The United States population is rapidly aging, and as it does the complexity of care and challenges to maintaining health continue to grow. This is especially true for older adults from vulnerable populations (OAVP), including those from sociodemographically disenfranchised communities who experience disparities in health care and outcomes, those with complex chronic illnesses, and those with dementia. Concerningly, research on OAVP is not keeping pace with the growth of these populations, owing in part to the shortage of investigators with clinical training in the care of older adults. For these reasons, we propose a T32 research training program with the long term goal of producing new investigators whose work leads to improvements in the wellbeing of OAVP. There will also be special research emphasis on health care delivery in the home as this care modality has shown great promise for improving outcomes for OAVP and Mount Sinai has considerable research and clinical experience with home-based medical care. The OAVP T32 will prepare scholars for successful research careers through: (1) Outstanding research training (well-match interdisciplinary mentorship team, diverse project opportunities, promotion of interdisciplinary collaboration, excellent research didactics through degree granting programs [MPH, MSCR, PhD], research skills development specific to the challenges of working with OAVP, training in the responsible conduct of research); (2) Insight into the clinical care and experiences of OAVP patients through limited clinical geriatrics training involving didactics and direct care responsibilities or shadowing for non-clinician scientists; (3) Professional career skills building (seminars on manuscript and grant writing and oral presentation skills, networking and collaboration opportunities, exposure to non-academic careers to broaden perspectives on professional avenues for improving care and outcomes for OAVP. The program will recruit 2 new post-doctoral scholars in each year of the 2-year training program, 10 in total, including physicians (MD/DO), non-physician clinicians with doctoral level training (e.g., RN, social worker, pharmacist with PhD or equivalent degree), and non- clinical post-doctoral scientists. Among physicians recruited to the program, most will lack geriatrics clinical training. Didactic training will occur through formal courses and seminars. Scholars will publish research manuscripts, present at national meetings, apply for career development awards and other research grants, and transition to full-time faculty-level positions in research or a related field in which their research skills can be effectively applied for the care of OAVP. The Program Director (PD) will work with the Program's Executive Committee to make key decisions about program management. The PD and Executive Committee will be guided in their work by Internal and External Advisory Boards, comprised of experts who can provide high level input into program performance and direction and growth. A broad but feasible and salient set of measures will be collected to guide the growth of the individual scholars and their mentors, and the program overall.
Older adults from vulnerable populations, including those who face disparities in care, and those with complex multimorbidity and dementia, experience poor health and quality of life, and while their numbers are growing, the research workforce needed to address their needs is small. We propose an interdisciplinary research training program to enable scholars, especially those without formal geriatrics or gerontology training, to develop the skills needed to become independently funded researchers in this field and to conduct research that leads to improvements in the health and quality of life of older, vulnerable adults.
