In addition to pursuing specific research opportunities, the NIA is developing the infrastructure to support future research, program management, and information dissemination to racial and ethnic minority groups. These include resources to train a skilled and diverse research workforce, providing necessary equipment and resources, and disseminating information to scientists and the public.
B1. Support research training and career development
Despite the existence of several NIA- and NIH-supported programs to increase the participation of minority students in research, minority researchers continue to be underrepresented in most fields of biomedical and behavioral research on aging. This underrepresentation limits the cultural and ethnic diversity of the research workforce as well as the important perspective that comes with such diversity.
The NIA is redressing this imbalance through developing and enriching existing efforts by organizations to recruit minority students to research. The NIA is supporting collaborations that link faculty and staff in different institutions who have the common interest of furthering minority participation in research careers. The goal of such initiatives is to increase the cultural and ethnic diversity of the research study and the workforce conducting the research on aging.
Action Plan: The NIA will continue its funding of 28 Alzheimer's Disease Centers (ADCs), included among which are 26 Satellite Diagnosis and Treatment Clinics (SDTC), designed to increase the diversity of the research patient pool and enhance the research capabilities of the Alzheimer's Disease Centers. Since initial funding of the satellites, minority recruitment into the ADC Clinical Cores has increased from 4% to 16%. The satellite clinics extend the diagnostic and management services as well as educational activities offered by the Alzheimer's Disease Centers to under-served areas. The satellite clinics also enhance the clinical research capabilities of the Alzheimer's Disease Centers through the diversification of the research patient pool by offering the opportunity to special population groups to enter clinical drug trials and to participate in other clinical research efforts. Many have hired minority staff to be the liaison with the communities. Most of the satellites focus on outreach, recruitment and retention of specific minority populations, often working closely with local and state agencies, health care organizations, churches, community clinics and housing projects. Many are developing culturally and language sensitive cognitive and dementia screening instruments, as well as neuropsychological and neurological examinations. Along with the parent ADCs, several are conducting studies on the onset and course of AD in specific minority populations. All ADCs have an Education and Information Transfer Core. This core supports both the development of professional staff to improve clinical and research skills related to Alzheimer's disease and outreach programs for the lay public that will publicize the ADRC and educate families and other caregivers about the disease. Cultural sensitivity is emphasized and, where appropriate, they outreach programs to minority groups and provide information structured so that it can effectively reach minority populations, including non-English-speaking people.
Two of the Centers have special relationships with African American Medical Schools, the University of Kentucky with Meharry Medical School in Nashville, TN and University of California at Los Angeles with the Martin Luther King/Charles Drew Medical Center in South Central Los Angeles. These relationships afford opportunities for minority patients and families to participate in clinical studies. Another NIA-sponsored program, the Research Centers for Minority Aging Research (RCMARs), has two centers that coexist and interact with ADRCs at Columbia University and the University of Michigan. This proximity includes opportunities for joint staffing and sharing of some programmatic initiatives such as recruitment and education of minority subjects and families.
As noted in the previous section, with the establishment of the NACC data about enrollments in all of the ADCs are collected in a central database. The NACC is also set up to fund cooperative studies involving a number of Centers, including studies involving minority issues. Examples of funded activities are disease progression in minority cohorts. Another is autopsy enrollment that provides the opportunity to do clinico-pathological correlations, an important tool in understanding differences between normal aging and disease pathologies. This is especially important in minority communities where a constellation of different diseases may together affect cognitive status.
Continue and build upon the successes of the existing Resource Centers for Minority Aging Research (RCMARs) to create scientific infrastructure for conducting research on disparities between and within various race/ethnic groups of minority and non-minority elders. Continue the mentoring of minority investigators for these objectives. Note: because of the breath of this initiative, RCMAR's goals crosscut several of the Strategic Plan's subgoals. Across sites, approximately 20% of the Centers' efforts are devoted to support for institutional resources including the management and administrative infrastructure of the Center, fixed equipment and facilities. Target year: reissue RFA FY 2001.
Action Plan: NIA will revise and reissue the RFA leading to the creation of the initial six RCMARs for the second iteration of this Center concept. The new RCMARs will include: (1) focused research on recruiting and retaining minority group members in research; (2) links between ongoing research for the purpose of recruiting and retaining minority members; (3) research links between other appropriate NIA supported Centers (e.g., AD Centers) and other funded initiatives; (4) development of race/ethnic sensitive, yet comparable measurement; (5) expanded opportunities of mentoring minority and non-minority investigators for research and sustained careers in the health of older minority populations; (6) opportunities to develop research and mentoring links between research institutions and Traditionally Minority Based Institutions; and (7) improve communication between researchers and minority end-result research users.
The OAIC program has contributed substantively to the growth of the geriatrics field through the success of the Centers' emphasis on career development of promising clinical investigators.
Action Plan: In recent years the OAICs have supported 1-3 minority supplements per year for the purpose of providing several years of career development support in aging research to minority candidates with an interest in aging research. It is expected that over the next five years this program will continue to provide career development opportunities to 1-3 minority candidates in aging research. The OAICs are an especially good site for learning a variety of methods and analytic approaches useful in aging research because of the concentration of aging researchers present, and the large amount of aging research carried out at the institutions which have successfully competed for these "centers of excellence in aging research."
Action Plan: The Office of Special Populations, Office of the Director, coordinates initiatives aimed at increasing the quantity and quality of research on minority health as well as increasing the number of racial and ethnic group investigators involved in research on aging. This office in concert with the NIA Minority Work Group is the lead contact for numerous minority activities including Minority Youth Initiatives, Minority Organizations Internship Programs, NIA Regional Meetings and outreach to minority and community organizations. For example, this Office plans, organizes and directs NIA's exemplary "Summer Institute on Aging Research." This one-week training initiative done in partnership with the Brookdale Foundation and the Office of Research on Minority Health is highly competitive and supports training experiences for scientists at the beginning stages of a research career in aging. Minority applicants are highly recruited to participate in this initiative.
Action Plan: This ongoing trans-NIA training initiative addresses five major activities by the NIA to enhance research training and career development for underrepresented minorities in aging research: (1) Research Supplements For Underrepresented Minorities, (2) Minority Pre-doctoral Fellowship Awards, (3) Minority Dissertation Awards, (4) Training Grant (T32) Add-On Slots, and (5) MERIT Minority Supplements. Reducing health disparities will require multiple approaches including increased inclusion of minorities in the health and medical research professions. The NIA will continue and expand its efforts to attract and train a diverse, highly skilled, workforce in aging research.
Action Plan: The Intramural Research Program (IRP) of the NIA has three options for reaching out and engaging underrepresented minorities in training opportunities at the Gerontology Research Center(GRC): Visiting Scientists, IRTA, and IRP Summer Students. Each of these programs is designed to enrich the diversity of the IRP staff and to provide cutting-edge training in NIA's laboratories.
The NIA Intramural Research Program is comprised of the GRC in Baltimore, Maryland, the Laboratory of Neurosciences (LNS) located in the NIH Clinical Center, and the Epidemiology, Demography, and Biometry Program (EDBP) located in the Gateway Building in Bethesda. Exclusive of EDBP, the IRP is organized into 10 Laboratories and Branches. The Research Resources Branch provides specialized resources to IRP investigators; and the Laboratory of Clinical Investigation, Longitudinal Studies Section (LSS) is responsible for administration and management.
The NIA Intramural Research Program has hired minority Preventive Medicine Residents from The Johns Hopkins University Medical Center for short-term appointments. One of these candidates is a co-author of the publication that addresses nursing home use in a biracial population (Am J Public Health 1993;83:1765-1767).
Action Plan: In 1975, the Minority Access to Research Careers (MARC) program was formally established. The impetus to develop the MARC program came at the end of the 1960s, in response to an increasing demand for minority scientists by academic institutions, industry, and government and a historically low proportion of minority group members among the nation's biomedical scientists. The MARC program supports biomedical research training for students and faculty members at 4-year colleges and universities with substantial minority enrollments (Rene and Fakunding, 1992).
The NIA was successful in recruiting a minority candidate through the Minority Access to Research Careers Program. Following her assignment in the Intramural program, this student continued toward the pursuit of her M.A. degree in counseling psychology at Howard University. We continue to advertise for research fellows to the predoctoral and postdoctoral training programs.
Action Plan: The Minority Biomedical Research Support (MBRS) program began in 1972 as an effort to strengthen institutional research capabilities and provide for faculty and student participation in research at 2- and 4-year colleges, universities, and health professional schools with substantial minority enrollments. This program primarily supports biomedical research projects, with an emphasis on promoting the involvement of undergraduate and graduate students and enhancing the overall research capabilities of the grantee institutions. The MBRS program awards include funds for students, who are selected by the grantee institutions, to participate in the faculty members' research. This continues to be a broad-based NIA program supporting a number of students and investigators at minority institutions across the United States.
Action Plan: The NIA EEO Manager and the Affirmative Action/Diversity Workgroup developed several goals from the Underrepresented Index (URI) analysis as a frame work for: (a) identifying problem areas in hiring minorities and women, (b) assessing the effectiveness of programs and activities, and (c) anticipating future directions and actions. The comprehensive evaluation serves as a systematic function to assess policies and guidelines relative to diversity. The EEO evaluation provides data to various internal organizations; measure to what extent the NIA strategies and objectives are met: and provides information to management to assess to what degree employees are aware and satisfied with training and career development programs. During FY 1999/2000, the EEO Manager and the EEO Specialist attended several professional and national conferences of minority group associations. These included (among others):
Action Plan: The NIA has taken several steps to increase the opportunity to identify minority investigators interested in biology of aging research. These are: a) co-funding a training grant that supports the travel of minority students and young minority investigators to present their research at the annual American Society for Cell Biology meetings, and/or to participate in the summer course on Molecular Biology of Aging at the Marine Biological Laboratories, Woods Hole, MA., b) invite Principal Investigators of research grants funded by NIA to apply for travel funds for minority students and investigators not already supported on their grants to attend scientific workshops, conferences and annual meetings relevant to topics in biology of aging, and c) provide a mechanism for minority students and investigators to self-identify their interest in participating in these same meetings and apply for travel funds allowing them to participate.
B2. Provide support for institutional resources
Continue and build upon the successes of the existing "Resource Centers for Minority Aging Research" (RCMARs) to create scientific infrastructure for conducting research on disparities between and within various race/ethnic groups of minority and non-minority elders. Across sites, approximately 20% of the Centers' efforts are devoted to support for institutional resources including the management and administrative infrastructure of the Center, fixed equipment and facilities. Target year: reissue RFA FY 2001.
Action Plan: RCMARs will continue to include and emphasize: (1) research links between other appropriate NIA supported Centers (e.g., AD Centers) and other funded initiatives; (2) expanded opportunities of mentoring minority and non-minority investigators for research and sustained careers in the health of older minority populations; (3) opportunities to develop research and mentoring links between research institutions and traditionally minority based institutions; and (4) improve communication between researchers and minority end-result research users. The RCMARS will forge relationships with Research Centers in Minority Institutions (RCMI) and states with limited research support. This plan of action should help to expand the Nation's capacity for the conduct of biomedical and behavioral research and is a component of the overall RCMAR mission described in the section under Goal B1 "Support research training and career development."
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