PROJECT SUMMARY Recognizing policy Anschutz this the need to increase representation of diverse older adults in clinical trials, NIH instituted a new (NOT-OD-18-116) requiring the inclusion of i ndividuals across the life span. The University of Colorado Medical Campus (AMC) has struggled to address adequately the ethical and scientific imperative of policy.Among AMC adult clinical trials, only 25% (n=498) enrolled even one subject over age 50 in Colorado during 2019. Hispanics were significantly underrepresented (5% of enrolled v. 22% of the state's population). Data by age strata show a noticeable drop in the number of participants 75+ -- the fastest growing age group in Colorado. We are failing to successfully recruit important segments of our state population to clinical trials. Further, only 4% of staff who do recruiting/ consenting for clinical trials at AMC are 60+. We have a major age-related disparity between those doing recruitment and those we need to recruit. We propose Research centralized to narrow this age gap by training and hiring diverse older adults to fulfill new paid positions as Engagement Specialists (RESs) and Informed Consent Specialists (ICSs) who will be part of our research support services.We will utilize well-established training infrastructure and adapt existing curricula, available through project partners, to prepare 45 diverse older adults in Years 1-3 for these new roles (Aim 1). Training will be rigorous, engaging cohorts of 15 diverse older adults in 6 months of immersive learning, including didactic and experiential, in-person and online/virtual components. Through team-based projects (a required component of training), diverse older adults will catalyze the development of new resources to support recruitment/retention. Once trained, RESs/ICSs will be hired by clinical research support centers/teams with extensive clinical trial networks across AMC and affiliated healthcare systems. RESs/ICSs will use their nuanced understanding of different populations to inform community outreach/engagement, and address these considerations appropriately to facilitate informed consent. In Years 2 and 3, we will organize “Research Roadshows” to bring research and research teams to diverse older adults throughout Colorado; we will travel to 8 geographically-distinct rural/frontier communities, each with a unique geo-political history, cultural milieu, and racial/ethnic composition (Aim 2). Our goal is to reach 2000 individuals. We will sustain engagement through multiple communication strategies that infuse messages/language and other products created by RESs/ICSs. These include novel approaches will increase both the percentage of AMC clinical trials that diverse older adults, and the percentage of diverse older adults in clinical trials.

PROJECT NARRATIVE We will recruit, train and hire diverse older adults into paid positions as research specialists who, as part of the enhanced clinical research infrastructure, will help catalyze innovative solutions to mitigate existing cultural divides between potential study participants and research professionals caused by differences in age, socio- economic status, education levels, rural versus urban locality, and health literacy. Leveraging this enhanced capacity, we will host Research Roadshow events to engage diverse older adults throughout rural/frontier communities in Colorado, providing fun, experiential opportunities to engage with research and research teams. We will promote enduring connections with diverse communities through expanded community outreach and engagement programming, enhanced facilitation of the informed consent process, and use of tailored communication strategies.