Team profile by Erin Lee, Alex Diaz, Devi Lakhlani, Kira Ward, Fern Corona Rizo and James Jackson IV

Over the past decade, Durham and its public schools have experienced a substantial increase in Latinx students (and their families). The Durham Public School system (DPS) has recently begun to address the needs of this rapidly-growing demographic. To properly serve and engage the rapidly changing demographics of students, Durham needs pedagogies and instructors, that (a) are conscious of social inequities, (b) hold affirming views and high expectations for students of color, (c) are familiar with the lives of students outside of school, (d) recognize an ethical and moral obligation to advocate for education that is equitable for all students, especially the traditionally marginalized, and (e) create inclusive classrooms that allow for building knowledge based on prior student experiences (Ladson-Billings 1994, Villegas 2007).

SALUD (Scholar Academy for Latinx United for Diversity) was originally founded to provide Latinx students at the City of Medicine Academy the opportunity to explore medical training, meet medical students, and learn from healthcare professionals in settings that consider their backgrounds and communities. A one-week program (in 2017) has expanded to a 12-session curriculum spanning the academic year (in 2019 and 2020¹⁾ that addresses social determinants of health disparities through a social justice lens while retaining a focus on health technology, science, and college access.² SALUD’s mission is “To inspire Durham Latinx youth to pursue health-related professions by critically exploring health through a social justice lens.”

Our team developed a program evaluation to determine the efficacy of the program and whether it had achieved its goals. Our research questions were: Were the SALUD program activities implemented as intended? How successful was the SALUD 2019-2020 Program in addressing and implementing its stated goals?

We evaluated the program according to three different 1Qareas:

• Social determinants of health (SDOH): How well does our curriculum teach students about SDOH as it relates to social justice in their community?

• College Preparedness and Health Profession Engagement: How well does our program prepare students to undergo the college application process?

• Inclusivity: How well does our program include individuals of different Latinx-specific experiences and language levels?

We created a qualitative survey with a series of 34 questions and 6 categories (Understanding of SDOH, Understanding of Session Material, Development of Academic Skills, Development of Personal Skills, College Prep and Future Aspirations, SALUD Support) to see how well the program had covered these three areas. Some of our critical findings included:

• There was an increased awareness of barriers and issues surrounding the Latinx Community
• Scholars noted a marked improvement in their self-confidence
• There was an increase in number of male participants from the 2019 to the 2020 cohort
• The greatest variation across responses were for those relating to college admissions for both cohorts

Our team found successes and challenges on varying levels, both program-specific and research-specific, as undergraduate team members also served as mentors to SALUD scholars to process the curriculum and guide discussions. Most of our challenges occurred while conducting our research for our program evaluation. It was challenging initially to develop measures that uncovered whether scholars found SALUD to be engaging and effective. Given the program’s many activities, one of our other challenges was to connect the stated goals of the program versus what was being implemented and it highlighted our need to refocus the program’s aspirations. We found that through our successes and challenges in actually implementing the program, we were able to define many of these areas.

On a program-implementation level, we as mentors spent a lot of time trying to figure out how to best engage our scholars. One of the challenges we had was tackling language barriers and making sure the activities and presenters were understood by primarily Spanish-speaking scholars (n=3 of 30). Thus, this translated into us creating an evaluation area centered on inclusivity. We also found that throughout the program, previously quieter scholars were able to further develop their communication skills through their increased participation in small groups and presentations. Scholars also demonstrated a new interest in public health on more nuanced levels, cultural, societal, economic, and political, through the exploration of SDOHs. Scholars were also able to engage in opportunities, such as the Duke Anatomy Lab, dissections, and standardized patient interviews, that are not readily available to other high school students. These all became crucial components to the areas within our program evaluation.

¹The SALUD program was not conducted in 2018 to conduct a comprehensive curriculum revamp.

² This program description was adapted from the SALUD website.