Improving Hispanic/Latino participation in preclinical Alzheimers disease Trials

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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.