Constance H. Fung, MD, MSHS is committed to becoming an independently-funded investigator who develops and implements patient-centered strategies for helping older adults make informed health care decisions that incorporate their preferences and needs. She has a particular interest in applying these strategies to care of older adults who have obstructive sleep apnea (OSA). Her unique background makes her an ideal candidate for this field of research. She has fellowship training and board certification in both Geriatrics and Sleep Medicine, fellowship training in Health Services Research, and leadership and research experience in improving patient care. Currently, Dr. Fung is supported by seed funding from the American Sleep Medicine Foundation and the UCLA/Hartford Center of Excellence. She is completing a qualitative study on barriers to OSA equipment use among older adults. Career development and training plan: This plan features an outstanding research and education environment at the David Geffen School of Medicine at UCLA, as well as interdisciplinary mentoring by researchers experienced in conducting sleep-related clinical trials in older adults, developing tools to improve shared decision making, and improving patient-centered care. Additional key resources include the UCLA/Hartford Center of Excellence, UCLA Clinical and Translational Science Institute, and the VA Greater Los Angeles Healthcare System Geriatrics, Research, Education and Clinical Center. This plan also features carefully selected formal coursework as well as hands-on training. Research plan: The overall goal of the proposed research is to develop and test a strategy for incorporating individual older adults'preferences and needs into treatment decisions about OSA. This project will develop and test a decision aid for older adults who are newly diagnosed with OSA and face various treatment options. In phase 1, she will explore the factors that impact OSA treatment decisions among older adults, using qualitative methods and a patient survey. In phase 2, she will use these findings to develop a decision aid tailored to older adults with OSA. In phase 3, she will collect feasibility data for a future randomized controlled trial that will compare the decision aid to an attention control. Information on process variables (e.g., recruitment rates) and effect size for primary (acceptance/adherence, decision-related outcomes) and secondary outcomes (sleep, other health-related, and health system outcomes) will inform the design of a future large-scale R01- or PCORI-funded trial. Skills developed from executing this training and research plan will enable Dr. Fung to become an independent researcher and leader in strategies for helping older adults incorporate their preferences and needs into medical decisions.

Public Health Relevance

Untreated sleep disorders such as obstructive sleep apnea (OSA) are associated with lower health-related quality of life and increased risk of other conditions that are associated with high medical costs such as stroke, cognitive impairment, and motor vehicle crashes. Many treatment options are available, but older adults with newly diagnosed OSA may have poor knowledge of their treatment options and difficulty choosing the option that is right for them, which contributes to under-treatment. The long-term goal of this award is for Dr. Fung to become an independent investigator who develops innovative strategies to help older adults choose a treatment that is right for them, based on their clinical characteristics, values and preferences.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZAG1-ZIJ-6 (M3))
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Salive, Marcel
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University of California Los Angeles
Internal Medicine/Medicine
Schools of Medicine
Los Angeles
United States
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Fung, Constance H; Martin, Jennifer L; Josephson, Karen et al. (2018) Cognitive Expectancies for Hypnotic Use among Older Adult Veterans with Chronic Insomnia. Clin Gerontol 41:130-135
Song, Yeonsu; McCurry, Susan M; Fung, Constance H et al. (2018) Sleep and Caregiving Experiences among Caregivers of Veterans in an Adult Day Health Care Program: A Pilot Study. Clin Gerontol 41:167-171
Song, Yeonsu; Washington, Donna L; Yano, Elizabeth M et al. (2018) Caregiving-Related Sleep Problems and Their Relationship to Mental Health and Daytime Function in Female Veterans. Behav Sleep Med 16:371-379
Hughes, Jaime M; Song, Yeonsu; Fung, Constance H et al. (2018) Measuring Sleep in Vulnerable Older Adults: A Comparison of Subjective and Objective Sleep Measures. Clin Gerontol 41:145-157
Fung, Constance H; Alessi, Cathy; Truong, Cindy et al. (2017) Patient-Provider Communication With Older Adults About Sleep Apnea Diagnosis and Treatment. Behav Sleep Med 15:423-437
Martin, Jennifer L; Schweizer, C Amanda; Hughes, Jaime M et al. (2017) Estimated Prevalence of Insomnia among Women Veterans: Results of a Postal Survey. Womens Health Issues 27:366-373
Fung, Constance H; Vaughan, Camille P; Markland, Alayne D et al. (2017) Nocturia is Associated with Poor Sleep Quality Among Older Women in the Study of Osteoporotic Fractures. J Am Geriatr Soc 65:2502-2509
Fung, Constance H; Veasey, Sigrid C (2017) Research Priorities in the Area of Sleep/Circadian Rhythm and Aging Research: Commentary on ""Report and Research Agenda of the American Geriatrics Society and National Institute on Aging Bedside-to-Bench Conference on Sleep, Circadian Rhythms, and Aging: Sleep 40:
Fung, Constance H; Martin, Jennifer L; Hays, Ron D et al. (2017) Patient-Reported Usability of Positive Airway Pressure Equipment Is Associated With Adherence in Older Adults. Sleep 40:
Carballo, Nancy J; Alessi, Cathy A; Martin, Jennifer L et al. (2016) Perceived Effectiveness, Self-efficacy, and Social Support for Oral Appliance Therapy Among Older Veterans With Obstructive Sleep Apnea. Clin Ther 38:2407-2415

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