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Alzheimer’s Association Funded Researcher Focuses on Disparities in Healthcare Delivery

Alzheimer’s Association Funded Researcher Focuses on Disparities in Healthcare Delivery
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October 6, 2020
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As the number of older Americans living with Alzheimer’s continues to grow, we know that not all populations are affected equally. Hispanics and Latinos are about one and one-half times as likely to develop Alzheimer’s than older whites. In order to learn more about this disproportionately affected population, a population that I am proud to be a part of, we must encourage participation in clinical trials and continue to study how Alzheimer’s disease affects people differently.

As we continue to support communities across the country through disease research and prevention efforts, we encourage more people from the Hispanic and Latino communities to pursue careers in science. Today’s young people will be the research leaders of tomorrow. 

Read on to learn about the important research work of Magaly Ramirez, Ph.D., and how she is continuing her investigations into disparities in healthcare delivery through a 2020 Alzheimer's Association Research Grant. Currently, the Alzheimer’s Association is investing over $208 million in 590 active best-of-field projects in 31 countries, spanning 6 continents. We are proud to continue bringing researchers together to accelerate methods of treatment, prevention and, ultimately, a cure for Alzheimer’s disease.

Maria C. Carrillo, Chief Science Officer, Alzheimer's Association

At the University of Washington School of Public Health, Magaly (Maggie) Ramirez, Ph.D., works in conjunction with the Latino Center for Health, allowing her to conduct collaborative research to help discover solutions that improve the health of Hispanics/Latinos burdened by disparities in health status and healthcare delivery. 

Dr. Ramirez, tell us how Alzheimer’s disease research became your focus.
I became involved in Alzheimer’s research in 2016, when I was a postdoctoral scholar at the UCLA Fielding School of Public Health. During that time, I received a small grant to study the information-seeking behavior of Latino family caregivers of people with Alzheimer’s disease and related dementias. Are people looking for information about the disease? How are they looking for it; how do they find it? This research was in collaboration with the USC School of Social Work and Rancho Los Amigos/USC California Alzheimer’s Disease Research Center. 

From this study, I learned that Latino family caregivers have pressing, unmet needs for culturally-relevant information and support, particularly as it relates to managing the challenging behavioral symptoms of dementia. I knew I wanted to be part of working toward a solution.

How has your own upbringing and culture been an inspiration for your work?
My parents are Mexican immigrants with less than a high school education. I grew up in Central Washington, where a large proportion of residents are Latino and work in the agriculture industry. 

Early on in my undergraduate career, I made it a goal to pursue an academic career focused on making a positive impact on the health and well-being of patients and their families. While in graduate school, I learned about racial/ethnic disparities in health and healthcare delivery. Given my background and upbringing, I was particularly drawn to inequities experienced by Latinos due to ethnicity and socioeconomic status, and I began focusing my work on this population. 

In 2016, I became the first person in my immediate and extended families to earn an advanced degree. As an assistant professor at the University of Washington School of Public Health, I’m now passionately pursuing a career that is focused on discovering solutions to eliminate inequities in health and healthcare that are experienced by Latinos.

You received a 2020 Alzheimer's Association Research Grant (AARG) for your Cultural Adaptation of a Behavioral Intervention for Latino Caregivers study. Tell us about this study. 
STAR-Caregivers is a program that trains family caregivers over multiple face-to-face sessions on how to best manage behavioral symptoms experienced by people with Alzheimer’s disease and related dementias. 

Research shows that STAR-Caregivers reduces family caregiver burden and depression. However, there are aspects of STAR-Caregivers requiring adaptation in order to address the culture-specific needs of Latino family caregivers. The proposed research asks how we can culturally adapt STAR-Caregivers for Latino caregivers, how we can make the program accessible to Latinos using a mobile application, and what Latino caregivers think about the program and the ability to access it on a mobile app.

Have you had to adapt to a virtual study environment during the COVID-19 pandemic? 
The study began in July of 2020, so we are still in the planning stages. Thankfully, the research methods involved in this study (including qualitative interviews) can be well-adapted to a virtual environment. We will be recruiting study participants by phone and interacting with them using video conferencing software.

Why is it important for the Hispanic/Latino population to be represented in clinical trials? 
In the next 40 years, the prevalence of Alzheimer’s disease and related dementias is expected to grow the fastest among Latinos compared to all other racial and ethnic groups in the United States. In its 2020-2025 Strategic Directions for Research, the National Institute on Aging reports that study participants in Alzheimer’s disease and related dementias research are mostly non-Hispanic whites. 

Expanding research to include populations disproportionately impacted by the disease is not only a matter of equity. It will also improve our knowledge about how to best serve these populations, rather than making assumptions based on research findings produced with mostly white populations.

What are your hopes for the future of Alzheimer’s research in the Latino community and overall?
Given the growing number of Latinos impacted by Alzheimer’s disease and related dementias, there is an urgent need to adapt STAR-Caregivers and other evidence-based services to improve cultural relevance and make them widely available. 

The Alzheimer’s Association Research Grant study is a first step in that direction. In the long-term, I hope that we are able to leverage advances in communication and information technology to disseminate evidence-based interventions in real-world settings. This would help improve the health and well-being of all family caregivers. 

About Maggie: Dr. Maggie Ramirez is an assistant professor in the Department of Health Services at the University of Washington School of Public Health. She has a Ph.D. in Industrial and Systems Engineering from the University of Southern California. Dr. Ramirez also completed a postdoctoral fellowship and an M.S. in Health Policy and Management at the UCLA Fielding School of Public Health. As a faculty member at the University of Washington, she was selected in the inaugural cohort of the CATALyST K12 Scholar Program, which trains early-career investigators in the methods of learning health system science and patient-centered outcomes methodology. 

Related articles:
Our Commitment to Research (content in English)
Datos y cifras (Facts & Figures, content in Spanish)
Investigación (Research, content in Spanish)

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