Culminating Experience in Women’s Health Research Anna Kaatz UW-Madison School of Medicine and Public Health MPH Final Presentation November 11, 2009

Outline Background Methods Results Discussion Conclusion Acknowledgments

Background Personal: –Teaching and Researching Women’s Health. –Research Question: Why are there gaps in women’s health research? Field Experience: –Mentor: Dr. Molly Carnes, Director of The UW-Center for Women’s Health Research Research Project: –Examination of NIH Peer Review for Gender Bias

Study Background A Critical, Interconnected Public Health Issue NIH Office for Research on Women’s Health (ORWH) & DHHS Office on Women’s Health Research (OWH): – The establishment and advancement of women in careers in biomedical research and academic medicine is linked to advancing women’s health research. –Female Scientists are more likely than males to study women’s health issues. Carnes et al. (2007). Women’s Health and Women’s Leadership in Academic Medicine: Hitting the Same Glass Ceiling? J.Women’s Health, 17(9),

Study Background The Problem:The Pipeline is “Leaky” Proportion of women in academic medicine, by educational stage and rank. Association of American Medical Colleges (2005). Women in US Academic Medicine: Statistics and Medical School Benchmarking,

Barriers to Women’s Career Advancement: Examining the Evidence Base There are enough women in the “pipeline” and women are equally committed as males to careers in academic medicine and research. Inequalities related to systematic gender bias pose the greatest barrier to achieving gender equity. Committee on Science, Engineering and Public Policy (COSEPUP) (2007) Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering. Washington, DC: National Academies Press

Study Question: Is Gender Bias in NIH Grant Peer Review a Barrier for Women’s Career Advancement in Academic Medicine and Research? Ley and Hamilton, 2008: Female MDs are less likely than males to receive initial, and renewal NIH R01 funding. Johnson, 2008: NIH Peer-reviewer bias affected 25% of funding decisions. Bornmann et al, 2007: Meta-analysis identified significant gender-bias in peer-review for scientific grants. Hosek et al, 2005: Female PIs receive 37% less funding than males from NIH, receive only 13% of multi-million dollar awards, and are less likely to reapply within two years. Carnes et al, 2005: Identified gender bias in selection criteria for the NIH Director Pioneer Award.

Study Methods Social Science IRB: “Examination of Words and Descriptors in NIH Grant Reviews” Collection of K, R, and T Grant Reviews for Awards with at least one Revision De-identification of Reviews Quantitative and Qualitative Analysis of Reviews for Gender Bias –Linguistic Inquiry Word Count (LIWC) –NVIVO

Preliminary Results R Awards are Focus of Analysis –Total R Awards: 201 –M: 144 F: 57 –28.4% of awards went to female PIs –91% of total females did revisions (39) A1: 54%, A2: 46% –77% of total males did revisions (81) A1: 60.5%, A2: 39.5% More females than males submitted multiple revisions. Male applications were approved more rapidly.

Preliminary Results Qualitative Observations: For applicants with similar backgrounds and qualifications, females are subject to more lengthy and critical reviews than males. –Similar to a study by Trix & Psenka, 2003: To describe female applicants reviewers use more “negative language,” “doubt raisers,” and more “language related to gender.” –Similar to a study by Schmader et al, 2007: More Standout Adjectives are used to describe male applicants (e.g. outstanding, exceptional, excellent, unique, strong).

Preliminary Results Methods for Successful Grant Writing: –Addressing every concern and question with evidence base responses. –Using same language as reviewers. –Emphasizing public health relevance. –Emphasizing capacity for innovation based upon personal skills and training.

Discussion: There is still a long way to go… –Finish Quantitative and Qualitative Analysis of Reviews. –Analysis of results. –Study results may contribute to many disciplines: grant writing, cognitive psychology, educational leadership, biomedical research, policy.

Conclusion: A Field Learning Experience in Research, Leadership, and Policy Research: –Using MPH training to study a public health problem Leadership: –Directing and Training two Interns –Leading Research Meetings Policy: –Participation in Working Group for Policy at NIH Office for Research on Women’s Health Regional Scientific Workshop

Acknowledgements Barb Duerst and all MPH faculty, staff and students. Dr. Molly Carnes, Dr. Carol Isaac, Vicki Leatherberry, Majiedah Pasha, Sharon Topp, Erin Aagesen, Katie Muratore, and Kristin Cox from the UW-CWHR. Dr. Nancy Worcester, Dr. Mariamne Whatley, Dr. Judy Houck, and Dr. CC Ford. My family, Sara Ishado, and Megan Reading

References Association of American Medical Colleges (2005). Women in US Academic Medicine: Statistics and Medical School Benchmarking, Association of American Medical Colleges (2005). The changing representation of men and women in academic medicine. AAMC Analysis in Brief 5(2):1-2, Bornmann, L., Mutz, R., Daniel, H.D. (2007). Gender difference in grant review: a meta-analysis. J. Informetrics 1: Carnes M, Geller S, Fine E, Sheridan J, Handelsman J. (2005) NIH Director's Pioneer Awards: could the selection process be biased against women? J Womens Health (Larchmt) Oct;14(8):684–91. Carnes et al. (2007). Women’s Health and Women’s Leadership in Academic Medicine: Hitting the Same Glass Ceiling? J.Women’s Health, 17(9), Committee on Science, Engineering and Public Policy (COSEPUP) (2007) Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering. Washington, DC: National Academies Press Hosek, S., et al. (2005) Genderdifferences in major federal external grant programs. Santa Monica, CA: Rand Corporation. Johnson, V. E Statistical analysis of the National Institutes of Health peer review system. Proc. Natl. Acad. Sci. USA 105: Ley, T.J., and Hamilton, B.H. (2008). The Gender Gap in NIH Grant Applications. Science, 322: Schmader, T., Whitehead, J., Wysocki, VH. (2007). A Linguistic Comparison of Letters of Recommendation for Male and Female Chemistry and Biochemistry Job Applicants. Sex Roles, 57: Trix, Frances and Carolyn Psenska. (2003). Exploring the Color of Glass: Letters of Recommendation for Male and Female Medical Faculty.” Discourse & Society, 4(2): Valian, Virginia. (1998). Why So Slow? The Advancement of Women. Cambridge, MA: MIT Press. Viner, N., Powell, P., Green, R. (2004). Institutionalized biases in the award of research grants: a preliminary analysis revisiting the principle of accumulative advantage. J. Research Policy 33(3): Wessely, S. (1998). Peer review of grant applications: what do we know? Lancet 352: Wennerås C, Wold A. (1997). Nepotism and sexism in peer-review. Nature,87:341–343. doi: /387341a0.