Bridging the Science-to-Service Gap in Aging Care: Prevention, Optimization and Living Well with Persistent or Serious Illnesses

Bridging the Science-to-Service Gap in Aging Care: Prevention, Optimization and Living Well with Persistent or Serious Illnesses The proposed T32 postdoctoral fellowship will address the pressing need for strengthening and increasing the amount of well-trained investigators positioned to advance the field of aging research through the development, testing, and implementation of nonpharmacological interventions across the spectrum from health to illness in both hospital and community settings. Despite advances in medical, social and behavioral sciences, a widely acknowledged science-to-service gap remains such that most interventions are either never developed for or implemented in the routine care of older adults in clinical or community settings. This gap is particularly apparent in the care of those with Alzheimer’s Disease and related dementias (ADRD), where there is a dearth of evidence-based approaches for persons living with dementia (PLWD) and their caregivers. A key reason for this “implementation cliff” is the lack of rigorous and comprehensive training in all stages of the NIH model for new investigators that enter the field of aging. We are well positioned to address this important gap because we have access to both an exceptionally talented pool of interdisciplinary trainees (PhD and MD) and an unparalleled network of interdisciplinary, NIH funded mentors and investigators with complementary expertise in early preventive strategies (e.g. treating ADRD risk factors to prevent onset), persistent disease management strategies (e.g., interventions to support PLWD, cancer and other persistent illnesses along the illness journey) and palliative care approaches (e.g., advanced ADRD care) across MGH Departments of Internal Medicine, Neurology and Psychiatry. Four new trainees who have recently completed their clinical training will enter the program each year and will receive a maximum of three years of support. Trainees will receive interdisciplinary mentorship across: 1) the Department of Internal Medicine Mongan Institute (including the Center for Aging and Serious Illness) 2) the Department of Psychiatry (including the Center for Health Outcomes and Interdisciplinary Research) and 3) the Department of Neurology (including the Massachusetts ADRD Research Center). Trainees will receive specialized didactic training that covers methods across the NIH stage model, as well as general research issues (biostatistics, qualitative and mixed methods, clinical trial management, scientific writing, social determinants of health, leadership skills and career planning) in preparation for career development awards or other independent applications to be submitted by the end of the fellowship period. We will also leverage training and collaboration with other NIA-funded Aging Centers throughout the country. Trainees will develop mentored clinical research projects that use the NIH stage model and will receive experiential training through their mentors’ NIH funded clinical trials. Our trainees will graduate with a deep understanding of the NIH stage model, skills to develop and implement scalable and effective interventions in clinics and community settings, and the research tools necessary to advance the science of aging and translate that science to better care across the care continuum.