6

Best Practices for Colleges and Universities

This chapter draws substantially from the research paper “Comprehensive Literature Review of Current and Promising Practices to Support Unpaid Caregivers in Science, Technology, Engineering, Mathematics, and Medical STEMM,” by Jessica Lee, J.D., Erin Frawley, M.Ed., and Sarah Stoller, Ph.D., which was commissioned for this study.¹

The report so far has outlined the existing family caregiving landscape, and the many challenges caregivers face as well as barriers to successful policy implementation. In the next set of chapters, the committee turns toward action. It is not simply enough to understand the reality of family caregiving in academic science, technology, engineering, mathematics, and medicine (STEMM); there is an immense need for concerted effort to address these challenges and provide greater support to not only help individual caregivers but advance equity and inclusion in STEMM and ensure the continuation of a strong and supported workforce to advance STEMM innovation. While there is no one-size-fits-all model, there are data and evidence to guide the kinds of approaches colleges and universities can take to implement effective policies that provide caregivers with the support they need. This chapter begins with a discussion of the foundational minimums that colleges and universities must meet to ensure legal compliance, given many reports of institutions that are noncompliant with existing laws, and considers policies addressing bias and discrimination. From there, the committee details current knowledge of the best practices for each of the remaining three policy areas covered by current institutional approaches as outlined in Chapter 4: leave, accommodations and adjustments, and direct care support. The committee defines best practices as those with a body of literature examining their effectiveness as well as evidence of application

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¹ The full paper is available at https://nap.nationalacademies.org/resource/27416.

and feasibility in a college and university setting. This is distinct from the innovative practices detailed later in Chapter 7, where there is more limited empirical evidence to support policy effectiveness and/or the policies have only been implemented in other domains. The chapter concludes with a discussion of practices to challenge existing cultural norms given the significant barrier this can pose to effective policies. Throughout the chapter the committee offers checklists for key actions to implement best practices based on committee expertise and review of the literature (see Boxes 6-1, 6-3, 6-5, 6-7, and 6-10 for best practices check-list) as well as call-outs of examples in action showcasing practices at institutions around the country (see Boxes 6-2, 6-4, 6-6, 6-8, 6-9, 6-11, and 6-12 for examples in action).

As evidenced in Chapter 5, even best practices can fail or face unintended consequences due to various structural and systemic barriers. Though these practices remain important and needed to support family caregivers, attention should always be paid to thoughtful implementation and evaluation to assess the true effect of new policies and procedures. Individual institutions should examine how any new practice works in their context and adjust as needed.

FOUNDATIONAL MINIMUMS FOR LEGAL COMPLIANCE

The minimum best practice for federal, state, or municipal laws affecting caregivers is compliance with the laws. But this is not always easy, as the legal regime surrounding caregiving is complicated. As there are many reports of instances where universities are not in full compliance with existing laws and regulations protecting family caregivers, a necessary starting point for any discussion of best practices for supporting family caregivers is ensuring a grounding in what institutions are legally required to do (Calvert, 2016; Gulati et al., 2022; Lee et al., 2017; Mensah et al., 2022; Williams et al., 2022). For more on these existing laws and regulations, see Tables 4-1 and 4-2 in Chapter 4, which provide an overview of legal mandates for both employees and students.

Effective Compliance with Laws Governing Students

Starting with Title IX of the Civil Rights Act of 1964, there are several areas where compliance and implementation of the law on college campuses may be lacking. Principally, Title IX prohibits discrimination based on sex in all educational programming. The ban includes discrimination on the basis

of pregnancy, but this has often been ignored by many institutions until recent years (Mason & Younger, 2014). Colleges and universities need to ensure their policies do not discriminate against pregnant students, notably by failing to provide as much leave as their medical provider says is medically necessary and by failing to provide pregnancy accommodations such as the ability to avoid exposure to toxics during laboratory research. More broadly, they need to create an environment where faculty and other university staff understand caregivers’ legal rights. Along with ensuring basic compliance, following these requirements to support student parents is also an issue of racial equity, as the majority of undergraduate student parents are students of color (Institute for Women’s Policy Research & Aspen Institute, 2019).

To maximize the effectiveness of federal laws that prohibit caregiving-related discrimination and bias, operationalizing key aspects (and enforcing them) at the institutional level is extremely important. Reuter (2006) calls for the enforcement of a “strict” policy to that end. Taking implementation of Title IX protections against discrimination as one example, and as noted in the legal compliance checklist in Box 6-1, a best practice is to ensure that anywhere Title IX is mentioned on campus communications materials, it should be highlighted that pregnant and parenting students have rights. Web pages and other communication materials also should be inclusive and representative of a wide variety of caregivers and parents (The Pregnant Scholar, 2022).

Though the 2023 Title IX regulations have yet to be released, it is also important for universities to understand future issues of compliance. One area is the provision of lactation accommodations for students. The new Title IX regulations once enacted include a clear requirement for educational institutions to provide their students with a clean, private, non-bathroom lactation space and the time to use it. To avoid negative consequences on a student’s education caused by missing class, universities should strive to place lactation rooms in areas readily accessible to the students who need them. Because students often struggle to arrange class schedules around their lactation breaks, supportive institutions often have a lactation policy making clear to faculty that these students should be excused without penalty (Clark et al., 2021; The Pregnant Scholar, 2020).

Additionally, the U.S. Department of Education’s draft revised Title IX regulations will require training of all employees on Title IX² (Office for

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² These revised Title IX regulations were expected to be enacted in October 2023 but have been delayed.

Civil Rights, 2022). Such training is especially important as the efficacy of Title IX offices is often hindered by a lack of knowledge and awareness of these protections. A recent study found that only 35 percent of those surveyed were aware of the Title IX office and resources offered. The new Title IX regulations require educational institutions to disseminate necessary information via their Title IX coordinator’s programming and grievance policies (Office for Civil Rights, 2022).

Effective Compliance with Laws Governing Faculty and Other Employees

Along with ensuring Title IX compliance for students, universities may need to address important compliance issues for faculty and staff. For example, it has been documented that various residency programs require individuals who take leave to work extra to “pay back” their leave before they take it (Gulati et al., 2022; Peters & Hartigan, 2023). In addition to possibly increasing the rate of pregnancy complications, this practice violates the Family Medical and Leave Act’s (FMLA’s) prohibition on denying legally protected leave or penalizing individuals for taking leave. It may also be an illegal form of sex discrimination when other employees are not required to make up work hours expected to be missed for incapacitation and serious health needs not related to pregnancy. It is essential that institutions stop forcing residents, physicians, and other employees to work additional hours to “make up” for their anticipated maternity leave (Gulati et al., 2022; Peters & Hartigan, 2023). Institutions need to realize that since those practices violate the FMLA, they are illegal.

Several mechanisms have been identified to provide funding for leave-talking in medical schools. Most promising is the University of California, San Francisco, policy, which provides for paid leave for faculty, financing it through a small contribution (less than 1 percent of salary) made by faculty for this purpose (University of California, San Francisco, 2020). As an alternative, Gulati et al. (2022) suggest that hiring locums, or a professional who can fill the role of a colleague for a temporary period, is one approach to manage anticipated staff demands associated with leave. Institutions may also want to consider providing support in negotiating a plan and coverage for duties during leave (Cardel et al., 2020).

Relatedly, it is illegal to require or pressure faculty to perform work during leave or to penalize someone for taking leave they are entitled to. A common finding is that faculty employees continue to work while on leave (Ollilainen, 2019; Schimpf et al., 2013). Requiring an employee to work

while on FMLA leave may constitute illegal interference with that leave, opening institutions to liability (Gulati et al., 2022). Studies have found that employees’ leave is viewed more favorably when they remain engaged while away, which can skirt close to or over the line of requiring work while on leave (Ollilainen, 2019). To avoid not just legal risk but also employee burnout, institutions should consider leave planning that sets clear terms and limits on any work being done while away and ensures that employee time working while on leave is tracked and not deducted from their leave allowance. For example, an employee who desires to continue to check work email and participate in decision-making may be able to take 14 weeks considering time spent working, rather than 12 weeks if no time was spent working during leave.

As of December 2022, new legal requirements are also in effect to provide as-needed lactation breaks and a private, non-bathroom lactation space for all workers who need it (U.S. Department of Labor, 2022). This law may ease some of the challenges long faced by lactating employees in STEMM in the absence of legal protections (Sattari et al., 2020; Shauman et al., 2018; Soffer, 2019); federal workplace lactation law previously excluded salaried and professional workers, such as faculty and physicians, leading many to treat providing lactation space as a special “favor” to women. This is especially important in a climate where many physician mothers report experiencing breastfeeding discrimination (Jain et al., 2022; Ortiz Worthington et al., 2019; Shauman et al., 2018).

Caregivers and pregnant employees also have legal protections against discrimination. One mechanism through which universities can aim to reduce discrimination is through making policies universal rather than contingent on a person’s position or identity and automatic rather than opt in. Recent research examines the case of tenure clock extensions. Based on an analysis of 508 universities, the authors find that universal, opt-out tenure clock extension policies predict an increase in the representation of all groups of women among tenured faculty following adoption. In contrast, tenure clock extensions available only to women or that are opt in increase the share of tenured White women but do nothing for women of color (Gonsalves et al., 2022). This underscores one way to address the intersectional nature of family responsibilities discrimination discussed in Chapter 4 and the barriers posed by lack of attention to intersectionality in Chapter 5. By making policies universal and automatic, there is less opportunity for faculty of color to be denied leave and other flexibility granted to White caregivers (Calvert, 2016).

Universities can also employ bias trainings and workshops and engage in self-studies to assess whether their programs are having the desired

outcomes. At a minimum, these workshops should cover bias against mothers, which is the strongest form of gender bias, and should inform participants that it is illegal to penalize fathers for taking parental leave (Correll et al., 2007). This material should be included not only in the basic antibias training but also in specialized trainings, such as trainings for department chairs and search committees. In addition, orientation trainings for new faculty should provide the basic information they need to know about treatment of pregnant and parenting students.

Finally, institutions must also consider that while many pregnant, postpartum, and caregiving employees may need changes in their work duties to protect their well-being, others do not. Supervisors may remove their pregnant employees from high-prestige positions in a misguided effort to keep these employees safe. This has been a particular concern in STEMM fields (Anderson & Goldman, 2020; Englander & Ghatan, 2021; Gulati et al., 2022). Forcing an employee to take an accommodation they do not want or to take leave when they are able to work with adequate protective equipment or other accommodations can be a violation of federal law (Equal Employment Opportunity Commission, 1964; U.S. Congress, 2021). Best practice is to provide a clear point of contact for the employee and to engage with them in an interactive process to identify accommodations that do not adversely affect their career.

Legal Compliance and Concern About Stigma and Retaliation

Along with the various practices needed to ensure greater awareness of existing laws and appropriate implementation, colleges and universities also need to consider potential barriers to reporting discrimination—particularly fear of retaliation. For policies to be most effective, colleges and universities need to consider these potential barriers. Other work has suggested that some ways to reduce fear of retaliation include providing clear and explicit language on actions taken to prevent bias and discrimination, establishing anonymous online reporting systems to safely report misconduct, and using independent committees to investigate complaints (Torres et al., 2023a, 2023b).

BEST PRACTICES FOR INSTITUTIONAL POLICIES

Policies Related to Caregiving Leave

Adopting a formal policy for caregiving leave with clear standards is a key mechanism by which institutions will make their policies easier for students, faculty, and staff to access, and for faculty and administrators to manage consistently and fairly (Bye et al., 2017; Daskalska et al., 2022; Kraus et al., 2021; Roselin et al., 2022). Yet, many institutions continue to provide leave on an individualized, ad hoc basis, a practice that can result in varied outcomes, including bias or other illegal practices (Roselin et al., 2022). Reducing heterogeneity across departments and individuals can ensure a more consistent application of leave and the ability to directly stipulate an expansive definition of family caregiving rather than implicitly assuming that leave for caregiving is or should only be for the care of nuclear family members. Clearly stipulating a broad definition of caregiving to include a wider community network is important to acknowledge and support the broader conceptions of family among communities of color and LGBTQ+ communities (Biblarz & Savci, 2010; Gerstel, 2011; McCann et al., 2000; Sodders et al., 2020; Tam et al., 2017; Weston, 1997). This can also help to address potential bias as detailed in one study of queer faculty mothers, where the author found queer mothers were less likely to be offered formal, paid leaves, potentially as a result of narrow assumptions that only a birthing parent would take leave (Stygles, 2016).

As institutions aim to formalize the leave policies and processes, other factors are also important to keep in mind. For example, gender-inclusive

leave policies allow for parents or caregivers of any gender to access the leave they need, but they may cause unintended consequences. Researchers have expressed concern that gender-blind leave benefits may hurt women, especially women faculty, who are less likely to use leave periods to further their academic work than are men (Burch et al., 2023; Feeny et al., 2014). The primary users of these policies remain women who give birth, with

leave being more common among women and people of color of all genders than their White male counterparts (Armenia & Gerstel, 2006; Herr et al., 2020). For this reason, leave policies should make clear that caregiving leave cannot be used for research activities, and to tie leave eligibility (along with tenure probation extensions) to birth recovery or caregiving of at least 20 hours per week (Burch et al., 2023; Williams & Lee, 2016). To the committee’s knowledge, however, the efficacy of these various leave policy options has not been assessed empirically.

Another approach to address the unique needs of birthing employees is to layer forms of leave. While all caregivers should be permitted to take time off when needed to provide care, birthing parents need to care for infants and simultaneously address their own health needs. As such, it would be appropriate to allow these employees to take additional time specific to their health. The best practice is to provide all caregivers a 12-week leave, and birthing caregivers could additionally be entitled to a leave term to account for their temporary incapacity (Williams & Lee, 2016). This could be covered under an institution’s disability leave policy to supplement the caregiving leave for birthing parents.

Research has found that it is more effective for leave to be provided as a standard benefit for employees rather than establishing onerous application requirements that may limit uptake (Roselin et al., 2022). Length of leave should also be made clear. Twelve weeks is generally seen as a standard for leave length and typically works well for employee leave policies. Universities, however, also need to consider other populations. Twelve weeks may work well for faculty and staff, but some research has suggested it can present challenges for student populations. Daskalska et al. (2022) note that lengthier leave terms can affect students’ ability to graduate on time. The authors of this study suggest institutions start with a 6-week leave policy for students with additional coursework accommodations to balance the need for leave, with the desire to maintain academic progress. Ultimately, more research is needed to determine the length of leave that is most beneficial to students beyond a 6-week minimum.

For students, taking leave may result in financial costs through accrued student loans and delayed earnings. Students may also lose access to health benefits, financial aid, and other benefits and support of enrollment while on leave (Kraus et al., 2021; Roselin et al., 2022). To address this, Roselin et al. (2022) found that several undergraduate medical programs ensured their students retained access to campus supports by providing an “enrolled academic adjustment” option allowing their students to reduce their academic duties while preserving their student status. Other adjustments could

include reducing course loads, allowing for virtual participation in coursework, and providing evening courses and accelerated programs (Clark et al., 2021; Contreras-Mendez & Cruse, 2021; Huerta et al., 2022; Ryan et al., 2021; Springer et al., 2009; Wladis et al., 2023).

Resident physicians also encounter challenges in taking leave and the ways in which this may delay progress and interrupt timelines in their programs. The American Academy of Family Physicians (AAFP) encourages programs to consider “home-study or reading electives” to minimize the time residents need to take off for family caregiving (Weinstein et al., 2019). AAFP also suggests proactively planning rotations to minimize disruption around the expected birth or adoption of a child and ensuring there is no “on-call time” during leave. Importantly, this requires planning to ensure the peers of residents on leave will not be required to make up the work. Programs can do so by including deliberate redundancy in staffing plans, or funding coverage by external staff (Weinstein et al., 2019). Part-time options may be useful for other medical trainees as well. For example, Weinstein et al. (2019) have called for the initiation of part-time graduate medical education, or GME, tracks, which could allow trainee physician caregivers to continue their education while meeting their family’s needs.

For faculty, stop-the-clock (STC) policies and other duty modifications can be important. It has now been nearly two decades since a report

from the American Council on Education strongly recommended that any penalties in the hiring or tenure process resulting from caregiving gaps be abolished (Marcus, 2007). Among other things, the report advised universities to allow faculty to extend the tenure probationary period by up to 2 years following a child’s birth or adoption. Many institutions already meet these goals. A major study of family-friendly academic policies conducted in 2007 concluded that “one of the biggest problems … isn’t that these kinds of benefits are not available for faculty with families. It’s getting faculty to take advantage of them” (Marcus, 2007). Both men and women express concern that they will be judged harshly during the tenure process if they have stopped the clock or taken family leave (Moors et al., 2022; Sallee, 2008).

As noted in Chapter 4, however, several studies have documented gendered consequences of STC policies of promotion and tenure. While these issues deserve more evaluation, experts have proffered several best practices designed to reduce the likelihood faculty feel they need to ensure their extension period remains “productive” and ideally reduce discrepancies for faculty who need to utilize a tenure extension period to address other needs. As noted before with caregiving leave, policies that normalize and require using leave for caregiving and not further advancement of research are important. Specifically, for STC policies, one solution is to implement agreements that faculty cannot use research products started during the leave period in tenure portfolios (Burch et al., 2023).

Another suggestion for reducing stigma around STC policies is for them to be opt out rather than opt in. Such policies normalize their use, sending the message that usage is expected (Burch et al., 2023). In 2005, Princeton changed its STC policy to require faculty to opt out, because so few faculty had sought to use the policy when it was structured on an opt-in basis. Women surveyed as part of the study that led to the policy change reported concern about being seen as less focused and less committed to their work should they elect to stop the clock (Marcus, 2007). And opt-out policies have been shown to produce benefits for the representation of women and particularly women of color among tenured faculty (Gonsalves et al., 2022).

An important element of an effective stop-the-clock policy is a requirement that notifies appointment and promotions committees that a faculty member who has stopped the clock should be evaluated as if they had the same number of years in service, not as if they had been in service during the period when the clock was stopped (Antecol et al., 2018; Beckerle et al., 2011; Ecklund & Lincoln, 2016). Unless the relevant committees receive

this guidance, STC policies can end up penalizing those they are designed to help.

Along with STC policies, there are various ways to structure and modify duties that could be used to accommodate the different needs and experiences of faculty performing different kinds of caregiving duties (for more details on duty modifications, see Chapter 7). Possible interventions include part-time work, job sharing, and adjusted tenure timelines. All these policies should be framed as career enhancing rather than limiting (Ibrahim et al., 2017).

Compared with part-time work in other sectors, specific challenges can arise when orchestrating part-time faculty appointments. With faculty work split across the functions of teaching, research, writing, and service, it is not always obvious which components of work can be cut back. Research supports offering faculty half-time appointments at full benefits, as well as temporary reductions of full-time appointments on a short-term basis to support faculty facing a particular life event (Koppes Bryan & Wilson, 2015). Studies of work-life support for academics also reference job sharing (or dividing one faculty position with benefits into two part-time positions with benefits) as another option (Koppes Bryan & Wilson, 2015) (for more detail on job sharing, see Chapter 7). Although there are precedents for job sharing, particularly internationally (Stoller, 2023), little research has tracked the prevalence of such policies and efficacy in the U.S. context (Koppes Bryan & Wilson, 2015). Importantly, these part-time appointments should not be marginalized and considered contingent gig work within the academy; instead, they should be treated as a valued, alternative path.

Most literature about modifications and accommodations relates to pregnant academics and new parents; additional information is needed regarding the interventions most helpful to employees who need modifications due to caregiving for family members and loved ones other than babies and children. For example, a 2007 study found that faculty providing older adult care were less likely to want to reduce their work hours than those caring for children (Keene & Prokos, 2007). Caregivers for adults may also need different communications approaches. A University of California, Davis, study of clinical and/or research biomedical faculty found that 24 percent of male and 14 percent of female faculty respondents needed accommodations to care for an adult or due to the death of a close family member (Shauman et al., 2018). Many of the existing family-responsive policies were not well utilized by these employees, as they were overwhelmingly unaware

of benefits or held misconceptions about the programs. Participants also reported that supervisors served as gatekeepers to policies—even in cases that they were not required to approve a particular benefit. Shauman et al. (2018) suggest this points to the need to train department chairs and other supervisors so that they are aware of policy details and the importance of facilitating access to the policies.

Policies Related to Direct Care Support

Caregivers in academia experience significant financial strain caused by both caregiving (e.g., paying for childcare) and its relationship to work (e.g., salary losses from taking leave or delaying tenure) and/or education (e.g., enrollment, persistence, and graduation). When caregivers are unable to meet their basic needs, their work and career suffer. For students, this is especially relevant. While basic needs insecurity is prevalent for most college students, the rates are especially high among parenting students, the majority of whom are students of color (Institute for Women’s Policy Research & Aspen Institute, 2019). In a 2019 survey, the Hope Center for College, Community, and Justice found that among 23,000 parenting students, 53 percent were food insecure in the last 30 days, and in the previous year, 68 percent had been housing insecure, and 17 percent have been homeless (Goldrick-Rab et al., 2020), and these inequities were only further exacerbated by the COVID-19 pandemic (White & Cruse, 2021). These kinds of inequalities are also important to note because while most individuals will care for a family member during their lives, women, LGBTQ+ individuals, and people of color are more likely to be driven into poverty as a result of this (Bose et al., 2021).

Given the challenges outlined above, caregivers need to have their basic needs met to most effectively perform their work or engage in their education. Centralizing support and providing resource navigation is an important practice for ensuring caregiving students are aware of and can most efficiently access basic needs programming organized in spaces that are often called student parent resource centers and provide information on childcare, grants, family housing, student and dependent insurance, and more (Coronel, 2020; Goldrick-Rab et al., 2020; Mason, 2022; Mason et al., 2007; Springer et al., 2009). Creating a university position specific to supporting student parents and their families can also help to institutionalize and better ensure the continuation of policies aimed to help family caregivers (Robertson & Weiner, 2013). Student parent survey participants have noted that “holistic

wraparound support,” including addressing their basic needs, was critical in ensuring their success (Contreras-Mendez & Cruse, 2021). Such efforts can be transformative. In a case study from a large mid-Atlantic university during the 2009–2010 school year, a campuswide movement had been initiated to collect a small student fee for resources for caregiving students. The fees collected created a subsidy for childcare, a dormitory for families, and lactation rooms on campus resulting in a 93 percent retention rate for pregnant and parenting students (Brown & Nichols, 2013).

Childcare

For students, postdocs and other trainees, faculty, and staff alike, access to different forms of paid caregiving is also crucial. While already well established, the COVID-19 pandemic dramatized the importance of access to childcare for academic parents (Bender et al., 2022). The vast majority of research on best practices to support caregivers in higher education proposes that institutions develop and maintain on-site childcare options that offer proximity to and an alignment with parents’ work needs (Cardel et al., 2020; Carr et al., 2017; Ibrahim et al., 2017; Ladores et al., 2019). In addition to meeting the basic needs of working parents, on-site childcare can signal a climate that is broadly supportive for caregivers (Carr et al., 2017). At the same time, universities should be thoughtful that this approach may not be preferred by all members of the institution. In particular, some research shows that Black mothers prefer to utilize other forms of childcare, such as kin-care or community care centers, given both concerns of potential racism in predominantly White care settings and a reflection of cultural preferences (Dow, 2015; Uttal, 1996). Given this, options for care subsidies or reimbursements for different arrangements off campus are additionally important.

These recommendations are in line with the unique time demands of a career in STEMM, which are less likely to be limited to the business hours of day care centers. Affordable on-site childcare, while largely beneficial to academic caregivers and the institutions that employ them, is just one of a wide array of strategies for meeting parents’ childcare needs and may be a better fit in some institutional contexts than others. A comprehensive 2020 study of best practices for supporting women and caregivers in STEM at universities in the United States recommends the development of a comprehensive suite of childcare support (Cardel et al., 2020). This includes a university childcare and family resources web page, and a point person who can serve as a family resources officer. Universities should also offer backup and emergency care options, childcare for snow days, childcare for any public-school holidays that conflict with university schedules, and access to summer camps nearby. They should also subsidize the costs of work-related travel to offset childcare expenses (Cardel et al., 2020). As noted in Chapter 5, however, the provision of childcare resources is not enough if the diverse needs of neurodivergent children and children with disabilities are not accounted for and parents of these children cannot access the more specialized services they need. In designing childcare resources, administrators need to ensure they are not implicitly assuming they are only providing support in the care of neurotypical children without disabilities.

As noted in Chapter 5, universities also need to be mindful of challenges of availability. Certainly, increasing childcare options on campus can help, but creative solutions may also be useful if a broad increase in on-site care is not possible. Such solutions could include allowing families who do not require full-time care Monday through Friday to select the days and times that they require, allowing for flexibility such that another family could utilize open slots. Additionally, universities can and should apply for federal and state grants such as the Child Care Access Means Parents in School Program, or CCAMPIS, which provides funds to support or establish childcare centers on campus to serve low-income students (U.S. Department of Education, 2023).

A large body of research additionally highlights the challenges that faculty, graduate students, and postdocs and other trainees experience with securing childcare during conference and fieldwork travel. These challenges tend to disproportionately disadvantage women, who continue to shoulder more caregiving responsibilities in families, and contribute to the “leaky pipeline.” Travel for research and conferences facilitates high-quality published work and is essential for networking (Knoll et al., 2019). It is, in other

words, critical for career development, particularly for junior scholars (Tower & Latimer, 2016). Some professional organizations, such as the American Society for Cell Biology, provide travel awards that parents can use for any combination of childcare support that will allow them to attend the annual meeting and present their science, for example, extended childcare hours, transportation, and accommodations for children and a caregiver along with the scientist parent, and transport of a relative to the scientist’s home to care for children in the parent’s absence (American Society for Cell Biology, 2022).

Universities, professional associations, research societies, and individual conferences all have a potential role to play in easing the burden on caregivers for their work travel. Recent scholarship on the challenges surrounding work travel for caregivers in higher education strongly recommends that universities and other organizations do more to offset faculty’s caregiving burden—whether for childcare, older adult care, or care for adult dependents with special needs (Baldiga et al., 2018; Calisi & Working Group of Mothers in Science, 2018; Tower & Latimer, 2016). There are different ways to support childcare either at home or at conferences and events. The recommended best practice is to offer faculty a variety of options, including financial support that allows families to meet their own needs and generously reimbursing reasonable expenses on a case-by-case basis.

The needs of caregivers vary widely based on the age and needs of their dependents. For example, a lactating parent might prefer financial support to travel with their baby and a partner or other caregiver, rather than receiving a subsidy to pay for extended childcare at home. The parent of an older child might need an arrangement that allows their child to remain at home and attend school. For parents caring for neurodivergent children or children with disabilities, needs may be even more complex and multifaceted. Depending on the child’s specific needs, parents may require assistance from a companion when traveling or need support for engaging a family member or trusted paid caregiver to look after their children while they are away. Regarding work travel, those with caregiving responsibilities in different disciplines may have different needs, even within STEMM. For instance, fields with field-based research obligations such as geology may pose significant obstacles for breastfeeding parents. Even within universities, departments should evaluate the unique challenges faced by their faculty caregivers to offer the most appropriate forms of support (Baldiga et al., 2018). All organizations involved in supporting caregivers traveling for work should assess and improve available options on an ongoing basis to ensure that they are meeting family’s needs (Boss et al., 2017).

Older Adult and Adult Dependent Care

As stated previously, nearly 20 percent of U.S. adults are providing unpaid family care to an adult age 18 and older (AARP & National Alliance for Caregiving, 2020). However, the needs and solutions for providing older adult care at academic institutions have been less studied than childcare. A recent article examining older adult care in academic medicine highlighted not only the general lack of investment in older adult care in the United States but also the ways in which current policies at many institutions are not designed with the unique needs of those caring for adults in mind (Sosa & Mangurian, 2023).

Best practices for providing older adult care and adult care support are myriad, yet they tend to center on assisting employees with securing care and reducing the mental strain of managing caregiving and end-of-life planning (Koppes Bryan & Wilson, 2015). For example, institutions have offered a variety of supportive programming, from support groups to respite care and meal preparation; however, the efficacy of these popular interventions is largely unstudied (Skarupski et al., 2021). Among early-career faculty surveyed at one university medical center, the most preferred types of caregiving assistance were the provision of a laboratory technician at work, a personal assistant or coach, and general household help (Hartmann et al., 2018). Preference for these forms of assistance varied by gender, with the

most popular intervention among women being household help and among men, the assistance of a laboratory technician at work.

In contrast to expectant parents, those caring for adults are less likely to have their caregiving status or needs known in the workplace (Dembe & Partridge, 2011; Gabriel et al., 2023). As such, it is particularly important for employers to proactively educate workers on their older adult care services and benefits (Calvano, 2013). Underutilization and fear of disclosure are significant barriers to employees gaining the full benefits of the programs (Calvano, 2013; Dembe & Partridge, 2011). In a study of faculty at a large research institution, 91 percent indicated they were unaware of their university’s policies and procedures for older adult care (Leibnitz & Morrison, 2015). Many reported difficulties finding the information they needed, with STEM faculty being significantly less likely to know institutional policies. As such, institutions should consider tailoring their offerings and communications strategies so that they are more effective in reaching those in need.

Important in the considerations of older adult care is the life stage of those faculty and employees most likely to need it. Though caregiving of older adults can occur at any stage, the “biggest squeezes” occur in early adulthood (primarily with children) and in the years preceding retirement (Patterson & Margolis, 2019). As such, institutions may want to consider offering older adult care support as a critical tool particularly for retaining

later-career faculty. There are limited data on the ramifications of older adult care support and retirement decisions in STEMM broadly, but studies in the medical field are instructive. Women physicians have fewer challenges with work-life integration in senior years, but they are still prevalent (Templeton et al., 2019). Faculty women in academic medicine were more likely than faculty men to be caregivers and to cite caregiving and health care as important factors in one study of retirement decisions (Levine et al., 2022). In contrast, another study found no significant difference in retirement intention related to gender and caregiving; however, this may have been influenced by the relatively young ages of the faculty in the sample (Skarupski et al., 2021). It may be that later-career faculty women are choosing to delay retirement due to caregiving demands; a study across several institutions found that 51 percent of late-career women faculty reported the need to care for relatives as a reason to delay retirement, as compared with 37 percent of men (Berberet et al., 2005). More research is needed to understand this dynamic and the potential to address gender and caregiving gaps in the late-career professoriate. Addressing the older adult care crisis may be particularly important in light of the benefits of faculty mentorship by senior women and people of color.

There is no national directed effort geared toward supporting mid- or later-career faculty with caregiving demands, unlike early-career faculty, who are more often managing the demands of childrearing (Skarupski et al., 2021). Institutions should ensure that, at minimum, their existing support policies (e.g., sick leave, flextime, altered working schedules) are marketed toward those who might need older adult care support, not merely those who are parenting (Leibnitz & Morrison, 2015).

CULTURAL SHIFTS TO CHALLENGE IDEAL WORKER NORMS

All the practices mentioned in this chapter can help to support family caregivers in academic STEMM, and the adoption and dissemination of these policies and practices can also serve to inform and express the priorities and expectations of institutions. Yet, even with the best policies and practices in place, the cultural norms in academic STEMM continue to limit utilization. In fact, recent research reported in Nature reveals that a toxic workplace culture is the main reason women leave academia (Sidik, 2023).

Work-life initiatives remain on the peripheries of organizational discourses and strategies, rather than as core dimensions of academic culture (Ernst Kossek et al., 2010; Kossek & Lee, 2022; Valantine & Sandborg, 2013), contributing to a culture that discriminates against caregiving. As Kossek et al. (2010) write, “work-life changes … [need to be] part of the core employment systems to enhance organizational effectiveness and not just as strategies to support disadvantaged, non-ideal workers.” Rather than an addendum, work-life inclusion must be foundational to the creation of university policies, to help dismantle cultural models of work and redefine academic excellence and success with flexibility in mind (Blair-Loy & Cech, 2022; Ernst Kossek et al., 2010). Without transparency and accountability, cultural schemas (i.e., the status quo) prevail, along with the accompanying biases that negatively affect the health and well-being of individuals and the state of scholarship and innovation more broadly (Christensen, 2013; Valantine, 2020).

To situate caregiving issues as central to the organizational culture of higher education, scholars and university administrators can adopt a range of strategies—at individual, departmental, and institutional levels. Offering a simple, individual-level strategy, Arora et al. (2020) propose the “COVID-19 CV Matrix” as a potential framework for documenting contributions, disruptions, and caregiving responsibilities during the pandemic, to aid in fair evaluations from tenure and promotion committees. Specifically, a sample matrix might consist of three columns, listing categories (e.g., research, education, media), activity (e.g., halted, prep for online transition, op-eds), and descriptions (e.g., reported to organization, summer research course, New York Times), respectively. Seeking to address concerns that the initial matrix did not adequately address the gendered and racialized impacts of the pandemic, Raja et al. (2021) have created a “CovidCV prototypical system,” which “creates

a color-coded CV from the user’s data entries documenting work and home life.” Specifically, users can document academic successes and setbacks, family events, such as birthdays, and ongoing struggles, such as the caring for a loved one, marking each entry as major or minor, good, bad, or neutral, and the feelings or emotions over the course of a given week (Raja et al., 2021). The goal of this system is to provide “the underlying ‘invisible context,’” by illuminating the conditions, events, and struggles that affect each faculty member’s ability to work and live in a holistic way (Raja et al., 2021). While created in the context of the COVID-19 pandemic, such a system could have continued benefits as it allows for the acknowledgment of life outside of work.

In addition to individual-level efforts, meso-level interventions, at the everyday level, are needed to provide educational and workplace supports for fostering equity and inclusion in academic environments (Kossek & Lee, 2022; Kossek et al., 2011; Ward & Wolf-Wendel, 2012). For example, Kossek and Lee (2022) examine how work-life issues intersect with gender and affect women’s career advancement (focusing on the business school context) and recommend actionable steps for leaders. Specifically, they highlight the importance of “work-life boundary control,” or the ability to control the separation, integration, and salience of work and nonwork roles to avoid role conflict or strain. Actions that can aid in this boundary management include scheduling meetings and events with family responsibilities in mind (i.e., from 9 a.m. to 3 p.m.); encouraging email breaks and vacations; celebrating egalitarian caregiving efforts; and recognizing nonwork achievements (Kossek & Lee, 2022). Notably, these suggestions are feasible and can be enacted in programs, departments, and colleges to target academic organizational cultures by placing work-life inclusion at the forefront.

At the institutional level, cultural solutions can also be implemented, especially through efforts to change leadership to engender cultural change (Valantine, 2020; Valantine & Sandborg, 2013). In fact, Valantine and Sandborg (2013) called for 50/50 leadership representation among women and men in academic medicine by 2020, arguing that closing the gender gap in leadership would help to usher in improvements in work-life integration and flexible work options. Though gender parity in academic leadership in science and medicine has yet to be achieved, Valantine (2020) notes its continued importance as a “seed [for] the cultural change necessary for inclusive excellence” and documents the system-level strategies that have been implemented in the National Institutes of Health’s (NIH’s) intramural research program to foster an organizational culture of inclusion and equity.

The NIH’s four integrative strategies include having an Equity Committee to track metrics of diversity and inclusion; diversifying candidate searches beyond personal, informal networks; providing bias educational training for all search and promotion committees; and establishing the Distinguished Scholars Program of roughly 15 tenure-track investigators with commitments to inclusive excellence (Valantine, 2020). Uniting the components of this plan is the common goal of changing the institutional culture of academic medicine through the increased representation of women and other underrepresented groups. Such strategies for cultural change can be used as a model for other institutions and will also lend support to individual actions (such as CV framing), as well as departmental or college-level efforts (such as work-life boundary management).

SUMMARY OF FINDINGS FROM CHAPTER 6

The challenges family caregivers currently face in academic STEMM are significant, and prevailing cultural norms and schemas can create significant barriers to addressing these challenges. No one solution provides the silver bullet that ensures a more welcoming and inclusive environment for family caregivers with the flexibility they need because the needs of family caregivers are diverse and complex. Instead, many opportunities exist to implement an array of policies and practices that can provide broad and flexible support to family caregivers in academic STEMM whether they are students, trainees, faculty, or staff. These best practices are not only nice to have, but highly beneficial to promoting an inclusive and welcoming STEMM environment that helps to further build and support this workforce and its innovation.

1. Ensuring legal compliance with requirements established by Title IX, FMLA (federal, state, and municipal), the Pregnant Workers Fairness Act, Title VII, and other key provisions established to protect caregivers is a necessary starting point for supporting caregivers in academic STEMM.
2. The legal patchwork is so complex that it is impractical to expect individual students or faculty to figure out the relevant legal rights and obligations that apply to them. An important best practice minimum is that Title IX offices be fully trained in students’ legal rights, and that students know when they should consult with Title IX officers. Equally important, leave and accommodations

2. decisions should not be left up to individual faculty members or department chairs without guidance from someone who is expert in navigating the complex legal environment, preferably a specially trained person in human resources with additional backup by someone in the provost’s office for faculty.
3. Foundational best practices for providing caregiving leave include adopting a formal policy with clear standards across the institution, ensuring gender-inclusive access to leave, ensuring leave is not used for research activities, offering leave as a standard benefit rather than requiring an onerous application process, providing paid leave, and making policies promoting flexibility opt out rather than opt in.
4. Many caregivers require accommodations to allow them to perform their roles both as caregivers and as staff, faculty, or students. Accommodations include course adjustments for students; part-time options for faculty, staff, and trainees; and stop-the-clock policies for faculty on the tenure track.
5. Bias and discrimination against caregivers still exist in STEMM. To address this, best practices include providing pertinent information in basic antibias trainings and in specialized trainings for search committees, department chairs, and the like.
6. Caregivers can face significant financial strain and would benefit from supports that address their basic needs, such as on-site childcare or childcare subsidies, support for adult care, and providing easy access to available resources online.
7. For policies supporting caregivers to have the biggest effect, cultural change is needed. Though challenging, important drivers of culture change exist at individual, departmental, and institutional levels to build greater trust, transparency, asking and listening, collaboration, and accountability.