The purpose of this K01 Mentored Research Scientist Development Award is to prepare Lisa C. Lindley, PhD, RN for an independent health services and policy research career with a special focus on pediatric end-of-life care. The career development plan entails three objectives to achieve the career goals of the candidate that include: 1) developing a clinical and policy grounding in pediatric end-of-life care;2) acquiring knowledge of advanced research methods and statistics;and 3) expanding research communication abilities. The development plan will consist of thoughtfully selected coursework and activities under the guidance of an expert mentorship and advisory team including Drs. Shih-Lung Shaw, Maureen Lyon, Jennifer Mack, Paul Erwin, and Don Bruce. The plan will also include conducting a study to examine hospice use among children that will lead to future R-series grant applications. The research project seeks to understand how the characteristics of children influence utilization of hospice care services. Using an innovative geographic information systems approach along with longitudinal administrative data, this study will employ a retrospective cohort design to address the following specific aims: 1) to explore geographic patterns of hospice use among children by describing the geographic distribution of pediatric hospice use, identify geographic clusters of pediatric hospice use, and compare geographic clusters of pediatric hospice use and nonuse;and 2) to examine the effects of child characteristics (i.e., geographic, demographic, health) on pediatric hospice use while controlling for community characteristics. It is anticipated that the results of the study will inform clinicaland policy initiatives on how to improve access to pediatric hospice care.

Public Health Relevance

This proposal directly addresses the public health concerns regarding access to health care among underserved and vulnerable populations such as children. Its results will represent one of the first initiatives to evaluate the influence of chil characteristics on hospice use and will provide preliminary guidance for geo-targeting resources and policies aimed at improving access to hospice care for children.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Research Scientist Development Award - Research & Training (K01)
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National Institute of Nursing Research Initial Review Group (NRRC)
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Aziz, Noreen M
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University of Tennessee Knoxville
Schools of Nursing
United States
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Lindley, Lisa C; Mack, Jennifer W; Bruce, Donald J (2016) Clusters of Multiple Complex Chronic Conditions: A Latent Class Analysis of Children at End of Life. J Pain Symptom Manage 51:868-74
Lindley, Lisa C (2016) The Effect of Pediatric Palliative Care Policy on Hospice Utilization Among California Medicaid Beneficiaries. J Pain Symptom Manage 52:688-694
Cozad, Melanie J; Lindley, Lisa C; Mixer, Sandra J (2016) Staff Efficiency Trends Among Pediatric Hospices, 2002-2011. Nurs Econ 34:82-9
Cozad, Melanie J; Lindley, Lisa C; Mixer, Sandy J (2016) Using Agency Nurses to Fill RN Vacancies Within Specialized Hospice and Palliative Care. Policy Polit Nurs Pract 17:147-155
Lindley, Lisa C; Mixer, Sandra J; Mack, Jennifer W (2016) Home care for children with multiple complex chronic conditions at the end of life: The choice of hospice versus home health. Home Health Care Serv Q :1-11
Lindley, Lisa C; Held, Mary L; Henley, Kristen M et al. (2016) Nursing Unit Environment Associated with Provision of Language Services in Pediatric Hospices. J Racial Ethn Health Disparities :
Lindley, Lisa C; Edwards, Sheri L (2016) Geographic Variation in California Pediatric Hospice Care for Children and Adolescents: 2007-2010. Am J Hosp Palliat Care :
Lindley, Lisa C; Cozad, Melanie J (2016) Nurse Knowledge, Work Environment, and Turnover in Highly Specialized Pediatric End-of-Life Care. Am J Hosp Palliat Care :
Lindley, Lisa C; Mixer, Sandra J; Cozad, Melanie J (2016) The Influence of Nursing Unit Characteristics on RN Vacancies in Specialized Hospice and Palliative Care. Am J Hosp Palliat Care 33:568-73
Lindley, Lisa C; Trujillo, Laura V (2016) End-of-Life Care for Hispanic Children: A Study of California Medicaid Beneficiaries. Hisp Health Care Int 14:164-169

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