Increasing Native Research Leadership Through an Early Career Development Program

Inequities impact American Indian, Alaska Native, and Native Hawaiian populations across various health conditions; in particular, many Native communities bear a disproportionate burden of substance use disorder. Such inequities persist despite concerted efforts of communities and significant research directed toward prevention and intervention. One factor hampering these efforts is the underrepresentation of researchers who are themselves Native and uniquely equipped to respond to the needs of their communities. This paper describes the innovative Native Children's Research Exchange (NCRE) Scholars program, now entering its ninth year of successful career development support for emerging Native scholars. We summarize the history of NCRE Scholars, outline the mentoring and training approaches taken to meet the unique needs of early-career Native scholars, and present key progress of program alumni. The current cohort of Scholars provide first-person perspectives on how four key program elements have supported their career development to date. NCRE Scholars has been an effective approach for supporting the next generation of Native research leaders and for helping to build an essential mass of Native researchers prepared to respond to Native community health priority needs.

Variations of a group coaching intervention to support early-career biomedical researchers in Grant proposal development: a pragmatic, four-arm, group-randomized trial

BACKGROUND

Funded grant proposals provide biomedical researchers with the resources needed to build their research programs, support trainees, and advance public health. Studies using National Institutes of Health (NIH) data have found that investigators from underrepresented groups in the biomedical workforce are awarded NIH research grants at disproportionately lower rates. Grant writing training initiatives are available, but there is a dearth of rigorous research to determine the effectiveness of such interventions and to discern their essential features.

METHODS

This 2 × 2, unblinded, group-randomized study compares the effectiveness of variations of an NIH-focused, grant writing, group coaching intervention for biomedical postdoctoral fellows and early-career faculty. The key study outcomes are proposal submission rates and funding rates. Participants, drawn from across the United States, are enrolled as dyads with a self-selected scientific advisor in their content area, then placed into coaching groups led by senior NIH-funded investigators who are trained in the intervention's coaching practices. Target enrollment is 72 coaching groups of 4-5 dyads each. Groups are randomized to one of four intervention arms that differ on two factors: [1] duration of coaching support (regular dose = 5 months of group coaching, versus extended dose = regular dose plus an additional 18 months of one-on-one coaching); and [2] mode of engaging scientific advisors with the regular dose group coaching process (unstructured versus structured engagement). Intervention variations were informed by programs previously offered by the NIH National Research Mentoring Network. Participant data are collected via written surveys (baseline and 6, 12, 18, and 24 months after start of the regular dose) and semi-structured interviews (end of regular dose and 24 months). Quantitative analyses will be intention-to-treat, using a 2-sided test of equality of the effects of each factor. An inductive, constant comparison analysis of interview transcripts will be used to identify contextual factors -- associated with individual participants, their engagement with the coaching intervention, and their institutional setting - that influence intervention effectiveness.

DISCUSSION

Results of this study will provide an empirical basis for a readily translatable coaching approach to supporting the essential grant writing activities of faculty, fellows, and other research trainees, including those from underrepresented groups.

Aging and Health of American Indians and Alaska Natives: Contributions from the Native Investigator Development Program

Objectives: To describe recent advances in our knowledge regarding the health and illness of older American Indians and Alaska Natives, and factors underlying why this special population lives 5.5 years less than the 78.5 years of U.S. all races. Methods: The articles in this supplemental issue, authored by participants in a National Institutes of Health-sponsored early research career development program, examine high priority health concerns that contribute to the increased risk of Native elders for chronic disease and resulting impairment that compromise their life expectancy. Results: Important insights into the roles that racial discrimination, food security, hypertension, alcohol consumption, memory problems, and military service play in the health and well-being of older American Indians and Alaska Natives. Discussion: Early career faculty development programs focused on increasing the diversity of the scientific workforce not only promote greater racial and ethnic minority representation in the field of aging, but can simultaneously add to the knowledge base regarding the health status and function of often ignored, vulnerable older members of communities that suffer significant health disparities.

Building Capacity for Productive Indigenous Community-University Partnerships

This paper describes capacity development as a key aspect of community-based research with indigenous communities. University research engagement with indigenous communities includes extensive, and often negative, historical antecedents. We discuss strategies for developing effective, egalitarian, and balanced indigenous community-university relationships to build research capacity of these communities, and to create sustainable partnerships to improve health and wellness, and to reduce health disparities. We draw on the experience of eight investigators conducting research with indigenous communities to assess effective strategies for building and enhancing partnerships, including (1) supporting indigenous investigator development; (2) developing university policies and practices sensitive and responsive to Indigenous community settings and resources, and training for research; (3) developing community and scientifically acceptable research designs and practices; (4) aligning indigenous community and university review boards to enhance community as well as individual protection (e.g., new human subjects training for Indigenous research, joint research oversight, adaptation of shorter consent forms, appropriate incentives, etc.); (5) determining appropriate forms of dissemination (i.e., Indian Health Services provider presentation, community reports, digital stories, etc.); (6) best practices for sharing credit; and (7) reducing systematic discrimination in promotion and tenure of indigenous investigators and allies working in indigenous communities.

Mentorship and Training to Increase Diversity of Researchers and Practitioners in the Field of Aging and Alzheimer's Disease: A Scoping Review of Program Characteristics

Objectives: Diversity is needed within the aging and Alzheimer's disease and related dementias (ADRD) research and practice workforce to comprehensively address health inequities faced by underrepresented minority (URM) older adults. We conducted a scoping review of training programs designed to diversify the pool of researchers and practitioners in the field of aging and ADRD. Methods: Online database searches yielded 3976 articles published from 1999 to 2019. Fourteen studies met the inclusion criteria. Results: All programs were from the United States and included URM populations. Nine programs included students, one targeted university faculty, and four targeted clinical staff. Only five programs were guided by theory. Discussion: Our review identified URMs' desire for culturally diverse and representative mentorship, the need for career development support at various training stages, and the importance of incorporating theory to program design. It also identified key characteristics for future program development, creation of systematic evaluation standards, and opportunities for promotion.

Universities without Walls: A Blended Delivery Approach to Training the Next Generation of HIV Researchers in Canada

(1) Background: Although HIV has not diminished in importance in Canada, the field of HIV research remains small, and the graduate students who decide to pursue careers within it feel isolated and uncertain about their professional skills and opportunities. Universities Without Walls (UWW) was created in 2009 to help redress these shortcomings. This paper presents a case study of UWW, a non-credit training program for emerging HIV researchers in Canada. In particular, we focus on the possibilities of experiential learning via online and blended delivery. UWW uses both online and in-person teaching modalities to teach engaged scholarship, interdisciplinarity, community-based research (CBR), intervention research, and ethics. (2) Methods: Using a case study, we elucidated the research question: “What are the factors that make Universities Without Walls a viable training environment in the contemporary HIV/AIDS field?” Focus groups were conducted with 13 UWW key stakeholders in 2012 during a program mid-point evaluation; in 2014, telephone or in-person interviews with the three directors were conducted by a UWW fellow (the 4th author of this paper), and in 2019 the authors analyzed the information and anecdotal evidence, which had been incorporated as thick description. In addition, fellows’ self-assessments via portfolio and results from formal learning assessments were included. We also thematically analyzed 65 student self-reports (2009–2015). (3) Results and Discussion: Each UWW cohort lasted 9 months to one year and was comprised of: a) sustained mentorship from the co-directors (e.g., phone conversations, assistance with grant writing, letters of reference, etc.); b) fortnightly online webinars that aim to develop fellows’ knowledge of community-based research (CBR), research ethics, intervention research, and interdisciplinary research; c) community service learning in the form of a “field mentoring placement”; d) face-to-face engagement with fellows and mentors, most notably at the week-long culminating learning institute; e) a stipend for fellows to carry out their training activities. The UWW pedagogical framework features experiential learning, critical pedagogy, and heutagogy made manifest in the field mentoring placements (community service learning), mentorship mediated by technologies, and in-person learning institutes. Our analysis showed that experiential learning was imparted by UWW’s a) transparency about its “implicit curriculum”, the attitudes, values, character, and professional identity imparted in the program as well as the overarching programmatic elements, such as commitment to diversity, the inclusion of those with lived experience, the flexible admissions policies and procedures, interdisciplinary faculty, flexible team, administrative structure, and valuing of technology in conducting research, learning, and teaching; b) curriculum co-designing and co-teaching, and c) sustaining a community of practice. The main results reported in our case study included significant “soft outcomes” for UWW fellows, such as developing a “social presence” as a precursor to lasting professional connections; learning to experience community-based research, intersectionality, and interdisciplinarity by interacting online with persons living with HIV, leaders in the field, and a variety of stakeholders (including nonprofit staff and policymakers). (4) Limitations: While fellows’ self-evaluation data were collected by an independent assessor and anonymized to the extent this was possible, the co-authors inevitably bring their preconceptions and positive biases to UWW’s assessment. As UWW was developed to function outside of traditional academic structures, it is unlikely that the UWW program could be transferred to a post-secondary environment in its entirety. UWW was also built for the socio-political environment of HIV health research. (5) Conclusions: The experiences of those involved with UWW demonstrate that explicit curricular components—such as interdisciplinarity, community-based research, intervention research, and applied ethics—can be learned through a blended delivery when combined with opportunities to apply the knowledge in ways, such as a field mentoring placement and a learning institute. Related to this outcome, our case study describes that implicit curricular components in the formation of a professional—the sense of self in the field as a researcher, student, and community member—can also be delivered through a blended model. However, the tools and activities need to be tailored to each student for their context, while pushing their disciplinarian and professional boundaries.

REFINING A SUMMER BIOMEDICAL RESEARCH TRAINING PROGRAM FOR AMERICAN INDIAN AND ALASKA NATIVE (AIAN) STUDENTS

Literature shows that students who enter the science, technology, engineering, mathematics, and medical-related (STEMM) pipeline at earlier stages of their career are more likely to be successful. This is especially true for underrepresented and economically disadvantaged students. Despite the increasing number of students entering the pipeline, American Indian and Alaska Native (AIAN) students still have a higher attrition rate compared to other ethnic groups. Educators and government agencies have worked to improve the success rate for AIAN students across all levels and fields by developing various programs aimed at training and mentorship. In 2007, the National Institute of Neurological Disorders and Stroke (NINDS) of the National Institutes of Health (NIH) in Bethesda, MD, increased their outreach efforts for recruiting AIAN students for the summer internship program. Our goal was to develop a culturally tailored research-training program that could recruit and retain AIAN students into STEMM degrees and careers. We adapted an existing program that provides training in biomedical science and mentorship at an NINDS research laboratory. From 2007 to 2016, of the 41 AIAN interns who participated, 35 (85%) remained in STEMM fields. Five interns obtained post baccalaureate positions at NIH and four entered graduate or medical school. These successful outcomes were brought about only after navigating myriad obstacles. We identified obstacles for AIAN student participation, and made adaptations to the summer internship. We made design decisions regarding recruitment, feasibility, lab placement and mentorship, supporting research and social networking, and sustaining AIAN culture. This design case highlights the obstacles and strategies for success that we developed.

Development of a Pilot Grants Program in Social Determinants of Health in American Indian Health: A Program for Increasing the Representation of Underrepresented Groups in Funded Research

The problem statement for this manuscript is to describe the literature on grant funding for underrepresented investigators, particularly American Indians, and detail the CRCAIH Pilot Grant Program and its success in developing underrepresented researchers (e.g. American Indian, early stage investigators). Grant funding is increasingly difficult to receive and the demographics of NIH grant awardees have shifted in recent decades to funding investigators that are more experienced. Additionally, racial disparities in awardees exist, particularly among American Indian (AI) researchers. Pilot grant funding mechanisms can be used by early stage investigators to collect preliminary data, which is beneficial for applying for NIH grants. The Collaborative Research Center for American Indian Health (CRCAIH) Pilot Grant Program (PGP) was aimed to increase research on the topic of social determinants of health in AI population health. Since there are no existing procedures for creating a PGP, CRCAIH created a PGP, and the processes are detailed here. Over four years, the CRCAIH PGP funded 15 projects with 47% of PIs or Co-PIs self-reporting as AI. Future directions for the CRCAIH PGP, including a mentoring program to provide more guidance and capacity building to the investigators, are also detailed.

Enhancing research careers: an example of a US national diversity-focused, grant-writing training and coaching experiment

Background and purpose

Preparing a successful research proposal is one of the most complex skills required of professional scientists, yet this skill is rarely if ever, taught. A major goal of the National Research Mentoring Network (NRMN) in the United States (U.S.) is to support the professional advancement of postdoctoral fellows and junior faculty from diverse populations by offering intensive coaching in the development of grant proposals early in their careers. This article highlights the National Institutes of Health’s (NIH) NRMN initiative to prepare diverse constituencies of early-stage biomedicine scientists for research careers by implementation of an evidence-based nationwide program of comprehensive grant writing and professional development.

Program and key highlights

NRMN delivers four unique but complementary coaching models: the Proposal Preparation Program from the University of Minnesota (UMN); Grantwriters Coaching Groups from Northwestern University (NU); Grantwriting Uncovered: Maximizing Strategies, Help, Opportunities, Experiences from the University of Colorado Anschutz Medical Campus (UC) and Washington State University (WSU); and Steps Towards Academic Research from the University of North Texas Health Science Center (UNTHSC). Because these programs cater to scientists at different career stages, rather than employ a single approach, each is uniquely tailored to test its efficacy at the national level. The first two models prioritize scientists with reasonably well-developed research projects who are ready to write proposals for specific NIH research competitions. The other two models target postdoctoral fellows and early-career faculty who need more extensive guidance in proposal development plans. To achieve scalability, all programs also recruit faculty as Coaches-in-Training to learn approaches and acquire particular group facilitation skills required by each model.

Implications

These efforts exemplify NRMN’s potential to enhance the career development of diverse trainees on a national scale, building research skills, competitiveness for obtaining faculty positions and capacities that will result in high quality research proposals from a diverse pool of applicants, thereby advancing innovations in science and diversifying the U.S. biomedical workforce.

The impact of the Nurse Faculty Scholars program on schools of nursing

BACKGROUND

The Robert Wood Johnson Foundation Nurse Faculty Scholars program was conceptualized as not only promoting the growth and development of early-career faculty but as enhancing the research infrastructure of scholars' schools of nursing.

PURPOSE

At the completion of the scholars' three years of support, deans/directors were asked to provide feedback regarding the institutional impact of the scholars' participation in the program.

METHODS

Phone interviews were conducted on the first five completed cohorts and a six-item questionnaire was developed to obtain some quantitative data.

DISCUSSION

The program was viewed as having accelerated the scholars' leadership and scholarship, and their influence within the school/university and regionally/nationally. Deans/directors generally agreed that the scholars' experience helped build the school's research portfolio.

CONCLUSION

Looking back on how the participating schools of nursing fared, one can say that the program's institutional expectations were achieved most of the time. The program helped scholars build their own reputations and that in turn had consequences for the school's standing as a whole. A number of components are described that can be replicated singly or in various combinations by schools/universities interested in adopting aspects of this program.

Mentoring programs for underrepresented minority faculty in academic medical centers: a systematic review of the literature

PURPOSE

Mentoring is critical for career advancement in academic medicine. However, underrepresented minority (URM) faculty often receive less mentoring than their nonminority peers. The authors conducted a comprehensive review of published mentoring programs designed for URM faculty to identify "promising practices."

METHOD

Databases (PubMed, PsycINFO, ERIC, PsychLit, Google Scholar, Dissertations Abstracts International, CINHAL, Sociological Abstracts) were searched for articles describing URM faculty mentoring programs. The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) formed the model for analyzing programs.

RESULTS

The search identified 73 citations. Abstract reviews led to retrieval of 38 full-text articles for assessment; 18 articles describing 13 programs were selected for review. The reach of these programs ranged from 7 to 128 participants. Most evaluated programs on the basis of the number of grant applications and manuscripts produced or satisfaction with program content. Programs offered a variety of training experiences, and adoption was relatively high, with minor changes made for implementing the intended content. Barriers included time-restricted funding, inadequate evaluation due to few participants, significant time commitments required from mentors, and difficulty in addressing institutional challenges faced by URM faculty. Program sustainability was a concern because programs were supported through external funds, with minimal institutional support.

CONCLUSIONS

Mentoring is an important part of academic medicine, particularly for URM faculty who often experience unique career challenges. Despite this need, relatively few publications exist to document mentoring programs for this population. Institutionally supported mentoring programs for URM faculty are needed, along with detailed plans for program sustainability.

Weaving the native web: using social network analysis to demonstrate the value of a minority career development program

PURPOSE

American Indian and Alaska Native scientists are consistently among the most underrepresented minority groups in health research. The authors used social network analysis (SNA) to evaluate the Native Investigator Development Program (NIDP), a career development program for junior Native researchers established as a collaboration between the University of Washington and the University of Colorado Denver.

METHOD

The study focused on 29 trainees and mentors who participated in the NIDP. Data were collected on manuscripts and grant proposals produced by participants from 1998 to 2007. Information on authorship of manuscripts and collaborations on grant applications was used to conduct social network analyses with three measures of centrality and one measure of network reach. Both visual and quantitative analyses were performed.

RESULTS

Participants in the NIDP collaborated on 106 manuscripts and 83 grant applications. Although three highly connected individuals, with critical and central roles in the program, accounted for much of the richness of the network, both current core faculty and "graduates" of the program were heavily involved in collaborations on manuscripts and grants.

CONCLUSIONS

This study's innovative application of SNA demonstrates that collaborative relationships can be an important outcome of career development programs for minority investigators and that an analysis of these relationships can provide a more complete assessment of the value of such programs.

Decolonizing strategies for mentoring American Indians and Alaska Natives in HIV and mental health research

American Indian and Alaska Native (AIAN) scholars in the fields of mental health and HIV face formidable barriers to scientific success. These include justifiable mistrust of historically oppressive educational systems, educational disparities, role burdens within academe, the devaluation and marginalization of their research interests, and outright discrimination. Research partners can work to dismantle these barriers by embracing indigenous worldviews, engaging in collaborative research partnerships, building research capacity within universities and tribal communities, changing reward systems, and developing mentoring programs. At the individual level, aspiring AIAN scholars must build coalitions, reject internalized colonial messages, and utilize indigenous ethical frames. The creation of a cadre of AIAN researchers is crucial to improving the health of AIAN peoples.

Personal journeys, professional paths: persistence in navigating the crossroads of a research career

Persistence in a research career can be readily understood within the trainee models that have emerged from undergraduate and graduate instruction. These models offer a common language for discussing training processes, serve as guides for assessing trainee needs, promise to render training programs that are more comprehensive and attentive than are current programs to the factors that contribute to academic and scientific persistence, and enable us to measure with greater precision, internal consistency, and generalizability the elements that logically belong in research career development programs.

Enhancing American Indian and Alaska Native health research: a multi-faceted challenge

The quality, relevance, timeliness, and impact of public health research among American Indians and Alaska Natives (AIAN) has improved markedly over the last several decades. These advances are attributable to the more careful fit between investigative methods and field exigencies, to the increased presence of Native scientists among research teams, to greater emphasis on meaningful collaboration between researchers and participating communities, and to new Federal investments in the infrastructure that supports health research within this special population. This paper describes the lessons learned from this recent progress, and highlights opportunities to promote further gains as well as continuing needs in developing our capacity to conduct policy relevant AIAN health research.