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; Edwards, Sheri L (2018) Geographic Variation in California Pediatric Hospice Care for Children and Adolescents: 2007-2010. Am J Hosp Palliat Care 35:15-20
Lindley, Lisa C; Held, Mary L; Henley, Kristen M et al. (2017) Nursing Unit Environment Associated with Provision of Language Services in Pediatric Hospices. J Racial Ethn Health Disparities 4:252-258
Lindley, Lisa C (2017) Multiple Complex Chronic Conditions and Pediatric Hospice Utilization among California Medicaid Beneficiaries, 2007-2010. J Palliat Med 20:241-246
Lindley, Lisa C; Newnam, Katherine M (2017) Hospice Use for Infants With Life-Threatening Health Conditions, 2007 to 2010. J Pediatr Health Care 31:96-103
Lindley, Lisa C; Nageswaran, Savithri (2017) Pediatric Primary Care Involvement in End-of-Life Care for Children. Am J Hosp Palliat Care 34:135-141
Keim-Malpass, Jessica; Lindley, Lisa C (2017) End-of-Life Transitions and Hospice Utilization for Adolescents: Does Having a Usual Source of Care Matter? J Hosp Palliat Nurs 19:376-382
Lindley, Lisa C; Colman, Mari Beth; Meadows Jr, John T (2017) Children with intellectual disability and hospice utilization. J Hosp Palliat Nurs 19:28-33
Lindley, Lisa C; Cozad, Melanie J (2017) Nurse Knowledge, Work Environment, and Turnover in Highly Specialized Pediatric End-of-Life Care. Am J Hosp Palliat Care 34:577-583
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
Cozad, Melanie J; Lindley, Lisa C; Mixer, Sandra J (2016) Staff Efficiency Trends Among Pediatric Hospices, 2002-2011. Nurs Econ 34:82-9

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