This story was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.

The youngest of five children born to Salvadoran immigrants, Jenny Bermudez grew up in Chelsea, a culturally diverse community just outside of Boston, where she always dreamed of becoming a nurse. Since junior year of high school, Jenny participated in the MGH Youth Scholars Program, which exposes underrepresented high school students to health and science career paths. As a Youth Scholars Alumna, she continued to receive coaching and support and worked as a patient care associate at the hospital alongside her mentor, Jennifer Mills, RN—becoming the first in her family to graduate from college. This past year, Jenny’s dreams were realized when she was hired as a full-time registered nurse at MGH.

"Everyone at MGH is a part of my family, and through them I took part in opportunities that benefited me both personally and professionally. I am so grateful to be here today, a recent nursing grad with a job at one of the world’s greatest hospitals." - Jenny Bermudez, BSN, RN

Education as a Key Social Determinant of Health

Understanding that there is a direct correlation between educational attainment and a person’s overall health and socioeconomic status, Massachusetts General Hospital (MGH) Youth Programs are committed to making long-term educational investments in the lives of our young people.

The Center for Community Health Improvement’s Youth Programs sit at the intersection of community health, education and youth development. Through diverse programming for young people from grades 3 through 12 and beyond, we seek to whet students’ appetites and curiosity about subjects related to science, technology, engineering and math (STEM).

Each year, we work with more than 1,000 youth from local public schools, along with 400 MGH staff and faculty (who serve as mentors and supervisors) in activities, internships and jobs that broaden horizons and foster exploration while building confidence and igniting passions for health and science careers and more.

In 2017, MGH employees volunteered a total of 15,730 hours engaging with the youth in our programs. Our youth are primarily from Boston and the surrounding cities of Chelsea and Revere. They are predominantly young people of color, with many coming from diverse, multi-cultural backgrounds. 

Our goal is to positively affect high school graduation rates, promote college attendance and persistence, and ensure our students’ abilities to thrive in the twenty-first century workforce.

Comprehensive Approach

Starting Early⁠—Elementary through Middle School

There is an educational gap for youth of color as it pertains to exposure to STEM, yet we know that:

• Children exposed to STEM opportunities at a very young age perform better in science and math than students who are not.
  
• Early exposure to science topics is important for a student’s career aspirations (Bathke, 2015).
  
• Connecting youth of color to healthcare professionals of color can create a “me too” attitude for the students.
  

Our programming begins at the elementary and middle school levels, where, in partnership with five local Boys and Girls Clubs, we provide after school STEM clubs for students in grades 3 through 8. Through the MGH Office of Diversity and Inclusion, medical and surgical residents of color act as guest speakers to inspire and motivate students. In 7th and 8th grade, many of the students continue on to our Senior STEM Clubs where they deepen their knowledge of STEM subjects through hands-on activities.

Another initiative that targets this age group is the MGH Science Fair Mentorship Program done in partnership with the James P. Timilty Middle School in Boston. Now entering its 29th year, this partnership pairs volunteer mentors from the hospital—researchers, clinicians, and other professionals—with students who travel to MGH (every other Friday morning for four months) to work on their projects.

Year after year, positive connections are forged that help students tap into their vision and aspirations for the future. Many of the students start off thinking that to work at MGH you must be a doctor or nurse, but they quickly learn, from their mentors and exposure to the hospital setting, that STEM careers extend to many different professions. Students are often paired with the same MGH mentor for two program years.

This past year, 13 of the 50 Timilty students presented their posters at the Boston Citywide Science Fair, and one of the 7th graders earned the highest score in the middle school division of the citywide competition. Along with Sr. STEM and the science fair program, 8th graders also have opportunities to work at MGH during the summer until they graduate from high school. The middle school programs serve as feeders to the MGH Youth Scholars Program.

The High School Years—MGH Youth Scholars

The MGH Youth Scholars initiative is a four-year program that engages the students in rigorous skill development, along with hands-on experiences related to STEM and professional development, with the goal of sparking college aspirations and supporting participants throughout their post-secondary education, ensuring that they enter the workforce confident and well prepared. We incorporate a developmental approach in preparing students with the cognitive strategies and contextual skills necessary for persistence to achieve their educational and career goals beyond high school.

In the 9th and 10th grades, students explore and redefine ideas about health care and scientific professions and are also offered academic support. Sample activities might include:

• Visiting the MGH Institute of Health Professions to explore the different roles and educational paths for nurses, physician assistants, speech and language pathologists, occupational therapists and physical therapists.
• Practicing a simulated knee surgery with the sports medicine department
• Discussing the training required for physicians while dissecting pig hearts with residents.
  

Overcoming Unique Challenges

Research indicates that students who are the first to attend college in their families are at higher risk for:

• Lack of college readiness
  
• Lack of familial support
  
• Financial instability (Stephens, Hamedani & Destin (2014)
  
• Less core academic preparation and lower SAT and ACT scores (Balemian & Feng, 2014)
  
• Lack of knowledge related to how college systems work, including how to apply, receive financial aid, and/or choose a major (Arnold, Lu & Armstrong, 2012)

First Generation College-Bound Students

Sixty percent of our Youth Scholars are the first to attend college in their families; therefore, our programs are designed to mitigate these risks by ensuring that the Youth Scholars receive the academic, social and emotional supports needed to thrive in high school. We’ve implemented intervention strategies that include:

• Providing a curriculum that promotes leadership development.
• Tailoring our support to meet individual students’ needs. We identify the students’ strengths and opportunities for growth by administering pre-and-post Holistic Student Assessments annually.
• Teaching students about mindfulness and the relaxation response. Stress management can be an issue for youth, particularly teens, and we provide this through a partnership with the Benson Henry Institute for Mind Body Medicine at Mass General. 

Young Men of Color

Another challenge is recruiting and empowering more young men of color. Research findings indicate that there is a large gap in representation in males of color in the STEM industry, and in 2010 the NSF reported that African American men represented just 3% of scientists and engineers working in STEM fields. Many of the hurdles that prevent young African American men from pursuing careers in STEM fields sound familiar—lack of role models, resources and “relatability.” (Bidewell, 2015) Of the roughly 160,000 African American male students who graduate high school each year, fewer than half even apply to a four-year school.

Currently, females comprise 67% of our Youth Scholars group. Our goal this year is to become more intentional in our outreach and recruitment efforts to young men of color. We are working on ways to achieve a 50/50 split of female and male participation by:

• Providing a series of workshops created and led by mental health professionals that focus on empowering the male students in our programs so that they have a greater chance of persisting in college.
• Partnering with organizations who serve males of color such as Becoming a Man (BAM). The BAM organization has programs at five local high schools, and this past summer we provided 16 BAM students with paid internships through the MGH Summer Jobs Program. We are working toward expanding our recruitment of BAM participants for the Youth Scholars program.

College and Beyond—Youth Scholars Alumni

Graduating from high school and moving on to college are major milestones for any young person. But, there may be particular challenges for first generation students once they arrive on college campuses. Racial under-representation, difficulty adjusting to college and low academic self-esteem can contribute to lower college graduation rates compared with their peers with at least one parent with a four-year degree (Stephens, Hamedani & Destin, 2014).

We have developed specific interventions to offset some of these challenges:

• First year experience college onboarding program —  To help the students prepare for the transition from high school to college, all Youth Scholar Alumni participate in this intensive multi-week experience the summer before their freshman year in college.
• Coaching — All alumni are provided with ongoing academic  coaching.
  
• Scholarships—The hospital provides merit-based scholarships, based on a student’s performance and need.
• Internships/Mentorships — Opportunities for paid internships connect students to their fields of study, and supervisors serve as mentors to the students, helping them build their knowledge and preparing them for life beyond college.
  

Now that the program has a critical mass of alumni who are graduating from college, MGH and its affiliate hospitals are working on strategies to expand employment opportunities to the Youth Scholar Alumni once they graduate from college.

Youth Scholars Alumni by the Numbers

• Over 60% of Youth Scholars Alumni are pursuing college degrees in health and STEM fields.
• 91% of MGH Youth Scholar Alumni reported that they did not or do not need to take any remedial courses in college, indicating that most students are entering college ready for their postsecondary studies.
• In 2017, 13 out of 19 MGH alumni college graduates were employed, and 9 out of 13 were employed at MGH or affiliate partners.

Our college persistence and graduation rates are significantly higher than a similar cohort of Boston Public School students.

"I first thought I wanted to be a doctor. I’m still in the health care field, but where I want to go has changed. Going through the program has allowed me to realize that." - Alumni College Graduate

"[Without YSP] I don’ t think I would have the experience that I have today. I’m a hard worker, but I wouldn’t have known, or probably wouldn’t have been able to get an internship at a hospital. I can put this on my resume now for medical schools. They [MGH] opened up doors for us I don’t think would have been opened without their help." - Alumni College Graduate

Summer Employment Opportunities

MGH Summer Jobs 2018:

• 240 high school students
• 15 college students
• 150+ supervisors
• 40,000 hours worked

"[Working at MGH] is an eye opener … now that I work with [the doctors] every day, it seems like the whole relationship with the patient, I kind of understand it now. It matters, and it’s important." - Alumni College Graduate

Teaching 21st Century Skills through Paid Internships

For over 25 years, MGH has partnered with local schools and community partners to recruit, select and hire over 200 high school students (per year) who are placed in full and part time internships through the hospital’s Summer Jobs Program. The six-week program allows us to expand our services to students who may not participate in the Youth Scholars program during the academic year. The program pairs students with MGH professionals who serve as mentors and exposes them to real-world experiences where they can explore careers and get job readiness skills at their respective sites and through a series of professional development workshops. In 2018, MGH was the lead employer in Boston to provide high school students living and attending schools in Boston, Chelsea and Revere with paid internships.

Empowering Youth: Building a Healthier Future

The MGH Center for Community Health Improvement’s Youth Programs provide robust opportunities for youth through targeted curriculum and hands-on experiential learning. By connecting youth to science, technology, engineering and math (STEM) and providing them with meaningful leadership opportunities, we’re fueling their desire to succeed academically, sparking an interest in college preparedness and inspiring them to enter the 21st Century workforce with a strong sense of academic fortitude and confidence.