Case selection.

The data include documents and interviews with administrators, faculty, staff, and student focus groups at the 10 BUILD sites. In 2014, 10 NIH BUILD multi-year awards were issued to undergraduate institutions across the country. Eligibility for competitive project awards included having less than $7.5 million in total NIH research funding, and at least 25 percent Pell Grant recipients. The sites are composed of two historically Black colleges and universities (HBCUs), five Hispanic-serving institutions (HSIs), one of which is also an Asian American/Native American/Pacific Islander-serving institution, and the rest of the campuses targeted outreach to special populations that are underrepresented in biomedical disciplines. Each NIH-funded site employed different innovative approaches to develop capacity for meeting program goals, including research skill building, training (for students and faculty), and infrastructure development [36].

Site visits.

From 2017–2018, the research team visited each BUILD site to conduct interviews, focus groups, and observations of the BUILD initiatives. Approved by the institutional review board at UCLA (IRB#15–002023), we obtained written consent from all participants in the study prior to conducting interviews. The team interviewed BUILD program leaders, program coordinators, faculty training participants, student participants, and senior leaders at the institution to understand the BUILD program at the local site and implementation strategies. Working with program principal investigators (PIs) or designated staff, the researchers identified and recruited over 500 staff and faculty participants in BUILD for individual interviews and focus group participants (see technical report, [37]. Interviews and focus groups ranged from 45 to 90 minutes each and were recorded, transcribed, and uploaded to Dedoose, a qualitative data analysis software package. At the conclusion of each site visit, the site visit team conducted a debrief meeting with BUILD program leadership to offer insights and clarify observations.

Coding and analyses.

The research team developed a codebook to account for institutional-wide, program-specific, faculty-specific, and student-specific levels of activities. The codebook deductively examined how existing literature on diversity in the biomedical sciences and the DPC “Hallmarks of Success” were present in the data. To understand BUILD implementation, the team also generated codes inductively to capture the exploratory nature of aspects of BUILD implementation that did not fit within the codes generated to align with the DPC Hallmarks of Success [38]. Coders also employed descriptive coding [39, 40] to summarize and organize the primary topic of excerpts. To ensure inter-rater reliability, or extent of agreement among data collectors with respect to interpretation of the phenomenon of interest [41], coding team members participated in an inter-rater reliability test on Dedoose using Cohen’s kappa statistic [42]. An intercoder reliability score of .96 across all ratings was reached based upon a pooled kappa estimate [43]. The research team created debrief reports after each site visit, which were shared with BUILD site PIs and local site leaders (see technical report, [37]). Using the debrief reports, transcripts, and codes, researchers wrote case narrative reports for each site in order to summarize themes within each site’s context [34]. Internal case narrative reports contained summaries and general impressions of each case as a first step in analysis.

Cross-case analysis.

While the research team generated data for the larger project, only the co-authors were involved in the final stages of analysis and writing for this specific study. Additionally, while a prior group of co-authors conceptualized and published the first version of the Inclusive Science model [11], only one co-author from the previous group was involved in the present analysis to systematically obtain evidence of the previously theorized model. We employed cross-case analysis to identify similarities and differences among the sites that inform the phenomenon of interest: dimensions of Inclusive Science [34]. We deductively sought evidence of each dimension of the original Inclusive Science model, while also inductively analyzed the case study data to generate modifications to the model. To do this, the co-authors used debrief reports; case narrative reports; BUILD site websites; a special issue featuring articles summarizing each BUILD site’s intended goals and initiatives [11], as well as relevant coded excerpts and raw transcripts in order to gain a holistic and nuanced understanding of patterns and themes. The co-authors ran data queries using Dedoose to pull specific codes related to the initial dimensions of Inclusive Science. To inductively analyze the data, the team read case narrative reports for each site and located additional codes and transcripts seeking evidence against the model, as well as evidence of additional practices not yet captured by the original conceptualization of the Inclusive Science model. To organize the data and analytical process, the co-authors created matrices to visualize the extent to which each BUILD site exhibited evidence of engaging in efforts related to the dimensions. The use of matrices allowed researchers to make contrasts and comparisons between institutions [39] and determine when the co-authors reached saturation for a particular assertion.

To further organize the large amount of case study data, the co-authors employed focused coding [44], and wrote analytic memos to make sense of the data and develop assertions for each Inclusive Science dimension. We met weekly during analysis to discuss findings and agreed upon a revised model and corresponding subthemes for each dimension of the model.

Limitations.

Limitations to this study include a focus on sites that were selected to receive funding from NIH as part of the BUILD initiative. Many campuses across the country employ interventions, and few will ever receive a substantial level of federal funding for comprehensive program initiatives lasting up to 10 years. However, case study research is not intended to be broadly generalizable; instead, it is focused on replications of cases, with each providing contextual insights into how these campuses utilized the grant funding and responded to the parameters of the award. Through explanation of each dimension of Inclusive Science that we identified, we offer a variety of examples so that other campuses might identify strategies that align with their own institutional context and constraints to advance Inclusive Science and PEER degree completion in STEMM.

The current study focused on the early years of implementation; therefore, a second limitation is that student outcomes are not the primary focus of the current analysis. While an analysis connecting Inclusive Science practices to outcomes is beyond the scope of this current study, future research will be able to make connections between strategies employed by sites and tangible outcomes such as biomedical graduation rates, persistence into biomedical graduate study, and measures of psychosocial outcomes such as science identity and self-efficacy as a result of BUILD interventions. Despite BUILD being in the early implementation and institutionalization phase of their respective programs, each BUILD site as well as the central evaluating body, the Coordination and Evaluation Center (CEC), has published evidence of outcomes [12, 13, 45]. As of fall 2022, BUILD sites have collectively supported over 2,473 undergraduate students—a majority of whom identify as individuals from groups considered underrepresented in STEMM by NIH—via participation in each site’s most intensive BUILD scholar and associate program activities [46]. Early findings indicate that participation in the BUILD scholar and associate program is associated with higher levels of reported science identity [47], and self-efficacy as a scientific researcher [48]. Additionally, BUILD program elements also expanded their programmatic efforts to support additional students on each campus via undergraduate research opportunities, curriculum changes, and professional development initiatives. Among student participants in the evaluation, the CEC has collected survey data from over 30,000 unique undergraduate student respondents at all BUILD sites [49]. The CEC works in collaboration with local BUILD evaluation teams to track participation in such activities in order to capture the reach of the BUILD initiative [50]. Local evaluations of BUILD have found a host of positive outcomes from BUILD-initiated department-level and institutional-level interventions aimed to increase quality active learning curricula in introductory science courses [51, 52]. The importance of mentorship for supporting biomedical research career development [47], whether from peers [53], professional staff, or faculty [54] also has also been a persistent finding from multiple BUILD sites. Out of the DPC evaluation, the National Research Mentoring Network has developed measures of biomedical mentors’ capacity to be culturally aware in mentor-mentee relationships [55]. Some BUILD sites developed successful models for providing mentoring in biomedical research to students from historically excluded groups. Due to interest in findings from this historic initiative, BUILD sites are developing plans to continue to evaluate the impact of the program beyond the last year of funding for its implementation.

Lastly, while not the focus of this study, another main aim of BUILD is to evaluate its efforts to disseminate findings that can inform the STEMM education community. For context, the number of first-year undergraduates alone who are enrolled in the evaluation of the project (includes students who participated in BUILD activities versus students who were not exposed to BUILD) include 32,963 first-year students; with 27% from families with an income < $30,000 annually and 25% reporting that they were first generation college students [49]. Throughout the findings for this study, we clarify whether participants reported program outcomes of Inclusive Science practices that they employed, or whether the co-authors identified outcomes based on triangulating data from multiple participants.

Increasing participation along the undergraduate pathway.

BUILD sites actively increased the number of potential biomedical participants along the undergraduate career pathway by allowing undergraduate students different entry points into biomedical research as a career option. While four of the 10 BUILD sites had programming for first-year students, the other six BUILD sites created program structures to allow students to apply for BUILD-related scholar programs and activities during sophomore, junior, or senior year, in addition to providing opportunities for community college students to apply to BUILD. The flexibility of the programs allowed students to enter biomedical career training at multiple points during their time in college. BUILD administrators explained the importance of providing multiple opportunities to expose students to biomedical career training in order to broaden perceived career possibilities and allow time for students to develop biomedical interests. For example, Xavier University of Louisiana (XULA) focused on coordinating all programs that result in a developmental sequence of research experiences throughout the college years. XULA also developed a post-baccalaureate program for students who missed research opportunities during their undergraduate years and/or lack research experience and preparation needed for graduate school. Thus, XULA’s program structure provided additional entry points into biomedical research experience and graduate study.

Removing barriers to recruitment and selection of scientific talent.

BUILD sites aimed to remove barriers to recruitment and selection of scientific talent through simplifying application processes, especially after realizing that requirements may have prevented some students from completing the application and as a result, never begin their pathway into a biomedical career. For example, the University of Detroit Mercy (UDM) changed their application process to allow students to come in for drop-in interviews for the BUILD program. While this was only a slight change to the process, one administrator noted, “I’m really surprised at what an impact that made in terms of increasing our pool of prospective students. [Introducing flexibility] removed a lot of the obstacles that I didn’t even know were obstacles.” Sites also removed barriers by broadening their application processes to include social science fields that overlapped with biomedical research and opening the application to individuals who initially had healthcare career aspirations rather than biomedical research career goals. These changes were based on a belief that this could be impactful for first generation college students, who are often encouraged to go into careers that seem more familiar (e.g., healthcare rather than biomedical research). Xavier University Louisiana (XULA) specifically expanded their application to include students who indicated interests in medical or pharmacy school. BUILD administrators believed that if they could get more students involved in undergraduate biomedical research training, they could increase students’ interests, self-efficacy, and intention to pursue a biomedical research career in addition to, or instead of, initial career goals aimed at healthcare careers. As part of recruitment and attracting a larger pool of potential applicants, other sites also provided ways for trainees to see science as a way to “give back” to their communities and as a way to encourage and connect science to larger societal goals.

Expanding definitions of target populations to train in science research.

NIH recently changed their definition of underrepresented groups (URGs) in order to more accurately address the issues of diversity and inclusion in STEMM. Portland State University (PSU) expanded their definition of who they consider “underrepresented” by including foster youth. In addition, PSU partnered with community colleges and four-year institutions in the Pacific Rim (e.g., Guam, American Samoa) and Alaska in order to target efforts toward other underserved groups such as Pacific Islander students. Providing opportunities and comprehensive support to individuals who may not typically have access to resources to propel success in biomedical science fields is critical for increasing participation of researchers from diverse backgrounds. However, while diverse groups produce higher rates of novel scientific research, their novel contributions are often devalued in the scientific workforce [56], which leads to the next dimension of expanding research and curricula arenas to better reflect PEER communities and research issues.

Curriculum reform and research training.

Within curriculum reform and research training, course (re)development was the most prevalent approach BUILD sites used to attract students. BUILD institutions developed courses for undergraduate students with the intent to develop their researcher self-efficacy and science identity. Courses primarily focused on training students on the mechanics of research and/or introducing them to interdisciplinary approaches to examining health disparities. Some BUILD programs required these courses for BUILD students and used them to prepare students who may not otherwise participate in research. Courses aimed to engage students who may otherwise be left out of research experiences and make students better prepared to undertake research. Many courses taught how to develop a research proposal, methodology, and theory, while others engaged students in practical application of research skills. At California State University, Long Beach (CSULB), students had the option to enroll in introductory and advanced research methods courses as well as classes to prepare them for other stages of the research process, such as grant writing. While many universities offer a summer bridge program, Morgan State University (MSU), for example, was unique in offering a summer training institute based on an entrepreneurial model whereby students are trained to design their own research and obtain funding, rather than the traditional apprentice model of research. During the eight-week summer program, prospective BUILD students learned “how to do health research” and prepare proposals.

By having students develop proposals and implement their project, faculty and administrators at MSU sought to develop students’ researcher self-efficacy. A program director explained that students can go on to courses that “provide them with more theory and more methodological background needed to complete the research” with the additional goal of preparing them for graduate studies. Developing students’ foundational research skills was critical across BUILD programs.

Notably, research courses were also utilized to develop students’ science identity and self-efficacy as researchers. Enrolling in laboratory courses enabled students to apply the skills they learned in previous coursework. By learning and applying research methods, BUILD institutions simultaneously aimed to teach students how to do research as well as “getting them to start to think like a scientist” (program faculty leader at Wayne State University, a partner institution of UDM), “instead of consuming knowledge” the courses encourage them to “start thinking about how they can learn to create knowledge.”

While this approach may be similar to current practice in research training, the intentional inclusion of underrepresented populations in these classes, and the added effort to structure training into programs and curriculum removes the guesswork for PEERS to enter biomedical training experiences. STEM BUILD at University of Maryland, Baltimore County (UMBC) includes community college students in their summer training course, thus reaching populations who typically do not have high rates of participation in undergraduate research. These efforts show that Inclusive Science focuses on preparation as well as enrollment of PEERs.

Interdisciplinary approaches to teaching in science.

BUILD institutions were invested in an interdisciplinary approach to teaching and training students on health disparities topics. Faculty and administrators emphasized the necessity of demonstrating how biomedical, social, and behavioral sciences, and the humanities are important in examining health-related topics. A CSULB program administrator shared:

I think more and more research is understanding you can’t just hang out in your little silo and move things forward; you have to work with other people. I think it’s really important for them to get a taste of that during their training so that they understand how more minds coming together and bringing in diverse ideas and thoughts from different, not just diverse people, but diverse disciplines, how that really enriches the research process and how it helps us to better understand what we’re trying to answer. It just brings a lot more expertise and resources to the table… that’s something that we really want to instill in [students].

Engaging researchers from different disciplines is viewed as necessary for the future of research and to address health disparities. Having students see the intersections of these disciplines as highly important in moving research forward guided curriculum development and training of biomedical students. Faculty developed courses across STEMM, social sciences, and humanities disciplines that focused on health-related topics. Several faculty used course-redesign grants provided by BUILD to develop new classes.

Additionally, several BUILD programs developed partnerships with departments in the social and behavioral sciences intended to establish interdisciplinary courses. For example, a faculty member at California State University, Northridge (CSUN) used a course redesign grant to develop a course on Asian Americans and health-related issues that differ by race/ethnicity. Additional examples of courses at other institutions included a race, science, and technology course at UDM, a collaboration between biology and dance at University of Alaska, Fairbanks (UAF), and a philosophy of ethics course at XULA. The University of Texas at El Paso (UTEP) developed several courses such as a sociology class under the Course-Based Undergraduate Research Experience (CURE) program, a health psychology course, and a mobile health technologies course in engineering. BUILD support gave way for faculty to develop courses that show students the relationship between a variety of disciplines and health-related issues.

A few programs trained students by exposing them to interdisciplinary research through presentations or mentoring experiences. Institutions used these approaches to bring faculty and researchers in disciplines outside of STEMM to show students how they can draw on other disciplines such as social sciences to inform their research and expand their understanding of a problem. Students were also exposed to interdisciplinary research by working with faculty in departments different from their own. A faculty member at UTEP described exposing their engineering student mentee to research in nursing, and at MSU a faculty member in psychology said that students in biology or engineering might seek them out because of the research they do. At SFSU, lab rotations were used to introduce students to interdisciplinary research.

Research on diverse communities.

BUILD institutions identified and developed courses that connected health-related research to issues of diversity and social justice. For example, UAF planned to require all undergraduate students to take an Alaska Native themed course, CSULB required BUILD students to take a health disparities course, and CSUN developed a race and technology class. These courses were intended to teach students about the connections between diversity and social justice and their relationship to health issues.

Institutions also focused on changing how they conduct research and departments became more responsive to students’ experiences and community needs. BUILD institutions were interested in tapping into students’ experiences and getting them to connect research skills to topics and issues of interest. UAF employed their locally developed One Health paradigm, whereby the relationship between human health, animal health, and the health of the environment are inextricably linked, as a way of connecting research with what is happening in students’ local communities [57]. A program director at UAF shared how this culturally responsive approach to looking at science resonated with students:

We were getting zero traction in being able to say, ‘Come to the university and learn how to pipette. Come to the university and learn about viruses. Come to the university and learn about molecular DNA work.’ But if we said ‘One Health,’ that’s what we’re here to teach you and work with you on…a concept that you’re already familiar with… That you live in the ecosystem and the health of the ecosystem where you hunt, fish, and live depends on your understanding of it… your interaction with that ecosystem at a medical level. They just went, ‘Yeah, I can do that because that’s important in my community. It’s important for my rural lifestyle and it’s important to my family and it’s important to my region. For me to understand the health of the fish, the health of the birds, the health of the ecosystem, climate change, virus problems.’

A UAF faculty member shared that it was important to make a “connection between the material that they’re learning and what’s happening in their world at home.” Similar sentiments were shared at other BUILD institutions, which sought to build research rooted in community needs. For example, a faculty member at CSUN shared the following story about a BUILD undergraduate participant and mentee who found meaning in connecting her community interests to research:

[BUILD student] realized down the line after doing some work in non-profit and community organizations that she wanted to go back and get her [bachelor’s degree]… [She] talked about the non-profit she created, which is amazing, but then when it links to academic work and talking about research, I think there was this thought about what research looks like. People have lab coats, beakers, smoke going off. My work is in implementation science and bridging and making academic community partnerships and linking her to a partner that in [local] county… When she saw, “This is research. We’re going out, we’re creating workshop materials on different mental health awareness topics all for the goal of connecting the Latino/Latina community to [county] health services” … now she’s working on this poster for [research symposium] where she’s taking the first author to lead it and realizing, “This is research. This is what this is about.” I think she needed to see the connections between what she was passionate about, and there’s also an area of research that’s big on community-based participatory research and bridging the science to practice gap.

Here, the faculty mentor’s culturally responsive practice of offering opportunities so that students can see how their interests can connect to biomedical research and benefit their local communities was critical to maintaining this Latina student’s interest in a biomedical career pathway.

Acknowledging histories and rebuilding trust in science research.

Systems of education and health-related research have inflicted harm to marginalized populations and led to distrust of higher education by communities. The use of Black and Indigenous communities for medical research [58], the Tuskegee experiment, and the use of HeLa cells without proper consent from Henrietta Lacks, a Black woman, and her family, are all examples of health-related research that has caused harm and fueled mistrust. Inclusive Science requires a reckoning with historical harm and acknowledging that it will take considerable time and effort to rebuild trust with communities. The faculty lead at UAF described the importance of acknowledging this harm and repairing relationships between minoritized communities and the field of science:

Western education has not been a positive thing, but a very negative influence. And we took children away and forced them to learn English at a period that was very critical to the development of their culture…and so they lost a lot of their history and when they came back, after years at these boarding schools, they didn’t speak their native language, they couldn’t talk to their parents or their grandparents. They didn’t have the skills they needed. They didn’t need it in the Western culture; they needed it in their own culture. So when we go into the community and say, ‘Hey, we want to give scholarships.’ They see it as, you’re going to take [the children] away, they’re never coming back. And we’ve lost this tremendous [asset], our future, our resources, our [community’s] future.

Acknowledging that institutions of higher education adversely impacted the existence of Indigenous culture and language and the ability for communities to pass them down to future generations is a culturally responsive approach that seeks to be honest about past harms continuing to shape relationships between the “ivory tower of academia” and Indigenous communities. Building trust became foundational to collaborating and serving many of the Native and rural communities of Alaska. A workshop facilitator noted that “the issue of trust is a really, really big one in communities, and it takes time to develop that.” They noted that this could not be done overnight, and researchers needed to spend time cultivating those relationships, working with American Indian studies faculty. They recognize that anyone interested in doing research in the community must account for time to cultivate a trusting relationship with the community since “it can take just that first year to really have the dialogues you need to have.”

Inclusive Science requires that institutions not only demonstrate the relevance and benefits of research to the community but do so in collaboration with community members and prioritize their most pressing concerns. Incorporating reciprocity in research is a component of restoring relationships with marginalized communities. Not only is research done with a sense of purpose, but there are also intentional efforts to bring students and their findings back to the community.

Fostering affirming environments to increase psychological sense of belonging.

We found evidence of faculty and staff learning how to better support students and create a psychological environment of support. Almost all sites offered some form of faculty mentor training (e.g., the National Research Mentoring Network [NRMN]’s Entering Mentoring or Culturally Aware Mentoring [CAM] training) with the goal of improving faculty capacity to mentor and train students in biomedical fields [61]. Faculty participants of these training sessions shared how the training helped improve their confidence in their ability to create a positive and affirming environment for their mentees and students in their classes. A few sites included “homework” or suggestions of practices that faculty could apply to improve the climate in their labs and classrooms. Some faculty expressed that they felt empowered with a larger toolkit to foster growth in students’ self-efficacy and science identity.

Sites also incorporated programs and events to build community among students and increase their sense of belonging to campus and the field of biomedicine. For example, UAF, UTEP, and PSU planned welcome events, socials, and mixers throughout the year to build community among BUILD-affiliated students, staff, and faculty. Several sites implemented learning communities and/or centers where students could socialize, study, and have a physical space where they belonged on campus.

In addition to creating physical environments & events to foster belonging, BUILD program administrators and faculty at many BUILD sites aimed to mitigate deficit-framed discussions about PEERs. An example of a deficit framing would be constantly reminding students that they lack math or science proficiency or are already at a disadvantage due to a lack of financial resources or lack of knowledge of the biomedical career pathway. To counter this, UTEP employed the strategy of utilizing an asset-based framework for their program [62] in which they reminded students about the assets they bring to science. Indeed, short-term interventions to remind minoritized students about the assets they bring to higher education have the potential to improve their overall capacity to thrive [63]. UTEP aimed to affirm their students’ potential and sense of belonging and is also in alignment with the university’s larger Student Success Initiative. Regarding ways that this approach gets put into practice with students, a senior administrator at UTEP shared:

Most colleges and universities…Their students come in and it’s just a set of problems and deficiencies that need to be overcome. That’s not our view… We’d ask [the students], "Well what do you think your assets are?" "Tell us about them?" And they looked at us, like… What are you talking about? Because no one through the education system in the schools really talked to them about that…we would toss out a suggestion, for example, "Well how many of you are bilingual or multilingual?" Everybody raises their hand and we say, well, don’t you think that, that’s an asset? And they looked at us and said, "Ah, that’s no big deal. Everybody speaks Spanish!" But no, it is a big deal…then we started talking about, well, where do we live? Well, we live in El Paso. Where is El Paso? It’s on the border. Well, maybe that’s an asset. You’re living in a very international community…[students] come to us with a bit of an edge and a bit of an advantage because of who they are and their life experiences. Now we’re going to help them hone those skills and those abilities so that they’re super-competitive. So they do great, they do well in the classroom and succeed academically but then they have the edge because they’re professionally developed. So we’re getting all faculty and in fact, including staff, engaged in this sort of professional development.

This asset-based approach employed at UTEP is also echoed by the faculty who support the BUILD program at UTEP. In an interview with two science faculty members and BUILD administrators, both faculty were adamant in sharing how talented their biomedical students were. One faculty member shared:

[The BUILD scholars] come from an underrepresented, probably poor background in most cases, but in my opinion, the students coming from those backgrounds are uniquely motivated compared to someone from a more affluent background. These students are just as capable as anybody else, so I don’t see it as a disadvantage at all to be honest. They’re bilingual. They’ve got a lot of assets they bring with them and it’s not a disadvantage, not one bit…I often hear that presented as a challenge, but it’s not a challenge. It doesn’t matter where anybody comes from, it matters where they go… I think that we find in a lot of our programs that the students are just as capable as anybody else and in many cases more motivated to succeed given where they come from.

Faculty and staff at UTEP and at other BUILD sites who expressed these attitudes toward their students often shared how these attitudes translated into students feeling like they not only belonged but could thrive and meaningfully contribute to biomedical research.

Developing awareness and skills to address systemic inequity.

A few sites had components of their faculty training curriculum that more explicitly provided context about historical exclusion and systemic inequity. Some campuses introduced curricula from social science fields into faculty training or structured weekly discussions with faculty. These training sessions were critical for exposing STEMM faculty to important research and theories that impact PEERs, particularly because STEMM faculty members shared that it was the only space where they had an opportunity to learn about such topics. Faculty mentor training at a few sites incorporated the concept of microaggressions—brief, common exchanges that send denigrating messages to people of color or individuals from a non-dominant group [64–66]. SF State not only focused on providing faculty with opportunities to address structural exclusion in STEMM through their Faculty Agents of Change program, but also provided training on the psychological concept of stereotype threat (i.e., fear of conforming to stereotypes about one’s social group) to the students in the BUILD program. Their goal was to acknowledge the realities of structural inequity on campus, and to equip students with skills to empower them to navigate their educational and career training. This unique approach of equipping students with knowledge of socio-contextual factors that may influence their experiences in biomedical training appears to protect PEERs intellectual performance and safety from stereotype-based evaluative concerns [67].

One of the most intentional strategies for addressing structural exclusion came from CSUN. Through intentional employment of Critical Race Theory into its program implementation, CSUN assembled a CRT advisory board, who, along with other collaborators, developed and implemented a CRT training model so that biomedical faculty could improve their understanding of race and racism in biomedicine. One of the CRT advisory board members explains their progress and goals of the training:

We’re getting new people. In fact, we’re actually training administrators and staff this summer using a similar curriculum… .with similar issues about power and microaggressions, but pitched at administrators and staff instead of faculty…We’re seeing what people need and what people want from us, and the skills that they want to gain…[We say] we want you to be able to understand power dynamics, and understand that power is infused in everyday situations in what we do with science and it impacts people differently… That’s our end goal, we’re getting there bit by bit.

Some of the faculty at the BUILD sites at minority serving institutions (MSIs) became convinced that mentor training was beneficial for improving their campus climate. For example, one faculty member and BUILD program director at XULA (an HBCU) shared:

I have been a faculty member at Xavier. This is my 22nd year, and I’ve had 87 minority students as my research advisees in the lab over this time, but there are things that I’ve learned through the mentor training in the past few years that I never knew. One was, for example, the stereotypes, you know, the implicit bias. I was never really aware of it…I’ve learned these skills at the mentor training after all these years, I see that I’ve become a much better mentor to my mentees. The mentor training, I think, is a very important aspect of the program.

This faculty member clearly experienced the impact of training they received to create affirming environments, even at an institution with a historic legacy of providing an affirming environment to Black students. Faculty and staff spoke of the need to recognize campus climate and to gain additional skills to actively create positive environments and mitigate systemic challenges PEERs face. As one program administrator at a BUILD site shared, regarding the impact of developing the knowledge and skills to address exclusion, “[it] not only gives them knowledge of, ‘This is a stereotype’… But how to impact [their] trajectory in the sciences…for the faculty, what are ways they can change their classroom environment so that would be affirming for students so that they would experience stereotypes less.”

Services to mitigate inequity.

BUILD institutions also invested in staff and services to meet students’ needs to help them continue their biomedical research training. These services included 1) financial support, 2) academic support, and 3) career development. Helping students achieve their full potential meant identifying resources that remove barriers to participation in biomedical training activities and provide resources that helped students develop skills for future steps such as applying to graduate school.

Financial support is a significant aspect of BUILD that opens opportunities for students to engage in research, work in laboratories, and participate in professional development activities such as conferences. Scholarships that cover high costs such as tuition and living expenses have been critical in increasing participation of PEERs across all BUILD sites. Some institutions such as PSU committed to raising scholarship funds for their first-generation students. The dean explained that such funding helps pay for costs such as tuition. Creating an inclusive environment that is responsive to students’ needs and that ultimately leads to addressing health disparities requires early investments that remove financial barriers.

Financial support also opens students’ networks and chances for gaining opportunities to pursue research in biomedical fields. Some students said that financial barriers limit their participation in professional development experiences. They felt unable to compete with a student who can pay for travel and conference expenses. Addressing these financial barriers can have long-term academic and career benefits for students. For example, the program director at CSUN shared that a BUILD student was specifically looking for a program that offered bioinformatics and found that the leading program was at an out-of-state institution that was not part of CSUN BUILD’s research partner institutions. The program director at CSUN said, "You know what? If this is what you need to get into your doctoral program, then let’s fund you.” The student went on to a summer research program at the out-of-state institution with financial support from BUILD and eventually went on to apply, get accepted, and enroll in the doctoral program at that institution as a result of BUILD’s investment in this summer research opportunity. Funding to complete an internship at an institution outside their partner network helped the student gain experience connected to academic interests and positioned the student to pursue a doctoral program at that institution. Financial support for students’ academic and professional careers results in students’ ability to be more engaged in research and thus more competitive as their career unfolds.

Providing academic support helped students excel in their classes. For some institutions, that meant hiring additional staff to meet students’ needs. For example, CSUN identified writing needs and hired staff that could provide writing support. A CSUN program administrator shared:

We have a very holistic program, I think. We try to do a good [support service] wrap around students, so it’s not just the tutoring, but sometimes it is. Sometimes their writing isn’t strong enough and so I help them with their statements of purpose, but now that the group is so large… right now, we’ve hired two writing coaches. One of them is for academics, so she helps them with their essays and assignments that they have that are writing intensive… she has certain slots that are available just for our students as they need it. We just hired another writing coach that’s focusing on really helping them polish their personal statements and research statements, their statements of purpose to get into graduate study.

CSUN recognized a potential academic barrier and hired staff members to work with students to strengthen writing skills. This helped students better prepare for their coursework, research applications, and have stronger personal and research statements. At other institutions, writing centers were available on campus and the BUILD programs leveraged these existing resources to assist students.

Staff at UMBC were also hired to provide supplemental academic advising to their BUILD students. A program administrator said the academic advisor “isn’t intended to replace their department advising, it’s assigned to supplement their departmental advising.” The supplemental advising was used to help students prepare schedules, prepare for department academic advising appointments, remind students about academic deadlines, and work through academic-related challenges.

How academic support is offered and framed by the institution is also important. Providing academic support due to a deficit view of students is not culturally responsive, but rather can be potentially harmful to students’ science identity development and self-efficacy. However, providing support to reduce barriers for students and begin to change systems to value science for all, rather than science only for those who are academically prepared and high achieving upon college entry, would be an inclusive science approach. A faculty member at CSUN elaborates on the changing mindsets regarding deficit thinking from her faculty peers:

Some faculty, working directly with students they haven’t normally hired or were positioned as those high-achieving students who would normally get the [science training] opportunities… I think some of the faculty have challenged some of their own deficit thinking about the student population here at CSUN in particular. It’s not completely resolved, but it’s started to melt that chilling effect that the science-oriented programs at CSUN had on a lot of the students of color… One of the greatest strengths about the BUILD program [is that it] has been able to bring together faculty… it’s this brain trust across the disciplines that’s really trying to holistically think about how can we work with students of color in the sciences and at the same time, rethink what science means to these students.

Provision of career development opportunities is another form of tangible support that fostered the career development of biomedical students. Career development support came in the form of specific positions created to provide science skill training (e.g., UAF’s Research Advising and Mentoring Professionals), career programs (e.g., workshops to develop CVs and graduate school personal statements), provision of internship and research opportunities, and sending students to biomedical conferences and symposiums. XULA embedded career development into their program model so that career development events and programs were seamlessly integrated into required meetings for BUILD scholars. In partnership with the Student Academic Success Office (SASO), the Center for Undergraduate Research and Graduate Opportunity (CURGO) and the Center for the Advancement of Teaching and Faculty Development (CAT+FD), XULA took the approach of building infrastructure to support additional staff positions in existing offices to bolster career development capacity for BUILD students and all other students majoring in a science discipline.

Institutionalizing change in recruitment practices through partnerships.

Almost all BUILD sites established formalized partnerships with local and regional educational institutions to encourage more PEER students to enter the biomedical sciences at their institution. Stakeholders at many institutions felt that BUILD activities allowed for the prioritization and overall strengthening of relationships with high schools and community colleges (referred to as pipeline partners) with populations of PEER students who can be supported by biomedical training resources at the BUILD site. The partnerships focused on recruitment of PEER students allowed BUILD sites to leverage partnerships that aimed to create lasting change in the compositional diversity of the entering class of first-year or transfer students with biomedical career interests. The culturally responsive recruitment strategies BUILD employed with partner sites also created lasting change in how institutions recruited biomedical talent from their local communities.

Providing students at the pipeline institution with information about how the BUILD site would provide financial support and biomedical research and mentoring opportunities and a more welcoming space for the potential student to thrive was critical in creating successful partnerships.

A community college partner with UDM, for example, articulated how BUILD activities directly strengthened UDM’s relationships with local community colleges:

One of the things that BUILD really was specific in doing was creating that connection…I’d had little interaction with UDM before this. But when I reached out, I had my contact … [who asked], “can you find me the students who’ve been through BUILD before, because there’s a little panel session, and there’s the poster session, and then there’s also a presentation [that is] going to talk about, ‘Here’s how you can come to U of D Mercy. Here’s the benefits, and opportunity.‴ So, really, [BUILD] made that pipeline…

Indeed, experiences from alumni with similar backgrounds to prospective recruits, coupled with the responsiveness of the BUILD site to provide what pipeline partners needed to recruit more students also proved to be helpful in cultivating successful pipeline partners.

Establishing partnerships with local high schools was another recruitment strategy. Several BUILD sites found success establishing partnerships with local high schools. establishing pipeline partnerships can also allow institutions to address local and regional barriers that often bar PEERS from accessing and entering the biomedical sciences. At MSU, two conferences allow for a greater understanding of what BUILD participation can do for students in the local community:

ASCEND [BUILD] does a lot of community outreach and involvement. We have two conferences through the year that center on BUILD. There’s one come September that we outreach to local high schools. But there are, I think, three different high schools and two different middle schools that every year they have this conference they reach out to… about 200 students that didn’t actually attend MSU that were here. And getting them interested, specifically in MSU but also even more so in ASCEND. Getting them in the room and showing them this is the really cool stuff you can do here.

Participants at UTEP described lack of knowledge about biomedical research as one area of disconnect between the university and the local community. At UTEP, BUILD orientation activities serve as a platform to build partnerships and connections with one specific community often ignored by outreach and recruitment efforts: parents. One program administrator explained how targeted outreach to students’ parents helps establish relationships with the community:

We had panelists from our research partners present about what it’s like to try to balance their children, their relationships, and their careers. Those types of workshops, we’re inviting parents as well, are to help parents start to see the possibilities for their students into the future, that they can have families and become research scientists.

UTEP exemplifies how their outreach and recruitment efforts are responsive to the needs and concerns of the individuals in their local community by including parents, guardians, and family members. BUILD sites’ efforts to strengthen the connection between biomedical research training, the institution, and the local population show how biomedical career recruitment efforts can be culturally responsive.

While pipeline partnerships provided opportunities to recruit a more diverse student pool, these intentional connections went beyond providing a stream of potential applicants by also focusing on systemic change. One faculty member at PSU saw the establishment of partnerships with community colleges in the Portland metropolitan area as a way to disrupt the educational impact of gentrification on underrepresented students:

One of the things I think EXITO is really interested in is bringing in [a local community college] because one thing [programs] learned over the last few years is that the gentrification that started in the north Portland area in the mid-80’s has really spread over time to southeast Portland and northeast Portland. And so our students of color are being pushed further and further east…we are able to add that community college to our program and we’re going to spend the next year, then, in the next cohort kind of nurturing [local community college’s] relationship.

Pipeline partnerships also have the ability to change mindsets about which students are able to “succeed” in the biomedical sciences. One faculty participant at a community college explained how the formalized partnership between their institution and CSULB has helped challenge the notion that academic performance as defined by a students’ GPA is the only indicator of the students’ scientific ability:

With the BUILD program, people are starting to realize you can have a student that maybe they’re not the A student of the class, or the student with the 4.0 but they have those [research] skills, and they’ve been able to show them…I’ve seen this in my lab class. I can have a student that has earned a B in my class, but they go to a professional conference with me, and they present their research. And to me, that speaks volumes more about their skill set than their GPA.

In this case from CSULB’s community college partner, the faculty member notes how they are noticing shifts in students’ self-efficacy as future biomedical researchers. Thus, partnerships can create an opportunity for faculty and staff at both the pipeline and receiving institution to influence and track how students are making meaning of their education and career training.

Although BUILD activities helped establish partnerships with local high schools and community colleges, sites like CSULB and UMBC reported that such connections were institutionalized long before BUILD initiatives actualized. One stakeholder at UMBC said that existing partnerships facilitated the efficacy of BUILD activities institutionally, rather than the other way around. Further, though most strove to build (or reinforce currently existing) partnerships with community college, such strides were not universally successful. CSUN struggled to build connections with regional community colleges, with one stakeholder arguing that the presence of larger research institutions in the area led prospective community college transfers to not “want to come to CSUN, [because] they see us as the bad outcome.” Thus, while partnerships are important for recruitment, institutional context may play a role in the success of sustaining or expanding partnerships. In CSUN’s case, the stakeholder alluded to potential competition among several research universities in the same geographic region. Coupled with messaging that students may be receiving from academic advisors about how “competitive, ‘top 100’ STEMM research universities are the main gateways to STEMM doctoral and professional degrees” [[68] p. 115], campuses may need to strategize on what potential partnerships could yield the most synergistic relationships in order to maximize impact. A campus might also commit to systemic change by redoubling efforts to build these partnerships, with an awareness that changing perceptions about an institution’s reputation for successfully fostering biomedical career talent may take time and additional effort.

In short, pipeline partnerships between BUILD institutions and local high schools and community colleges do more than simply alter the compositional diversity of the pool of prospective students for each site. Although not universally successful, pipeline partnerships were one strategy used by many institutions to tailor recruitment and enrollment efforts to address unique demographic challenges, while also addressing broad, systemic challenges facing PEERs in biomedical sciences.

Committing to student success through research partnerships.

The vast majority of BUILD sites established relationships with colleges, universities, and private research firms to expand student access to research, internships, and other professional development opportunities. Private research partners were particularly receptive to taking BUILD students from several institutions, including XULA and UAF. For some BUILD institutions, private partnerships were perceived as a low-stakes way for research firms to bolster research productivity through an increase in personnel. As one XULA professor noted, “To be honest, the partners, they want our students. They don’t care if they’re BUILD or [another federally funded STEMM scholarship] or not in a program. It’s something that’s fairly low budget, just a little bit of [someone’s coordination] time.” Research partnerships established with other colleges and universities were similarly understood to be mutually beneficial for all parties involved.

Research partnerships allowed for more than just the expansion of available research opportunities; they also provided BUILD sites the ability to address broader, systemic barriers that prevent PEERs from accessing the biomedical sciences. In turn, research partnerships enabled sites such as UAF and SFSU to build stronger connections with local diverse communities. At UAF, partnerships built with researchers in rural Alaska enabled BUILD students to do meaningful work that directly impacted their home communities–labor which research partners described as invaluable. By taking on SFSU students through their BUILD-facilitated research partnership, UCSF similarly was able to expand their own research by directly targeting community-level health disparities.

One SFSU BUILD stakeholder explained how the symbiotic research relationship between their institution and UCSF not only brought research to local communities, but also served to broaden participation of PEERs in biomedical research:

The UCSF folks, they want to work and solve problems in the community, but often they don’t have the access. Whereas our students and students and faculty do have that access, because they are literally from the community. So, it sort of kneads all the things together. [… the project] was very important, not only of course for the communities themselves… but for the students really understanding how what they’re learning on the theoretical level in the classroom is important. I think one thing that comes out in the research over and over, and my own area of expertise in research, is that people, women, and also men of color, are attracted to science and biomedical research when they feel they can give back, and also transform how the science is done. Because they bring a different perspective that hasn’t necessarily been there. That’s something that has been emphasized quite a bit through SF BUILD.

Another way research partnerships helped BUILD sites address systemic barriers to participation in biomedical sciences for underrepresented communities was through shifting the mindsets of external partners on the types of students that can succeed in research internships. Though many institutions formally fostered research partnerships with external stakeholders, such partnerships also formed organically through student and faculty participation in national conferences as supported by BUILD funding. Such was the case for MSU, where one stakeholder described BUILD students as “basically marketing our program” to potential research partners:

They went to the [annual national biomedical conference] a few years ago, and one of our students got an opportunity to intern at Roswell Park Cancer Institute. They were so impressed with her that the director of the program reached out to me and asked if we had any more students like her. He actually came down and spoke to our students during one of our interdisciplinary seminars and had lunch with them [after].

The emphasis BUILD activities place on integrating students into research opportunities and funding student travel to national associations is therefore not only vital to the development of students as biomedical researchers, but also to the development of flagship research partnerships between BUILD institutions and external research entities. Additionally, BUILD activities also carry the powerful potential to shift partners’ understandings about PEER students’ ability to thrive in the biomedical field.

While research partners mostly were receptive to working with BUILD institutions, some sites struggled to establish buy-in from their planned partners. For one BUILD site, the lack of “structured agreements” with research partners adversely impacted buy-in for external institutions to build partnerships: “We don’t have any funds to provide them [… which] has created a lack of continuity with being able to have faculty who are engaged in wanting to be partners with us.” When successfully sustained, however, research partnerships served as a vital strategy for BUILD sites to institutionalize connections with external research entities, expand the availability of research partnerships for students, and, in some cases, work to address structural barriers contributing to underrepresentation in the biomedical sciences.

Responding to local needs through community partnerships.

BUILD institutions also formed direct partnerships with community organizations, industry partners, and local research centers. BUILD activities facilitated the ability for these organizations to establish trust and contact with the BUILD site. The purposes for establishing community partnerships varied by site and partnership type, ranging from aims to recruit students into a particular biomedical industry to creating new research streams and projects that aimed to solve real-time community problems.

Two BUILD sites–PSU and UDM–described how prior existing relationships with the metropolitan Portland and Detroit areas (respectively) enabled them to build partnerships that served both students and their home communities. PSU, for example, leveraged existing property in Portland to partner with local companies to create physical spaces for students to participate in internships that can better prepare them for industry jobs while working directly in the community: “We can […] hopefully get them so that they get not just the real world experience, but they understand what the real challenges and obstacles that each of these companies sees is important in the future.” Additionally, CSUN was in the middle of organizing a cluster hire for health disparities faculty scholars, with one future long-term goal being that the newly hired faculty would establish community-based participatory research projects that would provide CSUN students with research training experience in addition to support for local community needs. As of 2022, CSUN’s efforts have successfully led to the development of the Health Equity Research and Education Center.

While less common–and sometimes less formalized–than pipeline or research partnerships, partnerships with community programs, companies, and stakeholders were ultimately no less powerful in their ability to help BUILD institutions work towards advancing equity in the biomedical sciences.