Underrepresented Groups Research Articles

Postdoc Perspectives on Leadership and Matters of Equity and Inclusion in Polar Science

AbstractIn 2023, the first Polar Postdoc Leadership Workshop convened to discuss present and future polar science issues and to develop leadership skills. The workshop discussions fostered a collective commitment to inclusive leadership within the polar science community among all participants. Here, we outline challenges encountered by underrepresented groups in polar sciences, while also noting that progress has been made to improve inclusivity in the field. Further, we highlight the inclusive leadership principles identified by workshop participants to bring to the polar community as we transition into leadership roles. Finally, insights and practical knowledge we gained from the workshop are shared, aiming to inform the community of our commitment to inclusive leadership and encourage the polar community to join us in pursuing action toward our shared vision for a more welcoming polar science future.

Unveiling Potential: Achieving Mission by Integrating Enrollment Management With Identity-Masked Holistic Admissions Practices

Abstract Purpose Holistic review for admissions is designed to mitigate the common systemic barriers applicants may face in their medical school application journey and the common mistakes committed by admissions committees, but limited literature outlines how this can be modeled. This study examined a blinded holistic admissions approach that emphasized mission and value alignment and the resulting characteristics of applicants by admission status. Method Application data from 2,027 applicants to The University of Texas at Tyler School of Medicine with complete secondary applications for the 2022 to 2023 cycle were analyzed. Applicants were categorized by the most advanced stage they reached in the admissions process: not selected for interview (n = 1,742), interviewed (n = 239), or accepted (n = 46). Data included information on students' geographic ties to East Texas, institutional mission alignment, academic preparation information, and Computer-Based Assessment for Sampling Personal Characteristics (CASPer) test results. Results In the not selected for interview and interviewed groups, mission commitment was significantly negatively associated with geographic ties (r = –0.189 and –0.209., respectively) and academic preparation (r = –0.195 and –0.241, respectively). In the not selected for interview group, higher mission commitment scores were significantly associated with lower CASPer scores (r = –0.110). In the interviewed group, higher geographic ties were significantly associated with lower academic preparation (r = –0.143) and lower CASPer scores (r = –0.280). Demographically, the accepted group had higher than expected counts of individuals who reported free or reduced lunch eligibility (14 vs 8), Pell Grant eligibility (22 vs 12), and family incomes of less than $50,000 per year (14 vs 6). Conclusions This study demonstrates successful and effective implementation of a mission-aligned holistic admissions process, with accepted students exemplifying the mission of the institution and representing traditionally underrepresented groups.

Exploring the Qualitative Experiences of Administering and Participating in Remote Research via Telephone Using the Montreal Cognitive Assessment-Blind: Cross-Sectional Study of Older Adults.

The COVID-19 pandemic caused a drastic shift in the practice of research and clinical services. It has been noted that cognition measured via in-person versus remote methods differ substantially, and it is possible that subjective and experiential differences exist between modalities. The aim of the study is to explore the perceptions of both researchers and older adult participants on the experience of remotely conducted research using a cognitive screener. We conducted a thematic analysis of the experience of engaging in remote research from both the participant (n=10) and researcher (n=4) perspectives. The research interaction was framed through teleadministration of the Montreal Cognitive Assessment-Blind (suitable for telephone administration) and administration of a subsequent semistructured debriefing interview. Participant perspectives were garnered during debriefing interviews, while researcher insights were collected via self-reported qualitative field notes completed following each research session. Data aggregated into themes of barriers and facilitators from the lenses of both participants and researchers. Participants noted facilitators including short instrument length, convenience, and presession contact; barriers included the length of the interaction, some tasks being more challenging on the phone, and the potential for participant dishonesty. Research assistants noted several facilitators: instrument length, rapport building, ability to prepare for and record sessions, and comfort with the protocol; barriers were items with too many response options, telephone issues (eg, response delays), and concerns about participant comprehension. These results suggest remote telephone-delivered cognitive screening tools as a feasible and acceptable method of research inquiry. The findings provide a starting point for the inclusion of diverse populations in research to capture underrepresented groups whose input would immensely benefit our understanding of remotely delivered cognitive screening measures. Further, we offer materials (eg, checklists), which can be used in future investigations to promote future inclusive research and increase generalizability.

1/20,000th of a Person?

Notice-and-comment rulemaking is a key function of the U.S. administrative state, thought to give members of the public access to the process of government decisionmaking. However, notice-and-comment rulemaking fails to accomplish that goal, and its deficiencies have critical implications for U.S. democracy and for the role of women and other traditionally underrepresented groups in that democracy. This Article examines the many ways in which notice-and-comment rulemaking has fallen short of its central purpose through a case study of a 2018–19 rulemaking dealing with enforcement of Title IX’s prohibition on sexual harassment. Members of the public, mobilized by activists, filed a historic 124,000+ comments in that rulemaking. This author created and led a “crowd-research” innovation to catalog ninety-four percent of those comments. Analysis of that rulemaking and its comments exposes rulemaking’s oligarchic tendency to value technocratic practices above democratic ones, a tendency that is particularly problematic in the case of rulemakings that implicate civil rights and discrimination. This Article proposes a path for agencies to avoid notice-and-comment rulemaking’s failings by supplementing traditional processes with a modified form of negotiated rulemaking.

Professional Identity in Speech-Language Pathology Students

Purpose: Professional identity (PI) serves to aid preprofessionals by contributing to a sense of purpose as students pursue their academic requirements. The importance of PI has been explored across other allied health fields including nursing, social work, and medicine. However, this topic has not been thoroughly investigated in communication sciences and disorders (CSD), and there is limited information on perceptions of PI among CSD students. Method: The current study is a secondary analysis of existing data. An adapted version of the PI Five-Factor Scale was administered via an anonymous online survey. Student participants self-reported perceptions of PI and perceived program support. Differences on the factors were tested using t tests and analysis of variance to explore differences between groups. Results: Significant differences were found between monolingual and multilingual students, with monolingual English-speaking students reporting higher perceptions of PI. There were no significant differences in PI between genders, racial groups, or first-generation students versus students of parents with varying educational backgrounds. Participant responses skewed toward a positive PI. Similar results were found for participants' perceptions of program support for PI across the five factors. Conclusions: PI has been extensively explored in allied health fields, but the topic has not been explored in speech-language pathology. Study findings can be used to help better serve students, particularly those from underrepresented groups. These data can support the recruitment and retention of culturally and linguistically diverse students with goals to increase the diversity of the pipeline of future professionals.

A meta-analysis on racial discrimination and alcohol use among Asian Americans.

Racial discrimination has been identified as a contributing risk factor for alcohol use among racially minoritized individuals. The aims of this study were to quantify the relationship between racial discrimination and alcohol use among Asian Americans, examine gender, age and generational status as moderators, and characterize ethnic group representation across the literature. A systematic literature search was conducted using PsycINFO, CINAHL, Web of Science, PubMed, Embase, and OpenDissertations. A random effects model using Pearson's r effect sizes was conducted on separate alcohol outcomes. Meta-regression analyses tested for moderating effects, and heterogeneity was examined by identifying outliers and subgroup differences. Risk of bias was assessed using a funnel plot and Egger's regression test. Twenty-two effect sizes were extracted from 18 studies, representing 8926 participants. A significant positive association was found between racial discrimination and alcohol consumption (k = 9, r = 0.13, 95% CI = [0.07, 0.19], I2 = 80.7%, p = 0.002) and problematic alcohol use (k = 12, r = 0.27, 95% CI = [0.12, 0.40] I2 = 93.7%, p = 0.002), but not binge use (k = 3, r = 0.08, 95% CI = [-0.49, 0.60], I2 = 95.0%, p = 0.64). Age, gender, and generational status were not significant moderators (p's > 0.10). When ethnic groups were reported, Chinese Americans were most represented (36.9%), while Indian Americans were notably underrepresented (1.18%). There is a small positive association between racial discrimination and alcohol consumption and problematic alcohol use among Asian Americans. Research should seek to fill gaps identified by this review, including the dearth of longitudinal work needed to establish temporal precedence, the limited understanding of racial discrimination on binge use and underrepresented ethnic groups in this field of research, and reducing heterogeneity between studies.

Inequity in exam experience

Online digital exams, both with and without online invigilation, have become a common form of assessment in Higher Education, particularly since the COVID-19 pandemic. However, the impact of online exams and online invigilation (proctoring) on student experience, stress levels, and academic performance remains underexplored, especially for disadvantaged or underrepresented student groups. Despite growing concerns over inequitable outcomes in Higher Education, there is limited large-scale research investigating how these online assessment methods may exacerbate existing disparities. This paper addresses this gap by analysing data from a large-scale survey (N = 16,010) conducted across five semesters at an Australian University (2021-2023). Specifically, it examines the exam preparedness and experiences of on-campus students who sat online digital exams with and without proctoring. By exploring the intersectionality of gender, international status, and language, the study aims to assess whether and how online proctoring exacerbates inequities among disadvantaged student populations. Our findings suggest that social and cultural factors significantly influence exam preparedness, stress levels, and perceived academic performance, with proctoring amplifying these disparities.

Phase III Cardiac Rehabilitation: Ambulatory Heart Groups - A Model From Germany.

Approximately 7,000 ambulatory (outpatient) heart groups (AHG) with 125,000 patients who are physically active on a regular basis have been established in Germany since the mid-1960s. Following phase II cardiac rehabilitation (CR), patients in an AHG aim to meet their set CR goals in groups of up to 20 participants under the instruction of a competent exercise therapist, and with regular attendance by a physician. Physical activity is the dominant aspect; psychosocial and educative elements are integrated to stabilize secondary cardiovascular prevention. Patients are legally entitled by German rehabilitation law to participate in AHGs. According to current studies, only 13-40% of all patients attend an AHG after phase II CR. In 2019, special AHGs for patients with high cardiovascular risk (chronic heart failure) were established. In the future, special emphasis needs to be placed on the recruitment of more patients into AHGs, particularly for the known under-represented groups (i.e., women, older patients, patients with low socioeconomic status). Furthermore, AHGs have to be established for patients with special needs (e.g., adults with congenital heart diseases). To date, the efficiency of AHG participation has still not been sufficiently investigated. A case-control study analyzing the long-term results of AHG participation reported an improvement in physical performance, as well as a reduction in cardiovascular morbidity (54%) and medical costs (approximately 47%). More superior investigations in this field are needed.

Equity-Centered adaptive learning (ECAL) in Mathematics: Personalizing education for underrepresented groups

Equity-Centered adaptive learning (ECAL) in Mathematics: Personalizing education for underrepresented groups

Gender, Racial-Ethnic, and Cohort Effects on STEM Interests: A Fourteen-Year Comparison

Gender and racial-ethnic disparities continue to exist in participation within science, technology, engineering, and mathematics (STEM) fields. Because vocational interests predict career choice and educational interventions to help promote STEM interest among underrepresented groups have increased, research is needed to assess if meaningful changes have occurred with STEM-related interests, particularly among women and people of color who have historically been underrepresented in the STEM workforce. The present study examines vocational interests in large samples of college students across two cohorts who completed the Strong Interest Inventory in 2005 ( N = 6,496) and 2019 ( N = 21,146). Results indicate that STEM-related interest levels have increased both across gender (i.e., men and women) and racial-ethnic groups, specifically for Black, Latinx, Asian, and White college students over this period. Notably, STEM-related interests declined or stayed the same across cohorts for Native American students. Additionally, the gap between women and men narrowed for the Investigative General Occupational Theme and STEM-related Basic Interest Scales. Finally, these results are discussed within the context of vocational interest development and societal STEM-related initiatives and focus on increasing STEM interests among underrepresented youth living in the United States.

30 years of terrestrial insect richness patterns across elevation: What have we learned? A global meta-analysis.

Understanding elevation variation in biodiversity is a classic question in ecology and has implications for understanding climate change impacts on mountain ecosystems. While insects are the largest group of animals, the global trend in insect species richness with elevation is unknown. To date, single studies and taxa-specific syntheses have provided no single picture, finding variable patterns of insect richness with elevation. A global synthesis across systems would provide a better understanding of how insect species richness changes with elevation and the possible environmental correlates of those patterns. We used published studies of terrestrial insect elevation gradients from 1990 to 2020 to ask: How do insect species richness change with elevation, and which environmental variables best explain this relationship statistically? With 1486 sites spanning 151 species richness-elevation gradients from 80 studies from four diverse insect taxonomic groups and five biomes, we found that overall proportional richness reached a low-elevation plateau and then decreased. We also show that mean annual temperature and seasonality best explain this trend. We suggest best practices and areas of interest for the future of insect richness-elevation studies, including underrepresented groups, geographic areas, and more standardized methods.

Factors Associated With First-Time NCLEX-RN Success at a Predominantly Black Institution.

Students from underrepresented groups, including those attending predominantly Black institutions, encounter challenges that hinder first-time success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN). This retrospective, descriptive study included a convenience sample (N = 122) of nursing students. Data for students who attempted the NCLEX-RN at three different time periods were used to identify factors associated with passing the NCLEX-RN on the first attempt. Students who scored 80 or higher in a medical-surgical course were more likely to pass the NCLEX-RN than those who scored below 80. Students' performance in predictor courses at predominantly Black institutions may determine success on the NCLEX-RN. Students who did not demonstrate success in identified program predictor courses may benefit from additional preparation and support prior to taking the NCLEX-RN. [J Nurs Educ. 2024;63(11):773-776.].

Arab founder variants: Contributions to clinical genomics and precision medicine.

Founder variants are ancestral variants shared by individuals who are not closely related. The large effect size of some of these variants in the context of Mendelian disorders offers numerous precision medicine opportunities. Using one of the largest datasets on Mendelian disorders in the Middle East, we identified 2,908 medically relevant founder variants derived from 18,360 exomes and genomes and investigated their contribution to the clinical annotation of the human genome. Strikingly, ∼34% of Arab founder variants are absent in gnomAD. We found a strong contribution of Arab founder variants to the identification of novel gene-disease links (n= 224) and the support/dispute (n= 81 support, n= 101 dispute) of previously reported candidate gene-disease links. The powerful segregation evidence generated by Arab founder variants allowed many ClinVar and Human Gene Mutation Database variants to be reclassified. Overall, 39.5% of diagnostic reports from our clinical lab are based on founder variants, and 19.41% of tested individuals carry at least one pathogenic founder variant. The presumptive loss-of-function mechanism that typically underlies autosomal recessive diseases means that Arab founder variants also offer unique opportunities in "druggable genome" research. Arab founder variants were also informative of migration patterns in the Middle East consistent with documented historical accounts. We highlight the contribution of founder variants from an under-represented population group to precision medicine and inform future prevention programs. Our study also sheds light on the added value of these variants in supplementing other lines of research in tracing population history. There is no funding for this work.

FairDRO: Group fairness regularization via classwise robust optimization

Existing group fairness-aware training methods fall into two categories: re-weighting underrepresented groups according to certain rules, or using regularization terms such as smoothed approximations of fairness metrics or surrogate statistical quantities. While each category has its own strength in applicability or performance when compared to each other, their successful performances are typically limited to specific cases. To that end, we propose a new approach called FairDRO, which takes advantage of both categories through a classwise group distributionally robust optimization (DRO) framework. Our method unifies re-weighting and regularization by incorporating a well-justified group fairness metric into the objective as regularization, but solving it through a principled re-weighting strategy. To optimize our resulting objective efficiently, we adopt an iterative algorithm and consequently develop two variants of FairDRO algorithm depending on the choice of surrogate loss. For in-depth understanding, we derive three theoretical results: (i) a closed-form solution for the correct re-weights; (ii) justifications for using the surrogate losses; and (iii) a convergence analysis of our method. Experimental results show that our algorithms consistently achieve state-of-the-art performance in accuracy-fairness trade-offs across multiple benchmarks, demonstrating scalability and broad applicability compared to existing methods.

A framework for training graduate students and campus communities in inclusive teaching.

While graduate student teaching assistants (TAs) contribute significantly to university education, many graduate programs across diverse disciplines offer limited formal pedagogical training. In turn, many researchers informally develop teaching and mentoring skills as they advance to faculty positions or related careers. This can perpetuate a lag in the implementation of inclusive educational environments despite the clear benefits demonstrated by recent pedagogical research. For instance, the integration of inclusive teaching strategies like universal design for learning, growth mindset feedback, and the use of relatable role models in curricula may help increase the persistence, success, and self-efficacy of traditionally underrepresented groups in the sciences. Additionally, research indicates that training graduate TAs in evidence-based practices may have benefits beyond teaching efficacy, such as greater confidence in research preparedness and science communication-skills applicable to any scientific field or career path. Here, we developed and implemented an inclusive teaching series for a marine science department that included: (i) campus-wide pedagogical journal article discussions and knowledge-sharing, (ii) expert-led interactive workshops on evidence-based teaching strategies, and (iii) a graduate TA professional development module on inclusive lesson planning with opportunities to teach and receive feedback. Based on our experiences, we share a framework and resources to facilitate a broader adoption of formalized TA training in inclusive teaching practices within graduate programs across a variety of fields.

Mental health and well-being in prisons and places of detention.

This study aims to address the critical mental health challenges faced by individuals in prisons and places of detention. By introducing and validating a novel conceptual framework that integrates social determinants of health with the stress process model, this study aims to provide actionable insights for improving mental health care in correctional settings. The research seeks to inform policymakers, prison administrators and mental health professionals about effective interventions and systemic reforms that can reduce recidivism, enhance rehabilitation and promote a more humane and just criminal justice system. This study uses a multi-method research design integrating a systematic literature review, qualitative interviews, multi-criteria evaluation (MCE) and a small-scale empirical study within a correctional facility. The systematic review follows PRISMA guidelines, analysing peer-reviewed articles, government reports and policy documents. Semi-structured interviews with 25 mental health professionals provide practical insights, whereas the MCE assesses intervention effectiveness based on expert consensus. The empirical study involves baseline assessments, intervention implementation and follow-up evaluations using validated tools, providing robust data to validate the proposed conceptual framework that integrates social determinants of health with the stress process model. This study finds that mental health disorders are significantly more prevalent in prison populations than in the general population, with interventions like cognitive behavioural therapy (CBT), peer support programs and trauma-informed care showing considerable effectiveness in reducing symptoms. Emerging technologies such as AI and telemedicine present promising avenues for enhancing care but require careful ethical consideration. The research also highlights the critical role of social determinants and the importance of systemic reforms, such as reducing solitary confinement and integrating prison health care with broader public health systems, in improving inmate mental health and reducing recidivism. This study's quasi-experimental design, while robust, may limit the generalizability of the findings to other correctional settings because of specific facility characteristics. Additionally, the sample size for qualitative interviews, although diverse, could have been larger to provide more nuanced insights, particularly for underrepresented groups. This study highlights the need for more longitudinal research to assess the long-term effects of interventions and the scalability of approaches across different cultural and legal contexts. Future studies should address these limitations by using more diverse sampling, larger sample sizes and extended follow-up periods. This study provides actionable insights for policymakers and prison administrators, emphasizing the need to integrate evidence-based mental health interventions, such as CBT and trauma-informed care, into prison reform strategies. It highlights the importance of training correctional staff in mental health first aid and the potential of emerging technologies like AI and telemedicine to enhance care delivery in resource-limited settings. Implementing these recommendations could significantly improve inmate mental health outcomes, reduce recidivism rates and promote a more humane and effective correctional system, with broader benefits for public health and social equity. Improving mental health care in prisons has significant social implications, particularly in promoting social justice and reducing inequalities. Effective mental health interventions can help break the cycle of incarceration and recidivism, particularly in marginalized communities disproportionately affected by the criminal justice system. By addressing the mental health needs of incarcerated individuals, society can foster safer communities, reduce crime rates and alleviate the economic burden on the criminal justice and health-care systems. Furthermore, enhancing mental health care in prisons reflects a commitment to human dignity, fairness and the rehabilitation of offenders, contributing to a more just and compassionate society. This study introduces a novel conceptual framework that integrates social determinants of health with the stress process model, specifically tailored for correctional facilities. It provides original empirical data from a real-world prison setting, offering new insights into the effectiveness of mental health interventions, such as CBT and trauma-informed care. The study's value lies in its comprehensive approach, combining quantitative and qualitative methods, and its focus on underrepresented populations in correctional settings. By addressing significant gaps in the literature, this research offers practical recommendations for policymakers and practitioners, contributing to improved mental health outcomes and reduced recidivism.

Bridging the Gap: Culturally Responsive Strategies for NIH Trial Recruitment

Abstract Objective To enhance recruitment and participation rates of non-Hispanic Black (NHB) and Hispanic adult patients in a NIH-funded clinical trial studying an emerging health technology. Data Sources and Study Setting This study includes primary data collected in Los Angeles, California from November 2020 through November 2023. Study Design To improve the representation of NHB and Hispanic patients in a NIH-funded (NCT04409353) trial on virtual reality for chronic lower back pain (cLBP), we conducted a multi-phase study utilizing a mixed-method approach. First, we conducted focus groups with NHB and Hispanic cohorts aged 18 and older; based on the feedback, we culturally adapted recruitment materials and study correspondences concordantly. Additionally, a cohort builder was used to filter the electronic medical record to isolate non-Hispanic Black (NHB) and Hispanic patients with cLBP for micro-targeted recruitment. These changes were collectively integrated when the parent NIH study had recruited 222 of its 385 final samples (57.7%), creating a pre-post comparison timepoint (May 17, 2022). Quantitative analysis was performed to assess the efficacy of the modified recruitment strategies by comparing the number of recruited and randomized NHB and Hispanic patients pre- and post-intervention. Data Collection/Extraction Methods Semi-structured focus groups were conducted with NHB and Hispanic patients and community members (age 18 and older). The focus groups were conducted online and recorded with participant consent; transcripts of the recording underwent inductive thematic analysis. Emergent themes directed the modification of study materials, including revised language and imagery, targeted outreach, and incorporation of treating physicians, were implemented in the second half of the study. Quantitative analyses were conducted following parent study completion by comparing records added to the screening database following the implementation of new recruiting methods (5/17/2022) to those added before. Principal Findings Thematic analysis of focus groups identified four key themes: mistrust, lack of interest, culture, and communication. Modifications to recruitment methodology resulted in statistically significant increases in the pre- to post-randomization success rate for the overall study population (p < 0.001), the NHB population (p = 0.011), and the Hispanic population (p < 0.015). When looking at each cohort at different points in the recruitment process before and after the intervention, in the Hispanic population, we saw significant increases in the number approached (p < 0.001) and number randomized (p < 0.001) and statistically insignificant increases in the NHB population approached (p = 0.067) and randomized (p = 0.295). Similarly, we saw that the changes in the recruitment letter led to a statistically significant increase in Hispanic recruitment (7.0 to 39.1%, p < 0.001) but not the NHB cohort (19.6 to 35.8%, p < 0.065). Conclusion This study introduces several culturally sensitive considerations and possible approaches for the design of recruitment materials, addressing mistrust, lack of interest, culture, and communication for use in NHB and Hispanic populations. Similarly, the described microtargeting techniques leverage the technological advancements in cohort building to improve the reach and efficiency of the randomization rate of underrepresented groups thereby enhancing clinical trial diversity.

Understanding the intersectional stigma of ageing, disability, and place: a systematic literature mapping review

Stigma is a key concept for social scientists interested in how certain groups in society are judged and treated negatively. Within housing studies this scholarship reflects longstanding interests within the discipline regarding the spatial impacts of social and urban policies on both people, and the places in which they live. We augment these debates by advocating for a more intersectional understanding of how stigma is shaped by identity. It presents findings from a systematic literature mapping review of research that has a combined focus on ageing, disability, place, and stigma across OECD countries. Given global trends around ageing populations and the impacts for health, this is an important, but often neglected aspect to stigma research. Our review highlights the advantages of combining a spatial approach to stigma with intersectional insights foregrounded in age and disability. This includes the further development of stigma as a concept from the perspective of under-represented groups: older and disabled people.

Impact of in-silico technologies in the development of high-risk medical devices on healthcare

Abstract This study examines the impact of in-silico technologies (IST), such as virtual cohorts and digital twins, on the development of high-risk medical devices within the healthcare sector. An iterative empirical approach combining a literature review, exploratory and in-depth interviews with stakeholders from academia, industry, regulators, healthcare professionals, and focus groups with patients across Europe, Japan, and the USA was employed to gain insight into the implications of IST on healthcare. The findings indicate that IST can reduce the time to market for medical devices, thereby facilitating faster, broader, and more equitable access for patients. The implementation of extensive early testing, optimized study designs and increased sample sizes in trials can facilitate the achievement of enhanced safety. The early identification of adverse effects can enhance the safety of medical devices and improve patient outcomes. Furthermore, IST may facilitate the inclusion of underrepresented groups, such as children, in clinical trials, thereby enhancing their representation in medical research. The reduction in costs associated with IST may facilitate innovation cycles. However, the impact on prices is contingent on competition. Furthermore, IST have the potential to reduce the need for animal testing. Nevertheless, several uncertainties and potential adverse effects have been identified. Physician training on new devices remains a bottleneck, which may limit the benefits of new products. Despite the advancements, a complete replacement of traditional clinical and preclinical trials with IST is not seen to be feasible. From a policy perspective, it is crucial to promote regulatory clarity by providing guidance for the usage of IST, to offer incentives for the adoption of IST, and to foster competition. These findings demonstrate the multifaceted potential benefits and challenges of IST, including enhanced safety, accessibility, and innovation in healthcare. Key messages • In-silico technologies can reduce time-to market of medical devices up medical device and improve safety for patients. • Challenges like physician training and regulatory guidance must be addressed to fully realize benefits of in silico technologies.

BELCOHORT: towards a population-based cohort for health research and policy support in Belgium

Abstract Background In the past decades much progress has been made in Belgium in the development and valorisation of population-based data collections which are directly or indirectly related to health. New surveys have been set up and the use of medico-administrative and environmental data for public health research gained momentum. However, no infrastructure is currently in place to link survey data with existing sources in a longitudinal perspective to address research questions directly relevant to health policy. BELCOHORT is a three-year pilot project aimed at developing a population based cohort enriched with these different data sources. The project is considered as a step towards a large population cohort in Belgium. Methods A first wave of participant recruitment was organized in February 2024 using the Belgian national register as a sampling frame, and 41,153 households were invited (targeted sample of 5000 individuals aged 18-69). A first baseline survey (online and paper) was organized and an annual follow-up is planned. Linkages procedures will be implemented with administrative data and geospatial data on air pollution and green space. The inclusion of data from physical examinations and biological samples will be explored. Results In the first recruitment wave the individual response rate was only 2.5%, leading to a sample of 1,947 participants. The sample showed an under-representation of women (45%), people aged 18-24 years (2%) and low educated people (21%). In total, 23% of participants opted to complete the first baseline questionnaire on paper. Stakeholder meetings have been started to implement the individual and geospatial linkages. Conclusions This project generate insights that will assist in methodological choices in the development of a large population cohort in Belgium. In the second recruitment lessons learned from the first data collection will be used to improve the response rate as well as the participation of under-represented groups. Key messages • This study provides insights on how existing population-based data collections including administrative and environmental data can be valorized in setting up a population cohort. • Recruitment strategies for a population cohort should be tested thoroughly and adapted in order to obtain a well-balanced sample composition.