-0.73). Parents who reported their infant's medical condition as more serious had higher enrollment rates (OR, 5.7; 95% CI, 2.0-16.3). Parents who enrolled their infant reported higher trust in medical researchers compared with parents who declined (mean [SD] difference, 5.3 [0.3-10.3]). There was no association between study comprehension and enrollment. In this study, the following factors were associated with neonatal clinical trial enrollment: demographic characteristics (ie, race/ethnicity, Medicaid status, and reported income), perception of illness, and trust in medical researchers. Future work to confirm these findings and explore the reasons behind them may lead to strategies for better engaging underrepresented groups in neonatal clinical research to reduce enrollment disparities.

Parental divorces and children’s educational outcomes in Senegal

This paper provides new evidence on the consequences of parental divorce for children in Africa. Using survey data that collected the detailed life histories of Senegalese women and of their children, we investigate how children’s educational outcomes are affected by their parents’ divorce. We use a sibling fixed-effects strategy that allows us to control for all the factors that are common to all children in a family, such as parental preferences regarding education or the level of education of the parents, alleviating concerns of omitted variable bias. We compare children who were old enough to have been enrolled in primary school at the time of the divorce to their younger siblings, for whom enrollment decisions had not yet been made at the time of the divorce. We find that younger siblings were more likely than their older siblings to have attended primary school. This higher level of investment does not persist in the long run: there are no differences between siblings when considering primary school completion. We find that custody and fostering decisions do not seem to mediate the positive effects on school attendance. Our findings are consistent with either an improvement of the financial situation (due to remarriage) or an increase in the decision-making power of mothers after the divorce.

Boosting pension enrollment and household consumption by example: A field experiment on information provision

In this study, we conduct a large-scale field experiment in the Guangdong province of China to examine the effect of informing individuals about government pension programs on their pension enrollment decisions and household consumption. Our field experiment lasts 12 months and involves 2539 individuals from 1064 households randomly selected from three cities in Guangdong. We send an informational brochure to participants, designed differently for those in the control and treatment groups, and repeat the intervention three times. We find that, compared to the control group, those who receive concrete examples of pension benefits show a greater increase in pension enrollment, with a significant effect for those aged 45–55 years. We also find that, among households headed by participants aged 45–55 years, those who receive personalized benefit information exhibit significantly higher consumption than the control group. These findings support the effectiveness of combining concrete and personalized information in designing informational material as well as the importance of targeting the most responsive population during information delivery.

To Pre-req or Co-req: An Assessment of Why Chemical Engineering Students Elect to Take a Course as a Prerequisite or as a Corequisite

In our chemical engineering curricula, students may enroll in introductory thermodynamics as a prerequisite to or as a corequisite with material and energy balances (MEB). We sought to determine why students enrolled in these courses in a given sequence whether it impacts performance. Students’ enrollment decisions were mostly based on logistics such as curriculum guides and scheduling issues. Students who enrolled in thermodynamics before MEB may have outperformed students who took them together.

Post-Compulsory Schooling of Youth in Turkey during the Great Recession: A Case of Pro-cyclical Enrollment

The impact of recessions on school enrollment is ambiguous. On one hand, recessions might increase the likelihood of enrollment due to decreasing opportunity costs of attending school. On the other hand, recessions might discourage enrollment due to reductions households have in funds available for education and deteriorating expectations about returns to education. In this paper, we empirically analyze how local unemployment rates affect enrollment decisions in Turkey during the period covering the Great Recession of 2008-2009. Our estimates show that the likelihood of enrollment in university undergraduate programs decreases during periods of and in regions experiencing higher unemployment, whereas the enrollment in high schools is not affected. This finding contradicts earlier findings of counter-cyclical enrollment in the context of developed countries. This contrast highlights the variations in the relative importance of the effect of income and expectations and in the potential long-term effects of recessions across countries. In particular, recessions might have longer-lasting negative effects in developing countries due to their adverse effect on human capital accumulation.

Admissions to Medical School during the COVID-19 Era without the MCAT.

As medical schools cope with the consequences of the COVID-19 pandemic, a new cohort of students will be admitted in the fall. Administrators are again challenged to make unprecedented enrollment decisions without standardized exams. This challenge provides unique opportunities to re-evaluate admission processes that has been employed since 1928 and support holistic admissions. This article highlights key factors that are being considered during current medical school admission cycles, including limited opportunities to take standardized exams, heightened student anxiety, and potential exam alternatives. These factors are framed and discussed within the context of the medical college admission test (MCAT) exam.

Parental decision making about clinical trial enrollment: A survey of parents of children with Fragile X syndrome.

Opportunities for patients to enroll in clinical trials for neurodevelopmental conditions are increasing. We studied what factors are associated with parents' decisional process to enroll their child in a clinical trial for a genetic neurodevelopmental condition (Fragile X syndrome). Parents (n = 354; mostly biological mothers of a child with Fragile X syndrome) were recruited through Fragile X syndrome advocacy groups. Parents reported attitudes about children in research, trust in child's doctor, threat resources (self-affirmation and dispositional optimism), and demographic and clinical characteristics in an online questionnaire. Three outcome measures assessed associations with these factors at different stages of the decision-making process. The three outcomes were (a) awareness about clinical trial opportunities, (b) enrollment decisions, and (c) decisional regret. Parents who were positive about involving children in research were more aware of clinical trial opportunities (OR = 3.27, 95% CI [2.11, 5.07]), were more likely to have enrolled their child in a clinical trial (OR = 1.69, 95% CI [1.12, 2.56]), and reported lower levels of decisional regret (β = -8.95, 95% CI [-16.38, -1.52]). Parents with higher threat resources had considered enrolling their child in a clinical trial (OR = 1.51, 95% CI [1.02, 2.23]) and reported lower levels of decisional regret (β = -8.73, 95% CI [-17.36, -0.11]). Among parents with lower levels of trust in their child's doctor, higher threat resources were associated with higher enrollment (β = 0.60, 95% CI [0.12, 1.08]). It may be possible to intervene on the factors (attitudes about children in research and threat resources) associated with clinical trial decision making to boost trial enrollment and promote informed decision making. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Informal recruitment channels, family background and university enrolments in Italy

This paper analyses the impact of informal recruitment channels on university enrolment decisions. A widespread diffusion of personal connections as an entry channel to the labour market may signal that social ties to well-off people are necessary to get a good job, thereby convincing students from poorly connected families that getting a tertiary education degree does not enhance their future socio-economic opportunities. By applying estimation techniques with instrumental variables to Italian microdata, I found that upper-secondary students coming from lower social classes are less likely to participate in tertiary education when they live in provinces where the percentage of newly tertiary graduates who found a job through informal channels is higher. My results are consistent with the hypothesis that the wide diffusion of ‘favouritism’ in local labour markets engenders a sense of ‘economic despair’ among poorly connected students, thereby worsening inequality of access to education and local socio-economic development.literature and the hypothesis