CORE B-1.
SPECIFIC AIMS """"""""We can't solve problems by using the same kind of thinking we used when we created them.""""""""[1] Albert Einstein's aphorism captures the dilemma central to the Native Investigator Development Program (NIDP). Decades of programs embodying a wide range of strategies, content, and participants have failed to produce a scientific workforce in which American Indian and Alaska Native (Al/AN) people find equitable representation. This inequity stems from many sources, but researchers in diverse sectors of higher education summarize it as a """"""""pipeline problem,"""""""" in which students drop out of the educational system at each transition point, until few remain to enter the highest levels. The U.S. Department of Education estimates that only 78% of AI/AN students graduate from high school, compared to 89% of White students.[2] Nationally, only 9% of Native students finish a college degree, compared to 21% of the general population.[3] The effect of these rates on doctoral-level achievement is painfully clear. In 2007, only 128 (0.03?/o) of all doctoral awardees in the life, physical, social, and engineering sciences were AI/AN?a minuscule proportion that has barely increased since 1995.[4] Disparities persist even when Native students complete terminal degrees and take university positions. A 2008 survey by the National Science Foundation identified only 100 AI/AN doctorates in all science and engineering occupations at American 4-year colleges and universities.[4] Further, the subset of faculty in this tiny group typically hold lower ranks and move into senior positions more slowly than their White peers, and many leave academia before achieving tenure.[5,6] Taken together, such """"""""pipeline problems"""""""" translate into a near-total absence of AI/ANs in health research. In 2006, only 24 of 35,000 grants funded by the National Institutes of Health (NIH) were led by AI/AN PIs.[7] A recent, widely cited article on the probability of receiving an R01 by race and ethnicity did not even include AI/ANs in its published tables because of inadequate representation;[8] an online-only supplement indicated that just 41 AI/AN PhDs had submitted an R01 over a 6-year period. The overarching purpose of the NIDP, which was founded and is directed by Dedra Buchwald, MD, is to prepare a cadre of post-doctoral Al/AN scientists who will work to reduce health disparities in older AI/ANs. In accordance with RFA-AG-12-012, our goal is to sustain an infrastructure that has dramatically increased the number of AI/AN investigators focusing on the health and well-being of Native elders, and to mentor them for sustained careers in the field. Modeled on the Robert Wood Johnson Clinical Scholars Program, the NIDP has been highly successful in providing intensive, long-term mentoring of promising AIAN social, behavioral, and health scientists, known as Native Investigators (NIs).[9] In honoring Spero Manson, PhD with the Herbert W. Nickens Award, the American Association of Medical Colleges cited the NIDP achievements. The NIDP also was honored by the Native Research Network, a non-profit national organization for Native researchers, for its achievements in training minorities for careers in health disparities research. As a collaboration between the University of Colorado Denver (UCD) and the University of Washington (UW), the NIDP has been continuously funded since 1998 by the National Institute on Aging (NIA), and supplemented by the Agency for Healthcare Research and Quality, National Human Genome Research Institute, National Cancer Institute, National Institute for General Medical Sciences, and the National Center on Minority Health and Health Disparities.
Our specific aims are to: 1) increase the number of Al/AN professionals capable of conducting research in areas of high priority among Native elders; 2) initiate and maintain learning and mentoring relationships between established researchers and junior Al/AN faculty, thus extending our existing network of well-trained, community-oriented investigators; 3) improve the analytic and methodological skills of such investigators by participation in secondary data analyses and primary data collection efforts (i.e.. Pilot Studies) intended to improve healthcare and reduce disparities in health status and access between Native and non-Native elders; 4) publish manuscripts based on the Pilot Studies (this serves as the 1st step toward the development of investigator-initiated grant applications led by Al/AN researchers);and 5) encourage Al/AN undergraduates to pursue research careers by linking them to NIs through electronic and in-person interactions. Racial and ethnic minorities suffer disproportionately from diseases that can be prevented or controlled.[10] Minority investigators are more likely than their White counterparts to focus on conditions and risk factors that most threaten these populations.[11] Equally important, they bring unique """"""""insider"""""""" perspectives and experiences that enhance their capacity to understand factors underlying health disparities. We propose to continue the notable efforts of the NIDP, which will have completed training of 32 AI/AN post-doctoral researchers between 1998 and early 2012. This strategic investment in junior faculty is a genuinely novel approach to an enduring problem?one that reliably adds Al/AN representation to the scientific workforce, one graduate at a time.
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