Expanding the CAARN to accelerate research on multiple chronic conditions with rural and African-American communities and health-care providers

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Project Summary/Abstract Three out of four older adults live with multiple chronic conditions (MCCs) that worsen health, shorten life span, and increase healthcare costs; this burden disproportionally affects African Americans. Despite the critical need for interventions to help older patients with MCCs improve self-management, existing programs have limited reach and effectiveness in underserved communities. Our long term goal is to increase the number and reach of self-management interventions available to improve the health of older adults with MCCs. The objective of this proposal is to create a mature and sustainable infrastructure that facilitates the formation and collaboration of research teams focused on the development and dissemination of effective new self-management interventions for older adults from African American and rural communities with MCCs. To achieve this goal, we will expand the Community-Academic Aging Research Network (CAARN), originally created in 2010 with NIH funding to facilitate development, testing, and/or dissemination of behavioral interventions to improve the health of older adults. To date, CAARN has facilitated community-research partnerships between 46 investigators and social services providers in 52 counties and 1 tribe. We propose to expand CAARN’s infrastructure from its primarily rural focus, to increase partnerships with health systems and African American communities, by providing: 1) trained research liaisons from partnering organizations representing health systems and African-American stakeholders; 2) training for researchers on building trust with African- American communities; 3) multidisciplinary experts who will consult during the design phase of interventions. These additions create a mature, sustainable CAARN infrastructure to accomplish our aims: Aim 1: Facilitate research to develop and test the feasibility of new multi-morbidity self-management programs for older adults that focus on activating patients towards self-management and empowering them to continuously engage in goal-setting and shared decision-making with their provider(s) to maximize behavior change; Aim 2: Demonstrate the effectiveness of new self-management programs for older adults with MCCs in improving quality of life, with a concentrated focus on rural and African-American older adults; Aim 3: Facilitate research to maximize dissemination, implementation, and reach of effective multi-morbidity self- management programs, particularly in rural and African-American populations. Using principles of community- based participatory research, CAARN will engage stakeholders from health systems, rural, and African- American communities on multidisciplinary research teams to develop, test, and research how best to disseminate interventions to reduce the substantial burden of MCCs. This should increase the availability of, and decrease the time to dissemination of, effective, practical interventions that are tailored to these communities and integrated into health systems to improve communications, clinical care, and health equity.