PROJECT SUMMARY Despite a growing demand for health care workers and evidence that a diverse health workforce is vital for public wellbeing, most young people lack awareness of health career options and how to pursue them. Narrow career exposure, insufficient advising, lack of encouragement to pursue STEM subjects, and lack of concordant mentors are significant barriers for Black and Latino/x youth—two groups consistently under-represented across health professions. This project will help these adolescents to overcome barriers and develop positive health identities so they are more confident in their ability to undertake challenging health career pathways and to make informed health decisions. To do so, a joint team from Hats & Ladders, Inc., Mentoring in Medicine, the University of Texas at Austin School of Human Ecology, CareerVillage and Applied Curiosity Research will design, develop, and test Hats & Ladders for Health: Data-driven Decision-Making for Future Health Citizens and Professionals (HLH). This blended digital experience targets 9th- and 10th-grade students and educators in general career and health education programs, and will consist of a digital gamified app, project-based activities, live health career panels, near-peer mentoring sessions, and a robust instructional toolkit with training videos, progress reports, lessons and other educator supports for providing accurate, actionable student feedback. The overall outcomes of HLH’s data-driven, inquiry-based, and inclusive intervention could have broad reaching public health impact, and are to (1) increase students’ confidence in their ability to pursue challenging health career pathways and solve problems along the way; (2) increase their ability to find, understand, and use information to make health-related decisions; and, (3) develop educators’ capacity to provide quality health career guidance and health literacy instruction. Designed to strengthen our organization’s impact on high school youth, our intervention will bring a novel set of interactions––as requested by our existing users––and use them to deepen inquiry-based learning related to health careers and literacy during the critical stage of early high school. In Phase I, the H&L R&D team will collect, analyze and input data from concordant healthcare professionals into a new health career database that we will integrate into the HLH app. To gather the data, we will develop, and test for relevance, an online survey targeting 500 racially and professionally diverse respondents through CareerVillage’s community of 3,000 health professionals (52% BIPOC) and 1,500+ Mentoring in Medicine volunteers. A subset of 25-30 survey respondents will participate in video interviews. Survey data and video snippets will be tagged with metadata and inputted into the database enabling us to recommend authentic and relevant health content to students with shared demographic and career attributes. We will test usability and feasibility of app designs and prototypes with students in small groups or dyads, and both app and dashboard components with educators using in-depth interviews. We will also adapt two student outcome measures, the Assessment of Adolescent Health Literacy and the Career Decision-Making Self Efficacy Scale, using expert reviews and cognitive interviews with students, and then test the measures with a sample of 400 students. All participants will be recruited from NYC Department of Youth and Community Development’s network of 180+ community-based organizations that work with NYC high schools. In Phase II, we will iterate and develop a near final product to pilot test in five NYC classrooms to further explore the usability, feasibility, and support from educators. Following the pilot test, in year two of Phase II we will implement a mixed-methods randomized controlled trial (RCT) to test the efficacy of the completed HLH innovation to impact students’ career efficacy and health literacy. The RCT, led by the External Evaluation team at Applied Curiosity Research, will help us determine the overall effectiveness of HLH to increase students’ health career efficacy and health literacy.

PROJECT NARRATIVE Despite long-standing efforts to diversify the health workforce, many Black and Latino/x adolescents lack the exposure, confidence and skills necessary to develop health career aspirations or to enact “health citizenship,” which are both prerequisites for equitable and effective public health. This project will design and develop a blended digital intervention––with a data-driven and gamified app, project-based activities, live career expert panels, mentoring sessions, and a toolkit for educators––to strengthen opportunities for under-represented youth to pursue health workforce careers and improve their overall health literacy.