Health Equity Core (H)

Alzheimer’s disease (AD) and AD-related dementias (AD/ADRD) disproportionally affect populations that have the greatest health care needs, are at the highest risk for poor outcomes and have the most limited access to health care (e.g., residing in rural communities). Providing high-quality dementia care to all Americans is a major public health priority, and is central to the design, conduct, and dissemination of embedded pragmatic clinical trials (ePCTs). The National Institute on Aging Imbedded Pragmatic AD/ADRD Clinical Trials (IMPACT) Collaboratory has made pivotal contributions towards ensuring that the concerns of high-risk, high-need people living with dementia (PLWD) and their care partners (CPs) are considered in various aspects of ePCTs, including: 1. Integrating trial design considerations in pilot and demonstration projects, 2. Prioritizing interventions targeting high-risk, high-need populations across requests for applications, 3. Creating guidance documents and training materials in this area, and 4. Operationalizing strategies to engage investigators in IMPACT programs (research grant applicants, training programs) from various disciplines and institutions across all regions of the US, and those conducting research on high-risk, high-need populations. In the renewal period, the High Risk Populations and Disparities Core (HRPDC) will intersect with all components across the Collaboratory. It will establish the STrategies to Reach Individuals with Dementia for Embedded pragmatic trials (STRIDE) Consortium, as a proactive cross-institutional partnership. STRIDE will provide a collaborative infrastructure to enhance the engagement of investigators from institutions across the US who have not typically engaged in ePCT research in IMPACT funding mechanisms, training opportunities and scientific advancement for ePCTs. The HRPDC Specific Aims are: Aim 1. To guide, monitor, and evaluate how considerations related to high-risk, high-need populations are integrated across the IMPACT Collaboratory by: incorporating the HRPDC Lead into the IMPACT leadership team, embedding HRPDC members in the other Cores and Health Care System Launchpads, and establishing a set of evaluation metrics; Aim 2. To support the design and conduct of ePCTs grounded in best practices; Aim 3. Enhance investigator capacity to design and conduct ePCTs in collaboration with the Project and Training Cores and in partnership with the STRIDE Consortium; and Aim 4. To develop and disseminate knowledge to advance best practices and methodologies on topics related to the integration of high-risk, high-need populations into the design and conduct of dementia care ePCTs. IMPACT: Ensuring that ePCTs address the concerns of PLWD and their CPs with greatest need for improved care is central to IMPACT’s mission. By adding the HRPDC Core Leader to the Leadership Team and embedding its members into scientific cores and launchpads, the Core will be well poised to advance IMPACT’s mission through strategic, tangible and measurable actions addressed in its four Aims.