Synergizing Career Development toward Improved Care of Older Adults across Specialties and Disciplines U24 RFAAG19024 Sue Zieman MD PhD and Basil Eldadah MD PhD National Institute on Aging ID: 726830
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Clinician-Scientists Transdisciplinary Aging Research (Clin-STAR) Coordinating Center:
Synergizing Career Development toward Improved Care of Older Adults across Specialties and Disciplines (U24)RFA-AG-19-024
Sue Zieman, MD, PhD and Basil Eldadah, MD, PhDNational Institute on AgingPre-Application WebinarOctober 29, 2018Slide2
Overview
BackgroundObjectives and Goals of the RFAApplication informationBudget informationPeer reviewImportant datesQuestions and answersSlide3
2008 Institute of Medicine Report:
Retooling for an Aging America: Building the Healthcare Workforce
Most older adults have multiple chronic conditions and see several specialistsInsufficient number of healthcare providers, especially specialists, with geriatric competencies. Need to recruit, retain, and educate specialists in geriatrics/gerontology.More multidisciplinary care strategies, communication, and research are needed.
http://www.nationalacademies.org/hmd/reports/2008/retooling-for-an-aging-america-building-the-health-care-workforce.aspx
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Building a Cadre of Aging-Focused Investigators in Specialties: NIA Efforts and Beyond
Centers ProgramsNIA Research Centers: Alzheimer’s, Demography, Pepper, RCMAR, Roybal, ShockNIA Research Centers Coordinating NetworkGrants
Training (T32/T35/MSTAR)GEMSSTARMentored K awards, including Beeson K76Jahnigen & Williams awardsDiversity supplementsIndependent investigator awards through organ/illness-based funding opportunity announcementsConferencesCross-specialty meetings (R13/U13 grants)
Butler-Williams Scholars Program
GEMSSTAR Scholars meetings
Beeson Scholars meetingsSlide5
Specialists Embracing Aging ResearchA Generation of Conferences Involving NIA
AGS Bench-to-Bedside Conference Series (https://www.americangeriatrics.org/programs/u13-conference-series)
Geriatrics for Specialists Conference SeriesAmerican College of Cardiology U13 Conference Series (https://www.acc.org/membership/sections-and-councils/geriatric-cardiology-section/section-initiatives/workshops) Cancer in Aging Research Group (CARG) U13 Conference Series (http://www.mycarg.org/u13_home) Common Themes
Research-agenda defining
Interdisciplinary
to
transdisciplinary
Expanding from organ/illness focus to aging focus (e.g., function, frailty, multimorbidity)
Early career focusSlide6
Geriatrics for Specialists Conference Series
Effros et al. Aging and infectious diseases: workshop on HIV infection and aging: what is known and future research directions. Clin Infect Dis 2009;48:149-171.Anderson et al. Prediction, progression, and outcomes of chronic kidney disease in older adults. J Am Soc Nephrol 2009;20:1199-1209.High et al. Workshop on immunizations in older adults: identifying future research agendas.
J Am Geriatr Soc 2010;58:765-776.Castriotta et al. Workshop on idiopathic pulmonary fibrosis in older adults. Chest 2010;138:693-703.Anderson et al. Acute kidney injury in older adults. J Am Soc Nephrol
2011;22:38-38.
Abecassis
et al. Solid-organ transplantation in older adults: current status and future research.
Am J Transplant
2012;12:2608-2622.
Halter et al. Diabetes and cardiovascular disease in older adults: current status and future directions.
Diabetes
2014;63:2578-2589.
Gould et al. Chronic wound repair and healing in older adults: current status and future research.
J Am
Geriatr Soc 2015;63:427-438 and Wound Repair Regen 2015;23:1-13.Kritchevsky et al. Pathways, Contributors, and Correlates of Functional Limitation across Specialties: Workshop Summary. J Gerontol A Biol Sci Med Sci 2018 https://doi.org/10.1093/gerona/gly093
American Geriatrics Society Bench-to-Bedside SeriesWhitson et al. American Geriatrics Society and National Institute on Aging Bench‐to‐Bedside Conference: Sensory Impairment and Cognitive Decline in Older Adults. J Am Geriatr Soc 2018 https://doi.org/10.1111/jgs.15506.Vaughan et al. Report and Research Agenda of the American Geriatrics Society and National Institute on Aging Bedside-to-Bench Conference on Urinary Incontinence in Older Adults: A Translational Research Agenda for a Complex Geriatric Syndrome. J Am Geriatr Soc 2018;66:773-782.Fung et al. Report and Research Agenda of the American Geriatrics Society and National Institute on Aging Bedside-to-Bench Conference on Sleep, Circadian Rhythms, and Aging: New Avenues for Improving Brain Health, Physical Health, and Functioning. J Am Geriatr Soc 2016;64:e238-e247.AGS/NIA Delirium Conference Writing Group, Planning Committee and Faculty. The American Geriatrics Society/National Institute on Aging Bedside-to-Bench Conference: Research Agenda on Delirium in Older Adults. J Am Geriatr Soc 2015;63:843-852.Alexander et al. Bedside-to-Bench conference: research agenda for idiopathic fatigue and aging. J Am Geriatr Soc 2010;58:967-975.Studenski et al. From Bedside to Bench: Does Mental and Physical Activity Promote Cognitive Vitality in Late Life? Sci Aging Knowl Environ 2006;10:pe21.Wieland GD. From Bedside to Bench: Research in Comorbidity and Aging. Sci Aging Knowl Environ 2005;39:pe29.Fried et al. From Bedside to Bench: Research Agenda for Frailty. Sci Aging Knowl Environ 2005; 31:pe24.
Specialists Embracing Aging Research
A Generation of Conferences Involving NIA – PublicationsSlide7
Specialists Embracing Aging ResearchA Generation of Conferences involving NIA – Publications
American College of Cardiology U13 Conference SeriesForman et al. Multimorbidity in Older Adults with Cardiovascular Disease.
J Am Coll Cardiol 2018;71:2149-2161Cancer and Aging Research Group U13 Conference SeriesMohile et al. Improving the quality of survivorship for older adults with cancer. Cancer 2016;122:2459-2568.
Flannery et al. Interventions to improve the quality of life and survivorship of older adults with cancer: The funding landscape at NIH, ACS and PCORI.
J
Geriatr
Oncol
2016;7:225-233.
Hurria et al. Designing therapeutic clinical trials for older and frail adults with cancer: U13 conference recommendations.
J Clin Oncol
2014;20:2587-2594.
Dale et al. Biological, clinical, and psychosocial correlates at the interface of cancer and aging research.
J Natl Cancer Inst
2012;104:581-589.Slide8
GEMSSTAR“Grants for Early Medical and Surgical Specialists’ Transition to Aging Research”
Designed as a first independent NIH award for early career physician- or dentist-scientists embarking on a career at the intersection of aging and their specialty/disciplineMost recent competition (now closed) at
https://grants.nih.gov/grants/guide/rfa-files/RFA-AG-19-021.htmlIndependently-supported Professional Development Plan to augment knowledge and skills in aging researchBiennial GEMSSTAR Scholars conference
https://www.nia.nih.gov/research/dgcg/grants-early-medical-surgical-specialists-transition-aging-research-gemsstar
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Funded by U13AG048721 to the American Geriatrics Society (2014-2019)
Venue for Scholars (past and current) to interact with each other, mentors, NIA/NIH StaffFocus on relevant aging scientific topicNetworking/collaborative opportunities with scholars, mentors, experts on topicAttendee-driven agendaHighlight research – poster sessionCareer development
Topics: Specialty Research in Frailty (March 2015)Walston et al. Integrating Frailty Research into the Medical Specialties—Report from a U13 Conference. JAGS 2017; 65:2134-2139Robinson TN et al. Frailty for Surgeons: Review of a National Institute on Aging Conference on Frailty for Specialists. Aging Research Models and Systems (September 2016)
Specialty Research in Dementia (May 2018)
https://www.americangeriatrics.org/programs/geriatrics-specialists-initiative/gemsstarjahnigen/gemsstar-u13-conferences
GEMSSTAR Scholars ConferenceSlide10
GEMSSTAR Scholars Conference
FeedbackMost valued aspect of fundingNew mentoring relationships
Collaboration with other scholars through poster sessionsMade aware of NIA ResourcesLaunch interest groups in professional societiesSmall collaborative groups have formedRequests for more frequent meetings, virtual mentoring communities, webinarsSlide11
What’s Next for Clinician-InvestigatorsFocusing on Aging Research?
How can we draw in additional clinician-scientists from other disciplines who are focusing on aging research?How can we link various individuals and communities of researchers in aging within their specialties and disciplines?How can we promote more transdisciplinary research across specialties
and disciplines?Slide12
RFA-AG-19-024 Clinician-Scientists Transdisciplinary Aging Research (Clin-STAR) Coordinating Center:
Synergizing Career Development toward Improved Care of Older Adults across Specialties and Disciplines (U24)Slide13
The Vision
Effective, transdisciplinary, patient-centered care of all older adultsSlide14
Choi and Pak. Clin Invest Med
2006; 29:351-364.Multidisciplinary: health care providers tend to treat patients independently and to share information with each other, while the patient may be a mere recipient of careInterdisciplinary
: a more profound level of collaboration in which constituents of different backgrounds combining their knowledge mutually complete different levels of planned careTransdisciplinary: researchers [and clinicians] from different fields not only work closely together on a common problem over an extended period but also create a shared conceptual model of the problem that integrates and transcends
each of their separate disciplinary perspectives
Types of team approachesSlide15
Choi and Pak. Clin Invest Med
2006; 29:351-364.PurposeTo organize activities and provide resources for the cultivation, connection, and synergy of clinician-scientists in aging research from disparate specialties across the US.
ObjectivesBuild upon the substantial investments made by NIA through the GEMSSTAR program and related career development efforts by supporting expanded activities and resources to reach a broader community of clinician-investigators nationally.
Clinician-Scientists Transdisciplinary Aging Research (Clin-STAR) Coordinating Center
RFA-AG-19-024Slide16
Goals of the Clin-STAR Coordinating Center
Convey scientific and research knowledge on aging, the care of older adults, and approaches to studying these areas among clinicians entering the aging research arena.Foster networking and collaboration
between the community of clinician-scientist leaders in aging research and the broader community of clinicians from a breadth of specialty training backgrounds wishing to focus on aging researchProvide mentoring and career development support for emerging clinician-scientists committed to pursuing aging research in their clinical specialty or disciplineAdvance transdisciplinary research
that focuses on improving patient-centered care in older adults.Slide17
*GOALS
Convey scientific and research knowledge
Foster networking and collaborationProvide mentoring/career development supportAdvance transdisciplinary research
Potential Activities (1 of 2)
Goals*
Potential Activity
Examples
A, B, C, D
Transdisciplinary aging research conferences
Aging-based didactics
Mentoring and career development component
Networking
Poster presentations
Build on successful GEMSSTAR conference model
B, CMentoring and career development activitiesMentoring in networks and one-on-oneGrant-writingWork-life balanceClinical-research balanceResearch team leadershipBNetworking and support of interest groupsIntra- and inter-specialty interest groups centered on a specific clinical problemVirtual research groupsNetworking ‘library’ of colleagues/research interest/institution/specialty.Travel funds to promote symposiaSlide18
*GOALS
Convey scientific and research knowledge
Foster networking and collaborationProvide mentoring/career development supportAdvance transdisciplinary research
Target audiences for activities may encompass all career stages and disciplines
GOALS*
POTENTIAL ACTIVITY
EXAMPLES
A, B, C
Webinars
Scientific/research knowledge topics
Career Development
Funding information from granting organizations
Problem-focused groups; e.g., frailty, cognitive impairment, driving, placement
B, D
Pilot project funding
Annual pilot awards for transdisciplinary research projects
Freezer studies, secondary analyses, feasibility studies
B, D
Research resource and tools collaborative
Provide universal assessment tools applicable across disciplines
Share research skills, guidelines, best practices, datasets, other unique resources
Potential Activities (2 of 2)Slide19
Potential target participants
Clinical disciplinesMedicine, surgery, dentistry, nursing, pharmacy, physical therapy, occupational therapy, speech-language pathology, respiratory therapy, clinical epidemiology, bioethics, othersMenteesPast/present GEMSSTAR awardeesUnsuccessful GEMSSTAR applicants
Butler-Williams ScholarsMSTAR granteesOthersMentorsAlumni of Beeson, GEMSSTAR, Williams/Jahnigen programsOther NIA-funded career development awardeesSenior investigators at NIA-funded centersOthersSlide20
Application Information
Investigators / EligibilityMulti-PD/PI arrangements are allowed, and encouraged where appropriateUS-based organizations are eligible to applyA foreign organization may be included in a consortium, but may not be the primary applicant
PHS Human Subjects and Clinical Trials Information formComplete if human subjects will be included (e.g., in pilot studies)If human subjects studies are anticipated, but definite plans cannot be described in the application, then they qualify as Delayed Onset Human Subjects studiesIf only Delayed Onset Human Subject studies are anticipated, then complete only one study record as follows:Study Title: enter “Multiple Delayed Onset Studies”
Check the “Anticipated Clinical Trial?” checkbox, unless you are certain that no clinical trials will ever be supported by your award
Address multiple delayed onset studies in a single justification attachment
If pilot studies will involve more than minimal risk research, include plans for developing data and safety monitoring plans and submitting them to NIA staff for approval over the course of the awardSlide21
Role of NIA Staff
Role of NIA StaffThe award will be a cooperative agreement and, upon award, will involve the following NIA staff:A program official who has normal scientific and programmatic oversight for the awardA scientific officer who will provide substantial scientific and programmatic involvement in the conduct of the Coordinating Center
NIA staff should not be named in the applicationPrior to submission, NIA staff can provide routine feedback about aims and answers to questionsSlide22
Budget Information
Budget limits$700,000 per year in direct costs; however, set-aside is $1,000,000 per year in total costs for 1 award.Consortium F&A costs are not included in the direct cost limitMaximum project period: 5 yearsSlide23
Peer review
Review by NIA-convened special emphasis panelExpertise assembled in response to applications receivedReview criteria as described in RFASlide24
Important Dates
Letters of Intent due January 4, 2019Letters of intent are not required, but strongly encouragedNot submitting a letter of intent does not preclude submission of an application Application receipt date is February 4, 2019 by 5:00pm local institution timeScientific peer review in June-July, 2019
Advisory Council in August, 2019Funding start by September 30, 2019Slide25
Q&A (1 of 3)
Q: The RFA calls for pilot projects. Should the U24 award pay for pilot projects, or does NIA have other funds to support pilot projects?A: If pilot projects are proposed in the U24 application, then it is expected that the U24 budget will cover the costs of those projects.Slide26
Q&A (2 of 3)
Q: The RFA has a “Clinical Trial Optional” designation. What does that mean?A: We have included the “Clinical Trial Optional” designation so that clinical trials can be accommodated as pilot projects if desired. Applicants may not know which pilot projects will be funded throughout the 5-year duration of the award, so the option of clinical trials is left open.
Note: We do not envision that the main focus of this award will be on one or more large clinical trials.Slide27
Q&A (3 of 3)
Q: Will a focus on Alzheimer’s Disease and Related Dementias (ADRD) make my application subject to a more generous payline?A: NIA has committed set-aside funds for this RFA, so an ADRD-focused application will not have a different
payline. However, it would make sense scientifically to include a focus on cognitive impairment and dementia because these are important aspects of transdisciplinary patient-centered care of older adults.Slide28
Thank you
NIAClinSTAR@nih.gov