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Journal of Neurology Research

Short Communication

Volume 12, Number 2, August 2022, pages 76-91

Toward Health Equity in Neuroscience: Current Resources and Considerations for Culturally Broadening Educational Curricula

Neuroscience has had a massive impact in both basic and clinical spheres over the past decades, but equity and access concerns remain. The proliferation and progress of research and translation has not gone unnoticed, with organizations such as the International Brain Initiative, the Canadian Brain Research Strategy, the US BRAIN Initiative, and the Human Brain Project representing the widespread support and interest in investing in and further developing the field on a global landscape. With psychologists, molecular biologists, computer scientists, chemists, engineers, and many others all encompassed under the broad scope of neuroscience, this highly interdisciplinary field is in need of an equally wide range of trainees with varied cultural backgrounds. Students may be inspired to pursue higher education in these areas, but there is no standard expectation that they be introduced to neuroscience prior to university. Science, technology, engineering and math (STEM) outreach is a priority today [1-3]; discourse on the importance of broadening educational perspectives to promote health equity writ large is limited [4-6].

Many organizations such as the Society for Neuroscience (SfN) [7], the Association for Psychological Science [8], and the National Institutes of Health [9] have responded to fulfill this need. SfN’s Brainfacts.org has its own editorial board, and the US-based National Science Teachers Association has published lesson plans for elementary, middle, high school and post-secondary education (https://www.nsta.org/lesson-plans), as has the National Biology Teachers Association (https://nabt.org/Resources-American-Biology-Teacher). University neuroscience departments, such as the one housed by the University of Minnesota (BrainU.org) have also implemented independent youth outreach programs to introduce neuroscience concepts to school-aged youth [8, 10-13]. With an ever-increasing focus on preparing the youth of today for the neurological sciences of tomorrow, guidance for customizing curricula that speaks to the diversity of perspectives and values are still needed. Indeed, as Rogers-Chapman highlighted in 2014, interest in pursuing STEM education from historically marginalized populations and people from low-income households rises steeply when their views and backgrounds are explicitly considered [14]. And, as Hahn et al [5] (2015) have argued, health equities are similarly improved when outreach is tailored for a community.

To encourage a similar trend in neuroscience outreach, the overarching objective of the present work, broadening the perspective through which curricula are designed and offered is one answer. Such adjustments will not only promote curiosity for the neurological sciences, but also instill confidence, capacity, and a sense of equitable belonging along the trajectory of training to professional choice and placement in a majority dominated field [15-17].

Institutional review board approval was not applicable. This study was conducted in compliance with the ethical standards of the responsible institution on human subjects as well as with the Helsinki Declaration.

We conducted two independent sets of searches to yield resources broadly for neuroscience based on the peer-reviewed literature, and resources specifically from the Canadian literature on Indigenous approaches to teaching about science, with a focus on brain and mind to complement it. Both searches, drawing upon methods described for example by Tricco et al [18] (2018) and Harding et al [19, 17] (2021), were conducted in May 2021.

We searched Google Scholar, Education Resources Information Center (ERIC), Web of Science, EBSCO Academic Search Premier, Education Source, Teacher Reference Center, and APA PsycInfo using the following search strings and related variants: “youth”, “neuroscience”, “brain”, “mental health, “curriculum”, “workshops” and “education” and their combinations to identify published neuroscience outreach programs and curricula. The databases were chosen based on their focus on education and resource development. Inclusion criteria were English-language full text, related to the design, implementation, and evaluation of a program with neuroscience content, targeted at youth in high school and younger, and involved workshop activities and curricula.

Test strings included terms in three categories for maximum capture: population (e.g., youth, adolescents, urban, rural), intervention (e.g., curriculum, teaching, outreach, early intervention, programming, ethical design), and topic (e.g., science, neuroscience, brain, mind, mental health, wellness, mental health literacy). Search terms were refined for a final capture of papers most relevant to our objectives. Returns were manually curated to exclude irrelevant articles that remained, and duplicates. We also cross-referenced returns with searches of the first 10 pages of Google Scholar and sites of SfN, Canadian Association for Neuroscience, International Brain Research Organization, and Human Brain Project for relevant material on youth education to ensure a closed set of papers.

We focused on Canadian Indigenous content for approaches to cultural adaptation of curricula given the geographic location of the author group, the commitment of this country to Truth and Reconciliation [20], and priorities for neuroscience recently articulated by the Canadian Brain Research Strategy [15]. In this regard, we conducted a search for papers on Indigenizing science curricula and outreach to youth in Canada as the specific lens for this aspect of the project. To achieve a complementary goal to the first search, we mined eight databases (Informit Indigenous Collection, Education Source, Education Resources Information Center (ERIC): Free, LearnTechLib, PsycINFO, Teacher Reference Center, and Web of Science) using key words and strings, and their variants and combinations, for “Canada”, “Indigenous”, “science”, “brain”, and “mind”.

To meet the resource delivery objectives of this work, the final set of eligible papers reporting on neuroscience curricula were organized according to year of publication, format and length of the program, range of neuroscience topics covered, populations targeted (e.g., age group), methods to assess the program, and overall impact of the outreach. Analysis and summary of the final set of articles on Indigenous approaches were adapted for details and variables most relevant to them by year of publication, population, intervention, topic, methods of assessment, and reported impact. Articles were read and reviewed by the authors for content relevant to resource delivery objectives of the work. Consolidated notes were organized in table format.

Thirteen papers reporting on neuroscience curricula met inclusion criteria (Fig. 1). Fifteen were excluded as they did not contain workshop-specific content. Full text was inaccessible for three. All papers were published between 2006 and 2020. Table 1 [21-33] summarizes the 13 articles analyzed in detail. The number of students reached by each of the programs ranged from 18 to 9,000.

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Figure 1. Search process, returns, and curation for youth neuroscience outreach literature.

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Table 1. Studies on Youth Neuroscience Outreach

Seven studies utilized pre-existing curricula or learning goals such as the BrainLink curriculum or the SfN core concepts and resources; five studies designed their own lesson plans and activities. Twelve of 13 articles reported on curricula based on workshops; one reported on a series of neuroscience workshops included into a school term [23]. The majority of these articles targeted the K-12 population, (10/13 articles) with the exception of one study that focused specifically on preschoolers [26] and two studies that targeted high schoolers [30, 32]. The majority of workshops included a combination of mini-lecture style presentations and hands-on activities (11/13 articles), which varied depending on the age range of the students, from building pipe cleaner neurons (2/13 articles) to sheep brain dissections (3/13 articles). One article provided in-depth guidelines for activities based on age range and student capability with varying activities within different categories such as neuroanatomy, drugs, neurologic and mental health disorders, and brain function [24]. Workshop duration varied from sessions of 45 - 60 min (5/13 workshops) to 8-h sessions (1/13 workshops). Program length ranged from 3 days [21] to 20 weeks [30]. The majority of the programs were designed and hosted by undergraduate students (10/13 articles). Six of 13 articles described curricula targeting underserved youth specifically.

All workshops taught basic neuroscience concepts. Four workshops included neurodegenerative diseases and disorders in their curriculum [23, 29, 32, 33]; three included drug and drug effects [27, 29, 33]. Across workshops, similar activities as described in the section above were used to teach structure and function of the brain and nervous system. Some workshops expanded beyond basic neuroscience to include skills such as understanding neuroscience in journal articles [28], sleep and dreaming [29], brain plasticity and learning [21, 26]), and genetics and behavior [21].

Results suggest that workshops are particularly effective in improving science communication skills (11/13 articles) and understanding of neuroscience concepts (12/13 articles) among youth. Eight articles described pre and post quizzes; two types of surveys were used by two workshops to assess impact both on neuroscience and STEM; five used one method or the other.

Undergraduate partnership programs provided an opportunity for undergraduates to utilize their knowledge of neuroscience topics and improve their science communication skills (6/13 workshops). Undergraduates themselves demonstrated an increase in skills related to science communication, leadership, teaching, organizational skills, self-confidence, and time management. For example, survey results from the Hope College Brain Awareness Week demonstrate that these events provided valuable skills and lessons for undergraduate students [25]. The average assessment of the impact of outreach (-5 = a significant negative impact on life or skills, 0 = no impact, 5 = a significant positive impact on life or skills) consistently fell above 2.24 with the highest impact being excitement about science communication (4.12 average), teaching skills (3.82 average), and communication skills (3.76 average).

Eighteen articles were included for Indigenizing teaching of western materials of 39 total. Sixteen were excluded from the total return of 31 as they did not contain methods on Indigenizing curricula; five were inaccessible. All papers were published between 2005 and 2020. The reports were a mix of primary research articles reporting on workshops, literature reviews, and case studies (Table 2) [34-51].

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Table 2. Studies on Indigenizing Science Curricula

Various tools were used to assess the workshops: interviews [34, 36, 38, 47, 50], self-assessments or self-reflections [36, 40, 46], and talking circles, group discussions, or storytelling [34, 39, 42-44]. Other assessment methods included the “what + how = value” equation [41]. Five articles reported that incorporating various features of Aboriginal pedagogy into teachings have significant impacts on student engagement, motivation, and general understanding [35, 38, 41, 50, 51].

Overall, the papers focused on approaches such as the medicine wheel of learning pedagogy, incorporating Indigenous protocol, and place-based education.

Seven of 18 articles described how the medicine wheel of learning pedagogy (MWLP) ensures that students “learn in a whole and balanced manner” and that all four dimensions of an individual are actively engaged and committed in the educational process [36]. These four dimensions are given varying names in the literature but overall tend to represent mental, spiritual, emotional, and physical elements. The MWLP encompasses the ideas of incorporating culture, promoting a good environment, and utilizing appropriate learning styles.

Twelve papers described how incorporating Indigenous culture requires including Indigenous protocols and educating children through traditional Indigenous approaches to learning and growing. The protocols included the use of talking circles (3/12), healing circles (3/12), prayers (3/12), storytelling (5/12), traditional medicine (2/12), two-eyed seeing (4/12), and involvement of Elders (6/12).

Six papers touched on the impact of place when conducting teaching. Two of these promoted delivering curricula on the appropriate land by hosting cultural events in the community, or by visiting local facilities to better connect the students to the material and highlight the interconnectedness of learning. The remaining four underscored the importance of directly participating with the natural world and incorporating hands-on learning to offer context and understanding.

The material available online on teaching neuroscience specifically and science more broadly to youth today represents an exciting array of conventional and novel approaches, and includes ways to assess their efficacy for nimble updating and refinement. Search engines have their limitations, and in this respect, we recognize that some programs may have been missed. In addition, we only focused on Canadian-based Indigenous methods towards broadening and acculturating curricula here. Some methods may be generalizable or transferable, but we recognize and respect the heterogeneity of all cultural groups. Other relevant resources that may be accessed to even further broaden teachings than those captured here are available from writings, for example, from self-healing communities [52, 53], addressing native culture within science curricula [54] and science standards in the USA [55, 56], and books such as No Snow Day for the Brain [57].

The resource here consolidates peer-reviewed reports on neuroscience curricula available at the time of this writing, as well as approaches that center on Canadian Indigenous epistemologies. The marriage of the two has not been previously attempted in the neurological sciences, and it applies to teaching students from all backgrounds beginning at the earliest stages of intervention. We do not attempt to directly compare the results from each phase of work or differentially value or evaluate the strengths or weaknesses of the different programs presented here. They are complementary and each has much to offer. Their attributes can be integrated and adapted in many ways in the evolution and delivery of future neuroscience curricula. The benefits conferred by such interventions are further reaching than simply increasing students’ interest in neuroscience. Indeed, early and acculturated education has been shown to improve health equity in underserved populations in three specific domains: increasing professional diversity, creating more accessible and relevant education, and boosting health literacy [4-6].

Health equity is improved when practitioners and researchers represent the various cultures and social backgrounds of the communities they serve. A representative clinical workforce engenders trust among patients, and better communication through common language. Trust is also enhanced in research when representation is proportionate to target populations, as is the opportunity for inclusive study designs and meaningfully generalizable results [4].

Achieving a diverse workforce in brain health is a direct result of the dedicated goal of capacity building, and capacity building is made possible when education is accessible and contextually relevant. As reported above, when curricula are adapted to specific populations, student interest and engagement increase [34, 35, 48, 50, 51], as do subsequent pathways to future educational attainment. The net result of accessible education is expanded and culturally diverse peer-to-peer and professional pools that have the on-the-ground capabilities and knowledge to directly impact health inequities.

Education is a social determinant of health, and educational interventions have been shown to enhance health literacy and improve health-related outcomes [5, 6]. Culturally adapted curricula embrace the nuances and distinctiveness of different populations, and recognize, respect, and uphold their autonomy and right to delf-determination.

The neurological sciences must embrace the need for an expanded educational dynamic. In doing so, the goals of enriched inclusivity of the field, capacity building, and global investment in health equity in both the present and future will be met. This commentary brings together curricula from the peer-reviewed literature for teaching neuroscience to youth alongside published methods that can broaden their reach and cultural meaningfulness. It provides a resource for engaging youth in neuroscience and is a move towards closing gaps in brain and health equity through outreach and capacity-building for diverse groups.

Acknowledgments

The authors acknowledge the contributions of Caterina Marra to this project, and thank Lydia Feng, Vyshu Manohara, Miles Schaffrick and Anna Nuechterlein for their editorial assistance. We also gratefully acknowledge reviewers for their helpful comments on a prior version of this manuscript.

Financial Disclosure

Supported in part by a Network/Catalyst grant from the Canadian Institutes of Health Research (CIHR) (#171583;03027 IC-127354) for the establishment of a Canadian Brain Research Strategy (JI, Co-PI), the Vancouver Coastal Health Research Institute and the North Family Foundation (JI). JI is a Distinguished University Professor and the UBC Distinguished Professor in Neuroethics.

Conflict of Interest

None to declare.

Informed Consent

Not applicable.

Author Contributions

AL and JI developed the concept for this report. CL and AL conducted the literature searches and analyzed the results. AL, JI, and CL interpreted the articles and wrote the manuscript. All authors discussed the report and reviewed the manuscript at all stages.

Data Availability

The authors declare that data supporting the findings of this study are available within the article.

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