Promoting Engagement and Clinical Trial Readiness for Alzheimer's Disease and Related Dementias Among Underserved Sexual and Gender Minorities - SUMMARY Sexual and gender minorities (SGM), defined here as individuals who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and/or another identity, continue to be underrepresented in Alzheimer’s disease and related dementia (AD/ADRD) clinical trials. Over 350,000 SGM older adults in the U.S. are currently living with AD/ADRD, and expected to increase to over a million by 2050. Several studies have found higher rates of subjective and objective cognitive impairment/decline and diagnosis of AD/ADRD among SGM communities compared with non-SGM communities. SGM subgroups, such as Black/African American, Hispanic/Latino/a/e/x, gender minorities, and lower socioeconomic backgrounds, have been found to experience increased rates of AD/ADRD and risk factors. Ensuring inclusion and participation in AD/ADRD clinical trials is crucial for advancing equitable clinical care and research for diverse aging populations. We will use community-engaged mixed methods research to identify specific barriers and facilitators affecting trial participation and co-develop a tailored AD/ADRD clinical trial readiness educational program to improve future trial engagement. This community-engaged and mixed-methods research proposal has three specific aims. In Aim 1, we will identify and explore domains of explore barriers and facilitators to AD/ADRD clinical trial participation through 8 to 10 focus groups (n=60). These findings will help to inform Aim 2 and the identification of intersectional correlates. In Aim 2, we will examine intersectional correlates of willingness to participate in AD/ADRD clinical trials among SGM older adults aged 50 and above (n=400). This survey will target four underrepresented groups—Black/African Americans, Hispanic/Latino/a/e/x, gender minorities, and low socioeconomic status individuals. Next, working with our community advisory board (CAB), we will co-design and evaluate the acceptability and usability of a community-tailored AD/ADRD clinical trial readiness educational program (Aim 3) for diverse SGM older adults aged 50+ (n=80). This study will enhance understanding of the barriers and facilitators of diverse SGM communities’ participation in AD/ADRD clinical trials; develop a community-tailored educational program and tools to ensure greater knowledge and promote opportunities for the community to participate AD/ADRD clinical trials; and disseminate lessons learned back to diverse SGM communities and AD/ADRD researchers and clinical trialists. Future studies will test the efficacy of our educational program, aiming to diversify enrollment and increase participation in AD/ADRD trials among SGM populations, with promise for advancing clinical care for diverse aging populations.
