The aims of this proposal are to 1) develop the candidate's capacity for and expertise in serving as a mentor to junior investigators studying aging in vulnerable adults; 2) perform patient oriented research on the prevalence, risk factors for and consequences of geriatric conditions in older homeless adults; 3) perform patient oriented research on the management and consequences of limiting symptoms in older homeless adults and 4) use the candidate's research as a platform for mentoring junior investigators in aging in vulnerable populations. The candidate, a General Internist who practices at an academic safety-net hospital, has established a high-impact, well-funded independent clinical research program with an outstanding publication record. In the 13 years since completing her General Internal Medicine fellowship, she has established herself as a successful mentor of trainees who have published high-impact research, become successfully funded, and continue to participate in patient-oriented research. The candidate has developed an extensive research portfolio focused on the health outcomes of vulnerable populations. As one of the first researchers to identify the aging of the homeless population, the candidate received R01 funding from the NIA to examine the interaction between life course events and the development of geriatric conditions in homeless adults aged 50 and older. Her work to date has influenced the development and expansion of key interventions to address the health of homeless populations, including supportive housing and respite care. This proposal will provide the candidate with protected time to increase her expertise, expand her mentoring program and develop new research focused on limiting symptoms in older homeless adults in order to guide the development of interventions to improve symptomatology and reduce reliance on the Emergency Department. In addition to gaining new expertise in aging research methods, the candidate will develop a formal mentoring program with plans for the recruitment, selection, development, and evaluation of mentees who will become leaders in patient-oriented research focused on aging vulnerable populations. She will work with each mentee to establish a focused career development plan in which they complete research projects and develop the skills needed to become independent investigators. These plans will make full use of the outstanding clinical research training environment at UCSF. She will leverage her leadership positions at UCSF to recruit more mentees interested in research on aging issues in vulnerable populations.

Public Health Relevance

This proposal will have unique public health importance because (1) it will increase mentoring of new clinical investigators interested in conducting research to improve care for vulnerable populations as they age, and (2) it will inform interventions to improve the management of limiting symptoms in older homeless adults, in order to improve their quality of life and decrease reliance on the Emergency Department.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
1K24AG046372-01A1
Application #
8891716
Study Section
Neuroscience of Aging Review Committee (NIA)
Program Officer
Salive, Marcel
Project Start
2015-05-15
Project End
2020-04-30
Budget Start
2015-05-15
Budget End
2016-04-30
Support Year
1
Fiscal Year
2015
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94118
Freitas, Daniel J; Kaplan, Lauren M; Tieu, Lina et al. (2018) Oral health and access to dental care among older homeless adults: results from the HOPE HOME study. J Public Health Dent :
Bazari, Adam; Patanwala, Maria; Kaplan, Lauren M et al. (2018) 'The Thing that Really Gets Me Is the Future': Symptomatology in Older Homeless Adults in the HOPE HOME Study. J Pain Symptom Manage 56:195-204
Sudore, Rebecca L; Cuervo, Isabel Arellano; Tieu, Lina et al. (2018) Advance Care Planning for Older Homeless-Experienced Adults: Results from the Health Outcomes of People Experiencing Homelessness in Older Middle Age Study. J Am Geriatr Soc 66:1068-1074
Tong, M; Tieu, L; Lee, C T et al. (2018) Factors associated with food insecurity among older homeless adults: results from the HOPE HOME study. J Public Health (Oxf) :
Vijayaraghavan, Maya; Olsen, Pamela; Weeks, John et al. (2018) Older African American Homeless-Experienced Smokers' Attitudes Toward Tobacco Control Policies-Results from the HOPE HOME Study. Am J Health Promot 32:381-391
Patanwala, M; Tieu, L; Ponath, C et al. (2018) Physical, Psychological, Social, and Existential Symptoms in Older Homeless-Experienced Adults: An Observational Study of the Hope Home Cohort. J Gen Intern Med 33:635-643
Hurstak, Emily E; Kushel, Margot; Chang, Jamie et al. (2017) The risks of opioid treatment: Perspectives of primary care practitioners and patients from safety-net clinics. Subst Abus 38:213-221
Lee, Chuan Mei; Mangurian, Christina; Tieu, Lina et al. (2017) Childhood Adversities Associated with Poor Adult Mental Health Outcomes in Older Homeless Adults: Results From the HOPE HOME Study. Am J Geriatr Psychiatry 25:107-117
Brown, Rebecca T; Hemati, Kaveh; Riley, Elise D et al. (2017) Geriatric Conditions in a Population-Based Sample of Older Homeless Adults. Gerontologist 57:757-766
Raven, Maria C; Tieu, Lina; Lee, Christopher T et al. (2017) Emergency Department Use in a Cohort of Older Homeless Adults: Results From the HOPE HOME Study. Acad Emerg Med 24:63-74

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