Mentorship in Patient-Oriented Research to Improve Health of Older Adults with Diabetes - ABSTRACT More than 16.5 million older adults, or 29.2% of U.S. adults ≥65 years, are living with diabetes. Older adults with type 2 diabetes (T2D) are a highly heterogeneous population, with wide variation in clinical complexity, functional status, and available personal, community, and clinical supports, which collectively impact their capacity for self- management, access to healthcare, and health. Reducing the disability, morbidity, and mortality caused by T2D in older adults therefore requires optimized selection of T2D pharmacotherapy, accessible delivery of high quality T2D care, and mitigation of adverse social determinants of health (SDOH). The growing population of older adults with T2D and the stagnant and unacceptably high rates of potentially preventable diabetes-related disability, morbidity, and mortality despite major advances in available T2D pharmacotherapies signal the need for rigorous patient-oriented research focused on T2D in older adults. The dual objectives of this Midcareer Investigator Award in Patient-Oriented Research (K24) are: 1) to provide Dr. McCoy with the time and resources necessary to mentor and support promising clinical investigators poised for careers in patient-oriented research and committed to improving the health of older adults with T2D; and 2) to generate essential evidence on the optimal treatment of T2D in older adults (Aims 1-2) and on the distribution and health impacts of multi-level, multi-dimensional drivers of health in this highly heterogeneous population (Aim 3), with opportunities for mentees to conduct impactful, distinct research investigations using a wide range of research methods, leveraging Dr. McCoy’s robust research infrastructure, and as part of a thriving interdisciplinary research team. The proposal’s research and mentoring activities will be conducted at the University of Maryland School of Medicine, which has a strong history of training physician scientists and clinical investigators in patient-oriented research, a well-developed infrastructure for education and research, and a large pool of talented trainees and junior faculty from different disciplines and backgrounds. Dr. McCoy’s interdisciplinary NIH- and PCORI-funded research program is ideally suited to support mentees across the University of Maryland system by providing access to rich real-world data; strong partnerships across the clinical practice to facilitate primary data collection; support of an exceptional team of collaborators and methodologists with complementary expertise in advanced causal inference methods, geospatial analyses, implementation science, and pragmatic trials; extensive career development and training opportunities; and a strong track record of dedicated and supportive mentorship. This proposal aims to strengthen Dr. McCoy’s mentorship capabilities and generate novel avenues for her mentees to succeed in bolstering their independent research careers, while simultaneously furthering Dr. McCoy’s continued career development as a physician scientist, mentor, and leader in patient-oriented research in T2D in older adults.
