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Competitive debate programs exist across the globe, and participation in debate has been linked to improved critical thinking skills and academic performance. However, few evaluations have been able to adequately address self-selection into the activity when examining its impact on achievement. This study evaluated the relationship between participating in a debate program and academic performance among high school students (N=35,788; 1,145 debaters and 34,643 non-debaters) using linked debate participation and academic record data from the Houston Independent School District. Academic performance was indicated by cumulative GPA and performance on the SAT college entrance exam. Selection into debate was addressed using propensity score methods informed by sociodemographic characteristics and 8th grade standardized test scores to account for pre-debate achievement. Debate participation was associated with 0.66 points (95% Confidence Interval (CI): 0.64, 0.68) higher GPA, 52.43 points (95%CI: 50.47, 54.38) higher SAT Math, and 57.05 points (95% CI: 55.14, 58.96) higher SAT Reading/Writing scores. Findings suggest that competitive debate is associated with better academic outcomes for students.

Prior work has demonstrated that debate is associated with academic achievement in high school. Whether debate in high school is predictive of better college outcomes beyond its established relationship with promoting college readiness as indicated by the ACT is unknown. This research examines and evaluates the impact of participating in a high school debate program on college matriculation and completion. Data come from a cohort of 6,411 high school graduates from the Chicago Public School system, 26% of whom participated in the Chicago Debate League, from 1997 to 2007. Logistic regression was used to estimate the relationship between debate participation and college matriculation, type of college attended, and college graduation, with college-readiness, as indicated by performance on the ACT, examined as a mediating variable. Debaters were more likely to matriculate to college, particularly to 4-year versus 2-year institutions, than comparison students and these relationships were largely explained by debaters' better performance on the ACT. However, debate was not associated with higher likelihood of graduating from college.

Background: Hispanics/Latinos in the United States experience both a health advantage and disadvantage in developing diabetes. Ethnic identity, a predictor of psychological well-being, has not been widely applied to physical health outcomes. The objective of this study is to apply what is known regarding ethnic identity and psychological health to physical health outcomes (diabetes) and to explore the moderating effect of education as a possible underlying mechanism of the Hispanic Health Advantage/Disadvantage. Specifically, this study examines (a) the association between ethnic identity and diabetes prevalence among adult Hispanics/Latinos and (b) determines whether education modifies this relationship. Method: Data come from the nationally representative adult U.S. household study, National Latino and Asian American Study (NLAAS), collected in 2001 to 2003 (N = 1,746). Multiple logistic regression was conducted to examine the relationship between ethnic identity, education, and their interaction with likelihood of diabetes. Results: Hispanics/Latinos with high ethnic identity have a higher odds of reporting diabetes among those with 13 to 15 years of education (odds ratio: 1.84; 95% confidence interval: 1.16-2.92) and a lower odds among those with 16+ years of education (odds ratio: 0.53; 95% confidence interval: 0.34-0.84). Ethnic identity is associated with diabetes prevalence and the relationship is moderated by educational attainment. Conclusion: Given the growth, diversity, and diabetes disparities among Hispanics/Latinos, our buffering and exacerbating findings exemplify the complexity and fluidity of theory in understanding psychological/behavioral processes. The findings highlight the importance of designing targeted health interventions that take into account the diverse psychosocial and educational experiences of Hispanics/Latinos.

Background and Objectives Although coordinated care (CC) seeks to improve patient experiences and ultimately health outcomes, evidence from empirical research on the impacts of CC is mixed. This study examined the relationship between CC and healthcare outcomes over a 4-year period among older adults with multiple chronic conditions. Research Design and Methods This observational cohort study is based on data from the 2016–2020 Health and Retirement Study. Analysis is limited to respondents with 2+ chronic conditions who completed an experimental module on CC in 2016 (n  = 906). Three domains of CC were assessed: perceptions, informal (family/friends) and formal (healthcare staff) tangible support, and technical support (using a "patient portal"). The longitudinal relationship between CC and health (e.g. pain, functioning, and self-rated health [SRH]) and healthcare (e.g. doctor visits, hospitalization, and care satisfaction) outcomes was investigated using mixed-effects models. Results Better perceptions of CC were associated with lower odds of ADL limitations (Odds ratio [OR] = 0.91; 95% CI = 0.84–0.99) and greater satisfaction with care (B = 0.04, 95% CI = 0.02–0.06). Receipt of more informal tangible support was associated with 1.34 higher odds of ADL limitations (95% CI = 1.19–1.51) and 1.74 higher odds of hospitalization (95% CI = 1.07–1.21). Use of technical support was associated with better SRH and greater satisfaction with care. Discussion and Implications The longitudinal relationship between CC and health is multifaceted. Although positive perceptions and more technical support have beneficial effects on health outcomes, higher utilization of tangible support may reflect a higher demand among older adults with more complex healthcare needs. [ABSTRACT FROM AUTHOR]

From 2018–2020, 19 states enacted Medicaid work requirements as a strategy for reducing program enrollment and overall cost. While these requirements were later rescinded, strategies to reduce Medicaid costs are likely to reemerge as states attempt to recover economically from the COVID-19 pandemic. Here, we evaluated the impact of Medicaid work requirements on adults aged > 50, a group that likely faces significant age-related chronic disease burden. Using 2016 Health and Retirement Study data, we evaluated the chronic disease burden of adult Medicaid beneficiaries aged 51–64 years (n = 1460) who would be at risk of losing their Medicaid coverage due to work requirements. We compared Medicaid beneficiaries working <20 hours per week (i.e. those at risk of coverage loss) to those working at least 20 hours per week on eight chronic health conditions, adjusting for demographic characteristics. Among those with chronic health conditions, we also evaluated differences in disease severity based on hours worked per week. Among those working fewer than 20 hours per week, odds of disease were greater for seven of eight chronic conditions, including history of stroke (OR: 5.66; 95% CI: 2.22–14.43) and lung disease (OR: 3.79; 95% CI: 2.10–6.85). Further, those with greater disease severity were likely to work fewer hours. Thus, the introduction of Medicaid work requirements would likely result in coverage loss and lower access to care among older Medicaid beneficiaries with multiple chronic health conditions. [ABSTRACT FROM AUTHOR]