A tool to facilitate inclusion of older adults in clinical research.

The 5Ts Framework was developed by our team in 2019 with support from the Duke Clinical & Translational Science Institute (CTSI) as a memorable way to organize and communicate best practices for inclusion of older adults in research. Each “T” is a useful reminder of the many proven strategies to support participation of older adults in clinical research.

Since 2019, we have continued to develop 5Ts trainings and resources to support research teams at our institution. During this process we have heard there is high demand for assistance recruiting older adults and that research teams have favorable views on the 5Ts Framework.  

During this time, the 5Ts also gained national recognition for its potential to improve inclusion across the lifespan. The 5Ts Framework has been described in both the NIH Inclusion Across the Lifespan-II Workshop and the FDA Roadmap to 2030 for Drug Evaluation in Older Adults as a potential strategy to improve inclusion of older adults in research.

With support from the Duke CTSI and Duke Pepper Center, this website was designed to introduce research teams (researchers and staff) to the 5Ts and facilitate sharing of best practices of inclusion of older adults in research. Efforts are also underway to determine how the 5Ts could be expanded to other underrepresented populations.  


5Ts Framework Team

Barrett Bowling Headshot

C. Barrett Bowling, MD, MSPH

Dr. Bowling is a geriatrician with research training in population health and chronic disease epidemiology. He has extensive experience leading and contributing to successful interdisciplinary research teams. Through his collaborative work, he developed the 5Ts Framework to improve communication with his research partners (i.e., epidemiologists, nephrologists, cardiologists, and other specialists) and proactively address challenges they face enrolling older adults in research studies.

Jennifer Thomas Headshot

Jennifer Thomas, MPH

Ms. Thomas is a Clinical Research Coordinator in the Department of Population Health Sciences, where she provides research project management support for large-scale studies using administrative claims data, qualitative research studies, and observational research relevant to older adults. She has been the lead coordinator for the 5Ts Framework program since 2019. Ms. Thomas is the lead author on a manuscript describing the potential value of the 5Ts from the perspectives of 50 community representatives from diverse backgrounds including older adults.   

Duke CTSI Integrating Special Populations Core

The 5Ts Framework has been supported by K.K. Lam, PHD and Sydney Sullivan, MPH of the Duke Clinical & Translational Science Institute (CTSI) Integrating Special Populations (ISP) Core. Dr. Lam is Clinical Health Project Leader for the ISP and an expert in reaching and including populations of adults and children who are often underrepresented in clinical research. Ms. Sullivan is an ISP Research Program Manager and has led efforts to expand the role of the 5Ts Framework to support inclusion of other special populations.