Racial Dispari+es in Outcomes a3er SCI: Twenty Years of Research. James S. Krause, PhD Medical University of South Carolina

Transcription

1 Racial Dispari+es in Outcomes a3er SCI: Twenty Years of Research James S. Krause, PhD Medical University of South Carolina

2 Funding This research was supported by the following field- ini+ated grants from NIDRR of OSERS of the US DOE #H133G #H133G #H133G #H133G H133G #H133A #H133B Support from NIH # 1R01 NS Support from the SCI Model Systems Grant #H133N ( ) #H133N ( )

3 Nature of Spinal Cord Injury Annual incidence in the United States is about 40 cases per million. Permanent sensory and motor loss Associated with early mortality May adversely affect func+on and may significantly affect quality of life. Majority of individuals with SCI are Caucasian (63%). Studies of racial- ethnic minori+es with SCI are rare. Exis+ng studies have primarily focused on African- Americans with SCI.

4 Purpose The purpose of this presenta+on is to: Describe mul+ple studies we have conducted related to outcomes a3er SCI Focus is on employment Highlight comparisons as a func+on of race/ ethnicity Discuss the prac+cal implica+ons of these findings for underrepresented popula+ons Discuss needs for future research.

5 Sources of Data 1. Spinal Cord Injury Model Systems 2. Longitudinal study from inpa+ent rehabilita+on 3. Minnesota/Georgia Aging study

6 Model Systems Study Krause, J. S., Kewman, D., DeVivo, M. J., Maynard, F., Coker, J. L., Roach, M. J., & Ducharme, S. (1999). Employment a3er spinal cord injury: An analysis of cases from the model spinal cord injury systems. Archives of Physical Medicine and Rehabilita7on, 80,

7 SCI Model Systems Federally funded centers of excellence in care and research in SCI Currently 14 centers All contribute data to the Na+onal Spinal Cord Injury Sta+s+cal Center (NSCISC) at the University of Alabama Birmingham We have analyzed some data from the NSCISC as related to minori+es.

8 Percentage Employed as a Func+on of Gender and Race Ethnicity Caucasian African American Hispanic Other Minority Male Female

9 Race- Ethnicity and Current Employment SCI Model Systems Data Gender Male (n = 2396) Female (n = 587) Caucasian (n = 2072) 36.3 (n = 1627) 28.3 (n = 447) African American (n = 596) 7.3 (n = 520) 11.7 (n = 77) Hispanic (n = 231) 12.9 (n = 194) 8.1 (n = 37) Other Minority (n = 75) 17.6 (n =51) 12.5 (n = 24) The n values in parentheses are total of number of cases that fell within the cell, not the number of cases working in that cell (i.e., for Caucasian males, there are 1,627 cases of which 36.3% are working).

10 Percentage Employed as a Func+on of Years of Educa+on and Injury Severity <11 years High School Diploma Associates Bachelors Masters C1- C4 ABC C5- C8 ABC T1- S5 ABC Tetra/para D

11 Race- ethnicity, Educa+on, and Employment a3er Spinal Cord Injury James S. Krause, PhD Lee L. Saunders, PhD David Staten, PhD

12 Objec+ve To u+lize data from the NSCISC to iden+fy the rela+onship of race- ethnicity with employment status, while evalua+ng the interrela+onships with gender, injury severity, and years of educa+on.

13 Hypotheses 1. To what extent are there dispari+es in employment outcomes as a func+on of race- ethnicity? 2. To what extent are there dispari+es in educa+onal anainment as a func+on of race- ethnicity? 3. To what extent do dispari+es in employment outcomes diminish for various levels of educa+onal anainment?

14 Study Sample The NSCISC is the largest cohort of persons with SCI in the United States. Inclusion criteria for the SCI Model Systems which contribute data to the NSCISC are: trauma+c SCI treated at a Model System within 1 year of injury residence inside a Model System catchment area informed consent. We established addi+onal study inclusion criteria of: must have Form I and at least one Form II in the NSCISC must have residual impairment at discharge (ASIA A- D).

15 Methods: Par+cipants N = 14,454 As this analysis focused on employment, we excluded person under age 18 or over age 64, persons who said they were homemakers, and students. We only had enough persons in the African- American, Caucasian, and Hispanic groups, so all others were excluded.

16 Methods: Measures We u+lized the following variables from Forms I & II of the data collec+on of the SCI Model Systems: occupa+on at follow- up occupa+on at injury educa+on at follow- up educa+on at injury injury severity at discharge from rehabilita+on SCI e+ology gender race ethnicity age

17 Educa+on by Gender and Race- Ethnicity Caucasian African- American Hispanic Male Female Total Male Female Total Male Female Total Total N 8,108 1,683 9,791 2, ,296 1, ,367 14,454 p- value* Column Percents Educa+on <12 Years /GED Associates Bachelors *p- value from a chi- square test <.0001

18 Employed by Gender and Race- Ethnicity Caucasian African- American Hispanic Male Female Total Male Female Total Male Female Total Total N 8,108 1,683 9,791 2, ,296 1, ,367 14,454 p- value* Column Percents Employed Yes No <.0001

19 Percent working at follow- up by race- ethnicity and educa+on status < 11 Years (n=3429) 12/GED (n=7680) Associates (n=859) Bachelors (n=1760) Masters/PhD (n=726) African- American (n=1255) (n=1731) (n=141) (n=128) (n=41) Caucasian (n=1489) (n=5379) (n=683) (n=1569) (n=671) Hispanic (n=685) (n=570) (n=35) (n=63) (n=14) Total Column % Total %

20 Interac+on term between race and gender from the mul+variable logis+c regression model.* Caucasian Hispanic African- American Female 0.9 ( ) 1.0 ( ) 1.7 ( ) Male *Odds ra+os and 95% confidence intervals are shown.

21 Minnesota- Georgia Studies As related to Employment/Earnings

22 Minnesota/Georgia Aging Study 35- year longitudinal study Started in Minnesota with 3 preliminary samples drawn in 1974, 1985, and 1993 Southeastern samples from the Shepherd Center in Atlanta, GA were added in 1993 and 2002 to increase racial- ethnic diversity (21.8% were non- white or Hispanic, 19.1% African- American). A total of 2,208 par+cipated over the years All par+cipants were adults with trauma+c onset SCI of at least one year dura+on

23 Racial Breakdown for Minnesota- Georgia Study

24 Study 1 Earnings Two stage model: Part 1 Predictors of employment status Part 2 Predictors of condi+onal earnings Combined Predictors of uncondi+onal earnings Condi+onal earnings = Earnings among those employed Uncondi+onal earnings = Earnings of all people, with those who are unemployed = $0 earnings Krause, J.S., & Terza, J.V. (2006). Injury and demographic factors predic+ve of dispari+es in earnings a3er spinal cord injury. Archives of Physical Medicine and Rehabilita7on, 87,

25 2 Types of Predictors Anributable differences = factors that cannot be directly manipulated as a func+on of changes in policy (e.g., gender, race, age, injury severity) Policy factors = those factors that can become the focus of policy changes to affect change in outcomes (e.g., educa+on)

26 Earnings Study 1 Minnesota- Georgia: 25 year Part 1: Anributable Differences for Binary Variables using Probit Results Variable Anributable Difference t- stat p- value Gender - Male Race non African American Age at study (35-49y) Age ( 50) Years since injury (11-20) Years since injury ( 21) Severity non Cervical Ambulatory Some educamon beyond high school (13-15y) College

27 Earnings Study 1 Part 2: Anributable Differences for Binary Variables using Exponen+al Regression Results Variable Anributable Difference t- stat p- value Gender - Male 15, Race non- African- American 19, Age at study (35-49y) Age ( 50) Years since injury (11-20) Years since injury ( 21) Severity - non- Cervical Ambulatory Some educa+on beyond high school (13-15y) College 35,

28 Earnings Study 1 Part 3: Anributable Differences for Binary Variables using 2- Part Model Results Variable Anributable Difference t- stat p- value Gender - Male 12, Race - non- African- American 16, Age at study (35-49y) Age ( 50) Years since injury (11-20) Years since injury ( 21) Severity - non- Cervical Ambulatory Some educamon beyond high school (13-15y) College 37,

29 Study 2 Earnings Similar methodology to Study 1 Uses 30- year follow- up data (Study 1 used 25- year follow- up data) Larger sample (Study 1 = 615; Study 2 = 1,296) Greater diversity of policy variables Krause, J.S., Terza, J.V., & Dismuke, C. (in press). Earnings among people with spinal cord injury. Archives of Physical Medicine and Rehabilita7on, 89,

30 Earnings Study 2 Minnesota- Georgia: 30 year Part 1: AD (for disparimes variables) and PE (for policy variables) using Probit results. Dispari+es Variable Anributable Difference t- stat p- value Gender - Male <0.01 Race - Caucasian <0.01 Age at the Study (35-49) Age (>50) <0.01 Severity non Cervical Ambulatory <0.01 Policy Variable Policy Effect t- stat p- value Some EducaMon Beyond HS (13-15 years) <0.01 College <0.01 Working at injury

31 Earnings Study 2 Part 2: AD and PE using ExponenMal Regression results Dispari+es Variable Anributable Difference t- stat p- value Gender - Male <0.01 Race - Caucasian Age at the Study (35-49) Age (>50) Severity non Cervical Ambulatory Policy Variable Policy Effect t- stat p- value Some Educa+on Beyond HS (13-15 years) College <0.01 Working at injury Return to same job Return to diff job, same company Number of Jobs since SCI Total years worked since SCI Percentage Mme since SCI Working <0.01 Employed by the government <0.01 Employed by private company <0.01 Employed by other

32 Earnings Study 2 Part 3: AD and PE using Two- Part Model results Dispari+es Variable Anributable Difference t- stat p- value Gender - Male <0.01 Race - Caucasian <0.01 Age at the Study (35-49) Age (>50) Severity non Cervical Ambulatory Policy Variable Policy Effect t- stat p- value Some EducaMon Beyond HS (13-15 years) <0.01 College <0.01 Working at injury Return to same job <0.01 Return to diff job, same company Number of Jobs since SCI <0.01 Total years worked since SCI <0.01 Percentage Mme since SCI Working <0.01 Employed by the government <0.01 Employed by private company <0.01 Employed by other <0.01

33 Summary - Employment Studies Employment rates are lower among minori+es. Although men typically are more likely to be employed than women, the reverse trend is observed for African- Americans. Educa+on is key to both return to employment and condi+onal earnings. The dispari+es in employment rates between men and women and between Caucasians and African- Americans are accentuated by further differences in earnings (i.e., women and minori+es are not only less likely to work, when they do, they make less money). Mul+ple policy variables are related to earnings.

34 References - Employment Studies 1. Krause, J.S. (1992). Employment a3er spinal cord injury. Archives of Physical Medicine and Rehabilita7on, 73, Krause, J. S. & Anson, C. A. (1996). Employment a3er spinal cord injury: Rela+onship to selected par+cipant characteris+cs. Archives of Physical Medicine and Rehabilita7on, 77, Krause, J. S., Sternberg, M., Maides, J., & Lones, S. (1998). Employment a3er spinal cord injury: Differences related to geographic region, gender, and race. Archives of Physical Medicine and Rehabilita7on, 79, Krause, J. S., Kewman, D., DeVivo, M. J., Maynard, F., Coker, J. L., Roach, M. J., & Ducharme, S. (1999). Employment a3er spinal cord injury: An analysis of cases from the model spinal cord injury systems. Archives of Physical Medicine and Rehabilita7on, 80, Krause, J.S., & Terza, J.V. (2006). Injury and demographic factors predic+ve of dispari+es in earnings a3er spinal cord injury. Archives of Physical Medicine and Rehabilita7on, 87(10), Krause, J.S., Terza, J.V., & Dismuke, C. (in press). Earnings among people with spinal cord injury. Archives of Physical Medicine and Rehabilita7on, 89,

35 Subjec+ve Aspects of Voca+on

36 Minnesota- Georgia Study (cont.) Defini+on: One of two components of quality of life. It reflects the individual s subjec+ve appraisal of her/ his life, rather than their actual ac+vity panerns (their sa+sfac+on with finances, as opposed to how much they make). Krause, J. S. (1998). Dimensions of subjec+ve well being a3er spinal cord injury: An empirical analysis by gender and race/ethnicity. Archives of Physical Medicine and Rehabilita7on, 79, Krause, J. S. (1998). Subjec+ve well being a3er spinal cord injury: Rela+onship to gender, race/ ethnicity, and chronologic age. Rehabilita7on Psychology, 43,

37 Subjec+ve Well- being Scale Scores as a Func+on of Race Race Scale Caucasian Minority F dfs Sa+sfac+on ** 3, 443 Problems , 498 Engagement , 537 Nega+ve Affect , 571 Health Problems , 570 Finances *** 3, 578 Career OpportuniMes *** 3, 475 Living Circumstances ** 3, 576 Interpersonal Rela+ons , 543 *p <.05 ; **p <.01 ; ***p <.001 Note: Norma+ve scale scores are T- scores with a mean of 50 and standard devia+on of 10.

38 Collabora+ve Study of Gender, Par+cipa+ng ins+tu+ons: Race, & Aging Shepherd Center in Atlanta, GA; Rancho Los Amigos Na+onal Rehabilita+on Center in Downey, CA; Craig Hospital in Englewood, CO; Santa Clara Valley Medical Center in San Jose, CA. Specifically designed to over sample racial- ethnic minori+es and women.

39 Racial- Ethnic Breakdown for Collabora+ve Study: Time 1

40 Subjec+ve Well- being Scales as a Func+on of Race- Ethnicity American Caucasian African- American Indian, Alaskan Na+ve Hispanic Male Female Male Female Male Female Male Female Engagement Nega+ve Affect Health Problems Finances Career OpportuniMes Living Circumstances Interpersonal Rela+ons *p<.05; **p<.01; ***p<.001 Race F (df) (3, 455)* (3, 458)* (3, 449) (3, 457)*** (3, 425)*** (3, 456)*** (3, 397)**

41 References Subjec+ve Well- being 1. Krause, J. S. & Anson, C. A. (1997). Adjustment a3er spinal cord injury: Rela+onship to gender and race. Rehabilita7on Psychology, 42(1), Krause, J. S. (1998). Community reintegra+on a3er SCI: Rela+onship to gender and race. Topics in Spinal Cord Injury Rehabilita7on, 4, Krause, J. S. (1998). Dimensions of subjec+ve well being a3er spinal cord injury: An empirical analysis by gender and race/ethnicity. Archives of Physical Medicine and Rehabilita7on, 79, Krause, J. S. (1998). Subjec+ve well being a3er spinal cord injury: Rela+onship to gender, race/ethnicity, and chronologic age. Rehabilita7on Psychology, 43, Krause, J. S., Coker, J. L., Charlifue, S., & Whiteneck, G. G. (1999). Depression and subjec+ve well being among 97 American Indians with spinal cord injury. Rehabilita7on Psychology, 44, Krause, J. S., Broderick, L. E. & Broyles, J. (2004). Subjec+ve Well- Being Among African- Americans with Spinal Cord Injury: An Exploratory Study Between Men and Women. Neurorehabilita7on, 19,

42 Voca+onal Interests a3er Recent Spinal Cord Injury: Comparisons Related to Gender and Race Model Systems Study Krause, J. S., Saunders, L. L., Staten, D., & Rohe, D. E. (2011). Voca+onal interests a3er recent spinal cord injury: Comparisons related to gender and race. Archives of Physical Medicine and Rehabilita7on, 92,

43 Objec+ve To compare voca+onal interests as a func+on of gender and race among persons with recent SCI, as previous research used almost exclusively white male par+cipants.

44 Background Limited research from nearly 2 decades ago suggested SCI selec+vely occurs to men whose voca+onal interests are consistent with the Realis+c theme of the Holland typology, indica+ve of a preference for ac+vi+es and occupa+ons requiring physical strength and dexterity. Despite the importance of the early studies, there are significant gaps in the literature, par+cularly related to women and nonwhites. Furthermore, there has been a changing panern of e+ology and demographics of SCI since the conduct of the preliminary studies. The general literature on race and voca+onal interests raises ques+ons as to the generalizability of the findings. Since e+ologies of SCI vary as a func+on of race, there are reasons to hypothesize a different panern of interest may be revealed for nonwhites.

45 Methods: Par+cipants Par+cipants were recruited from the Shepherd Center and met 6 eligibility criteria: 1) Trauma+c SCI 2) Some residual deficits 3) Currently hospitalized 4) At least 16 years of age 5) Race/Ethnicity of White or Black, non- Hispanic 6) Assessed within first 6 months a3er injury onset 500 completed materials Averaged 50 days post- injury at assessment

46 Methods: Measures 1994 Strong Interest Inventory (SII), Form T317 6 General Occupa+onal Themes 25 Basic Interest Scales grouped within the General Occupa+onal Themes SII scores are based on comparisons between gender specific norma+ve groups (Male General Reference Sample, Female General Reference Sample). Gender- based comparisons of scores between men and women reflect how the sample of men and women differ from each other rela+ve to their norma+ve group.

47 General Occupa+onal Themes (GOT) and Basic Interest Scales (BIS) Realis+c Agriculture Nature Military Athle+c Mechanical ac+vi+es Inves+ga+ve Science Mathema+cs Medical Science Ar+s+c Music/drama Art Applied arts Wri+ng Culinary arts Social Teaching Social services Medical service Religious ac+vi+es Enterprising Public speaking Law/poli+cs Merchandising Sales Organizing/management Conven+onal Data management Computer ac+vi+es Office services

48 Analysis Descrip+ve sta+s+cs were used to summarize the characteris+cs of the study sample and scores on the SII. MANOVA was u+lized with follow- up tests to iden+fy significant differences as a func+on of gender and race (whites and blacks). Separate MANOVAs were run for the GOT and BIS.

49 Par+cipant Characteris+cs Breakdown by race and gender 5.2% White male White female 22.0% Black male Black female 56.8% 16.0%

50 Panern of interests on the GOT for white males

51 Panern of interests on the GOT for black males

52 Panern of interests on the GOT for white females

53 Panern of interests on the GOT for black females

54 Panern of interests on the GOT for white males, black males, white females, and black females

55 Scores on the GOT as a func+on of race and gender Full Sample Male Female White Black Gender Race Sex*Race N=500 N=394 N=110 N=364 N=136 Mean Mean Mean Mean Mean F F F Realis+c *** Inves+ga+ve * 5.6* 2.3 Ar+s+c *** 10.3** 1.9 Social *** 32.6*** 0.0 Enterprising *** 1.6 Conven+onal *** 60.7*** 1.5 * p<.05, ** p<.01, ***p<.001

56 Scores on the BIS as func+on of race and gender Whites scored 5 points or higher on 2 scales within the Realis+c theme: Agriculture and Nature. Blacks scored 5 points or higher on 8 scales: Social Services Medical Services Religious Ac+vi+es Merchandising Organizing/Management Data Management Computer Ac+vi+es Office Services

57 Scores on the BIS as func+on of race and gender Interac+ons were observed on 2 scales: Sales and Art. On Sales, white males scored higher than white females (m=52.6, f=50.0), yet black males scored lower than black females (m=56.0, f=59.3). For Art, while black females scored only slightly higher than black males (m=43.4, f=45.4), white females scored substan+ally higher than white males (m=40.2, f=47.2).

58 Scores on the GOT and BIS as a func+on of the combina+on of gender and race White Males Black Males White Females Black Females N=283 N=110 N=80 N=26 Panern RESCIA RECSIA SCEARI CESAIR Mean (SD) Mean (SD) Mean (SD) Mean (SD) Realis+c 55.2 (10.0) 52.8 (11.0) 41.3 (7.8) 43.5 (8.6) Inves+ga+ve 42.6(10.9) 44.2(11.1) 39.1(9.1) 44.8(10.6) Ar+s+c 38.1(9.7) 42.2(9.6) 45.3(10.4) 46.0(11.8) Social 43.5(10.4) 50.3(12.1) 49.4(12.3) 56.2(12.7) Enterprising 46.3(10.9) 51.6(12.1) 47.5(9.6) 56.3(14.1) Conven+onal 43.3(8.9) 51.0(12.0) 48.1(11.0) 58.9(12.0)

59 Stability of Voca+onal Interests a3er Recent Spinal Cord Injury: Comparisons Related to Gender and Race Model Systems Study Krause, J.S., & Ricks, J.M. (under review). Stability of Voca+onal Interests a3er Recent Spinal Cord Injury: Comparisons Related to Gender and Race. Archives of Physical Medicine and Rehabilita7on.

60 Objec+ve To iden+fy the stability of voca+onal interests first assessed during inpa+ent rehabilita+on for SCI and again an average of days post- injury to determine the extent to which stability of interest varies as a func+on of race and gender. Follow- up to earlier inpa+ent voca+onal interests study using the SII

61 Hypotheses 1. To what extent will mean scores on the GOT and BIS from the SII change over the first 2 1/2 years pos+njury as a func+on of race and gender? 2. To an extent will interests change as a func+on of gender and race, as measured by stability coefficients (i.e., the extent to which the same people will be high or low on any given scale).

62 Methods: Par+cipants Two follow- ups to the inpa+ent study were conducted. Same inclusion criteria Of the original 500 par+cipants, 304 returned completed materials on 1 of the 2 follow- ups and 195 responded to neither follow- up. For those who completed both follow- ups (n=135), we used that with the greatest interval of +me between assessments.

63 Methods: Measures The 1994 edi+on of the SII was used. Also used were the 4 special scales of the SII including: Work style, Learning environment Leadership style Risk taking/adventure.

64 Analysis Descrip+ve sta+s+cs were used to summarize the characteris+cs of the study sample and scores on the SII. We iden+fied the extent to which anri+on was selec+ve by comparing those who did not respond to follow- up with those who did respond and compared them on baseline demographic, injury, and GOT scores. A repeated measures general linear model was used to analyze changes in scale scores over +me.

65 Par+cipants Characteris+cs

66 Changes in interest over +me (GOT) Cohort by +me interac+ons were significant for 4 of the 6 GOT (all except Realis+c and Social), whereas none of the main effects for +me were significant. On each of the GOT for which a significant interac+on was observed, the range of difference in the means between the 4 groups in the cohort decreased between baseline and follow- up. For instance, for the Inves+ga+ve theme, the scores ranged from 38.4 (white women) to 46.6 (black women) at baseline, with follow- up scores only ranging between 42.4 (black women) to 44.8 (white men). Similarly, the scores of black women declined on each of the 4 scales, whereas they increased, at least minimally, for each of the other 3 groups.

67 GOT means by gender and race

68 GOT means by gender and race

69 GOT means by gender and race

70 GOT means by gender and race

71 GOT means by gender and race

72 GOT means by gender and race

73 Changes in interests over +me (BIS) There were no significant main effects for +me on the BIS. Significant cohort by +me interac+ons were also observed for 16 of the 25 BIS including: Nature, Military, Athle+c, Science, Mathema+cs, Medical Science, Music/ Drama, Art, Applied Arts, Wri+ng, Social Services, Public speaking, Law/Poli+cs, Merchandising, Computer ac+vi+es, and Office services. For the most part, the panern was similar to that of the GOT, with some noteworthy differences.

74 Changes in interests over +me (BIS) For the Nature scale, both black men and black women reported declines, whereas white men and white women reported increases. For Athle+cs, the primary decline was for black men. Science, Mathema+cs, Music/Drama, and Computer skills also indicated declines for both black men and black women, although the declines for black men were much smaller. There was a significant main effect for 1 of the special scales, Risk- taking/adventure, where each cohort reported at least minimal gains. There was also a significant interac+on effect for Learning Environment. Declines were reported by black women, whereas other cohorts reported increases.

75 Stability Coefficients The average stability coefficients for the GOT ranged from a low.35 (black men) to a high of.61 (white women) with.57 across the full sample. The average for black women was.45. A similar panern was observed for the BIS, as black men reported the lowest average coefficient (.35) followed by black women (.51), white men (.57) and white women (. 59). The varia+on for special scales was somewhat smaller, ranging from , with the lowest coefficients again observed for black men and the highest coefficients for white women.

76 Stability Coefficients White Men (n=169) White Women (n=66) Black Men (n=55) Black Women (n=14) Overall (n=304) Scale Average GOT Average BIS Average Special Scales RealisMc 0.52 *** 0.67 *** 0.42 *** *** InvesMgaMve 0.58 *** 0.54 *** 0.39 ** *** ArMsMc 0.63 *** 0.44 *** 0.35 ** *** Social 0.51 *** 0.69 *** ** 0.59 *** Enterprising 0.48 *** 0.50 *** 0.28 * *** ConvenMonal 0.50 *** 0.79 *** 0.41 ** 0.57 ** 0.61 *** Work style 0.63 *** 0.70 *** 0.50 *** 0.74 ** 0.75 *** Learning Environment 0.76 *** 0.70 *** 0.41 ** 0.64 ** 0.69 *** Leadership Style 0.67 *** 0.64 *** 0.47 *** 0.59 * 0.63 *** Risk Taking/ Adventure * p<.05, ** p<.01, *** p< *** 0.72 *** 0.62 *** ***

77 Key Findings Follow- up interests tended to be much more homogeneous across gender and race when compared with baseline interests. This directly reflects decreases in several GOT and BIS among black women. In some select cases, declines were also observed among black men on the BIS. Changes were unevenly distributed as a func+on of gender and race. White women, who reported the most depressed profiles at baseline, reported the largest increase in each of the GOT. Some changes were noted among white men and black men; however, the interests of black women had clearly declined by follow- up. Black men appeared to have the least stable interests between the +mes of measurement. Although black women showed the greatest average decline in mean interests, their interests appeared to be more stable in terms of the stability coefficients which reflect the rela+ve rank ordering of par+cipants on any par+cular scale.

78 Summary and Conclusions

79 Ongoing Collabora+ons If you are represen+ng a historically black college or university, Hispanic serving ins+tu+on of higher educa+on, American Indian tribal college or university, or another ins+tu+on of higher educa+on whose minority student enrollment is at least 50% and interested in addi+onal webcasts on developing dispari+es research, please contact us.

80 Contact Informa+on For more informa+on on future dissemina+on, contact Karla Swayngim Reed Visit our website: hnp:// Principal Inves+gator: James S. Krause

81 THANK YOU!