I-REACH: Infrastructure for Research in Equity, Aging, Cancer and Health

I-REACH：公平、老龄化、癌症和健康研究基础设施

• 批准号: 10707516
• 负责人: Lucile Lauren Adams-Campbell
• 金额: $ 21.64万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10707516
• 关键词: Acceleration; Address; Affect; Age; Aging; Agreement; Area; Award; Behavioral; Cancer Center; Cancer Survivor; Cancer Survivorship; Caring; Cause of Death; Chronic Disease; Clinical; Clinical Research; Collaborations; Communities; Data; Databases; Discipline; Disease; Disparity; Distance Learning; Educational Curriculum; Elderly; Enrollment; Equity; Exposure to; Funding; Future; Geriatrics; Gerontology; Geroscience; Goals; Grant; Health; Health Care Costs; Infrastructure; Intervention; Investments; Knowledge; Laboratories; Malignant Neoplasms; Maryland; Mentors; Methodology; Minority; Minority Groups; Older Population; Oncology; Phase; Population; Quality of life; Race; Reduce health disparities; Research; Research Infrastructure; Research Personnel; Resources; Scholars Program; Scientist; Self Efficacy; Senior Scientist; Site; Socioeconomic Status; Source; Survivors; Training; Trust; Underrepresented Minority; United States National Institutes of Health; Universities; Variant; Woman; Work; cancer care; care systems; career; career development; clinical care; cohort; data resource; demographics; disparity reduction; ethnic disparity; ethnic minority; ethnic minority population; health disparity; health equity promotion; human old age (65+); improved; innovation; meetings; minority communities; minority engagement; minority scientist; mortality; pre-doctoral; programs; racial disparity; racial minority; racial minority population; recruit; secondary analysis; social; stakeholder perspectives; success; trend

Cancer is the second most common chronic disease and cause of death in older adults. By 2030, three- quarters of the 22 million cancer survivors will be 65 and older and the number of survivors from racial/ethnic minority groups will increase by 99% vs. 31% for Whites. These trends are creating an ethnogeriatric and fiscal imperative, with healthcare costs of disparities doubling to $50 billion by 2050 due to aging of minority groups and persistently low quality of life and survival. We are ill-prepared to address these crises because there is limited evidence to guide clinical care or efforts to reduce disparities among older cancer survivors. This paucity of data is exacerbated by the low numbers of underrepresented minority (URM) scientists leading studies and limited engagement of minority stakeholders to enhance trust in research, resulting in an under- representation of older minority survivors in studies. Progress has been further hampered by the fact that while researchers from aging and oncology each study disparities, there is no infrastructure integrating these disciplines. To fill this urgent gap, the “Infrastructure for Research in Equity, Aging, Cancer and Health” (I- REACH) will use a multi-level disparities framework to integrate geroscience and stakeholder perspectives into transdisciplinary research bridging the fields of aging, disparities and cancer. I-REACH brings together under one umbrella the accumulated expertise of four cancer center hubs (Georgetown, University of Maryland, Karmanos/Wayne State, UCLA), stakeholders, all the major NIA Center programs and national geriatrics, gerontology and cancer organizations. The goals of I-REACH are to: 1) expand the scientific workforce and increase the proportion of URM scientists committed to, and supported in careers at the intersection of aging, disparities and cancer, and 2) deploy this workforce to accelerate discovery and provide evidence for interventions to improve the health of all older cancer survivors. These goals will be accomplished with three Cores and two Programs in overlapping phases using a distributed resource, distance-learning approach. In the two-year R21 phase, we develop, implement and begin to evaluate Cores (Aim 1) and prepare for R33 transition: a Career Development Core providing a mentoring program and a foundational curriculum; a Data Resources Core enabling use of secondary data to fill knowledge gaps in our disparities framework; and a Stakeholder Core to integrate stakeholder perspectives and support recruitment of older minorities. In the three-year R33 phase, the Cores will be deployed to provide a two-year mentored Scholars program for pre- doctoral, doctoral and early stage to senior scientists (Aim 2) and a Pilot program (Aim 3) funding small grants to address evidence gaps in our multi-level framework and build sustainability and disseminate results (Aim 4). Eighty-six scientists (65% women and 36% URM) have already agreed to participate. I-REACH will provide value-added to the NIH by bridging NIA and NCI priorities and addressing areas not covered in other programs. I-REACH is ideally timed to address needs of a rapidly growing diverse, older population.

癌症是老年人第二常见的慢性疾病和死亡原因。到 2030 年，三 2200 万癌症幸存者中的四分之一将是 65 岁及以上，并且来自种族/族裔的幸存者人数 少数族裔将增加 99%，而白人则增加 31%。这些趋势正在创造一种民族老年学和财政学 由于少数群体的老龄化，到 2050 年，医疗保健费用差异将翻一番，达到 500 亿美元 以及持续低下的生活质量和生存率。我们没有做好应对这些危机的准备，因为 指导临床护理或减少老年癌症幸存者之间差异的努力的证据有限。这 由于代表性不足的少数族裔（URM）科学家数量较少，导致数据匮乏。 研究和少数利益相关者的参与有限，以增强对研究的信任，导致研究不足 研究中老年少数族裔幸存者的代表性。进展进一步受到阻碍，因为虽然 来自老龄化和肿瘤学的研究人员各自研究差异，但没有整合这些研究的基础设施 学科。为了填补这一紧迫的空白，“公平、老龄化、癌症和健康研究基础设施”（I- REACH）将使用多层次的差异框架将老年科学和利益相关者的观点融入到 连接老龄化、差异和癌症领域的跨学科研究。 I-REACH 汇集了 四个癌症中心（乔治敦、马里兰大学、 Karmanos/韦恩州立大学、加州大学洛杉矶分校）、利益相关者、所有主要的 NIA 中心项目和国家老年病学， 老年学和癌症组织。 I-REACH 的目标是： 1) 扩大科学队伍和 增加 URM 科学家致力于老龄化交叉点职业并得到支持的比例， 差异和癌症，2) 部署这支队伍来加速发现并提供证据 改善所有老年癌症幸存者健康的干预措施。这些目标将通过三个方面来实现 核心和两个项目处于重叠阶段，使用分布式资源、远程学习方法。在 在两年的 R21 阶段，我们开发、实施并开始评估核心（目标 1）并为 R33 做准备 过渡：职业发展核心提供指导计划和基础课程；数据 资源核心能够使用二手数据来填补我们差异框架中的知识空白；和一个 利益相关者核心整合利益相关者的观点并支持招募老年少数群体。在 在为期三年的 R33 阶段，核心将被部署为预科生提供为期两年的指导学者计划 博士、博士和早期阶段到高级科学家（目标 2）和试点计划（目标 3）资助小额赠款 解决我们多层次框架中的证据差距，建立可持续性并传播成果（目标 4）。 86 名科学家（65% 为女性，36% 为 URM）已同意参加。 I-REACH将提供 通过连接 NIA 和 NCI 的优先事项并解决其他领域未涵盖的领域，为 NIH 带来增值 程序。 I-REACH 非常适合满足快速增长的多元化老年人口的需求。