ABSTRACT - Community Engagement Core Health disparities between rural and urban residing individuals is well documented including a lack of understanding and research participation from rural residing individuals in epidemiological studies, low health literacy, and lack of access to healthcare. Texas Tech University Health Science Center (TTUHSC), through The Garrison Institute on Aging (GIA) and the F. Marie Hall Institute for Rural and Community Health, have a strong track record of providing critical services to rural communities to address rural health challenges including data collection to understand barriers faced and providing critical services to these rural areas. These institutes have more than 20 years of substantive relationships with the rural hospitals and clinics around rural Texas, including Texas Organization of Rural and Community Hospitals, and Federally Qualified Health Centers (FQHCs). Therefore, we are well equipped to accomplish the following aims. First, we will strengthen, optimize, and formalize partnerships with community leaders and organizations through establishment of a Community Partnership Network and Advisory Board. Aim 1 will focus on establishing robust sustainable partnerships to create a supportive Network that will provide guidance and co-creation of community-engaged research. Community assessments and listening sessions will inform structure and composition of the newly formalized Community Partnership Network and Community Advisory Board. Second, we will implement new programs and services to promote participation in research, increase recruitment and retention, improve health literacy, and increase clinical services. Based on the barriers and needs identified in Aim 1, we will utilize a more targeted approach in implementing epidemiological studies, community engagement activities to reduce isolation, educational activities to improve health literacy, and clinical services to improve access to care. Third, Disseminate, evaluate, and expand outreach programs, community education programs, and clinical services within organizational practices and policies. We will implement Stage 4 and 5 of NIH Stage Model as we conduct implementation and dissemination in the area of community engagement, education, and clinical services. This Community Engagement Core will leverage existing partnerships and provide infrastructure to facilitate meaningful engagement of rural communities in research and educational projects which will benefit them.
ABSTRACT – Research Project 2 There is a lack of understanding of differences between risk and protective factors for Alzheimer's Disease and Alzheimer's Disease Related Dementias (AD/ADRD) between urban and rural residing aging adults, which is mostly due to a lack of epidemiological datasets of aging adults in rural areas. Further, persons in rural areas face significant challenges related to AD/ADRD including validated diagnostic tools, access to providers (i.e., neurologist; neuropsychologists), interventions for persons with AD/ADRD to reduce negative downstream effects (e.g., isolation; mental health), respite for family caregivers, and assessment of disease progression. This is troubling as persons in rural communities have higher rates of AD/ADRD, despite being underdiagnosed, and are more likely to be diagnosed at later stages of the disease than urban-residing persons, limiting treatment options. Aim 1: Improve and enhance Project FRONTIER to investigate the effects of psychosocial risk factors on neurocognitive functioning (Aim 1a) and compare (Aim 1b) these risk factors between rural and urban populations utilizing Project FRONTIER and nationwide databases. We will utilize Project FRONTIER database to investigate the relationship between psychosocial factors (e.g., stress, emotion regulation, education, depression) and environmental factors (e.g., pollution) on aspects of neurocognitive functioning (e.g., working memory; executive functioning). The results will be compared with current datasets (i.e., National Health Interview Survey; Health and Aging Brain Study - Health Disparities) of urban samples that have the same variables in order to investigate the extent to which there are differences in risk and protective factors between urban samples and Project FRONTIER’s rural sample. Aim 2: Establish 3D Convolutional Neural Networks (CNN) models in the Project FRONTIER cohort (aim 2a) as a neuroimaging biomarker for early detection and staging of the progression of neurocognitive functioning utilizing the Project FRONTIER database and compare to urban datasets (aim 2b) (i.e., National Health Interview Survey; Health and Aging Brain Study - Health Disparities). We will randomly select participants (n=200), over a 3-year span to investigate a 3D Convolutional Neural Networks model compared to standard of care for diagnosing AD/ADRD (i.e., neurocognitive assessment). Convolutional Neural Networks (CNNs) are state-of-the-art AI tools for image processing, with increasing applications in biomedical diagnosis. Successful completion of this project will improve our understanding of risk and protective factors for this unique rural population.
