Dr. Kushel is a Professor in the Department of Medicine at the University of California, San Francisco (UCSF) and Director of the UCSF Center for Vulnerable Populations (CVP). Trained as a general internist and health services researcher, Dr. Kushel has mentored numerous individuals at various levels of training over the past decade. She has done this while building a thriving research program focused on aging in vulnerable populations, with a particular focus on the growing population of older adults experiencing homelessness. She is currently funded by the NIA to fund the HOPE HOME Study, a cohort study of adults who are 50 and older and homeless at study entry who her team has been following since enrollment in 2013-2014. During her initial K24 award period, she received additional NIA funding, including an R01 to examine family relationships in homeless older adults and an R34 to develop advance care planning materials for formerly homeless older adults living in permanent supportive housing. She mentored 39 trainees, and published 45 papers, the vast majority with mentees as first author. With the renewal of her K24 award, she will extend her research program by adding a focus on sleep in older adults with an experience of homelessness, continue her efforts to mentor junior investigators who study aging in vulnerable populations, and redouble her efforts to mentor trainees from backgrounds underrepresented in research. The overall aims of this K24 renewal proposal are: (1) Using HOPE HOME longitudinal data, examine the association of individual (e.g. health status), behaviors (e.g. substance use), social (e.g. relationships) and environmental (e.g. housing status and environment) with poor sleep in older homeless-experienced adults; (2) Using qualitative methods, examine barriers and facilitators of sleep quality in older-homeless experienced adults; (3) Using participatory design, develop a toolkit for homeless system and housing providers to promote sleep in older homeless adults. The mentoring goals of this award include increasing Dr. Kushel?s expertise in mentoring researchers from groups historically underrepresented in biomedical sciences. The K24 would insure sufficient time to pursue this next phase in Dr. Kushel's research while protecting time to devote to mentoring investigators in aging research for vulnerable populations. She has designed complementary research and mentoring plans to create a synergistic effect of mentoring and research. The proposed mentoring, research, and career development activities leverage existing infrastructure, resources, and training initiatives provided by NIH including the UCSF Clinical and Translational Science Institute (CTSI), SF Building Infrastructure Leading to Diversity (BUILD), MSTAR, the National Clinician Scholars Program and several of UCSF?s T32 supported research fellowships including the Primary Care Research and Aging Research Fellowships.

Public Health Relevance

This proposal will have public health importance because (1) it will increase mentoring of junior scientists interested in conducting patient-oriented research to improve care for vulnerable aging populations, and (2) it will inform interventions to improve sleep management in older homeless adults, in order to improve their quality of life and decrease worsening of geriatric conditions.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
2K24AG046372-06
Application #
10127435
Study Section
Neuroscience of Aging Review Committee (NIA)
Program Officer
Salive, Marcel
Project Start
2015-05-15
Project End
2025-12-31
Budget Start
2021-01-01
Budget End
2021-12-31
Support Year
6
Fiscal Year
2021
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
94143
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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