By Madison Haywood
Madison Haywood is a Health Equity Intern who has been working with Salus Populi since Spring 2021. She has been involved in project efforts including initial curriculum development, curriculum edits, and program evaluation.
From left: Health Equity Interns Madison Haywood, Maya Clark, and Krystal Abbott at Northeastern University's RISE Expo in Spring 2023.
In Fall 2021, Salus Populi debuted its first judicial education program (JEP) seeking to provide guidance and training to judges on how the law impacts social determinants of health (SDOH), including socioeconomic status, racism/discrimination, and housing access and quality. Judges wield enormous authority over these critical SDOH; however, this topic is not discussed in legal education. The interactive and discussion based Salus Populi course uses evidentiary materials from the law and health science disciplines to demonstrate the key principles of the program. Through this robust four-unit curriculum, Salus Populi aims to better inform judges on the relationship between SDOH and law. Since its first session in Fall 2021, Salus Populi has reached over 550 attendees through nine (9) judicial education programs. To measure the impact and quality of the program, participants are asked to complete a pre- and post- survey before and after the training.
Salus Populi is a collaboration between Northeastern University's Center for Health Policy and Law and Institute for Health Equity and Social Justice Research (IHESJR). To further their mission and foster student involvement, the IHESJR provides opportunities for internships, aptly named Health Equity Interns (HEI). HEI are undergraduate students interested in furthering the health equity mission of the Institute. During the Spring 2023 semester, three HEI were paired with Salus Populi and worked on various projects. One major project was a preliminary analysis of responses from the pre- and post- surveys.
Following the administration and completion of the surveys, the HEI worked to craft a template for an internal report that would summarize preliminary analysis of the pre- and post- surveys from Fall 2021- December 2022. This template for the preliminary reports highlighted key information such as changes in knowledge, attitudes, and beliefs surrounding SDOH and their application to judicial work. There were many iterations of the template as interns learned by trial and error which methods best captured the responses. The preliminary reports summarized qualitative and quantitative data from the surveys. The qualitative data was captured through open-ended response questions to detail participants’ legal work, reason for attendance to Salus Populi, and learning goals. The quantitative methods employed a 4-point Likert-type scale to measure participants’ perceived understanding of SDOH, the impact of SDOH on individual and population health, the application of SDOH in the judicial context, and the effect of SDOH on judicial decision-making. Low response rates were a common theme among the five reports compiled for the trainings completed in, or for, Massachusetts, Ohio, Rhode Island, and the District of Columbia. Strategies to improve these rates were considered; however, no incentives could be provided for survey participation due to attendees' status as members of the judiciary. Despite low response rates for post-training surveys, there appeared to be a general positive trend in participants’ understanding of and attitudes towards the SDOH as indicated by the change in average agreement scores.
The HEI presented the reports and creation process at Northeastern’s Research and Creative Endeavor, Innovation, Scholarship, and Entrepreneurship Expo (RISE). This internal conference hosted by Northeastern allows undergraduate and graduate students to showcase research and creative projects pursued throughout the academic year. Students engaged with peers and faculty in an exchange of information and ideas. Common questions asked of HEI at the conference included logistics of the trainings, if this was a required course administered by law schools, and next steps for the evaluation.
In the spirit of continuous improvement and lasting impact, the Salus Populi evaluation team continues to use preliminary reports with the goal of informing program improvements. In the future, the information gathered in the preliminary reports will continue to inform Salus Populi’s effectiveness as a JEP and opportunities for growth within the broader context of improving the JEP. Building off the work of the preliminary reports, the Salus Populi Evaluation team created a more comprehensive evaluation report for Fall 2023 which included the use of more sophisticated inferential statistics and preliminary report of ongoing qualitative interviews with participants.