A Natural Experiment of College-Ready Programs on Health Among Low SES Minorities

描述（由申请人提供）：在社会经济地位低的少数群体中，我们的“大机会”提案解决了NCMHD研究的优先事项，“健康的社会决定因素倡议”。观察性研究表明，教育程度低与不良健康行为和不良健康结果（包括预期寿命大幅缩短）有关。在本研究中，我们将利用自然实验来检验一种新的教育模式对青少年健康和健康行为的影响。洛杉矶联盟（Los Angeles Alliance）的“大学准备计划”（College-Ready Programs）迄今已在八所高中实施，初步数据显示，该计划似乎显著提高了洛杉矶低收入、少数族裔学生的教育成绩。在洛杉矶联合学区（LAUSD）的其他地方，只有50-70%的九年级学生最终从高中毕业，只有三分之一的毕业生达到了进入加州四年制公立大学的学术要求。相比之下，几乎100%进入联盟的九年级学生完成高中学业，通过高中毕业考试，并被接受进入四年制大学。联盟的平均学术表现指数（API）得分为735，比LAUSD的平均632高出近2.5个标准差。虽然这些结果似乎太好了，没有一些选择偏见，但与LAUSD学校相比，联盟学校有更多的少数民族学生，英语学习者，免费/减少午餐的学生，以及没有高中文凭的家长。因为洛杉矶联盟学校的录取是基于随机抽签的，所以在自然实验中观察教育成就对健康的影响的机会非常难得。我们在健康差异、青少年和心理健康、教育和社会网络方面的多学科专家团队将使用准实验研究设计来确定联盟大学预备学校对教育成就、健康和与健康相关的行为有什么影响。我们将对申请联盟高中的学生进行抽样，并将被联盟学校（联盟组）录取并就读于联盟学校的学生与就读于另一所高中（对照组）的学生进行比较。此外，我们将探讨一些潜在的潜在机制（如健康态度、社会网络、父母参与、日常结构），这些机制可能解释联盟学校如何影响健康和健康行为。洛杉矶联盟学校是新的，尚未正式学习。然而，为期两年的NIH重大机会基金将有助于迅速确定大学准备计划的影响。如果教育影响健康的假设和大学准备计划是成功的，如初步数据显示，拟议的研究结果将提供非凡的和令人信服的证据，不仅可以实现教育改革，而且这种改革有广泛的社会效益，包括更好的健康。这些结果可以激发新的研究和努力，通过教育改革和针对健康的社会决定因素的其他干预措施来改善健康。观察性研究将教育程度低与不良健康行为和不良健康结果联系起来。因此，提高教育成绩的干预措施可能对改善健康产生深远影响。我们将利用一项自然实验来研究教育对健康和健康行为的影响，通过检验一种新的教育模式，根据初步数据，这种模式极大地提高了洛杉矶贫困少数族裔学生的教育成绩。

DESCRIPTION (provided by applicant): A natural experiment of College-Ready Programs on health among low SES minorities Our "Grand Opportunities" proposal addresses the NCMHD research priority, "Social Determinants of Health Initiative." Observational studies have linked poor education to worse health behaviors and worse health outcomes including substantially shorter life expectancy. In this proposed study, we will take advantage of a natural experiment and examine the impact of a new education model on adolescent health and health behaviors. The Los Angeles Alliance "College-Ready Programs" have been employed in eight high schools so far and appears to have dramatically raised the educational achievement of low-income, minority students in Los Angeles according to preliminary data. Elsewhere in the Los Angeles Unified School District (LAUSD), only 50-70% of 9th graders eventually graduate from high school, and only one-third of graduates meet the academic requirements to attend a California 4-year public university. In contrast, almost 100% of entering Alliance 9th graders complete high school, pass the high school exit exam, and are accepted to a 4-year college. Alliance's average Academic Performance Index (API) score is 735, nearly 2.5 standard deviations higher than the LAUSD average of 632. While these results may seem too good to have occurred without some selection bias, Alliance schools have more minority students, English-learners, students on free/reduced lunch, and parents without a high school diploma compared to LAUSD schools. Because acceptance to an LA Alliance school is based on a random lottery, a very rare opportunity exists to observe the impact of educational achievement on health in a natural experiment. Our multidisciplinary team of experts in health disparities, adolescent and mental health, education and social networks will use a quasi-experimental study design to determine what impact the Alliance College-Ready schools are having on educational achievement, health and health-related behaviors. We will sample students who apply to an Alliance high school and compare those who are accepted to and attend an Alliance school (Alliance Group) with those who attend another high school (Control Group). Furthermore, we will explore some potential underlying mechanisms (such as health attitudes, social networks, parental involvement, daily structure) that might potentially explain how the Alliance schools influence health and health behaviors. The LA Alliance Schools are new and not yet formally studied. However, two-year NIH Grand Opportunity funding will help quickly identify the impact that the College-Ready Program is having. If education influences health as hypothesized and the College-Ready Program is as successful as preliminary data suggests, the results of the proposed study will provide extraordinary and compelling evidence that not only can education reform be achieved, but also that such reform has a wide range of benefits to society including better health. These results could stimulate new research and efforts to improve health through education reform and other interventions targeting the social determinants of health. H Observational studies have linked poor education to worse health behaviors and worse health outcomes. Thus an intervention to improve educational achievement may have a profound impact on improving health. We will take advantage of a natural experiment to study the impact of education on health and health behaviors, by examining a new education model that is, according to preliminary data, dramatically improving educational achievement among poor, minority students in Los Angeles.