scholarly journals Leveraging insights from behavioral science and administrative burden in free college program design: A typology

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Kelly Rosinger ◽  
Katharine Meyer ◽  
Jialing Wang
Keyword(s):  
Program Design ◽  
Policy Design ◽  
Behavioral Science ◽  
Eligibility Criteria ◽  
College Costs ◽  
Administrative Burden ◽  
College Programs ◽  
Behavioral Supports ◽  
Maintenance Requirements ◽  
Do So

Amid concerns over college affordability, many communities and states have enacted free college programs, and the Biden administration has brought momentum to federal free college discussions. Today, hundreds of college promise programs exist in communities across the country, including at least 20 state-sponsored free college programs. While free college policies have the potential to increase enrollment by reducing college costs, substantial variation in program design likely shapes how effective these programs are at expanding college access and reducing racial and economic disparities. This paper leverages insights from administrative burden and behavioral science to develop a typology of statewide free college programs, offering a framework for examining how policy design reduces (or increases) the burden individuals are likely to incur in receiving free college benefits. To do so, we collected data on design features of free college programs (e.g., eligibility criteria, application procedures, maintenance requirements) and created indices capturing the extent to which each program imposes administrative burden and, conversely, offers behavioral supports to help students navigate the aid process. Our findings offer insight for policymakers as they design free college programs and provide context for researchers examining the effectiveness and equity outcomes of statewide free college programs.

Objective Measures of Surgeon Nontechnical Skills in Surgery: A Scoping Review

2021 ◽  
pp. 001872082199531
Author(s):  
Jackie S. Cha ◽  
Denny Yu
Keyword(s):  
Situation Awareness ◽  
Cognitive Skills ◽  
Behavioral Science ◽  
Assessment Tools ◽  
Objective Measures ◽  
Communication Model ◽  
Eligibility Criteria ◽  
Surgical Performance ◽  
Nontechnical Skills ◽  
Objective Metrics

Objective The purpose of this study was to identify, synthesize, and discuss objective behavioral or physiological metrics of surgeons’ nontechnical skills (NTS) in the literature. Background NTS, or interpersonal or cognitive skills, have been identified to contribute to safe and efficient surgical performance; however, current assessments are subjective, checklist-based tools. Intraoperative skill evaluation, such as technical skills, has been previously utilized as an objective measure to address such limitations. Methods Five databases in engineering, behavioral science, and medicine were searched following PRISMA reporting guidelines. Eligibility criteria included studies with NTS objective measurements, surgeons, and took place within simulated or live operations. Results Twenty-three articles were included in this review. Objective metrics included communication metrics and measures from physiological responses such as changes in brain activation and motion of the eye. Frequencies of content-coded communication in surgery were utilized in 16 studies and were associated with not only the communication construct but also cognitive constructs of situation awareness and decision making. This indicates the underlying importance of communication in evaluating the NTS constructs. To synthesize the scoped literature, a framework based on the one-way communication model was used to map the objective measures to NTS constructs. Conclusion Objective NTS measurement of surgeons is still preliminary, and future work on leveraging objective metrics in parallel with current assessment tools is needed. Application Findings from this work identify objective NTS metrics for measurement applications in a surgical environment.

Psychological Aspects of Cancer Screening

2019 ◽  
Author(s):  
Christian von Wagner ◽  
Wouter Verstraete ◽  
Sandro Stoffel
Keyword(s):  
Cancer Screening ◽  
Behavioral Science ◽  
Informed Choice ◽  
Universal Coverage ◽  
Target Population ◽  
Sociodemographic Factors ◽  
Opportunity Costs ◽  
Eligibility Criteria ◽  
Screening Programs ◽  
Patient Reported

Cancer screening aims to detect cancer before the appearance of symptoms. Applying a proactive and systematic approach, cancer screening programs invite every person in the target population automatically. Many countries have established guidelines that define criteria and principles on whether to implement screening programs for specific conditions. Despite the universal coverage of these programs, inequalities have been observed in their uptake based on various sociodemographic factors: gender, age, ethnicity, socioeconomic status (SES), educational level, and marital status. Behavioral science provides key performance indicators of these programs. Psychological factors such as perceived benefits (e.g., ability of the program to diagnose early or even prevent cancer) and barriers (e.g., opportunity costs relating to test attendance or completion), as well as people’s cancer and screening-related beliefs and perceptions of their own susceptibility to cancer, play a crucial role in cancer screening uptake. Furthermore, there is increasing awareness among professional bodies for the need to balance the public health benefits against individual costs, including financial and opportunity costs associated with participation and potential longer-term harms, such as receiving a cancer diagnosis that would never have caused any symptoms or problems). These recent developments have led to stronger emphasis on monitoring patient-reported experiences and ensuring that participation is based on informed choice. In addition, some of these issues have also been addressed by more fundamental changes to the screening paradigm such as more personalized approaches (using additional genetic and epigenetic information) to establishing eligibility criteria. The acceptability of using this information and its implication to offer more or less intensive screening and developing effective ways to understand the ability of the program to communicate this information are key challenges for the clinical, research and policy making community.

scholarly journals Using Real-World Data to Rationalize Clinical Trials Eligibility Criteria Design: A Case Study of Alzheimer's Disease Trials

2020 ◽  
Author(s):  
Qian Li ◽  
Yi Guo ◽  
Zhe He ◽  
Hansi Zhang ◽  
Thomas J George ◽  
...  
Keyword(s):  
Patient Safety ◽  
A Priori ◽  
Research Network ◽  
Underrepresented Populations ◽  
Real World Data ◽  
Eligibility Criteria ◽  
Serious Adverse Events ◽  
Large Research ◽  
Do So

Low trial generalizability is a concern. The Food and Drug Administration had guidance on broadening trial eligibility criteria to enroll underrepresented populations. However, investigators are hesitant to do so because of concerns over patient safety. There is a lack of methods to rationalize criteria design. In this study, we used data from a large research network to assess how adjustments of eligibility criteria can jointly affect generalizability and patient safety (i.e the number of serious adverse events [SAEs]). We first built a model to predict the number of SAEs. Then, leveraging an a priori generalizability assessment algorithm, we assessed the changes in the number of predicted SAEs and the generalizability score, simulating the process of dropping exclusion criteria and increasing the upper limit of continuous eligibility criteria. We argued that broadening of eligibility criteria should balance between potential increases of SAEs and generalizability using donepezil trials as a case study.

scholarly journals Stratified randomization for platform trials with differing experimental arm eligibility

2021 ◽  
pp. 174077452110288
Author(s):  
Subodh Selukar ◽  
Susanne May ◽  
Dave Law ◽  
Megan Othus
Keyword(s):  
Cancer Therapeutics ◽  
Standard Of Care ◽  
Worked Examples ◽  
Single Trial ◽  
Eligibility Criteria ◽  
Safety Issues ◽  
Use Of Resources ◽  
The Common ◽  
Conventional Methods ◽  
Do So

Background: Platform trials facilitate efficient use of resources by comparing multiple experimental agents to a common standard of care arm. They can accommodate a changing scientific paradigm within a single trial protocol by adding or dropping experimental arms—critical features for trials in rapidly developing disease areas such as COVID-19 or cancer therapeutics. However, in these trials, efficacy and safety issues may render certain participant subgroups ineligible to some experimental arms, and methods for stratified randomization do not readily apply to this setting. Methods: We propose extensions for conventional methods of stratified randomization for platform trials whose experimental arms may differ in eligibility criteria. These methods balance on a prespecified set of stratification variables observable prior to arm assignment that remains the same across experimental arms. To do so, we suggest modifying block randomization by including experimental arm eligibility as a stratifying variable, and we suggest modifying the imbalance score calculation in dynamic balancing by performing pairwise comparisons between each eligible experimental arm and standard of care arm participants eligible to that experimental arm. Results: We provide worked examples to illustrate the proposed extensions. In addition, we also provide a formula to quantify the relative efficiency loss of platform trials with varying eligibility compared with trials with non-varying eligibility as measured by the size of the common standard of care arm. Conclusions: This article presents important extensions to conventional methods for stratified randomization in order to facilitate the implementation of platform trials with differing experimental arm eligibility.

scholarly journals Methods to address confounding and other biases in meta-analyses: Review and recommendations

2021 ◽  
Author(s):  
Maya B Mathur ◽  
Tyler VanderWeele
Keyword(s):  
Meta Analysis ◽  
Internal Validity ◽  
Sensitivity Analyses ◽  
Eligibility Criteria ◽  
Unmeasured Confounding ◽  
Affect Studies ◽  
Evidence Strength ◽  
Recent Developments ◽  
Meta Analyses ◽  
Do So

Meta-analyses contribute critically to cumulative science, but they can produce misleading conclusions if their constituent primary studies are biased, for example by unmeasured confounding in nonrandomized studies. We provide practical guidance on how meta-analysts can address confounding and other biases that affect studies' internal validity, focusing primarily on sensitivity analyses that help quantify how biased the meta-analysis estimates might be. We review a number of sensitivity analysis methods to do so, especially recent developments that are straightforward to implement and interpret and that use somewhat less stringent statistical assumptions than earlier methods. We give recommendations for how these methods could be applied in practice and illustrate using a previously published meta-analysis. Sensitivity analyses can provide informative quantitative summaries of evidence strength, and we suggest reporting them routinely in meta-analyses of potentially biased studies. This recommendation in no way diminishes the importance of defining study eligibility criteria that reduce bias and of characterizing studies’ risks of bias qualitatively.

Is Three Years Enough?

1988 ◽  
Vol 81 (1) ◽  
pp. 11-14
Author(s):  
Bert K. Waits ◽  
Franklin Demana
Keyword(s):  
Graduation Rates ◽  
Career Choices ◽  
Remedial Mathematics ◽  
Colleges And Universities ◽  
Mathematics Placement ◽  
Mathematics Skills ◽  
University College ◽  
College Programs ◽  
The University ◽  
Do So

It is well known that students needing remedial mathematics when they enter colleges and universities are at serious risk. Only about one-third of the students with remedial mathematics placement actually graduate (Demana and Waits, n.d.). Further, those who do graduate, do so in a limited number of areas that require little or no mathematics. Graduation rates and career choices depend heavily on the mathematics skills students possess upon entering the university. College programs in engineering and scientific areas are essentially out of reach for students who enter the university needing remedial mathematics

scholarly journals Six Focus Behaviors for Policymakers to Mitigate Climate Change

2020 ◽  
Author(s):  
Kate Heller ◽  
Michael Berger ◽  
Antonius Gagern ◽  
Abdurakhim Rakhimov ◽  
John Thomas ◽  
...  
Keyword(s):  
Policy Design ◽  
Behavioral Science ◽  
Top Down ◽  
Emissions Reductions ◽  
Reduce Emissions ◽  
Mitigate Climate Change ◽  
Behavioral Mechanisms ◽  
The Impact ◽  
Carbon Dioxide Equivalent ◽  
The U.S

Policymakers have a crucial opportunity to help avert climate catastrophe with policies that promote emissions reductions. Policies informed by behavioral science principles that encourage individuals to reduce emissions can effectively complement broader top-down policies such as carbon pricing, provided they focus on those behaviors with the highest potential to reduce emissions. We conducted an analysis to identify behaviors that have the greatest practical potential to reduce emissions in the U.S. and modeled the impact of their uptake. Our analysis identifies six priority behaviors that, if adopted by 5-10% of the U.S. population, can lower current national emissions by 464 million tons of carbon dioxide equivalent per year (MtCO2e/year), or 7% overall annually. We identify promising behavioral mechanisms that can inform policy design for each of these behaviors.

Rationale, Design and Sustainability of Long-Term Care Insurance in Japan – In Retrospect

2007 ◽  
Vol 6 (3) ◽  
pp. 423-434 ◽  
Author(s):  
Naoki Ikegami
Keyword(s):  
Daily Living ◽  
Long Term Care ◽  
Community Care ◽  
Institutional Care ◽  
Eligibility Criteria ◽  
Term Care ◽  
New Public ◽  
Long Term Care Insurance ◽  
Do So

When Japan introduced a new public long-term care insurance in 2000, the eligibility criteria and benefits were designed so that those who had been receiving services would be able to continue to do so. Five years later, benefits were reduced by a partial levying of hotel costs in institutional care, and restricting the provision of instrumental activities of daily living support services in community care for those requiring only light care. Whether these revisions are effective in containing costs and whether a decision should be made to cover all ages and all disabilities are the issues for the future.

scholarly journals The network limits of infectious disease control via occupation-based targeting

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Demetris Avraam ◽  
Nick Obradovich ◽  
Niccolò Pescetelli ◽  
Manuel Cebrian ◽  
Alex Rutherford
Keyword(s):  
Policy Design ◽  
Policy Instruments ◽  
Control Policy ◽  
Unintended Consequences ◽  
Contact Network ◽  
Economic Productivity ◽  
Network Information ◽  
Occupational Contact ◽  
Pharmaceutical Interventions ◽  
Do So

AbstractPolicymakers commonly employ non-pharmaceutical interventions to reduce the scale and severity of pandemics. Of non-pharmaceutical interventions, physical distancing policies—designed to reduce person-to-person pathogenic spread – have risen to recent prominence. In particular, stay-at-home policies of the sort widely implemented around the globe in response to the COVID-19 pandemic have proven to be markedly effective at slowing pandemic growth. However, such blunt policy instruments, while effective, produce numerous unintended consequences, including potentially dramatic reductions in economic productivity. In this study, we develop methods to investigate the potential to simultaneously contain pandemic spread while also minimizing economic disruptions. We do so by incorporating both occupational and contact network information contained within an urban environment, information that is commonly excluded from typical pandemic control policy design. The results of our methods suggest that large gains in both economic productivity and pandemic control might be had by the incorporation and consideration of simple-to-measure characteristics of the occupational contact network. We find evidence that more sophisticated, and more privacy invasive, measures of this network do not drastically increase performance.

scholarly journals The Elements of Effective Program Design: A Two-Level Analysis

2014 ◽  
Vol 2 (2) ◽  
pp. 1-12 ◽  
Author(s):  
Michael Howlett ◽  
Ishani Mukherjee ◽  
Jeremy Rayner
Keyword(s):  
Policy Making ◽  
Program Design ◽  
Program Effectiveness ◽  
Policy Design ◽  
Policy Research ◽  
Major Theme ◽  
Design Practices ◽  
Effective Program ◽  
Level Analysis

Policy and program design is a major theme of contemporary policy research, aimed at improving the understanding of how the processes, methods and tools of policy-making are employed to better formulate effective policies and pro-grams, and to understand the reasons why such designs are not forthcoming. However while many efforts have been made to evaluate policy design, less work has focused on program designs. This article sets out to fill this gap in knowledge of design practices in policy-making. It outlines the nature of the study of policy design with a particular focus on the nature of programs and the lessons derived from empirical experience regarding the conditions that enhance program effectiveness.

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