Community Liaison and Recruitment Core (CLRC)
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Although minority populations – particularly Black and Latino adults – have the highest rates and are at highest risk for Alzheimer’s disease and related dementias (ADRD), to date inclusion of these populations (patients, care partners and dyads) in ADRD research remains low and inconsistent. Testable, scalable methods are urgently needed, founded on a science of ADRD diversity to drive quantifiable, precision approaches in recruitment, engagement, and retention (RER). Community engagement and study enrollment barriers, already multi-factorial, are compounded for Black and Latino populations, limiting researchers’ ability to address health disparities in ADRD. Without critical developments in RER science, investigators risk exacerbating – or worse, misunderstanding – existing health disparities in ADRD and ADRD research by failing to include Black and Latino communities in cutting-edge ADRD behavioral health research. The Community Liaison & Recruitment Core (CLRC) activities are directly aligned with the Mass-ENVISION theme to provide resources, training, and sustained and tailored mentoring to UiM scientists in ADRD-related behavioral interventions following the NIH Stage Model, the NIA Health Disparities Framework, and the CDC and NAM prevention frameworks, in both community and hospital settings. The CLRC will advance the science of diversity in ADRD behavioral interventions research via 4 Specific Aims: 1) Operationalize a precision science of diverse recruitment, engagement, and retention into ADRD research; 2) Convene a stakeholder group of Black and Latino individuals to determine optimal recruitment and engagement strategies for these populations in ADRD behavioral interventions research; 3) Provide RCMAR Scientists with practical examples of RER strategies in a separately funded digitized trial to be launched at Whittier Street Health Center, a local Federally Qualified Health Center; 4) Train and provide sustained and tailored mentoring of RCMAR Scientists in a community-engaged science of recruitment, engagement, and retention. The CLRC is led by Dr. Jonathan Jackson, an expert in ADRD and methods for recruitment, engagement and retention of minority populations in research. The CLRC will foster crosspollination of resources with the Massachusetts Alzheimer’s Research Center (MADRC) and Boston University Alzheimer’s Research Center (BU-ADRC) and will establish and grow community collaborations across the Massachusetts and larger New England areas.
Massachusetts Center for Alzheimer and dEmeNtia behaVIoral reSearch In minOrity agiNg (Mass-ENVISION) is a proposed new Alzheimer's-related Resource Centers for Minority Aging Research (AD/ADRD RCMAR) that will address the critical need for mentored research training for underrepresented in medicine (UiM) scientists in the development, testing, and implementation of behavioral interventions across hospital and community settings, for racial and ethnic minority older adults with Alzheimer’s Disease and Related Disorders (ADRD) and their informal care partners. There is a dearth of evidence-based behavioral interventions to support minority older persons with ADRD, their informal care partners, and dyads, as well as a critical gap in the number of UiM scientists poised to mitigate this shortage. To address these research and resource gaps, Mass-ENVISION will identify UiM scientists who are committed to ADRD behavioral health and interventions research and will support training and development of independent UiM scientists poised to eliminate health disparities and inequities in ADRD behavioral health. Further, Mass-ENVISION would become the only RCMAR to serve the entire New England region, which is in critical need of this resource. Mass-ENVISION, a collaboration of Massachusetts General Hospital (MGH), Boston University (BU) and Cambridge Health Alliance and their medical school affiliations (Harvard Medical School, BU School of Medicine), university-affiliated hospitals, other Boston and MA- area research centers, satellite hospitals and community clinics, will provide RCMAR Scientists with interdisciplinary, comprehensive training and sustained and tailored mentoring in ADRD behavioral health and interventions research using the revised NIH Stage Model, the Science of Behavior Change, prevention approaches under the Centers for Disease Control disease stage-based (i.e., primary, secondary, tertiary) and the National Academy of Medicine target-based (indicated, selective, universal) frameworks, and the NIA Health Disparities Research Framework. Mass-ENVISION will collaborate closely with other NIA-funded Centers and their investigators, including the Massachusetts Alzheimer’s Disease Research Center (MADRC), Boston University ADRC (BU-ADRC) and Boston Claude D. Pepper Older Americans Independence Center, to translate biological and epidemiological advances as mechanistic targets for ADRD behavioral interventions. Mass-ENVISION will be led by a UiM PI, Dr. Okereke (Director, MGH Geriatric Psychiatry and MGH Psychiatry Center for Racial Equity and Justice), with strong collaborative track records with team members and Core Leads/Co-Leads, who are also from diverse and UiM backgrounds (e.g., Black, Asian, Latino, first generation at college) and have complementary expertise in ADRD, health disparities and health equity research, social and behavioral health, behavioral interventions, implementation science, and interdisciplinary science. Mass-ENVISION will have 4 Cores: Leadership and Administrative, Research Education Component, Data and Analysis, and Community Liaison and Recruitment. Cores will be composed of investigators who are diverse with respect to backgrounds, institutional affiliations in MA and Greater Boston, disciplines, and research and training skills, to facilitate Mass-ENVISION’s success in developing an inclusive research mentoring environment and a diverse biomedical research workforce to advance health equity in ADRD behavioral health.
The aim of the Research Education Component (REC) is to grow infrastructure and provide mentorship and pilot funding to early career investigators from underrepresented in medicine (UiM) backgrounds as delineated by NIH and this RFA (e.g., racial and ethnic minorities, women, first generation college students) who are interested in the developing, testing and implementing behavioral interventions for minority ADRD patients, care partners and dyads, following the revised NIH Stage Model, the Science of Behavior Change, the NIH Health Disparities Research Framework and the Center for Disease Prevention and National Academy of Medicine Prevention models. The REC will work closely with the Community Liaison and Recruitment Core (CLRC) and with the Massachusetts Alzheimer’s Disease Research Center (MADRC) and Boston University ADRC (BU-ADRC) RECs (both focused primarily on biomarkers) to allow for crosspollination of resources and knowledge including translating novel biological mechanisms into behavioral health intervention targets. The REC will support: 1) mentoring in ADRD and interdisciplinary behavioral research; 2) mentoring in health disparities, minority aging and community engaged research; 3) developing of a pilot studies program to support UiM early career investigators. Rates of ADRD are increasing drastically, with the greatest burden among minorities. Much of ADRD research has been focused on understanding the biology of disease, with less focus on behavioral health interventions for primary, secondary and tertiary prevention. Further, the burden of ADRD impacts not only the affected persons but also their informal care partners. There is a critical need for research to translate scientific advances into behavioral health interventions in both community and hospital settings to decrease ADRD burden for minority patients, care partners and dyads. The REC will directly address this need by leveraging: the interdisciplinary expertise at Massachusetts General Hospital (MGH), Boston Medical Center (BMC), Cambridge Health Alliance and affiliated clinics; the outstanding resources of Harvard and Boston University including MADRC, BU-ADRC; a NIA funded behavioral health ADRD R25; and numerous other important collaborators in the Boston area. The REC will also work closely to integrate activities and mentoring with other AD/ADRD RCMARs. The REC will be co-led by Ana-Maria Vranceanu (clinical psychologist) with expertise in behavioral health, ADRD, health disparities and community-engaged research, and a strong track record of mentoring, and Maureen O’Connor (clinical psychologist) who has expertise in ADRD and neuropsychology and leads the BU-ADRC REC. Specific aims are: 1) to develop and support a pilot project program (3 pilots/year; $40,000 each) from UiM investigators that fit the theme of the center; 2) to support the career development of pilot awardees (who will be named RCMAR Scientists) through a rigorous mentoring program; 3) to support mentoring of RCMAR Scientists in health disparities, ADRD and behavioral interventions following the NIH Stage Model, NIA Health Disparities Framework, and CDC and NAM prevention models; 4) to develop and implement an evaluation plan for aims 1, 2 and 3 in coordination with the Leadership and Administrative core of Massachusetts Center for Alzheimer and dEmeNtia behaVIoral reSearch In minOrity agiNg (Mass-ENVISION).
The goal of the Leadership and Administrative Core (LAC) is to provide the overall infrastructure and scientific and intellectual leadership of the translational, interdisciplinary, collaborative, and investigator development functions that are expected of an AD/ADRD RCMAR. The Scientific Theme of Mass-ENVISION (Massachusetts Center for Alzheimer and dEmeNtia behaVIoral reSearch In minOrity agiNg) is the training and sustained and tailored mentoring of underrepresented in medicine (UiM) scientists in developing, testing and implementing of scientifically rigorous behavioral health interventions for persons with ADRD (Alzheimer disease and related dementias) and their informal care partners in hospital and community settings. The rationale for selecting this scientific theme is the critical need for new ADRD behavioral interventions as well as the need to diversify biomedical research, consistent with the call for ADRD behavioral research under RFA-AG-23-025. All RCMAR Scientists will receive training in ADRD behavioral health and interventions research anchored to the newly revised (2022) NIH Stage Model, the Science of Behavior Change, the NIA Health Disparities Framework and the CDC (Centers for Disease Control) and NAM (National Academy of Medicine) prevention models. The LAC will conduct its work through 3 Specific Aims. Aim 1. Establish the leadership, infrastructure and community to support the Mass-ENVISION Scientific Theme. The LAC will: Provide administrative leadership, oversight and facilitation of scientific interactions and collaborations across all Cores and component institutions, as well as with other regional NIA Centers, including 2 Alzheimer’s Disease Research Centers (ADRCs); Ensure that principles and practices of diversity, equity, inclusion, accessibility and anti-racism are integrated throughout all Cores and RCMAR Scientists’ training experiences; Promote a community-centered focus to the work conducted by all Cores. Aim 2. Support rigorous training and career development for RCMAR Scientists in the Mass-ENVISION Scientific Theme. The LAC will: Coordinate with the Research Education Component and Data and Analysis Core teams to support training of RCMAR Scientists in knowledge and methodologically rigorous application of novel ADRD behavioral health and interventions. Aim 3. Evaluate success of the RCMAR and of RCMAR Scientists. The LAC will: Create systems, resources and processes for monitoring of mentoring success and progress of RCMAR Scientists and pilot studies; Monitor, record and report performance metrics of this RCMAR and support dissemination of successful systems, resources and processes to other RCMARs, ADRCs and the scientific community. The LAC team will consist of PI Dr. Okereke, Associate Director Dr. Budson, a Program Manager, and LAC members Drs. Blacker, Gomez-Isla, Hyman and Keuroghlian; it includes senior leadership members of both the Massachusetts ADRC and Boston University ADRC. The LAC features high levels of leadership, administrative experience, and complementary skills to oversee and facilitate effective and impactful interactions and collaborations across all Cores, partnering institutions, stakeholders, and programs, to support the achievement of all Aims of Mass-ENVISION.
