Improving Hispanic/Latino participation in preclinical Alzheimers disease Trials

项目摘要 尽管长期努力改善招募少数族裔患阿尔茨海默病及相关疾病 痴呆症(ADRD)研究，美国拉美裔/拉丁裔在ADRD中的代表性仍然严重不足 随机临床试验。更多拉美裔/拉美裔美国人的代表性对于确保安全性和有效性至关重要 在日益多样化的美国人口中，干预措施和结果的普适性。临床前AD 在追求改进的ADRD疗法方面，试验将是必不可少的，并且在要求无症状方面是独一无二的 个人接受生物标记物测试并向研究伙伴登记。然而，目前还不清楚这些是否 独特的要求对招募拉美裔/拉丁裔参加临床前AD试验提出了具体挑战。 当务之急是我们发现并测试新的干预措施，以改善拉美裔/拉丁裔在这些方面的招募 审判。鉴于我作为流行病学家的背景，在健康差距研究方面有着坚实的基础，我有 进行这项研究的奉献精神。通过这次K01指导研究科学家的职业发展 获奖后，我建议接受必要的培训和研究经验，以弥补几个差距，并成为 ADRD招聘科学领域的领先者。我的主要假设是，年长的拉美裔/拉美裔美国人不太愿意 比他们的非西班牙裔(Nhw)同行更多地参与临床前AD试验，部分原因是可以修改 易于干预的行为因素。为了验证这一假设，我提出了三个具体的研究目标：(1) 首先，我将检查不同的人在参与临床前AD试验的意愿上的差异 西班牙裔/拉美裔和非拉美裔白人(NHW)来自全国1800名老年人口样本 回答网络小组调查的成年人。(2)接下来，我将通过面对面的认知访谈，找出关键 100名当地社区老年人参与意向的行为决定因素 拉美裔/拉丁裔，特别关注背景因素、文化信仰/价值观、研究素养、以前 在医疗保健系统、研究态度和感知的需求/益处方面的经验。(3)最后，我将使用一个 干预地图规划方法，用于系统开发和试点测试行为干预，即 在文化和语言上适当，旨在提高西班牙裔/拉美裔参与AD临床前阶段 审判。研究结果将为一项大型多中心试验提供初步数据，以测试使用随机 接近。为了实现这些目标和我成为一名独立调查员的目标，我提议 在广泛的ADRD培训中，通过教学指导、体验式学习和 田野。我将利用加州大学欧文阿尔茨海默病研究中心的资源 (A)获得关于反兴奋剂研究核心原则的基础知识，(B)获得混合-- 方法：(C)熟练设计行为干预措施；(D) 培养进行多中心研究所需的领导技能，推动我的研究向前发展。

Project Summary Despite longstanding efforts to improve recruitment of minorities into Alzheimer’s Disease and Related Dementias (ADRD) research, US Hispanics/Latinos continue to be severely underrepresented in ADRD randomized clinical trials. Greater representation of Hispanics/Latinos is critical to ensure the safety and efficacy of interventions and the generalizability of results across an increasingly diverse US population. Preclinical AD trials will be essential in the pursuit of improved ADRD therapies and are unique in requiring asymptomatic individuals to undergo biomarker testing and to enroll with a study partner. It is unclear, however, whether these unique requirements pose a specific challenge to the recruitment of Hispanics/Latinos into preclinical AD trials. It is imperative that we discover and test novel interventions to improve recruitment of Hispanics/Latinos to these trials. Given my background as an epidemiologist with a solid foundation in health disparities research, I have the dedication for undertaking this research. Through this K01 Mentored Research Scientist Career Development Award, I propose to receive the necessary training and research experience to address several gaps and become a leader in ADRD recruitment science. My overarching hypothesis is that older Hispanics/Latinos are less willing than their Non-Hispanic (NHW) counterparts to participate in preclinical AD trials, due in part to modifiable behavioral factors amenable to intervention. To test this hypothesis, I propose three specific research aims: (1) First, I will examine differences in willingness to participate in preclinical AD trials between diverse Hispanics/Latinos and Non-Hispanic whites (NHW) from a national population-based sample of 1,800 older adults who respond to a web panel survey. (2) Next, through in-person cognitive interviews, I will identify key behavioral determinants of intention to participation in a sample of 100 local community dwelling older Hispanics/Latinos, with a particular focus on contextual factors, cultural beliefs/values, research literacy, previous experiences with the healthcare system, research attitudes and perceived need/benefit. (3) Lastly, I will use an Intervention Mapping planning approach to systematically develop and pilot test a behavioral intervention that is culturally and linguistically appropriate and designed to improve Hispanic/Latino participation in AD preclinical trials. Findings will provide preliminary data for a large multicenter trial to test the intervention using a randomized approach. To accomplish these aims and my goal of becoming an independent investigator, I propose to engage in extensive ADRD training through didactic instruction, experiential learning and mentorship by the leaders in the field. I will leverage resources from the University of California, Irvine Alzheimer’s Disease Research Center to (a) acquire foundational knowledge of core principles in ADRD research, (b) gain experience in mixed- methods approaches in recruitment science, (c) become proficient in designing behavioral interventions, and (d) develop the leadership skills necessary to conduct multicenter studies and propel my research forward.