Enrollment Patterns Research Articles

Abstract 10714: Disparities in Cardiovascular Investigator-Initiated Research Studies

Introduction: Recently there has been a much-needed focus on disparity and inequity in cardiovascular disease (CVD) care. Race, ethnicity, sex, and geography are shown to impact CVD care and outcomes. Perhaps one of the reasons for this is the lack of diversity and representation in CVD research studies, especially in non-sponsored research studies. Here we examine three investigator-initiated clinical CVD trials to describe current enrollment patterns and compare them to the comparable populations. Methods: Three Intermountain Healthcare, internally funded, CVD clinical trials were examined. These studies include a pragmatic trial, a randomized unblinded treatment trial, and a biobanking registry. Basic study characteristics and the comparison populations are shown in Table 1. Results: Demographic comparisons are shown in Table 2. Females were equally or slightly more represented in the studies. Minority races were under-represented in the pragmatic trial and the biobank registry. Rural or frontier counties were under-represented in the pragmatic trial and randomized trial. Hispanic/Latino patients were under-represented in all studies. Conclusions Females were well represented in all studies, but other minority groups were under-represented. The largest under-representation was for Hispanic/Latino patients. The reasons and mechanisms that may lead to under-representation and the impact on research results are unknown and deserve further study. While addressing these disparities may increase research costs (e.g., translation costs), future studies will benefit from the development of new resources and processes, and ultimately could lead to better care.

Selected Articles from This Issue

Evaluations of cancer etiology and safety and effectiveness of cancer treatments are predicated on large numbers of patients with sufficient baseline and follow-up data. To assess feasibility of FDA's Sentinel System's electronic healthcare data for surveillance of malignancy onset and examination of product safety, this study by Haug and colleagues examined patterns of enrollment surrounding new-onset cancers. The study found that the FDA Sentinel System's electronic healthcare data may be useful for characterizing relatively short latency cancer risk, examining cancer drug utilization and safety post diagnosis, and conducting surveillance for acute adverse events among patients with cancers. As a national distributed system with electronic health data, the Sentinel system provides opportunity for rapid pharmacoepidemiologic assessments relevant in oncology.This study sought to clarify and extend a 2018 descriptive study by the Centers for Disease Control and Prevention that reported high pediatric cancer incidence in New Hampshire. Statistically comparing national, regional and state data, this new study by Rees and colleagues confirms that the Northeast has the highest pediatric cancer incidence in the country, and that no single state within the Northeast is a statistical outlier. These findings emphasize the need for partnerships between northeastern states’ health departments and epidemiologists, to understand the causes of the region's high burden of pediatric cancer, and to identify possible solutions.Prior studies suggest there are persistent racial/ethnic disparities in overall and breast cancer mortality among women with metastatic disease, yet to what extent comorbidity burden contributes to these disparities is unclear. In this retrospective cohort study of 995 women newly diagnosed with metastatic breast cancer in a large diverse, integrated healthcare system, Wallner and colleagues found that medical comorbidities such as diabetes, and hypertension were common. They also found comorbidities were associated with an increased risk of both overall and breast cancer mortality and may influence disparities in these outcomes among women with metastatic breast cancer. Optimizing the management of comorbidities may therefore help to reduce these disparities and improve mortality outcomes in women with metastatic breast cancer.Lung cancer is the leading cause of cancer-related death. Smith-Byrne and colleagues used two complementary approaches to triangulate the role of circulating isovalerylcarnitine (IVC) in lung cancer aetiology - one based on genetic measurements of IVC in large genome-wide associations studies and one based on direct measurements of IVC in pre-diagnostic samples from population cohorts. The authors observed a protective effect for IVC that was independent of tobacco exposure (ORlog10 = 0.43, 95% CI: 0.29–0.63). Circulating IVC is modifiable through diet and warrants further investigation for a potential role in lung cancer prevention.

Born too late? How relative age affects college enrolment patterns

ABSTRACT The month in which we are born affects our experience of and progress through the education system and is known as the relative age effect. This study reports on a project in which the author conducted mixed methods research into the impact of different birth months on enrolment patterns and participant experiences within further education in England, a neglected sector for this research area. This paper challenges the current view that the negative impact of being born later in an academic year cohort dissipates with age. Analysis of the findings shows that enrolment patterns are skewed towards the summer months for those entering the further education college in the study and that the month of May should be included in the definition of summer months. Summer-born study participants were aware of their relative age at a social and physical level, but made no connection to their academic progress. This paper argues that relative age is a significant driver for enrolment to and, therefore, subsequent performance within further education, which should be monitored alongside other better known disadvantage factors, with the aim to reduce and eliminate this systemic disadvantage.

Enrollment patterns and site-level predictors of Black participant recruitment to a multisite randomized clinical trial (RCT) of endocrine therapy adherence support.

68 Background: Accrual of racial and ethnic minority patients (pts) to clinical trials has been an ongoing challenge in research. Barriers exist at many levels of engagement including trial availability, screening biases, strict enrollment criteria, and structural racism. Lack of trial diversity has led to less generalizable medical evidence, suboptimal data for toxicity and efficacy of cancer treatments, poorer outcomes and continued mistrust by communities of color in research processes that exclude or marginalize them. Site factors and study design strategies associated with successful recruitment of diverse study populations are understudied. Methods: Alliance A191901 is an RCT testing combinations of text and telephone support to promote endocrine therapy adherence among breast cancer survivors. It oversamples Black participants and those < 50 years at thresholds of 30% each. Administrative enrollment data was used to track and describe monthly accrual trajectory by race among the initial 50% of participants (n = 590) and to examine associations between % Black participants accrued and accruing site characteristics, including site type, geographic region, % Black population in the site’s zip code and volume of pts by race accrued to recent (2018-2019) Alliance trials, using χ2 tests. We also examined patterns of Black participant accrual before and after closure of the A191901 study to non-Black participants. Results: At 50% accrual, 124 sites had enrolled at least 1 participant. Among 590 participants, 9.7% were Black and 22.5% were < 50 years. Neither site type nor volume was associated with % Black participants recruited. Sites in the South recruited higher proportions of Blacks (19.0% vs 5.6% for Midwest, the lowest region, p < 0.001). Neighborhood racial composition was positively associated with accrual of Black participants (17.2% at sites from highest Black composition vs. 2.3% in lowest, p < 0.001). Recruitment trajectories of Black participants consistently lagged those of non-Black participants in the first half of the study; however, Black participants recruited per month numerically increased after the study reached target accrual of non-Blacks and closed to non-Black participants. Conclusions: Sites in neighborhoods and geographic regions with larger Black populations recruited higher proportions of Black participants, but site type and volume were not associated with recruitment of Black participants. Closure of non-Black study strata based on predetermined accrual targets may positively impact recruitment trajectories of Black participants, but further study is needed. Site selection based on neighborhood composition and geography may be an appropriate tool for increasing trial diversity. Support: UG1CA189823. Clinical trial information: NCT04379570.

The Impact of COVID-19 on Community College Enrollment and Student Success: Evidence from California Administrative Data

Abstract This paper examines how the pandemic impacted the enrollment patterns, fields of study, and academic outcomes of students in the California Community College System, the largest higher-education system in the country. Enrollment dropped precipitously during the pandemic—the total number of enrolled students fell by 11 percent from Fall 2019 to Fall 2020 and by another 7 percent from Fall 2020 to Fall 2021. The California Community College system lost nearly 300,000 students over this period. Our analysis reveals that enrollment reductions were largest among black and Latinx students, and were larger among continuing students than first-time students. We find no evidence that having a large online presence prior to the pandemic protected colleges from these negative effects. Enrollment changes were substantial across a wide range of fields and were large for both vocational courses and academic courses that can be transferred to four-year institutions. In terms of course performance, changes in completion rates, withdrawal rates, and grades primarily occurred in the spring of 2020. These findings of the effects of the pandemic at community colleges have implications for policy, impending budgetary pressures, and future research.

Pattern of human resource development in Indian agricultural universities

Agriculture is the primary sector of Indian economy contributing substantially towards GDP of the country. Qualified and quality human resources contribute significantly towards agricultural sector in the economy. The present study (2021) attempts to analyze the human resource development in terms of enrollment pattern of students in undergraduate (UG) course of agriculture and allied sciences and reflects on evolving strategies for attracting talented students in this sector. Present study shows that there is a close correlation with State Value of Output in agricultural sector and number of students enrolled in higher agricultural and allied studies. Presently, there are 74 agricultural universities (AUs) under the National Agricultural Research Education System and the present study attempts to analyze the student enrollment patterns of under-graduate students in agricultural universities of India for meeting the scientific manpower needs towards achieving targeted agricultural growth. Five years of enrollment data (2015–20) across AUs was considered. Human resource development in terms of enrolment in the higher agricultural education of agricultural universities is quite low when compared to enrolment of students overall in higher education and pattern of enrollment of girls varied in different regions of the country. This study has brought out an important aspect linked to higher agricultural education that the State Value of Output in agriculture has a positive association with enrollment of the students in higher agricultural education from the state in agricultural sector. It is important to assess the future human resource needs for the various sub-sectors of agriculture.

Enrollment of Individuals From Racial and Ethnic Minority Groups in Gynecologic Cancer Precision Oncology Trials.

To characterize whether enrollment patterns in precision oncology clinical trials for gynecologic cancers reflect the racial and ethnic diversity of patients with gynecologic cancers in the United States. ClinicalTrials.gov was queried to perform this cross-sectional review. We included precision oncology trials -defined as trials using molecular profiling of a tumor or the patient genome to identify targetable alterations to guide treatment-of ovarian, uterine, cervical, and vulvar cancers in the United States. National Cancer Institute Surveillance, Epidemiology, and End Results and United States Census Bureau data were used to estimate cancer burden and the expected number of trial participants by race and ethnicity for each gynecologic cancer. The ratio of actual-to-expected participants was calculated. A ratio greater than 1 signified overenrollment. A random effects meta-analysis was performed to assess the relative weights of individual trials. We identified 493 trials, 61 of which met inclusion criteria. There were 2,573 patients enrolled in ovarian cancer trials, 1,197 in uterine cancer trials and 162 in cervical cancer trials. Non-Hispanic White women were overrepresented overall (enrollment ratio 1.26, 95% CI 1.20-1.32) and across all cancer types on subgroup analysis. Asian women, non-Hispanic Black women, and Hispanic women were underrepresented overall (enrollment ratios 0.63, 95% CI 0.41-0.86; 0.51, 95% CI 0.36-0.66 and 0.30, 95% CI 0.23-0.36, respectively). In subgroup analyses, Asian women and non-Hispanic Black women were underrepresented in ovarian and uterine cancer trials and Hispanic women were underrepresented across all cancer types. Non-Hispanic Black women, Asian women, and Hispanic women with gynecologic cancers are underrepresented in precision oncology trials. Few U.S.-based precision oncology trials exist for uterine and cervical cancers, which have a high burden of morbidity and mortality among racial and ethnic minority groups. Failure to equitably enroll patients who belong to racial and ethnic minority groups may perpetuate existing disparities in gynecologic cancer outcomes.

Sequestration of Speciality Providers in California’s MediCal Dental Program

The California MediCal Dental Program is health coverage designed to fill the need for critical dental care for low-income patients. By analyzing patterns of enrollment and payment in health care services, research can shed light to the dental care that low-income patients are receiving, and will further support programs that raise the standard of care for DentiCal patients. While the number of registered dental specialists rises from year to year, this does not necessarily indicate that the providers are localized where they are needed, and might reflect a sequestration of providers in urban locations, leaving more rural patients at risk.

Leveraging data for policy change: A descriptive analysis of Latino men’s postsecondary enrollment and degree attainment patterns in Texas

This study examines the educational outcomes of Latino men in Texas by conducting a descriptive policy-focused disaggregate analysis of longitudinal data from the 8th Grade Cohort Longitudinal Study and the Integrated Postsecondary Data System (IPEDS). Based on our analysis, we provide context and understanding of the progress made towards meeting the goals set forth in 60x30TX, a statewide higher education plan led by the Texas Higher Education Coordinating Board. Our findings reveal educational equity disparities by looking at the postsecondary enrollment and degree/certificate completion patterns of Latino men in Texas. In addition, we provide an analysis of differences in educational equity disparities across various regions of the state. We share policy planning implications informed by practitioner input to better contextualize our findings.

Leveling the playing field: Identifying barriers and patterns of endometrial cancer clinical trial enrollment for underrepresented groups (013)

<b>Objectives:</b> Non-White women with endometrial cancer have worse outcomes than White women, even when controlling for tumor factors. Clinical trial enrollment may mitigate disparities by providing access to novel therapies and guideline-concordant care. Disparities in clinical trial enrollment by race have been described, and the race was only reported in Gynecologic Oncology Group trials beginning in 1994. We aimed to determine clinical trial eligibility criteria that would adversely impact enrollment of underrepresented groups and assess the diversity in clinical trials for which demographic information was published. <b>Methods:</b> We searched Clinicaltrials.gov for endometrial cancer studies in the United States conducted between 1998 and 2021. Studies of all stages from currently recruiting to published studies were included. Studies were excluded if they included other sites of disease. The inclusion and exclusion criteria of each study were reviewed to determine if demographic factors were used as screening criteria. For published studies, we identified demographic variables that were included in the study. Our outcome of interest was the enrollment of minorities in clinical trials and the characterization of inclusion/exclusion factors that would adversely impact enrollment of groups historically underrepresented in trials. Data were compared using Chi-square tests and descriptive analysis. <b>Results:</b> A total of 260 endometrial cancer trials were included in the study. Of these, 27 (10%) studies specified language in inclusion/exclusion criterion, 23 (9%) trials excluded all non-English speakers, however, four (2%) studies included Spanish speakers. Observational studies were more likely to exclude non-English speakers than clinical trials (8/36, 22% vs 19/224, 8%, p=0.019). University-sponsored studies were more likely to have language exclusions than industry-sponsored trials (25/140, 18%, vs 0/31, 0%, p<0.001). Of 105 studies with published results, 98 (93%) reported age, 61 (58%) reported race, 23 (22%) reported ethnicity, 7 (7%) reported education, 6 (6%) reported income, and 3 (%) reported marital status. No studies reported insurance, language, or religion. Of studies with race and ethnicity information available, we observed that 80% of the pooled cohort was White, 10% Black or African-American, 4% Hispanic, and 4% Asian. Native-American, Hawaiian, mixed-race all constituted <1% of the cohort. <b>Conclusions:</b> Over the last three decades, one in ten studies in gynecologic oncology did not allow non-English speakers to enroll in clinical trials. Allowing access to clinical trials regardless of primary language may decrease barriers to enrollment for women historically underrepresented in trials. Though there is increased awareness of the importance of diversifying clinical trial enrollment, demographic information remains omitted in many studies. Improving demographic data reporting is imperative and can identify additional barriers to trial enrollment.

New-Onset Cancer Cases in FDA's Sentinel System: A Large Distributed System of US Electronic Healthcare Data.

Evaluations of cancer etiology and safety and effectiveness of cancer treatments are predicated on large numbers of patients with sufficient baseline and follow-up data. To assess feasibility of FDA's Sentinel System's electronic healthcare data for surveillance of malignancy onset and examination of product safety, this study examined patterns of enrollment surrounding new-onset cancers. Using a retrospective cohort of patients based on administrative claims, we identified incident events of 19 cancers among 292.5 million health plan members from January 2000 to February 2020 using International Classification of Diseases (ICD) diagnosis codes. Annual incident cases were stratified by sex, age, medical and drug coverage, and insurer type. Descriptive statistics were calculated for observable time prior to and following diagnosis. We identified 10,697,573 incident cancer events among members with medical coverage. When drug coverage was additionally required, number of incident cancers was reduced by 41%. Medicare data contributed 61% of cases, with similar duration trends as other insurers. Mean duration of follow-up prior to diagnosis ranged from 4.0 to 4.6 years, whereas follow-up post diagnosis ranged from 1.1 to 3.3 years. Approximately a third (36.1%) had at least 2 years both prior to and following diagnosis. The FDA Sentinel System's electronic healthcare data may be useful for characterizing relatively short latency cancer risk, examining cancer drug utilization and safety after diagnosis, and conducting surveillance for acute adverse events among patients with cancers. A national distributed system with electronic health data, the Sentinel system provides opportunity for rapid pharmacoepidemiologic assessments relevant in oncology.

Critical Race Theory within Graduate Education: Connecting Theory with Practice

Graduate enrollment patterns of students of color suggest that a gap in graduate enrollment persists between Black and Latinx students and White students despite an overall increase in enrollment. Graduate enrollment depends, in part, on student aspirations for graduate study, which is influenced by undergraduate student success and sense of belonging. Using a lens of Critical Race Theory, this paper seeks to explore the nature of undergraduate student experience and how it impacts aspiration to graduate study. It also provides a framework to facilitate equity-minded academic advising, providing a positive space for students of color to explore graduate aspirations.

An analysis of government-sponsored health insurance enrolment and claims data from Meghalaya: Insights into the provision of health care in North East India.

The Megha Health Insurance Scheme (MHIS) was launched in 2013 in the North-East Indian state of Meghalaya to reduce household out-of-pocket expenditure on health and provide access to high-quality essential healthcare. Despite substantial expansion of the MHIS since the scheme's inception, there is a lack of comprehensive documentation and evaluation of the scheme's performance against its Universal Health Care (UHC) objectives. We analysed six years of enrolment and claims data (2013-2018) covering three phases of the scheme to understand the pattern of enrolment, utilisation and care provision under the MHIS during this period. De-identified data files included information on age, sex, district of residence, the district of provider hospital, type of hospital, date of admission, status at discharge, claimed category of care, package codes, and amount claimed. Descriptive statistics were generated to investigate key trends in enrolment, service utilisation, and Government health spending under the MHIS. Approximately 55% of the eligible population are currently enrolled in MHIS. Enrolment increased consistently from phase I through III and remained broadly stable across districts, gender, age group and occupation categories, with a small decline in males 19-60 years. Claims were disproportionately skewed towards private provision; 57% of all claims accrued to the 18 empanelled private hospitals and 39% to the 159 public sector facilities. The package 'General Ward Unspecified' was responsible for the highest volume of claims and highest financial dispensation across all three phases of the scheme. This likely indicates substantial administrative error and is potentially masking both true burden of disease and accurate financial provision for care under the MHIS. Anti-rabies injections for dog/cat bite contributed to 11% of total claims under MHIS III, and 1.6% of all claims under MHIS II. This warrants investigation to better understand the burden of animal bites on the Meghalayan population and inform the implementation of cost-effective strategies to reduce this burden. This paper describes the first analysis of health insurance enrolment and claims data in the state of Meghalaya. The analysis has generated an important evidence base to inform future MHIS enrolment and care provision policies as the scheme expands to provide Universal Health Coverage to the state's entire population.

Analysis of phase I clinical trials (Ph1-CT) new enrollment patterns in the immuno-oncology era.

e14549 Background: Immuno-Oncology (IO) has revolutionized anticancer therapeutics and changed the early drug development paradigm. Positive results and limited access to IO drugs in some countries have led to increased enrollment in IO Ph1-CT at an earlier timepoint in patients (pts) disease journey. We evaluated the impact of IO era on enrollment patterns in Ph1-CT. Methods: We retrospectively reviewed pts with recurrent/metastatic solid tumors enrolled in Ph1-CT from January 2018 to June 2021 at the Phase 1 Unit of Catalan Institute of Oncology (ICO), Barcelona, Spain. The primary goal was to assess Ph1-CT enrollment patterns, including use of molecular pre-screening/personalized drug matching, and the availability of alternative standard of care (SOC). Overall response rate (ORR) was assessed according to RECIST 1.1. Clinical benefit rate (CBR) was defined as complete/partial response+stable disease for ≥6 months. Median progression-free survival (mPFS) and overall survival (mOS) using Kaplan-Meier method were provided. Results: A total of 175 pts were enrolled in Ph1-CT. Median age was 54 years (range 43-75), Male:Female = 99:76, 99% had ECOG 0-1. The most prevalent tumors were: 32 (18%) breast, 31 (18%) colorectal, 25 (14%) urogenital and 23 (13%) glioblastoma multiforme. One hundred forty-six (83%) pts were enrolled in Ph1-CT with IO (alone or in combination) and 29 (17%) pts with targeted therapy (TT). Molecular pre-screening tests were required in 24 (14%) pts (22 pts IO vs 2 pts TT trial). Eleven (42%) pts were pre-screening failures. Screening failure (SF) rate was 19%, the main reason being clinical worsening for 7 (4%) pts. Thirty-three (19%) pts had an alternative SOC treatment available at time of enrollment. One hundred two (58%) pts had received ≤1 prior lines and 26 (89%) were IO-naïve. Finally, 129 (74%) out of 175 pts enrolled were treated within Ph1-CT. Out of 129 treated pts, ORR was achieved in 18 (14%) pts (3% complete response) and 44 (34%) had stable disease. CBR was observed in 36 (28%) pts. mPFS was 2.8 months and mOS was 10.9 months. Toxicity grade 3-4 occurred in 25 (19%) of pts and 6 (5%) pts had to interrupt treatment. Seventy-one (55%) pts received subsequent therapies: 22 (17%) in Ph1-CT; 49 (38%) SOC. Eleven (9%) pts received IO as subsequent therapy. Decline in ECOG status (baseline vs end of treatment) occurred in 65 (50%) pts. Conclusions: In our cohort of Ph1CT pts, there has been an increasing number of pts enrolled in IO trials compared to TT. Most pts received treatment within Ph1-CT at an earlier timepoint in the course of their disease (1st or 2nd lines). Our results suggest a clear impact of the IO era on the trends of Ph1-CT availability and enrollment patterns.

Does Taking a Few Courses at a Community College Improve the Baccalaureate, STEM, and Labor Market Outcomes of Four-Year College Students?

Although diverse patterns of college enrollment have gained attention in recent years, few studies have looked at students who take courses at four-year and two-year colleges simultaneously. Using a propensity score matching approach to compare outcomes of four-year college students who earned up to 10 credits at two-year colleges, termed "supplemental enrollment," with four-year college students who did not supplementally enroll, we find that supplementally enrolled students had higher bachelor's degree attainment, and better employment outcomes. Subgroup results suggest that supplemental enrollment may improve STEM degree attainment outcomes, particularly for low-socioeconomic-status and female students.

Effects of COVID-19 on home visiting services for vulnerable families: A cross-state analysis of enrollment, engagement, and attrition patterns.

COVID-19 has resulted in massive health and economic consequences, with effects felt most acutely by populations that were disadvantaged prior to the pandemic. For families with young children, the effects have been compounded by service interruptions, though there is a lack of empirical evidence that demonstrates how COVID-19 has affected home visiting programs. This cross-state study is the first to examine the effects of the pandemic on home visiting enrollment, engagement, and retention patterns. Program implementation records gathered from 2017-2020 in Arkansas and Wisconsin were analyzed. Both states operate a large network of home visiting programs that serve predominantly low-income families and that are supported by the federal Maternal, Infant, and Early Childhood Home Visiting program. Trends prior to COVID were compared to post-COVID trends (March 12 to December 31, 2020) in program enrollments, service capacity, visitation frequency, service modalities, attrition rates, and service duration. Compared to average pre-pandemic enrollments from 2017-2019, post-COVID enrollments decreased by 33-36%. Total visits fell by 15-24%; the percentage of completed visits relative to expected visits declined more modestly. However, the average duration of services increased post-COVID while rates of early program dropout decreased. The findings suggest that enrollment and engagement in home visiting decreased during the COVID-19 pandemic, which is unfortunate given the large number of vulnerable families served nationwide. Further research is needed to examine how COVID affected both consumer and program behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

More students and more diverse: new trends in international mobility to Portugal

Growing numbers of students from non-Portuguese speaking countries, designated as ‘non-Lusophone students’, signal the diversification of the international student population in Portugal. Until recently, international students came almost exclusively from other Portuguese-speaking countries. Employing social network analysis, the paper analyses the enrolment patterns of non-Lusophone students in Portuguese higher education – by institution type, qualification and discipline – to understand what aspects in particular attract these students. Findings indicate that public universities are mostly attractive for their doctoral degrees, in various disciplines, with students coming from very diverse regions. Public polytechnics enrol few non-Lusophone students, continuing to rely on the traditional Portuguese-speaking public. Private institutions attract Western and Southern European students, to integrated masters in Health programmes. Implications for institutions in other semi-peripheral countries intending to diversify their international students are highlighted: the identification of their strengths, at discipline or degree level, and the target-publics likely to find their programmes appealing.

The intersectionality of race, disability, gender, and employment through the Project SEARCH lens

BACKGROUND: People with intellectual and developmental disabilities (IDD) face chronically low rates of employment and high rates of poverty. These effects are amplified for women and ethnic minorities. Project SEARCH was developed to help address this disparity in employment. OBJECTIVE: This report looks at the demographic make-up of Project SEARCH participants and compares employment outcomes by gender, race and ethnicity, and disability type. METHODS: Authors examined data from 3,773 interns in the United States during the 2018-19 program year. Data were entered by representatives of 523 licensed program sites into the Project SEARCH database, which is accessed via a secure online Member Portal. RESULTS: The demographic make-up of Project SEARCH interns was representative of the U.S. population, but with some overrepresentation of racial and ethnic minorities and underrepresentation of females, consistent with patterns of enrollment in special education. There were no large differences in employment outcomes of Project SEARCH graduates based on race, ethnicity, gender, or disability type. Some small differences were observed, and these will be explored further in future studies. CONCLUSIONS: Project SEARCH serves a diverse population effectively and equitably. However, there are some differences in outcomes that warrant further investigation.

School-Level Predictors of Speech-Language Therapy Enrollment

Purpose: There are extensive concerns about the size of speech-language caseloads in schools. However, little empirical data exist regarding the patterns of speech-language services enrollment. We reviewed data from several hundred schools in a large state to explore the role of school-level factors in speech-language case enrollment. Method: Child count and enrollment data reports from a stratified sample of schools located within 12 Florida school districts ( N = 808) were drawn from the Florida Department of Education portal for the 2018–2019 school year. Three school districts were selected from each of several population sizes. To control for school population size, the raw numbers for each variable were converted into proportions. To examine the relations among variables, multiple correlational and regression analyses were conducted. Results: The results indicated that two school-level factors significantly predicted the total speech-language services enrollment and language therapy enrollment (e.g., proportion of students of low socioeconomic status [SES], passing the state reading assessment), whereas three school factors significantly predicted the speech therapy enrollment (e.g., proportion of low-SES students, passing the reading assessment, and enrolled in English as a second or other language services). Conclusions: The outcomes of this study suggested that school factors can predict speech-language service enrollment, which offers important implications for decision makers in schools. Implications for educational practices and further research are presented.

College or Bust… or Both: The Effects of the Great Recession on College Enrollment for Black and Latinx Young Adults

This article looks at whether the Great Recession led to changes in two-year and four-year college enrollment patterns for students aged 18–24. In particular, I examine how the probability of enrollment changed for Black and Latinx students. It is not initially clear whether the Great Recession would increase or decrease college enrollment for these populations. On the one hand, higher unemployment rates could prompt people to enroll in college, but on the other, reduced credit availability could decrease an individual’s ability to cover costs. I use the severity of the recession in different states to compare how enrollment changed in states that had relatively larger increases in the unemployment rates during the recession using the Current Population Survey (CPS) October Education supplements from 2002 to 2012 as the data source. I find that the probability of college enrollment increased after the onset of the Great Recession for Black students. There is some weak evidence that enrollment might have increased for Latinx students. Enrollment was not more likely in states with higher than average unemployment rates.