The applicant?s career goal is to be an independent investigator whose research assures the successful, ethically-informed translation of the preclinical Alzheimer?s disease construct into clinical practice. As a first step toward that goal, the applicant seeks to answer a fundamental question: how does the requirement that participants in preclinical Alzheimer?s disease trials enroll with a knowledgeable informant or ?study partner? affect diverse recruitment and the study partners themselves? This question is important because until it is answered, it will be difficult to meet the overarching goal of the NIA?s National Strategy for Recruitment and Participation in Alzheimer?s Disease Clinical Research, which is to engage broad segments of the population in research to better understand and eventually cure Alzheimer?s disease. The overall objective in this application is to understand the effects of the study partner requirement in preclinical Alzheimer?s disease research. The central hypothesis is that race, gender, and the nature of the relationship between the participant and the study partner (i.e., spousal/non-spousal) affect both the availability of a study partner to participate and the study partner?s research experience. The rationale for the proposed research is that understanding the effects of the study partner requirement has the potential to facilitate diverse recruitment and inform the future of biomarker disclosure in clinical practice. Guided by strong preliminary data, the applicant will test this hypothesis by pursuing three specific aims: (1) Describe how a study partner?s knowledge of a preclinical Alzheimer?s disease trial participant?s brain amyloid status influences the study partner?s psychological well-being and planning for the future, and examine the differences by race, gender, and relationship. (2) Characterize the role of the study partner in the preclinical Alzheimer?s disease trial enrollment decision, and examine the differences by race, gender, and relationship. (3) Identify psychosocial determinants associated with the intention to ask someone to serve as a study partner in a preclinical Alzheimer?s disease trial, the beliefs associated with those determinants, and the differences in intention by race, gender, and relationship. Under the first and second aims, individual interviews, which have already been established as feasible in the applicant?s hands, will be used to understand key aspects of the study partner experience. Under the third aim, the applicant will conduct a nationally-representative survey of older adults. This approach is innovative because it departs from the status quo by focusing on study partners rather than exclusively on preclinical Alzheimer?s disease trial participants. The proposed research is significant because it is expected to inform the design of preclinical Alzheimer?s disease trials to enhance recruitment and biomarker disclosure practices. The training activities during the grant period have been designed to advance the applicant?s career goal and will build on expertise in research ethics, health law, policy, and nursing, refine knowledge of research methods, and develop critical knowledge of Alzheimer?s disease care and research.
The proposed research is relevant to Alzheimer?s disease because understanding the effects of the ?study partner requirement? is ultimately expected to promote recruitment of research participants representative of the total U.S. population and to inform the future of biomarker disclosure when a disease-modifying treatment is discovered. Thus, the proposed research and training plan is relevant to the NIA?s goal of engaging broad segments of the population in research to better understand and eventually cure Alzheimer?s disease.
