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Despite receiving little academic attention, open enrollment has the greatest potential among school choice policies to transform the governance of local school districts because all student transfers occur within the public school system, meaning that families and governance structures in two (or more) school districts are impacted by open-enrollment decisions. In this conceptual disconnection we demonstrate how open enrollment complicates the traditional educational ecosystem dramatically by altering existing relationships and introducing new actors and relationships into how school districts establish and implement policies. We then complicate the traditional analysis of open enrollment through the lens of Critical Policy Analysis, alongside an example from an Arizona school district, to illustrate the ways that racism and other forms of oppression are often overlooked, yet salient in (mis)shaping democratic governance in a political ecology disrupted by open enrollment.

Background: Cancer disparities exist for Hispanic men with prostate cancer and their caregivers that could be reduced through exercise. Exercising Together© is a six-month, evidence-based dyadic resistance training program that promotes teamwork between prostate cancer survivors and their spouses to improve physical, mental, and relational health outcomes. The purpose of this study was to elicit feedback and recommendations from stakeholders on the Exercising Together© intervention to inform the cultural adaptation of this program for Hispanic men with prostate cancer. Methods: We conducted a virtual Community Engagement Studio (V-CES) with community expert stakeholders representing the Hispanic and cancer care communities in Southern Arizona. The V-CES process included orientation, presentation of the research, guided discussion, and evaluation. The V-CES was audio recorded, transcribed, and rapidly analyzed to identify actionable feedback and contextual adaptations. Results: Nine stakeholders (6/9 male; 5/9 Hispanic) completed all V-CES activities. Through stakeholder engagement and feedback from the V-CES, adaptations to the original Exercising Together© intervention included: (1) inclusion of the cancer survivor's identified caregiver, who may not be a spouse; (2) availability in English and Spanish; (3) shortening the intervention to 3 months; (4) remote delivery of the intervention; and (5) incorporation of low burden procedures. Conclusion: Findings from our V-CES informed the adaptation of a culturally relevant dyadic progressive resistance training program for Hispanic men with prostate cancer and their caregivers. [ABSTRACT FROM AUTHOR]

Background: Hispanics and American Indians (AI) have high kidney cancer incidence and mortality rates in Arizona. This study assessed: (1) whether racial and ethnic minority patients and patients from neighborhoods with high social vulnerability index (SVI) experience a longer time to surgery after clinical diagnosis, and (2) whether time to surgery, race and ethnicity, and SVI are associated with upstaging to pT3/pT4, disease‐free survival (DFS), and overall survival (OS). Methods: Arizona Cancer Registry (2009–2018) kidney and renal pelvis cases (n = 4592) were analyzed using logistic regression models to assess longer time to surgery and upstaging. Cox‐regression hazard models were used to test DFS and OS. Results: Hispanic and AI patients with T1 tumors had a longer time to surgery than non‐Hispanic White patients (median time of 56, 55, and 45 days, respectively). Living in neighborhoods with high (≥75) overall SVI increased odds of a longer time to surgery for cT1a (OR 1.54, 95% CI: 1.02–2.31) and cT2 (OR 2.32, 95% CI: 1.13–4.73). Race and ethnicity were not associated with time to surgery. Among cT1a patients, a longer time to surgery increased odds of upstaging to pT3/pT4 (OR 1.95, 95% CI: 0.99–3.84). A longer time to surgery was associated with PFS (HR 1.52, 95% CI: 1.17–1.99) and OS (HR 1.63, 95% CI: 1.26–2.11). Among patients with cT2 tumor, living in high SVI neighborhoods was associated with worse OS (HR 1.66, 95% CI: 1.07–2.57). Conclusions: High social vulnerability was associated with increased time to surgery and poor survival after surgery. [ABSTRACT FROM AUTHOR]

Despite the plethora of schooling options in Indigenous communities, the public policy debate, research, and discourse on school choice is almost entirely absent a specific engagement with how school choice intersects issues relevant to American Indian youth and tribal nations. This article suggests that Indian Country is an important and unique context for understanding the meaning and processes of school choice because of the government-to-government relationship between tribal nations and the federal government, the sovereign status of tribal nations, the nation-building goals of tribes, and the muddled history of schooling options within Native communities. We offer an alternative way of conceptualizing "school choice" that is more applicable to Indigenous communities and that has yet to be articulated in the literature. First, while schooling options have existed in Indian Country for much longer than has been the case in other communities, the presence of schooling options has not historically been centered upon offering youth and families "choices." Instead, it has been about "control"--control of the schooling offered to Indigenous youth, and therefore, control of youth and communities themselves. Second, while school choice policies focus on "autonomy" as an important governance principle to prompt change in traditional public school systems, "sovereignty" has and remains the most salient governance issue within Indigenous communities.

Introduction and Objectives: Various studies have identified single-nucleotide polymorphisms (SNPs) associated with nonalcoholic fatty liver disease (NAFLD) and related traits, including ones located in or near the LYPLAL1, GCKR, PPP1R3B, TM6SF2, MBOAT7, and PNPLA3 genes. However, these SNPs were identified primarily in populations of European ancestry. This study examined the associations of these previously identified SNPs with hepatic steatosis in a sample of Mexican-origin adults living in Southern Arizona. Materials and Methods: A total of 307 Mexican-origin adults between the ages of 18 and 64 with a body mass index (BMI) of 25 kg/m2 or higher were genotyped at the following SNPs: rs12137855 (LYPLAL1), rs1260326 (GCKR), rs4240624 (PPP1R3B), rs58542926 (TM6SF2), rs641738 (MBOAT7), and rs738409 (PNPLA3). Hepatic steatosis was assessed by transient elastography (FibroScan-) with controlled attenuation parameter. Regression models examined the association between each of the six SNPs and hepatic steatosis. BMI was examined as a potential modifier of the genetic associations. Results: Participants were, on average, 45 years old and mostly female (63%) with an overall mean hepatic steatosis of 288.1 dB/m. Models showed no associations between LYPLAL1, GCKR, PPP1R3B, TM6SF2, or MBOAT7 and hepatic steatosis. Only PNPLA3 was statistically significantly associated with hepatic steatosis in both unadjusted and adjusted models (p<0.01). There was no effect modification observed with BMI. Conclusions: SNPs associated with NAFLD in populations of European descent did not strongly contribute to hepatic steatosis in individuals of Mexican-origin, except for rs738409 (PNPLA3). Further efforts are necessary to explore additional SNPs that may be associated with NAFLD in this high-risk population. [ABSTRACT FROM AUTHOR]

Background/Context: Nationally, almost a quarter of charter school students attend a school managed by a for-profit education management organization (EMO). EMOs have full executive authority over the operation and management of schools, including curriculum and instruction decisions. Because charter schools are funded with public dollars, critics have raised ethical issues associated with operating them for-profit. Purpose/Objective/Research Question/Focus of Study: This study compares the academic achievement of EMO-managed charter schools with other charter schools and traditional public schools in Arizona. Whereas prior EMO research has focused on total scores in mathematics and reading as the academic achievement variables, this study delves further by analyzing subtest scores that distinguish between basic and complex thinking skills. We use more sensitive test data in an effort to examine the differential impact of the educational practices of EMO-managed charter schools on academic achievement. Research Design: Student-level longitudinal test data are used for Arizona students who were enrolled in Grades 2-6 in 2001 and who remained in the same sector (EMO, non-EMO charter, or traditional public school) for the next 3 years. The test data include total scores for reading and mathematics, as well as subtest scores divided into basic and complex thinking skills. The analyses are based on a model that estimates the level of academic achievement in Year 3 using the sector of attendance as predictors and a twice-lagged achievement variable along with the other student-level covariates. Findings/Results: For students who remained in the same sector for 3 consecutive years, attendance in non-EMO-managed charter schools had a positive effect on achievement results in total mathematics. The outcome was driven by higher scores in mathematics procedures, the basic skills subtest. For students who remained in the same sector and same school for 3 consecutive years, EMO-managed charter schools exhibited a positive effect in reading vocabulary, a basic skills subtest, and a negative effect in reading comprehension, the complex thinking subtest. Conclusions/Recommendations: Previous research has illuminated many common teaching and learning characteristics of EMO-managed charter schools, such as drill and practice and standardized curricula that can be delivered by less experienced teaching staffs. Our results are the first empirical indication that the academic environments of EMO-managed charter schools may be associated with higher levels of academic achievement in basic skills at the expense of achievement in complex thinking skills, at least in reading. In all, the results are modest, but they deepen the available evidence about the academic impact of EMO-managed charter schools.

This article uses state-level achievement data to examine the academic progress of Arizona American Indian elementary public school students before and since the implementation of the No Child Left Behind (NCLB) Act. In most subjects and grades, American Indian students are making greater progress since the implementation of NCLB. Generally, American Indian students outpace all other major racial/ethnic groups. Compared to their White counterparts, however, American Indian students are most often either falling further behind or are not making sufficient progress to close the achievement gap. Most of the progress since NCLB coincides with changes to Arizona's state assessments and once data from a one-time test score spike are omitted, the achievement rates of American Indian students drop precipitously. The volatility of these results raises concerns about the integrity of state assessments in high-stakes accountability systems. Finally, recommendations are made to improve the NCLB large-scale assessment and evaluation provisions.

This article focuses on how parental school choices affect the degree of racial and academic segregation in charter schools. The research design allows for a direct comparison of the racial and academic conditions of the district schools students exited to the charter schools they entered. Parents choose to leave more racially integrated district schools to attend more racially segregated charter schools. Simultaneously, parents enroll their students into charter schools with at least the same degree of academic integration as the district schools that students exited. The academic and racial segregation results are then used to test the extent to which students congregate into specialized charter schools according to hypothesized patterns. The findings call into question the assertion of charter school advocates that segregated conditions in charter schools are the result of students self-selecting into specialized charter schools. (Contains 4 tables and 4 figures.)

This study captures the impact of school choice decisions by comparing the racial composition of the district schools students exited to the charter schools they entered. Charter school catchment areas are operationalized using a statewide student-level database to track school attendance patterns of individual students over 4 years. Charter elementary school choosers enter charter schools that are more racially segregated than the district schools they exited, although on entrance into high school, choosers enter charter schools that are as racially segregated or more integrated than the district schools they exited. In addition, racial segregation patterns are the result of White flight and Black and Native American students self-segregating into charter schools that are more racially isolated than the district schools they exit. (Contains 6 tables and 4 notes.)

Objectives: Levels of knowledge about the sexual transmission of Zika virus are consistently low in populations at risk of a mosquito-borne outbreak, including among women of childbearing age and women who are pregnant or intend to become pregnant. We investigated the effectiveness of sources of public health messaging about sexual transmission to women who are pregnant or intend to become pregnant in Arizona. Methods: In 2017, we conducted an Arizona-statewide survey 15 months after the initial release of US guidelines on sexual transmission of Zika virus. We used Poisson regression, adjusting for demographic factors, to estimate the likelihood among women who were pregnant or intended to become pregnant of knowing that Zika virus is sexually transmitted relative to other women of childbearing age. We used multinomial logistic regression models to explore associations with most used health information sources, either in person (eg, medical providers) or online (eg, Facebook), categorized by extent of dependability. Results: Women who were pregnant or intended to become pregnant had similarly poor knowledge of the sexual transmission of Zika virus as compared with other women of childbearing age (adjusted prevalence ratio = 1.14 [95% CI, 0.83-1.55]). Only about one-third of all respondents reported knowledge of sexual transmission. Reliance on high- vs low-dependability information sources, whether in person or online, did not predict the extent of Zika virus knowledge among women who were pregnant or intended to become pregnant. Conclusion: As late as the second year of local Zika virus transmission in the United States, in 2017, women in Arizona were not receiving sufficient information about sexual transmission, even though it was available. To prepare for possible future outbreaks, research should explore which aspects of Zika information campaigns were ineffective or inefficient. [ABSTRACT FROM AUTHOR]

Despite receiving little academic attention, open enrollment has the greatest potential among school choice policies to transform the governance of local school districts because all student transfers occur within the public school system, meaning that families and governance structures in two (or more) school districts are impacted by open-enrollment decisions. In this conceptual disconnection we demonstrate how open enrollment complicates the traditional educational ecosystem dramatically by altering existing relationships and introducing new actors and relationships into how school districts establish and implement policies. We then complicate the traditional analysis of open enrollment through the lens of Critical Policy Analysis, alongside an example from an Arizona school district, to illustrate the ways that racism and other forms of oppression are often overlooked, yet salient in (mis)shaping democratic governance in a political ecology disrupted by open enrollment. [ABSTRACT FROM AUTHOR]

Background/Context: Nationally, almost a quarter of charter school student's, attend a school managed by a for-profit education management organization (EMO). EMOs have full executive authority over the operation and management of schools, including curriculum and instruction decisions. Because charter schools are funded with public dollars, critics argue that the profit motive may divert funds away from academics and have a negative impact on student achievement. Purpose/Objective/Research Question/Focus of Study: This study compares the academic achievement of EMO-managed charter schools with other charter schools and traditional public schools in Arizona. Whereas prior EMO research has focused on total scores in mathematics and reading as the academic achievement variables, this study delves further by analyzing subtest scores that distinguish between basic and complex thinking skills. We use more sensitive test data in an effort to examine the differential impact of the educational practices of EMO-managed charter schools on academic achievement. Research Design: Student-level longitudinal test data are used for Arizona students who were enrolled in Grades 2-6 in 2001 and who remained in the same sector (EMO, non- EMO charter, or traditional public school) for the next 3 years. The test data include, total scores for reading and mathematics, as well as subtest scores divided into basic and complex thinking skills. The analyses are based on a model that estimates the level of academic achievement in Year 3 using the sector of attendance as predictors and a twice-lagged achievement variable along with the other student-level covariates. Findings/Results: For students who remained in the same sector for 3 consecutive years, attendance in non-EMO-managed charter schools had a positive effect on achievement results in total mathematics. The outcome was driven by higher scores in mathematics procedures, the basic skills subtest. For students who remained in the same sector and same school for 3 consecutive years, EMO-managed charter schools exhibited a positive effect in reading vocabulary, a basic skills subtest, and a negative effect in reading comprehension, the complex thinking subtest. Conclusions/Recommendations: Previous research has illuminated many common teaching and learning characteristics of EMO-managed charter schools, such as drill and practice and standardized curricula that can be delivered by less experienced teaching staffs. Our results are the first empirical indication that the academic environments of EMO-managed charter schools may be associated with higher levels of academic achievement in basic skills at the expense of achievement in complex thinking skills, at least in reading. In all, the results are modest, but they deepen the available evidence about the academic impact of EMO-managed charter schools. [ABSTRACT FROM AUTHOR]

This article uses state-level achievement data to examine the academic progress of Arizona American Indian elementary public school students before and since the implementation of the No Child Left Behind (NCLB) Act. In most subjects and grades, American Indian students are making greater progress since the implementation of NCLB. Generally, American Indian students outpace all other major racial/ethnic groups. Compared to their White counterparts, however, American Indian students are most often either falling further behind or are not making sufficient progress to close the achievement gap. Most of the progress since NCLB coincides with changes to Arizona's state assessments and once data from a one-time test score spike are omitted, the achievement rates of American Indian students drop precipitously. The volatility of these results raises concerns about the integrity of state assessments in high-stakes accountability systems. Finally, recommendations are made to improve the NCLB large-scale assessment and evaluation provisions. [ABSTRACT FROM AUTHOR]

Objectives. The purpose of this study is to assess if students enter charter schools at an academic disadvantage compared to students who make other types of school-choice decisions, such as transferring between district schools, from a charter to a district school, or staying in the same school. We assess the demographic and academic characteristics of students prior to choosing to attend a charter school in comparison to students who made other types of school-choice decisions and broaden the operational definition of a “disadvantaged” student when exploring differences between charter and district students to include academic achievement prior to entering a school. Methods. The analysis is conducted with student-level panel data and a progressive series of ANCOVA models that were estimated using ordinary least squares (OLS) regression. This methodology allows for a comparison of the mean differences in academic achievement among students who made different types of school-choice decisions while controlling for student-level covariates. Results. Students who transferred from district to charter schools had the lowest levels of prior academic achievement compared to students who made other types of choice decisions. Conclusions. When Arizona charter authorizers face the deluge of renewal decisions that are approaching, the quality of education available to the next generation of charter school students is at stake. Renewal decisions will impact what choices are available going forward and, given the comparative academic disadvantage of charter school students prior to entering, those decisions should take into consideration the starting point for students entering charter schools. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is a highly lethal cancer with few treatment options available to patients. Most HCC cases in Arizona, a state with a high proportion of Hispanic adults, have not been included in recent reports of HCC incidence. This study describes trends in HCC incidence and stage at diagnosis among Arizona residents between 2009–2017 and reports on racial and ethnic disparities for these outcomes. The Arizona Cancer Registry was used to identify Arizonans aged 19 or older diagnosed with liver cell carcinoma diagnosed between 2009–2017. A total of 5043 cases were examined. Adjusted annual and 3-year HCC incidence rates (per 100,000) were examined for non-Hispanic White (NHW) and Hispanic adults. The total age-adjusted HCC incidence rate increased significantly between 2009–2012 and then declined significantly between 2012–2017. Across nearly all years, age-adjusted HCC incidence in Hispanic adults was twice that of NHW adults. Hispanic adults were more likely to be diagnosed at a later stage across all time periods. The disparity in 3-year age-adjusted HCC incidence rate between NHW and Hispanic adults decreased between 2009–2017. Whe total age-adjusted HCC incidence rate increased significantly between 2009–2012 and then declined significantly between 2012–2017. Across nearly all years, age-adjusted HCC incidence in Hispanic adults was twice that of NHW adults. Hispanic adults were more likely to be diagnosed at a later stage across all time periods. The disparity in 3-year age-adjusted HCC incidence rate between NHW and Hispanic adults decreased between 2009–2017. [ABSTRACT FROM AUTHOR]

Mexicans in the United States have been reported to maintain practices of Mexican traditional medicine at comparably higher rates than most other populations, including other Latino sub-groups. In this cross-sectional study, we examined the pre- and post-migration traditional medicine practices of first-generation immigrants from Mexico living in southern Arizona. Our objective was to assess how migration affected Mexican immigrants' ethnomedical practices and to better understand the mechanisms and motivating factors for the post-migration maintenance of practice. We designed a survey instrument based off prior qualitative data on traditional medicine practices and translated it into Spanish. The survey measured the rates and frequency of six domains of lay healing practices: herbal medicine, healing foods, self-medication with over-the-counter medicine, and three types of specialty healers (curandero/a, and sobador/a, or partero/a), and asked questions about knowledge sources, reasons for maintaining practice post-migration, and to what extent participants believed the remedies were effective. The research team fielded the telephone-based survey from April 2022 to February 2023 to 300 first-generation adult Mexican immigrants residing in southern Arizona. A series of proportions tests were conducted to examine differences in reliance on lay healing pre- and post-migration as well as to assess differences between women's and men's lay practices. The data indicate a general, but moderated decline in lay medical practices post-migration, with the usage of expert healers declining at much higher rates than the three self-care domains. Women tend to use herbal medicine and healing foods at higher rates than men post-migration. This cross-sectional quantitative study confirms prior research indicating that traditional medicine practices are heavily relied upon by Mexican origin people both pre- and post-migration. These findings suggest that public health messaging and medical providers should better address and harness Mexican immigrants' lay medical practices in order to optimize health in this population. • 92.3 % of Mexicans surveyed continued using traditional medicine post-migration. • Mexican women were more likely than men to maintain some lay medical practices. • Food-based remedies showed no statistically significant decline post-migration. • Frequency of lay medical practices in Mexico affected post-migration rates. • Mexicans cited manifold reasons for continuing traditional medicine in the US. [ABSTRACT FROM AUTHOR]

Liver cancer is a highly fatal condition disproportionately impacting American Indian populations. A thorough understanding of the existing literature is needed to inform region-specific liver cancer prevention efforts for American Indian people. This integrative review explores extant literature relevant to liver cancer in American Indian populations in Arizona and identifies factors of structural inequality affecting these groups. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the methodology, and a literature search was conducted in PubMed, EMBASE, CINAHL, and PsycInfo for articles including Arizona American Indian adults and liver disease outcomes. Seven articles met the inclusion criteria in the final review. Five of the studies used an observational study design with secondary analysis. One article used a quasiexperimental approach, and another employed a community-engagement method resulting in policy change. The results revealed a lack of empirical evidence on liver cancer prevention, treatment, and health interventions for American Indian populations in Arizona. Research is needed to evaluate the high rates of liver disease and cancer to inform culturally relevant interventions for liver cancer prevention. Community-engaged research that addresses structural inequality is a promising approach to improve inequities in liver cancer for American Indian people.