Engagement Core

痴呆症的差距是一个重大的、迅速升级的公共健康威胁。例如，黑人和拉丁裔成年人 与非拉丁裔白人(NLW)相比，患阿尔茨海默病(AD)的可能性高达三倍，但 他们在研究中的代表性仍然很低。此外，代表不足的人口(URP；例如，黑人， Latinx；低SES)还承担着不同的生物和社会文化脆弱性的负担，这意味着 痴呆症的风险，但痴呆症的病因和这种脆弱性的作用仍然知之甚少。此外, 社区参与研究(CER)是成功招募URP的一种循证方法，但 缺乏广泛实施的可扩展性。此外，缺乏民族文化/语言多样性、文化多样性 称职的痴呆症劳动力可能会进一步加剧这些挑战。因此，2019年更新的国家 应对AD的计划和NIA咨询委员会(NOT-AG-18-047)建议确定 AD中的健康差异研究。ADNI4的S参与核心将通过以下方式解决这些紧迫的优先事项：1) 增加ADNI4中代表性不足人群的参与；2)培养多样化的、具有文化内涵的 与URP合作的合格劳动力；以及3)调查痴呆症的种族文化差异。为此， 客户关系核心将通过部署可扩展、密集且了解文化的CER来实现这些目标 约20,000+个人(50%-60%来自URP)完成数字筛选以识别4,000人 有AD血液生物标志物的参与者，其次是面对面(n=500；50%-60%的URP)或远程 (未纳入临床的20,000人中的其余部分)纵向评估。此核心将与Project密切合作 1和其他ADNI4核心支持其目标，并确保URP全面和身临其境地参与所有 学习组件。我们的全面、多方面计划包括：(1)基于CER的数字参与 宣传运动；。(2)成立多元化的参与队伍，包括社区研究联络，以推广市区重整计划。 通过与当地社区组织(CBO)的社区参与招聘，以及 社区研究导航员通过向所有人提供导航支持来促进保留/参与 参与者和研究伙伴；(3)将获得额外财政支持的多元化招聘中心站点(n=20) (4)社区伙伴关系(例如，国家和地方社区组织) 将通过我们的社区-科学伙伴关系委员会促进；(5)以文化知情的方法解决 URP招募/参与的障碍(例如，信任、负担)，并提供更好的民族文化特征 (6)劳动力培训，以提高所有ADNI调查人员和工作人员的文化能力， 并在五年内为总共15名ADNI4学者(URP实习生和早期职业生涯)提供指导培训 调查人员)。本核心中详述的活动和目标被认为是总体成功的关键 并对推进招募科学、告知临床试验、解决 紧迫的AD劳动力短缺，具有文化能力的研究人员，以及改善公共卫生。

Dementia disparities are a major and rapidly escalating public health threat. For instance, Black and Latinx adults are up to three times as likely to develop Alzheimer’s disease (AD) compared to non-Latinx whites (NLW), yet they remain greatly underrepresented in research. Further, underrepresented populations (URPs; e.g., Black, Latinx; low SES) also bear a disparate burden of biological and sociocultural vulnerabilities that confer increased dementia risk, but dementia etiologies and the role of such vulnerabilities remain poorly understood. In addition, community-engaged research (CER) is an evidence-based approach for successful URP recruitment, but has lacked scalability for broad implementation. Further, the lack of an ethnoculturally/linguistically diverse, culturally competent dementia workforce may further exacerbate these challenges. Thus, the 2019 update to the National Plan to Address AD and the NIA Advisory Council (NOT-AG-18-047) have recommended the prioritization of Health Disparities research in AD. ADNI4’s Engagement Core will address these urgent priorities through: 1) increasing the engagement of underrepresented populations in ADNI4; 2) cultivating a diverse, culturally competent workforce to work with URPs; and 3) investigating ethnocultural disparities in dementia. To this end, the Engagement Core will achieve these aims by deploying a scalable, intensive, and culturally-informed CER approach for ~20,000+ individuals (50-60% from URPs) to complete the digital screener to identify 4,000 participants with AD blood biomarkers, followed by either in-person (n = 500; 50-60% URPs) or remote (remainder of the 20,000 not enrolled in clinic) longitudinal evaluations. This Core will work closely with Project 1 and the other ADNI4 Cores to support their aims and assure the full and immersive participation of URPs in all study components. Our comprehensive, multi-faceted plan includes: (1) a CER-based Digital Engagement Campaign; (2) a Diverse Engagement Team, including Community Research Liaisons to promote URP recruitment through community-based engagement with local community-based organizations (CBOs), and Community Research Navigators to promote retention/engagement via providing navigational support to all participants and study partners; (3) Diversity Recruitment Hub Sites (n = 20) that will receive additional fiscal and instrumental support for URP recruitment; (4) Community Partnerships (e.g., national and local CBOs) that will be facilitated through our Community-Science Partnership Board; (5) Culturally-informed Methods to address barriers to URP recruitment/engagement (e.g., trust, burden) and provide better ethnocultural characterization of the sample; and (6) Workforce Training to enhance cultural competency of all ADNI investigators and staff, and provide mentored training to a total 15 ADNI4 Scholars over five years (URP trainees and early career investigators). The activities and goals detailed in this Core are deemed essential for the overarching success of ADNI-4 and have important implications for advancing recruitment science, informing clinical trials, addressing the urgent AD workforce shortage of culturally-competent researchers, and improving public health.