Principal Investigator: Manney Carrington Reid
Title: Cornell Roybal Center for Translational Research on Aging
Web address: www.citra.org
Contact e-mail: mcr2004@med.cornell.edu
Over the last five years, the Cornell Institute for Translational Research on Aging (CITRA) has developed innovative approaches to facilitate translational research on aging in community settings. In this renewal, the Center seeks to apply this extensive body of work to promoting translational research on the topic of pain and pain management in later life. This theme is of critical importance for translational efforts, because pain is a highly prevalent, costly, and frequently disabling disorder in later life and causes substantial suffering. Successful solutions to the problem of later-life pain will require moving basic
behavioral and social science findings more rapidly into programs, practices, and policies targeting older adults. The specific aims of the Center will be to:
- Translate the findings of basic behavioral and social science research into treatments, intervention programs, and policies that improve the health and well-being of older adults who suffer from or are at increased risk for pain;
- Promote translation of evidence-based practices, treatments, and interventions across diverse venues to improve the management of pain;
- Develop and test innovative methods, tools, and strategies that facilitate successful translation of evidence into practice;
- Maintain and expand an effective infrastructure for conducting translational research on aging and pain, taking advantage of the diverse, multicultural environment of New York City; and
- Leverage the substantial intellectual, fiscal, clinical, and other resources of the academic collaborators in this application, thereby achieving results that would not be attainable by any one institution alone.
To accomplish these aims, we will expand our Roybal Center, which currently includes the strengths and expertise of Cornell University’s Medical College and its social and behavioral science faculty, to partnership with Columbia University’s Mailman School of Public Health. Further, we will fully integrate two major Cornell-affiliated academic institutions into the Center that have extensive academic expertise and resources devoted to pain and pain management: Memorial Sloan Kettering (Oncology and Palliative care) and the Hospital for Special Surgery (Arthritis and Rehabilitation). This expansion of the Cornell Roybal Center will be called The Cornell-Columbia Institute for Translational Research on Aging (C-CITRA). This unique partnership brings together two of the most prominent institutions in the field of gerontology and geriatrics, both of which have a long history of translational research activities, extensive community partnerships, and large pools of potential affiliates and mentees.
Specific Aims
Over the past five years, the Cornell Institute for Translational Research on Aging (CITRA) has developed innovative approaches to facilitate translational research on aging in community settings. We now seek to apply this extensive body of work to promoting translational research on pain and pain management in later life. This theme is of critical importance for translational efforts, because pain is aprevalent, costly, and frequently disabling disorder in later life and causes substantial suffering. Furthermore, a complex set of social, behavioral, and biological factors typically interact to precipitate pain-related disability aswell as to moderate associated outcomes. Cornell’s Roybal Center will build on its previous accomplishments, expand to take advantage of extensive resources in the area of pain and pain management, and create a novel collaboration among prominent research centers and community agencies in the diverse environment of New York City. The specific aims of this renewal application are to:
- Translate the findings of basic behavioral and social science research into treatments, intervention programs, and policies that improve the health and well being of older adults who suffer from or are at increased risk for pain. Successful solutions to the problem of later life pain will require moving basic behavioral and social science findings more rapidly into interventions and treatments targeting older adults. Despite the extensive research literature on the extent and consequences of pain in later life, translational research on the topic has been limited. To bridge this gap, this application will create an interdisciplinary translational research center with pain as its focus. The center will support researchand intervention studies with the goal of generating ageappropriatepain practices, treatments, and policies.
- Promote translation of evidence-based practices, treatments, and interventions across diverse venues to improve management of pain. A major strength of this application is the rich array of settings (such as senior centers, home health care, and long-term care) with an ethnically diverse population of older adults in which translational research activities can be conducted. Formal evaluation of the Center’s activities will be carried out to determine which types of programs are best suited for specific practice settings, acknowledging the reality that successful translation will be influenced by a broad array of individual, provider, social, and organizational factors.
- Develop and test innovative methods, tools, and strategies that facilitate successful translation of evidence into practice. Creating improved methods to translate evidence more rapidly and effectively into practice is a critically important challenge for the social and behavioral sciences. Acknowledging this reality, Cornell’s Roybal Center has achieved national recognition as a leader in the development and testing of new techniques to facilitate translational research in aging. Capitalizing on this innovative work, the Center will promote implementation of these methods in a wider range of settings (adding partnerships with home health care and nursing homes) to determine their generalizability. Equally important, the Center will continue to foster the development and testing of new methods to facilitate the translation of evidence into practice and in so doing will measurably expand understanding of the science of translation.
- Develop and maintain an effective infrastructure forconducting translational research on aging and pain.CITRA has established one of the most extensivecommunity-researcher partnerships in New York City. Partner agencies and organizations include the city’s 300 senior centers that provide services to over 300,000 individuals; case management agencies; mental health providers; and naturally occurring retirement communities. In this proposed renewal, we will expand CITRA’s network to include new partners that provide excellent venues for translational research on pain: specifically home health care and nursing homes. In the research component, we will expand our partnerships to include prominent Cornell-affiliated centers that conduct research across the full spectrum of pain disorders including: chronic non-cancer pain, cancer related pain, acute pain, as well as pain occurring in the context of palliative care. This expanded infrastructure will allow the Center to promote a broad array of translational research initiatives informed by community, public health and clinical perspectives. Taking advantage of New York City’s multicultural and multi-ethnic environment, specific initiatives will involve ethnic minority older persons, given established disparities in pain as a function of race/ethnicity.
- Leverage the intellectual, fiscal, clinical, and other resources of the academic collaborators in this application, thereby achieving results that would not be attainable by any one institution alone. This application builds on the past five years of joint effort between clinical geriatrics and geropsychiatry researchers at Cornell’s Weill Cornell Medical College and social and behavioral scientists at Cornell’s Ithaca campus. In this renewal, we maintain this highly successful academic partnership and broaden it to include the Mailman School of Public Health at Columbia University. The renewal maximizes and extends Roybal funding through the efficiencies of common pilot programs, training grants, clinical sites, faculty/trainees, and a wide variety of other important resources, including Cornell’s Clinical and Translational Science Center (CTSC) and various programs at Columbia. Three central hypotheses drive the structure and conceptual frameworkof this proposal: Advancing age, frailty, and belonging to an ethnic minority group significantly increase risk for both under assessment and under treatment of pain. The deleterious impact of pain is most pronounced among socio-economically disadvantaged ethnic and racial minority populations. The methods and techniques to promote community-research partnerships developed bythe Cornell Roybal Center over the past five years arelikely to result in pragmatic interventions that have a realistic chance of being adopted by the varied providers who come in daily contact with older persons in pain. Translational approaches/initiatives developed by the center should be broadly applicable to other prevalent geriatric syndromes/conditions, increasing the potential for widespread diffusion and dissemination of center related products.