Bridging the Science-to-Service Gap in Aging Care: Prevention, Optimization and Living Well with Persistent or Serious Illnesses

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PROJECT SUMMARY: Bridging the Science-to-Service Gap in Aging Care (BRIDGE THE GAP): Prevention, Optimization and Living Well with Persistent or Serious Illnesses The proposed T32 postdoctoral fellowship will address the pressing need for strengthening and diversifying the pipeline for well-trained clinician investigators positioned to advance the field of aging research through the development, testing, and implementation of clinical and behavioral preventive interventions (CBPIs) across the spectrum from health to illness across all care settings (e.g., hospital, nursing homes) and in the community for individuals and their informal caregivers. Despite advances in medical, social and behavioral sciences, a widely acknowledged science-to-service gap remains such that most interventions are rarely implemented in the routine care of older adults in clinical or community settings. This gap is particularly apparent in the care of those with Alzheimer’s Disease and related dementias (ADRD), where there is a dearth of evidence-based approaches to support persons living with dementia (PLWD) and their caregivers across the disease trajectory. A key reason for this “implementation cliff” is the lack of rigorous and comprehensive training in all stages of the NIH model for new clinical investigators that enter the field of aging. Further, to date, very little research has been focused on prevention of age-related negative consequences. We are well positioned to address this important gap because we have access to both an exceptionally talented pool of interdisciplinary trainees (PhD and MD) and an unparalleled network of interdisciplinary, NIH funded faculty mentors and investigators with complementary expertise in CBPIs in primary prevention (e.g. treating ADRD risk factors to prevent onset), secondary prevention (e.g., prevention of emotional distress in ADRD), and tertiary prevention (e.g., increasing quality of life in ADRD). Two new trainees who have recently completed their clinical training will enter the program each year and will receive a maximum of three years of support (maximum 6 trainees at one time). Trainees will receive interdisciplinary mentorship across 1) the Department of Internal Medicine Mongan Institute (including the Center for Aging and Serious Illness) 2) the Department of Psychiatry (including the Center for Health Outcomes and Interdisciplinary Research) and 3) the Department of Neurology (including the Massachusetts ADRD Research Center). Trainees will receive specialized didactic training that covers methods across the NIH stage model, trial design and community engaged research across primary, secondary and tertiary prevention, biostatistics, clinical trial management, scientific writing, health disparities and social determinants of health, leadership skills and career planning, in preparation for career development awards or other independent applications to be submitted by the end of the fellowship period. Trainees will develop mentored clinical research projects that use the NIH stage model and will receive experiential training through their mentors’ NIH funded clinical trials. Our trainees will graduate with a deep understanding of the NIH stage model, skills to develop and implement scalable and equitable preventive interventions in all care settings, and the research tools necessary to advance the science of aging and improve care for our growing older adult population.