Improving the economic, social, and health outcomes of vulnerable populations.

For people who face physical, cognitive, or environmental challenges, life is too often a series of setbacks that can include high rates of unemployment and poverty, chronic medical problems, poor educational outcomes, or social isolation. Through effectively applied research, the KDHRC program on Vulnerable Populations helps people deal with such challenges and setbacks and achieve healthier and more successful lives.

The Cochlear Implant Support Center: Online Resources for Older Adults

The Cochlear Implant Support Center will be an online support center to help older adults with CIs optimally use and benefit from their CIs.

Project PENCIL

Project PENCIL offers practical, research-based support to parents and teachers of children with chronic illness and intermittent school attendance by increasing their ability to navigate the school system and advocate for school services with less stress and greater confidence.

Cochlear Implant University (CIU)

CIU supports students with cochlear implants with self-advocacy training in their transition into higher education.

The Cochlear Implant School Toolkit

The Cochlear Implant School Toolkit helps parents and teachers build knowledge, attitudes, and self-efficacy to manage the educational needs of children with CIs and provides parents and teachers with practical skills to understand, navigate, and advocate for school services.

Publications

KDHRC contributes to the fields of public health, health communication, and organizational studies through our academic and mainstream publications.

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Boosting Students' Knowledge of and Attitudes About Science

Eric C. Twombly, Nicole I. Wanty, & Kristen D. Holtz, KDH Research & Communication
Research Brief

Science literacy and academic achievement on science topics empower youth to think critically and understand and apply scientific findings in their daily lives. However, students in the United States perform lower on science achievement tests than many of their international peers. Only 68 percent of fourth grade students perform at or above a basic achievement level. This rate drops to 59 percent by eighth grade and 54 percent by twelfth grade. KDH Research & Communication developed Attitude Boost (AB), a multimedia curriculum, to build elementary and middle school students’ positive attitudes toward science and increase science literacy and achievement. This research brief presents the findings of the AB outcome evaluation among fifth and eighth grade students.

November 2016
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Boosting Students' Knowledge of and Attitudes About Science

Eric C. Twombly, Nicole I. Wanty, & Kristen D. Holtz, KDH Research & Communication
Research Brief

Science literacy and academic achievement on science topics empower youth to think critically and understand and apply scientific findings in their daily lives. However, students in the United States perform lower on science achievement tests than many of their international peers. Only 68 percent of fourth grade students perform at or above a basic achievement level. This rate drops to 59 percent by eighth grade and 54 percent by twelfth grade. KDH Research & Communication developed Attitude Boost (AB), a multimedia curriculum, to build elementary and middle school students’ positive attitudes toward science and increase science literacy and achievement. This research brief presents the findings of the AB outcome evaluation among fifth and eighth grade students.

November 2016
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Evaluating an Effort to Improve Parents' Ability to Obtain Educational Services For Their Chronically Ill Children: Lessons from Project PENCIL

Rosa M. Steen, Eric C. Twombly, Louise C. Palmer, & Kristen D. Holtz, KDH Research & Communication

Parents are instrumental in obtaining and managing educational services for a student with a chronic illness, but may lack the knowledge to do so. Project PENCIL’s parent component contains information for parents to address the academic and social needs of their student with a chronic illness and aims to significantly increase parents’ knowledge about the educational services available for their student with a chronic illness. This research brief presents the evaluation findings of Project PENCIL’s parent component.

August 2014
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Evaluating an Effort to Improve Parents' Ability to Obtain Educational Services For Their Chronically Ill Children: Lessons from Project PENCIL

Rosa M. Steen, Eric C. Twombly, Louise C. Palmer, & Kristen D. Holtz, KDH Research & Communication

Parents are instrumental in obtaining and managing educational services for a student with a chronic illness, but may lack the knowledge to do so. Project PENCIL’s parent component contains information for parents to address the academic and social needs of their student with a chronic illness and aims to significantly increase parents’ knowledge about the educational services available for their student with a chronic illness. This research brief presents the evaluation findings of Project PENCIL’s parent component.

August 2014
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Assessing a Program to Improve Teachers' Ability to Effectively Implement Educational Accommodations for Chronically Ill Learners: Lessons from Project PENCIL

Louise C. Palmer, Rosa M. Steen, Eric C. Twombly, & Kristen D. Holtz, KDH Research & Communication

Children with chronic illness comprise roughly 20 percent of school-aged students in the United States. Due to their illnesses, these students miss an average of 16 school days annually, compared with three days for typically healthy children. The combination of chronic illness and school absences negatively impacts such children’s academic and social experience. KDH Research & Communication developed Project PENCIL (Protecting the Educational Needs of Chronically Ill Learners), a training program to improve the ability of Kindergarten through fifth grade teachers to provide educational accommodations in their classrooms for children with chronic illnesses. This research brief presents the evaluation findings of Project PENCIL Teachers’ Guide prototype.

October 2014
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Assessing a Program to Improve Teachers' Ability to Effectively Implement Educational Accommodations for Chronically Ill Learners: Lessons from Project PENCIL

Louise C. Palmer, Rosa M. Steen, Eric C. Twombly, & Kristen D. Holtz, KDH Research & Communication

Children with chronic illness comprise roughly 20 percent of school-aged students in the United States. Due to their illnesses, these students miss an average of 16 school days annually, compared with three days for typically healthy children. The combination of chronic illness and school absences negatively impacts such children’s academic and social experience. KDH Research & Communication developed Project PENCIL (Protecting the Educational Needs of Chronically Ill Learners), a training program to improve the ability of Kindergarten through fifth grade teachers to provide educational accommodations in their classrooms for children with chronic illnesses. This research brief presents the evaluation findings of Project PENCIL Teachers’ Guide prototype.

October 2014
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Building Knowledge and Positive Attitudes as a Basis for Social Acceptance for Children with Cochlear Implants

Nicole I. Wanty, Eric C. Twombly, Kristen D. Holtz, & Louise C. Palmer, KDH Research & Communication

Children with differences, such a cochlear implants (CIs), are at greater risk for low social acceptance than typical children. Social acceptance is the extent to which a child can successfully initiate and maintain reciprocal relationships with his or her peers. Low social acceptance early in life often relates to lasting poor self-esteem and social isolation. KDH Research & Communication developed a peer education intervention entitled Making Sense of Your Senses, which consists of an 8-minute DVD and structured classroom lesson implemented by the classroom teacher that defines and describes a CI and hearing loss and inclusive ways encourages typical peers to act in socially inclusive ways. This research brief examines the effectiveness of the peer education intervention to build typical peers’ knowledge and positive attitudes to support the social acceptance of children with CIs.

April 2013
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Building Knowledge and Positive Attitudes as a Basis for Social Acceptance for Children with Cochlear Implants

Nicole I. Wanty, Eric C. Twombly, Kristen D. Holtz, & Louise C. Palmer, KDH Research & Communication

Children with differences, such a cochlear implants (CIs), are at greater risk for low social acceptance than typical children. Social acceptance is the extent to which a child can successfully initiate and maintain reciprocal relationships with his or her peers. Low social acceptance early in life often relates to lasting poor self-esteem and social isolation. KDH Research & Communication developed a peer education intervention entitled Making Sense of Your Senses, which consists of an 8-minute DVD and structured classroom lesson implemented by the classroom teacher that defines and describes a CI and hearing loss and inclusive ways encourages typical peers to act in socially inclusive ways. This research brief examines the effectiveness of the peer education intervention to build typical peers’ knowledge and positive attitudes to support the social acceptance of children with CIs.

April 2013
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The Evaluation Results of a Public Health Tool to Help Teachers Effectively Accommodate and Teach Children with Cochlear Implants in Mainstream Classrooms

Louise C. Palmer, Jana Eisensten, Eric C.Twombly, Kristen D. Holtz, & Nicole I. Wanty, KDH Research & Communication

Over 28,400 deaf or hard of hearing children in the United States wear cochlear implants, which bypass the damaged or nonfunctioning parts of the ear to create a representation of sound for the wearer (National Institute on Deafness and Other Communication Disorders, 2011). Increasingly, children who wear cochlear implants enter mainstream schools, where they attend classes with typically-abled peers. KDH Research & Communication developed The Cochlear Implant School Toolkit to help elementary school students with cochlear implants and their teachers, parents, and peers overcome the challenges that may accompany their entrance into a mainstream school. This research brief reports on the evaluation of the Teachers’ Guide and DVD components of the Cochlear Implant School Toolkit.

November 2011
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The Evaluation Results of a Public Health Tool to Help Teachers Effectively Accommodate and Teach Children with Cochlear Implants in Mainstream Classrooms

Louise C. Palmer, Jana Eisensten, Eric C.Twombly, Kristen D. Holtz, & Nicole I. Wanty, KDH Research & Communication

Over 28,400 deaf or hard of hearing children in the United States wear cochlear implants, which bypass the damaged or nonfunctioning parts of the ear to create a representation of sound for the wearer (National Institute on Deafness and Other Communication Disorders, 2011). Increasingly, children who wear cochlear implants enter mainstream schools, where they attend classes with typically-abled peers. KDH Research & Communication developed The Cochlear Implant School Toolkit to help elementary school students with cochlear implants and their teachers, parents, and peers overcome the challenges that may accompany their entrance into a mainstream school. This research brief reports on the evaluation of the Teachers’ Guide and DVD components of the Cochlear Implant School Toolkit.

November 2011
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Exploring the Use of the Internet by Caregivers of People with Autism Spectrum Disorders to Obtain Caregiving Information

Eric C. Twombly, Kristen D. Holtz, & Alison Daub, KDHRC
Working Paper 10-001

This paper reports on data from a population of caregivers of people with Autism Spectrum Disorders (ASD) to examine the extent and motivations for their use of the Internet to obtain information on caregiving. We find considerable interest for Web-based information, but a strong bifurcation among respondents on the preferential type of information. The majority of respondents indicate that Web sites that provide factual information about caregiving are most important. Other respondents see the Internet as a vehicle for social exchanges about ASD. Regardless of their preferred method to consume Web-based information, all respondents reported using Web sites to obtain caregiving information.

December 2010
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Exploring the Use of the Internet by Caregivers of People with Autism Spectrum Disorders to Obtain Caregiving Information

Eric C. Twombly, Kristen D. Holtz, & Alison Daub, KDHRC
Working Paper 10-001

This paper reports on data from a population of caregivers of people with Autism Spectrum Disorders (ASD) to examine the extent and motivations for their use of the Internet to obtain information on caregiving. We find considerable interest for Web-based information, but a strong bifurcation among respondents on the preferential type of information. The majority of respondents indicate that Web sites that provide factual information about caregiving are most important. Other respondents see the Internet as a vehicle for social exchanges about ASD. Regardless of their preferred method to consume Web-based information, all respondents reported using Web sites to obtain caregiving information.

December 2010
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Minimizing Institutional and Instructional Barriers to Increase Students' Health Literacy Through Genetics Education

Stephanie N. MacLaverty, Eric C. Twombly, & Kristen D. Holtz, KDHRC
Working Paper 09-001

One traditional avenue to developing health literacy is through health educational curriculum in primary and secondary schools. However, recent policy shifts that emphasize core curriculum learning standards decreased the ability of schools to offer health content. Thus, supplementing the core genetics curriculum with health content is a possible approach to increase health literacy in the current educational environment. Qualitative data suggest that control is the primary institutional and instructional barrier to the adoption and use of supplemental genetics educational materials. However, teachers report that supplemental educational materials with specific elements can help minimize this barrier and allow teachers flexibility to maximize the health content they can deliver. But to effectively build health literacy, supplemental materials must relate genetics to personal health. When combined with effective teaching practices, such as inquiry-based activities and content that is adaptable to different levels of student ability, supplemental genetics materials may help minimize barriers and make genetics education an effective conduit to build students’ health and genetic literacy.

November 2009
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Minimizing Institutional and Instructional Barriers to Increase Students' Health Literacy Through Genetics Education

Stephanie N. MacLaverty, Eric C. Twombly, & Kristen D. Holtz, KDHRC
Working Paper 09-001

One traditional avenue to developing health literacy is through health educational curriculum in primary and secondary schools. However, recent policy shifts that emphasize core curriculum learning standards decreased the ability of schools to offer health content. Thus, supplementing the core genetics curriculum with health content is a possible approach to increase health literacy in the current educational environment. Qualitative data suggest that control is the primary institutional and instructional barrier to the adoption and use of supplemental genetics educational materials. However, teachers report that supplemental educational materials with specific elements can help minimize this barrier and allow teachers flexibility to maximize the health content they can deliver. But to effectively build health literacy, supplemental materials must relate genetics to personal health. When combined with effective teaching practices, such as inquiry-based activities and content that is adaptable to different levels of student ability, supplemental genetics materials may help minimize barriers and make genetics education an effective conduit to build students’ health and genetic literacy.

November 2009
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Evaluation of a Peer-Focused Intervention to Increase Knowledge and Foster Positive Attitudes Toward Children with Tourette Syndrome

Kristen D. Holtz, KDHRC & Greta K. Tessman, Emerson College and Tufts University
Working Paper 07-002

This study examines the impact of a video-based intervention to increase children’s knowledge and positive attitudes toward a peer with Tourette Syndrome (TS). TS, a neurological disorder characterized by verbal and motor tics, is a confusing and potentially stigmatizing disorder. Although symptoms wax and wane over the life span, TS typically begins in childhood and peaks at puberty. The available literature suggests that people with TS are at risk for social rejection; because TS is primarily a childhood disorder, many of the social adjustment problems experienced by people with the disorder have their roots in negative childhood experiences in the classroom.
An intervention was developed and evaluated using a pretest, posttest control group study. Children exposed to the intervention video showed greater changes in knowledge, positive attitudes, and behavioral intentions than a control group. Such interventions may have potential to improve social outcomes for children with differences.

August 2007
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Evaluation of a Peer-Focused Intervention to Increase Knowledge and Foster Positive Attitudes Toward Children with Tourette Syndrome

Kristen D. Holtz, KDHRC & Greta K. Tessman, Emerson College and Tufts University
Working Paper 07-002

This study examines the impact of a video-based intervention to increase children’s knowledge and positive attitudes toward a peer with Tourette Syndrome (TS). TS, a neurological disorder characterized by verbal and motor tics, is a confusing and potentially stigmatizing disorder. Although symptoms wax and wane over the life span, TS typically begins in childhood and peaks at puberty. The available literature suggests that people with TS are at risk for social rejection; because TS is primarily a childhood disorder, many of the social adjustment problems experienced by people with the disorder have their roots in negative childhood experiences in the classroom.
An intervention was developed and evaluated using a pretest, posttest control group study. Children exposed to the intervention video showed greater changes in knowledge, positive attitudes, and behavioral intentions than a control group. Such interventions may have potential to improve social outcomes for children with differences.

August 2007
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The Impact of Peer-Education on Classroom Outcomes for Children with Tourette Syndrome

Kristen D. Holtz, KDHRC & Sid J. Schneider, Westat
Working Paper 06-002

A peer-education videotape was developed for elementary school classes with a student with Tourette Syndrome, a chronic, frequently stigmatizing tic disorder. Triads consisting of a child with Tourette Syndrome, the child’s parent, and the child’s teacher were randomly assigned to either an intervention or control group. The triads completed sets of instruments three times, over five weeks. Only the intervention group received the videotape, as part of a classroom presentation between the first and second data collection times. The results indicated that the triads in both groups perceived gradual improvements in the children’s social adjustment. The intervention and control groups, however, also differed in several respects. In the intervention group, the parents reported that their children acquired more friends following the classroom presentation. The children, however, reported having fewer friends at school, less athletic competence, and worse physical appearance. The implications of the results for peer-education interventions are discussed.

December 2006
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The Impact of Peer-Education on Classroom Outcomes for Children with Tourette Syndrome

Kristen D. Holtz, KDHRC & Sid J. Schneider, Westat
Working Paper 06-002

A peer-education videotape was developed for elementary school classes with a student with Tourette Syndrome, a chronic, frequently stigmatizing tic disorder. Triads consisting of a child with Tourette Syndrome, the child’s parent, and the child’s teacher were randomly assigned to either an intervention or control group. The triads completed sets of instruments three times, over five weeks. Only the intervention group received the videotape, as part of a classroom presentation between the first and second data collection times. The results indicated that the triads in both groups perceived gradual improvements in the children’s social adjustment. The intervention and control groups, however, also differed in several respects. In the intervention group, the parents reported that their children acquired more friends following the classroom presentation. The children, however, reported having fewer friends at school, less athletic competence, and worse physical appearance. The implications of the results for peer-education interventions are discussed.

December 2006
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Vulnerable Populations

Programs in this focus area support the parents and teachers of young children with cochlear implants as they navigate the school system; train young adults with cochlear implants in self-advocacy; and help children with chronic illnesses navigate absences to thrive in school.

Staff Contact
Nicole I. Wanty
Research Associate