Advanced Research Institute (ARI): Supporting the Geriatric Mental Health Research Pipeline

Abstract

The Advanced Research Institute (ARI) in Mental Health and Aging is a NIMH-funded mentoring network to help transition early-career faculty to independent investigators and scientific leaders. Since 2004, ARI has enrolled 184 Scholars from 61 institutions across 34 states. We describe the ARI components and assess the impact and outcomes of ARI on research careers of participants. Outcomes of ARI graduates (n = 165) came from NIH Reporter, brief surveys, and CVs: 87.3% remained active researchers, 83.6% performed scientific service, and 80.6% obtained federal grants. A population-based analysis examined NIMH mentored K awardees initially funded from 2002–2018 (n = 1160): in this group, 77.1% (47/61) of ARI participants versus 49.5% (544/1099) of nonparticipants obtained an R01. Controlling for time, ARI participants were 3.2 times more likely to achieve R01 funding than nonparticipants. Given the struggle to reduce attrition from the research career pipeline, the effectiveness of ARI model could be relevant to other fields.

OBJECTIVES

Background

Ongoing development of independent investigators is vital to translational clinical science, yet maintaining this pipeline is challenging.¹ One key bottleneck is the transition of early-career faculty to scientific leaders with independent research funding. In 2005, the National Academy of Science alerted the nation that the average age of first-time recipients of an NIH research grant had risen to 42 years. Despite efforts to change this trajectory, the data had not budged by 2010,² and had even climbed to 44 years by 2020.³ This problem has prompted NIH to enhance career development initiatives that explicitly target early-career faculty including recognition of Early-Stage Investigators and NIH Research Education Program Awards (R25).

The Advanced Research Institute (ARI) in Mental Health and Aging is a NIMH-funded mentoring network established in 2004 to provide early-career faculty with a mentored, educational program: 1) to foster the transition to independent investigators, and 2) to promote professional development as scientific leaders. A growing body of empirical evidence demonstrates that mentoring is associated with an early-career investigator’s greater productivity, vitality, and retention.^4–7 Evidence suggests that outside mentoring increases productivity and subjective success.^8,9 The ARI program combines outside mentoring with experiences to build leadership, research networks, and help junior researchers obtain independent funding. Other similar programs have been developed such as the CHIPS Research Training Institute focusing on research on services for children and adolescents.

In this report, we review the original components of the ARI program (mentors, Scholars, Spring Retreat) described previously¹⁰ and then move to describe the new components added during the pandemic (ARI Grand Rounds, Presubmission Review, Mentored Biostatistics Faculty Program, and CAMP). We quantify the career outcomes through February 2023 of 165 Scholars who graduated from ARI in terms of scientific leadership and independent funding. To examine independent funding outcomes we present a population-based analysis of a subgroup of ARI Scholars (NIMH career development awardees) to compare the success of ARI Scholars in achieving NIH R01 funding to NIMH career development awardees who did not attend ARI.

Original ARI Program Components

ARI components: Mentors

Mentoring networks offer unique opportunities for developing researchers to tailor their mentoring experience to meet where they are in their research careers and their specific needs.^11,12 The ARI faculty includes a national, multidisciplinary network of senior and mid-career scientists with complementary skills spanning the translational spectrum from neuroscience to implementation science within the field of late-life mental health. ARI Mentors can guide the formulation of scientific questions suitable for funding, help develop study designs to address these questions and identify needed pilot data. They work with their mentees to identify the appropriate funding mechanisms, strategies to get feedback from potential funders, and any areas needing expert consultation (e.g., biostatistics, clinical trials methodology). Mentors critique draft grant applications in terms of substance and style. To facilitate career development, mentors advise on challenges in their home institution (e.g., promotion, raises, conflicts), managing time and adhering to short and long-term timetables, balancing between clinical, research, teaching, and mentoring activities, integrating work and home life, building successful scientific collaborations and teams, identifying career leadership opportunities, and developing as mentors to junior colleagues.

ARI components: Spring retreat and ongoing mentoring

The ARI Spring Retreat is the formal forum in which Scholars meet with their Mentors, other program faculty, and consultants. The 4-day Spring Retreat is attended by Scholars, Mentors, Biostatisticians, NIH program officers and includes seminars, workgroup presentations, and one-on-one meetings where Scholars present their ideas and obtain feedback from their small groups with includes ARI faculty and Scholars, NIMH staff and Biostatisticians. They revise their ideas each day and prepare to present again. After the Spring Retreat, Scholars and Mentors plan to follow up and work together until the Scholar achieves an R01, or graduates at the end of 2 years.

New Program Components

Since the 2011 publication, we have continued to add components to the ARI Program designed to strengthen its impact. In addition, during the pandemic, ARI activities moved to virtual delivery, and additional components were added to support Scholars.

Mentored Biostatistics Faculty Program was developed by ARI’s biostatistician faculty to increase the number of biostatisticians able and willing to collaborate with geriatric mental health researchers.¹³ The program provides early career statisticians experience and guidance in working effectively with investigators and knowledge of geriatric mental health. Mentored Biostatistics Faculty participate in the Spring Retreat by shadowing senior Biostatisticians and by receiving career mentoring. To date, ARI has competitively selected four cohorts (n = 12) from 11 different academic centers. After ARI, they have contributed to the ARI network by leading webinars, serving as presubmission grant reviewers, and collaborating with Scholars in successful grant submissions. Two of the Mentored Biostatistician faculty are now Associate Statistical Editors for American Journal of Geriatric Psychiatry.

ARI Grand Rounds were developed in response to the pandemic’s travel restrictions, giving Scholars opportunities to present their full body of research virtually to a national audience. For 3 years, ARI Scholars’ monthly Grand Rounds has had robust attendance. Given its success in extending Scholar’s academic reach, the program is now a permanent component of ARI.

External presubmission Review is offered to Scholars who are ready to submit their R01 proposals. The prereview is conducted at least 2 months prior to submission when Scholars have a fully prepared R01 application. Prior to the prereview expert external reviewers write NIH-formatted reviews and then during the review they participate in NIH-style study sections (observed by Scholars) and provide in-depth written feedback. Scholars have the opportunity to discuss feedback with reviewers to strengthen their applications.

CAMP: CIMA-ARI Mentoring Program at American Association for Geriatric Psychiatry (AAGP) Annual Meeting was developed to give recent ARI graduates opportunities to both hone their mentoring skills and remain meaningfully engaged in the network. CAMP also provides a new, actively guided, entry point for people to join the research community. ARI leadership worked with the Career Institute of Mental Health of Aging (CIMA) director, AAGP research committee, and AAGP executive director to launch CAMP at the 2023 AAGP annual meeting. The pilot included: 1) recruitment of recent ARI graduates to serve as CAMP Mentors with guidance from senior researchers; 2) solicitation of applications from new AAGP meeting attendees; 3) matching Mentors with Mentees based on shared research interests; 4) Afternoon semi-structured meeting of CAMP Mentees, Mentors, and senior researchers, and 5) Attendance at the ARI/CIMA reception.

Methods

Recruitment of scholars

The target group size each year is 16 Scholars to ensure that each Scholar will have adequate mentoring and access to scientific consultants. Recruitment begins with an annual call for applications in September with brief informative emails that include a link to the ARI website to 1) Recent and current NIMH mentored K awardees in aging-related areas (identified from the RePORTER system); 2) NIA level-1 K awardees in mental health-related areas (also from RePORTER); 3) All current and former participants/faculty of ARI and CIMA/SRI; 4) NIMH T32 Directors; and 5) Members of relevant professional organizations. In addition, Directors send personal emails to targeted individuals (e.g., those recommended by NIMH program officers or ARI faculty and to potentially qualified candidates identified by the NIH RePORTER system). Recruitment materials strongly encourage potential applicants to call ARI leadership to discuss the program itself and its appropriateness for the potential candidate.

Each applicant must submit a current curriculum vitae, a draft R01 proposal, or previously submitted R01 and a 500-word description of their current program of research, mentoring, and scientific advisory needs as well as 2 letters of recommendation. The majority of individuals who ultimately submit a formal application are qualified and a good match for the program. Applications are reviewed by the Steering Committee who rates each candidate and recommends potential Mentors. Careful attention is paid to the development of a balanced group of Scholars, including a conscious effort to recruit women and under-represented ethnic minorities.

Sample

For this report, we first describe ARI participants across 20 cohorts. Second, we examine the outcomes of the 18 cohorts who have completed ARI. Third, we report examine outcomes of all NIMH mentored K awardees initially funded 2002-2018 (n = 1,160), a subset of whom participated in ARI (n = 61).

Outcomes

We examined two types of outcomes that reflect the two major objectives of ARI, scientific leadership, and independent funding. Scientific leadership includes academic retention and promotion, research mentoring, scientific service (i.e., NIH Study Sections, journal reviews), and ongoing grant funding (federal/state, foundation, industry). These data were drawn from Scholars CVs and a brief survey. Independent funding is defined as obtaining a NIMH awarded R01 (or equivalent) grant as a PI and was assessed using the NIH RePORTER. The brief survey also included space for comments where Scholars shared the aspects of ARI that they perceived as most helpful.

Results

Number and characteristics of all participants: ARI enrolled 20 cohorts of Scholars (n = 184) from 2004 to 2023. Scholars represented 61 different academic centers in 33 states; 120 (65.2%) were women, 28 (15.2%) were underrepresented minorities, 68 (37.0%) had MD degrees (including 19 MD/PhDs) and 116 (63.0%) had PhD/equivalent degrees. The majority (111, 60.3%) had received a mentored NIH K award; most others had VA or other career development support and/or history of small grant funding.

Analysis 1: Outcomes of all Graduated ARI Scholars

Approach

To date, ARI has graduated 18 cohorts (2004-2021) of Scholars (n = 165). Their outcomes as of February 2023 were assessed using data from the NIH RePORTER database, CVs, and questionnaires. Outcomes included: 1) Academic retention and promotion, 2) continued research activities, 3) scientific service (i.e., NIH Study Sections, journal reviews), and 4) grant funding (federal/state, foundation, industry). Outcomes included:

Research retention and promotion: Of the 165 graduates, 144 (87.3%) remained engaged in research of as February 2023; most others were full-time clinicians or administrators. Since participating in ARI, most graduates (142/165; 86.1%) had contributed to geriatric psychiatry through scientific service (e.g., reviewing for journals or NIH Study sections; mentoring research trainees and K awardees), and most (130/165; 78.8%) had received academic promotions. Of note, seven graduates are now Department Chairs.

Post-ARI grant funding: Following ARI, 80.6% (133/165) of Scholars obtained federal grant funding (e.g., NIH, CDC, VA, DoD), 69.1% (114/165) received NIH grant funding, and 55.2% (91/165) received an NIHR01.

Analysis 2: ARI’S Impact in a Defined Population

Approach

ARI purposely recruits highly accomplished new investigators who demonstrate the capacity and drive to benefit from the program. Because ARI was not a randomized trial, there is no unbiased comparison group to measure ARI’s “added value” in this talented group. Thus, our second approach to evaluating ARI’s impact was to start with a similarly talented population and compare the likelihood of receiving an R01 between those in the population who participated in ARI versus nonparticipants. Replicating previous analyses,¹⁰ we defined our population as all NIMH K awardees initially awarded in 2002–2018 (n = 1,160), a subset of whom participated in ARI (n = 61). This time span includes Ks awarded in 2002 who were potentially eligible for ARI in 2004 (ARI’s first year) through Ks awarded in 2018 who were potentially eligible for ARI in 2020 (leaving 2 years to achieve an R01 by 2022). We chose this population because all K awardees have already been “selected” through a competitive NIH-review process that evaluated their potential success in developing into an independent investigators and achieving R-level funding.

Results

We used the NIH RePORTER to examine R01 grants awarded to this population of NIMH K awardees as of September 30, 2022. Seen in the figure 1, 77.1% (47/61) of those who participated in ARI versus 49.5% (544/1,099) of nonparticipants achieved an R01 by September 30, 2022 (Chi = 17.55, df = 1, p = 0.0001). Controlling for the first year of K funding, in this group of NIMH K awardees, ARI Scholars were 3.16 times more likely (p <0.0002) to achieve an R01 than other K awardees.

FIGURE 1.

Success of NIMH mentored K awardees (awarded 2002–2018) in receiving an NIH R01 by September 30, 2023.

Comments About ARI

The ARI program is multimodal program and the support for each Scholar is personalized based on their scientific trajectory. As part of the brief survey Scholars added comments about how the ARI program was most helpful to them. We have grouped the comments into three categories: mentoring/networking, shaping the research proposal, and influencing science (Table 1)

TABLE 1.

Scholar Comments About the ARI Program

ARI Fosters Mentoring and a Network of Researchers

ARI has helped create and influence a cooperative and promentoring environment throughout academic geriatric psychiatry. It has not only benefitted the individual mentees and their grant submissions, but it has also influenced the whole research community, including the second-generation mentees, and so on.

I am grateful for having been invited to ARI. The main benefit in my case was networking.

The faculty at ARI was a tremendous resource. They genuinely cared about junior faculty and other trainees and were willing to spend a great deal of time on grant proposals. In addition, the mentor assigned to me continued to have phone call meetings to “check in.”

Both the SRI/CIMA and the ARI were outstanding experiences. Not only were the retreats themselves extraordinarily productive, the relationships and networks that have formed as a result of my participation in these programs continue to support and advance my career to this day (and likely into the future)

The Advanced Research Institute (ARI) has been the most valuable training experience of my career. The combination of intensive workshops and longitudinal mentorship has been instrumental in helping me achieve my career goals.

I know that the time I have spent at ARI as a mentor was extremely beneficial in refining and improving my own interactions with my local mentees, and in part been responsible for enhancing the number of funded K applications for mentees at my institution. So, therefore in addition to the impact of the mentoring that occurs through ARI directly, there is a ripple effect at each institution that participates.

ARI Shapes the Research Proposal

ARI is an indispensable resource to help assure young researchers can successfully navigate the challenging transition to full scientific independence

Attending ARI as a junior faculty was immensely valuable. The retreats provided me with the opportunity to immerse myself in the development of my R01 application. ARI allowed me to focus and receive critical feedback on plans for my R01 application in a way that just was not possible on campus amidst the daily grind of teaching and running smaller studies

The ARI experience was of course invaluable to me as a trainee—I brought the reviews from a VA Merit grant to ARI and with the feedback and mentoring I received, I was able to convert the submission into a funded grant.

ARI enabled me to organize my thinking to get my first R01.

The ARI was extremely beneficial to me in preparing to write my first R01 award application, which I recently learned was funded.

ARI was a game-changer for me. I sincerely appreciate my ARI mentors for being able to see my potential and pushing me forward to achieve my first R01

ARI Influences Science

ARI was instrumental in challenging me to think of the ultimate research trifecta: innovative, impactful, and important science that ultimately reduces the burden of late-life mental disorders

I still feel that my ARI experience was truly one of the most important professional development experiences I have been fortunate enough to participate. It changed the way I conduct research.

I bring the mentoring I received at ARI to my work as a researcher, reviewer, mentor, and department chair. The range of perspectives and the collaboration is a model for my work.

CONCLUSIONS

The ongoing development of independent investigators contributing to the health of individuals and the public is integral to the NIH’s mission. It also promotes a vibrant culture of research essential to ensuring that patients receive the highest quality of care. A key challenge to the research pipeline is the transition from early-career faculty to independent investigators and scientific leaders. This paper reports outcomes of the Advanced Research Institute (ARI) in Mental Health and Aging, a mentoring network and education program led by senior researchers dedicated to this goal. Two sets of outcome analyses indicate the program’s positive impact.

ARI is one of three inter-related academic networks that support geriatric mental health¹⁴ researchers. The NIH-funded CIMA (R25 MH112484) is earlier in the pipeline and prepares new investigators to begin a research career in geriatric mental health.¹⁵ The American Association of Geriatric Psychiatry (AAGP) is the primary subspecialty organization dedicated to geriatric mental health, engaging investigators across the career spectrum.

Geriatric psychiatry has a robust research base spanning disciplines from basic neuroscience to implementation science. ARI supports Scholars across these different areas. The cross-talk across the disciplines is a notable strength in ARI making the whole greater than the sum of its parts. Synergy across disciplines is recognized as a key component of innovation.¹⁶ Recently, Reynolds and Weissman¹⁷ described ARI as a model for how transdisciplinary science can be supported and encouraged.

Over 20 years, ARI’s model of mentorship and career research development has demonstrated success in preparing new generations of researchers to achieve independent funding, become scientific leaders, and conduct high-impact research in mental health and aging. Given the nation’s struggle to reduce attrition from the research career pipeline, evidence of the model’s effectiveness is relevant to the wider community of clinical and translational researchers, research institutions, policy-makers, and funders committed to promoting the pipeline of early career researchers and their transition to independence.

Highlights.

• What is the primary question addressed by this study?

  What are the components and outcomes of a mentoring program to promote independence and scientific leadership and to improve the likelihood of research funding?

• What is the main finding of this study?

  The Advanced Research Institute (ARI) in Mental Health and Aging participants had sustained research activity, scientific service, and among NIMH Career Development awardees, ARI participants were 3.2 times more likely to achieve R01 funding than nonparticipants.

• What is the meaning of the finding?

  With outside mentors, methodology support, and an expanded network, the ARI mentoring program can support the growth of researchers building independence.

DATA STATEMENT

The data reported has not been previously presented.