Examining Recruitment Practices for Servingness during COVID-19: Perspectives from Institutional Agents at an Emerging Hispanic-Serving Institution (HSI)

The COVID-19 pandemic hit in March 2020 as high school seniors were receiving their college admission notifications for fall. Many postsecondary institutions shifted outreach efforts to online formats. This qualitative study examines how virtual recruitment at an emerging HSI incorporates culturally responsive practices from the perspective of institutional agents (IAs) who were involved in these efforts. We also consider how IAs perceive the broader commitment of the institution to serve Latinx/a/o students. Our findings expose limitations in effectively recruiting Latinx/a/os in virtual formats due to the digital divide. The IAs identify ways in which the university was not equipped to overcome unreliable broadband access and technology. These agents maintain a critical lens to identify how the institution can expand capacity and ensure that the work of supporting Latinx/a/o students is a shared responsibility and not concentrated on a few staff. The findings further raise awareness of the continued language divide in disseminating information to families who do not speak English. Our study provides insights on how universities nationwide and across the world can transform recruitment practices to more intentionally support minoritized students and families as they make enrollment decisions into college.

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

Aims: 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. Methods: 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. Results: 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. Conclusions: 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.

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.