The Art of Speeding Up Science

Ann Dozier, Ph.D.

URMC was one of the first U.S. institutions to receive a $40 million Clinical and Translational Science Award, and the National Institutes of Health plans to ultimately present 60 such contracts as part of its push to cut delays that keep good bench research from reaching bedside application. To learn more about the art of speeding up science, Pulse sat down with Ann Dozier, Ph.D. An associate professor of Community and Preventive Medicine at URMC, Dozier spearheads the Clinical and Translational Science Institute’s efforts to improve recruitment and retention in clinical research.

Pulse: Why is the NIH so intent on accelerating research?

Dozier: Because research progress tends to get stuck. Believe it or not, it can take 25 years for a finding to move from an idea in the lab to actual therapeutic use in humans. Part of the idea behind awarding these CTSAs is to challenge funded institutions to address the root causes of research bottlenecks, and to remove complexities that unnecessarily slow down the progress of good science.

Pulse: Is that what this “translation” buzzword means? To progress from an idea to an actual practice?

Dozier: That’s part of it. Still, when we toss around the term “translation,” it means so much more than having a finding become a recognized treatment or recommendation. It means that this finding then goes on to ultimately make us healthier. Even after pouring billions of dollars into health research, there are major disconnects between the NIH monies invested and the CDC’s reported “returns,” or results. We can’t only pursue research that fascinates us – we need to choose avenues of study that have the capacity for concrete application and real impact, improving the health of the population. And really, since much of this research is conducted with taxpayer dollars, we have an additional responsibility to focus on priorities that the community views as important for improving their health.

Pulse: So, translation means translating from the bench, to the bedside, to actual health improvement. What sorts of things can get in the way?

Dozier: Across the country, one of the biggest struggles is populating studies – getting enough people to volunteer to be in a clinical or health research trial. Research recruitment works best when it piques the volunteers’ interest, addresses a condition or issue relevant to them, and uses a study design that is “user friendly” for the volunteer – that is, one that does not place undue demands on them.

Pulse: As a recruitment consultant, tell us – what ultimately drives people to participate in research?

Dozier: Obviously, there’s the scenario where a person suffers from a condition with no recognized therapy, so they may be interested in trying experimental answers. In other cases, even when there are available treatments, being in a study may give them the possibility of trying a new treatment. Other volunteers are motivated by altruism – the notion that by participating they are bettering others or their community; or maybe this is a gesture of support for a family member living with the condition. Perhaps one of the most powerful motivators – especially if the study features a behavioral intervention – is the possibility that this could be the elusive key to finally making a substantial health overhaul, like losing unwanted weight, quitting smoking, etc.

Pulse: These all seem like excellent reasons. What would keep someone from becoming a study subject?

Dozier: Let’s be honest – most folks perform a quick (often subconscious!) risk-benefit calculation when faced with an opportunity. In colloquial terms, this is the “what’s in it for me?” phenomenon. Will I get some sort of free medical care? Will I be shaping better health for future generations – say, for my grandkids? We then weigh these possible perks against the “hassle factor” (will the study have me jumping through too many hoops?), the “ouch factor” (the need to give blood samples or receive injections), and the privacy factor (the willingness to share some personal health information). To improve the odds that a study is funded and populated, we encourage researchers to understand their potential subjects and limit the number of barriers to participation, including eligibility and other protocol requirements.

Pulse: Is there a particular recruitment challenge that you’re addressing now?

Dozier: We’re focusing on outreach to Latinos and African-Americans, which historically have been underrepresented in research. Having them involved is critical. Medications or treatments may function better or worse in different groups, so we should seek to know as much as we can about whom each medicine is most effective for. We need diverse participation from all ethnicities for a comprehensive analysis. This is true for all types of studies – even those that might be more psychological or behavioral in nature, such as testing an exercise program or a diet regimen.

Pulse: Where should I go if I want to learn more about participating in clinical research?

Dozier: The best place to go to get involved is www.healthresearch.urmc.edu, where you can find local studies and a link to www.ResearchMatch.org. This secure website is like eHarmony for clinical research; individuals interested in research enroll and then periodically receive information on research opportunities. ResearchMatch leaves the choice to participate completely up to you. Remember, we need healthy volunteers too!

Pulse: What tips do you have for researchers who want to master the art of recruitment?

Dozier: The best advice we have is to not assume you understand the population from whom you are seeking volunteers. You should seek input about how best to reach them, perhaps requesting a recruitment consultation, talking with members of this community or others who have studied it. Do this before you even apply for the grant! It may seem backward, but recruitment needs to inform and guide study design, not be an afterthought. A small amount of additional upfront planning can make the difference between a project being funded and a project being passed over.

To contact Ann Dozier, send an e-mail to Ann_Dozier@urmc.rochester.edu.

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