Inclusion and participation of older adults from underrepresented populations in cognitive aging and Alzheimer's disease-related research

项目摘要/摘要 阿尔茨海默病(AD)是一个主要的公共卫生负担，对代表性不足的人影响不成比例 人口(URP)，包括代表性不足的民族群体和社会经济地位较低的群体。 在AD临床研究中，URP的代表性长期偏低，这项研究具有大量的科学和伦理意义 后果。社会人口和其他因素对多个因素的单独和相互作用的贡献 研究参与的水平，包括注册、保留和完成研究任务，都不是很好 明白了。基于目前的健康差距理论框架，如生物心理社会文化模型， 需要考虑多种因素。因此，这项提议的总体科学目标是 不同研究中影响URP包涵性和参与性的多种生物-心理-社会因素 环境，特别侧重于民族血统和低教育程度的URP。一种创新的方法将 通过利用来自不同研究的三个现有队列来检验这些重要的假设 设置：(1)脑健康注册中心(BHR)，一个与认知老化相关的纵向研究注册中心， N&gT；70,000；(2)阿尔茨海默病倡议(ADNI)，一项临床观察性AD研究，N&gT；2,000，以及(3) 健康和退休研究(HRS)，一项基于人口的老龄化研究，N&GT；20,000。两个主要假设 是(1)URP状态与研究参与度之间的关联受到多个因素的影响 生物心理社会文化因素。我们将研究生物心理社会文化因素对URP的调节作用。 参与BHR和ADNI的研究；(2)AD试验的资格标准导致以下方面的代表性不足 厄普斯。我们将把当前AD试验资格标准的列表应用于基于人群的HRS样本，以 确定合格/不合格参与者的社会人口学特征并进行统计比较。我们会 进一步探讨试验设计特征对试验资格的贡献。这个项目既具有高度的新颖性又 具有重大意义，因为它将是第一个对多种生物、心理和社会文化因素进行深入研究的机构 在各种不同的环境中影响URP的包容性和参与性。更好地理解了 生物心理社会文化因素对URP研究的参与是阐明研究来源的关键 参与差距经常影响URP。因此，结果可能会对公共卫生产生重要影响。 影响，因为这项研究可能会为有针对性的研究纳入和参与战略提供信息，以改善 多样性。这项研究计划是以候选人最近的过渡为基础的培训计划的补充 从临床研究心理学到老龄化和AD领域，因此包括(1)认知方面的培训 老龄化/AD及相关临床试验；(2)复杂数据集分析、高级生物统计学；(3)AD差异； (4)URP研究参与差距；(5)专业发展。研究与训练相结合 计划将为候选人成功的独立研究生涯做好准备，专注于增加多样性 在认知老化和阿尔茨海默病的研究中。

PROJECT SUMMARY/ABSTRACT Alzheimer’s disease (AD) is a major public health burden and disproportionately affects underrepresented populations (URPs), including underrepresented ethnoracial groups and those with low socioeconomic status. URPs are chronically underrepresented in AD clinical research, which has substantial scientific and ethical ramifications. The separate and interacting contributions of sociodemographic and other factors to multiple levels of research participation, including enrollment, retention, and study task completion, are not well understood. Based on current health disparities theoretical frameworks, like the biopsychosociocultural model, multiple factors need to be considered. Therefore, the overall scientific objective of this proposal is to investigate multiple biopsychosocial factors affecting inclusion and participation of URPs in different research settings with a specific focus on ethnoracial and low educational attainment URPs. An innovative approach will be used to examine these important hypotheses by leveraging three existing cohorts from different research settings: (1) the Brain Health Registry (BHR), a cognitive aging-related longitudinal research registry, N>70,000, (2) the Alzheimer’s Disease Initiative (ADNI), an in-clinic observational AD study, N>2,000, and (3) the Health and Retirement Study (HRS), a population-based aging study, N>20,000. The two main hypotheses are (1) Associations between URP status and research participation are affected by multiple biopsychosociocultural factors. We will examine the moderating role of biopsychosociocultural factors on URP research participation in BHR and ADNI; (2) Eligibility criteria of AD trials contribute to underrepresentation of URPs. We will apply a list of current AD trial eligibility criteria to the population-based HRS sample to determine and statistically compare sociodemographic characteristics of eligible/ineligible participants. We will further explore the contributions of trial design characteristics on eligibility. This project is both highly novel and significant as it will be the first to conduct an in-depth examination of multiple biopsychosociocultural factors affecting URP inclusion and participation in a variety of different settings. Improved understanding of the role of biosychosociocultural factors on URP research participation is critical to elucidate sources of research participation disparities frequently affecting URPs. Thus, results are likely to have important public health implications, as this study may inform targeted research inclusion and engagement strategies to improve diversity. This research plan is complemented by a training plan that builds on the candidate’s recent transition from clinical research psychology to the aging and AD field, and therefore includes training in (1) cognitive aging/AD and related clinical trials; (2) complex data sets analysis, advanced biostatistics; (3) AD disparities; (4) URP research participation disparities; (5) professional development. The combined research and training plans will prepare the candidate for a successful independent research career focused on increasing diversity in cognitive aging and AD research.