This article reports on two studies investigating reader stance, navigation, and response in expository hypertext. Subjects in the studies included 69 and 147 adult readers prompted to adopt either an efferent or aesthetic stance when reading a 36-node expository hypertext. Reading was followed by recall and essay writing tasks. Results of the studies indicate that prompts can be designed to induce readers to adopt more efferent or aesthetic stances. Main effects for stance on navigation and the essay response measures were found. Aesthetic readers were found to attain higher levels of understanding and tended to rely more heavily on a built-in reading path that was part of the hypertext interface. Graphic analyses revealed wide variability in the navigational strategies of readers, with distinctive visual patterns that appeared to be related to reader stance. Exploratory analyses examining data collapsed across both studies suggest node size may play a role in navigation and response and may interact with reader stance. The studies suggest that navigation has an important role in online literacy transactions and that usability of online materials may be enhanced by accounting for reader variables such as stance in the design of interface elements.

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Background: It is estimated that 91% of stroke risk can be attributed to modifiable risk factors; however, on a population level, these risk factors are not well controlled. One recent response to reducing the burden of stroke has been to improve childhood knowledge about stroke. The purpose of our initiative was to educate high school students about stroke and careers in neuroscience. Methods: Thirteen students in Yale University Pathways to Science Summer Scholars participated in a 5-day program called Stroke Busters. Summer Scholars is a free summer science day program for rising 10th- 12th grade students. The demographic breakdown is 32% Asian, 30.1% Black, 20.4% Latinx, 15.5% White, and 1.9% Middle Eastern. Stroke Busters is a program within Pathways that includes an interactive stroke lecture, mock stroke code simulation, interactive mechanical thrombectomy demonstration, and a workshop where students created their own stroke learning materials. Students completed an 8 question pre and post-test that assessed stroke knowledge. Results: Between 7/11-7/15/22 thirteen students participated in Stroke Busters . The average test scores increased from 38% to 73%. Prior to the program, eight students (62%) listed that a stroke occurred in the brain and four students (31%) correctly identified the acronym “FAST”; 100% of students got these items correct in the post-test. The score for identifying 4/4 stroke symptoms improved from 56% to 92%. Twelve students provided feedback; the overall satisfaction rating for the program was 4.44/5. Students commented on the stroke simulation as the most enjoyable part of the program. Conclusion: In this high school stroke educational program students improved their knowledge about stroke significantly. This is the first stroke education program to our knowledge that focuses on high school students using a multi-day curriculum led by a diverse group of healthcare professionals.