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

项目总结/摘要 阿尔茨海默病（AD）是一个主要的公共卫生负担， 人口（URPs），包括代表性不足的族裔群体和社会经济地位低的群体。 URPs在AD临床研究中的代表性长期不足，该研究具有实质性的科学和伦理价值。 后果社会人口学和其他因素对多种疾病的单独和相互作用的贡献 研究参与水平，包括入学率，保留率和研究任务完成率，都不好 明白根据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，本提案的总体科学目标是： 探讨影响URPs在不同研究中的纳入和参与的多种生物心理社会因素 特别关注少数民族和低教育程度的URPs。创新的方法将 通过利用来自不同研究的三个现有队列， 背景：（1）脑健康登记处（BHR），一个认知老化相关的纵向研究登记处， N> 70，000，（2）阿尔茨海默病倡议（ADNI），一项临床观察性AD研究，N> 2，000，以及（3） 健康与退休研究（HRS），一项基于人口的老龄化研究，N> 20，000。两个主要假设 （1）URP状态和研究参与之间的关联受到多重影响 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 BHR和ADNI的研究参与;（2）AD试验的资格标准导致 URPs。我们将对基于人群的HRS样本应用当前AD试验合格性标准列表， 确定并统计比较合格/不合格受试者的社会人口统计学特征。我们将 进一步探索试验设计特征对合格性的贡献。这个项目既非常新颖， 这是第一次对多种生物心理社会文化因素进行深入研究， 影响URP在各种不同环境中的包容和参与。更好地了解 生物心理社会文化因素对URP研究参与是关键，以阐明研究来源 参与不平等经常影响到URPs。因此，研究结果可能对公共卫生 影响，因为这项研究可能会告知有针对性的研究纳入和参与战略，以改善 多样性这一研究计划是由一个培训计划，建立在候选人的最近过渡补充 从临床研究心理学到老龄化和AD领域，因此包括（1）认知 老龄化/AD和相关临床试验;（2）复杂数据集分析，先进的生物统计学;（3）AD差异; (4)URP研究参与差异;（5）专业发展。联合研究和培训 计划将准备候选人成功的独立研究生涯，重点是增加多样性 在认知老化和AD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.