The applicant has a unique background in studying health care transitions from pediatric to adult health care given her dual board in internal medicine and pediatrics combined with a health services research background through the Robert Wood Johnson Clinical Scholar Program. Her research is aimed at studying and formulating interventions that will address barriers and facilitators to chronic illness care for children with special health care needs as they transition from the pediatric to adult health care setting. The applicant has extensive experience in quantitative methods and survey development through her previous work. Through the proposed career development activities she seeks to gain additional skills toward being an independent investigator through the proposed program of training in qualitative research methods, studies in longitudinal data analysis, and in program development and evaluation. Her research agenda is to generate rigorous evidence to improve the quality of health care provided to patients through interventions that integrate patients, health care providers, health care systems and community organizations. The applicant proposes to accomplish this through two main objectives in this career development award. First, she will study what particular barriers and facilitators exist for youth and young adults with complex chronic conditions during the transitioning period. She will be using a mixed methods approach combining information from in-depth qualitative interviews with results from quantitative analyses of the 2005-2006 National Survey for Children with Special Health Care Needs. Second, she will take the information from the descriptive studies to design, implement and evaluate a city-based pilot intervention. This intervention is being created to improve health care delivery for youth and young adults with special health care needs as they age into the adult health care system via improved linkages to providers and community organizations. Through the proposed career development activities, the applicant seeks to acquire new skills in qualitative methods and advanced quantitative skills that will complement her existing research skills in order to improve health care delivery to youth and young adults with complex chronic conditions.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Clinical Investigator Award (CIA) (K08)
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Study Section
Special Emphasis Panel (ZHS1-HSR-A (02))
Program Officer
Anderson, Kay
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University of California San Francisco
Schools of Medicine
San Francisco
United States
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Edwards, Jeffrey D; Vasilevskis, Eduard E; Yoo, Erika J et al. (2015) Adults with childhood-onset chronic conditions admitted to US pediatric and adult intensive care units. J Crit Care 30:201-6
Okumura, Megumi J; Saunders, Mara; Rehm, Roberta S (2015) The Role of Health Advocacy in Transitions from Pediatric to Adult Care for Children with Special Health Care Needs: Bridging Families, Provider and Community Services. J Pediatr Nurs 30:714-23
Lawson, Erica F; Hersh, Aimee O; Trupin, Laura et al. (2014) Educational and vocational outcomes of adults with childhood- and adult-onset systemic lupus erythematosus: nine years of followup. Arthritis Care Res (Hoboken) 66:717-24
Okumura, Megumi J; Ong, Thida; Dawson, Diana et al. (2014) Improving transition from paediatric to adult cystic fibrosis care: programme implementation and evaluation. BMJ Qual Saf 23 Suppl 1:i64-i72
Houtrow, Amy J; Maselli, Judith H; Okumura, Megumi J (2013) Inpatient care for children, ages 1-20 years, with spina bifida in the United States. J Pediatr Rehabil Med 6:95-101
Edwards, Jeffrey D; Houtrow, Amy J; Vasilevskis, Eduard E et al. (2013) Multi-institutional profile of adults admitted to pediatric intensive care units. JAMA Pediatr 167:436-43
Houtrow, Amy J; Okumura, Megumi J; Hilton, Joan F et al. (2011) Profiling health and health-related services for children with special health care needs with and without disabilities. Acad Pediatr 11:508-16
Houtrow, Amy J; Okumura, Megumi J (2011) PEDIATRIC MENTAL HEALTH PROBLEMS AND ASSOCIATED BURDEN ON FAMILIES. Vulnerable Child Youth Stud 6:222-233
Okumura, Megumi J; Kerr, Eve A; Cabana, Michael D et al. (2010) Physician views on barriers to primary care for young adults with childhood-onset chronic disease. Pediatrics 125:e748-54
Okumura, Megumi J; Van Cleave, Jeanne; Gnanasekaran, Sangeeth et al. (2009) Understanding factors associated with work loss for families caring for CSHCN. Pediatrics 124 Suppl 4:S392-8