Mentoring Researchers in Advance Care Planning for Older Adults at Risk for Alzheimer’s Disease and Related Dementias and their Caregivers

The aims of this proposal are to (1) enable the candidate to further develop her research program focused on improving advance care planning (ACP) and medical decision making for older adults, particularly individuals and persons with limited health literacy; (2) expand her research to older persons with mild cognitive impairment (PMCI) at risk for Alzheimer’s Disease and Related Dementias (ADRD) and caregivers of PMCI or ADRD; and (3) use her research platform to mentor junior investigators interested in patient-oriented aging research, both within Geriatrics and other subspecialties. The candidate is a Geriatrician and Palliative Medicine physician who has established a well-funded, high-impact, independent clinical research program with an outstanding publication and mentoring record. In the past decade, she has established herself as a successful mentor of students, residents, fellows, and junior faculty who have published high-impact aging research, become successfully funded, and continue to participate in patient-oriented research in aging. The candidate has also developed an extensive research portfolio focused on creating and testing literacy-appropriate health education materials to improve ACP and medical decision making for older adults. She developed an expanded ACP paradigm that focuses not only on one-time treatment decisions, such as for cardiopulmonary resuscitation (CPR), but also on the process of preparing patients and caregivers to communicate their wishes and to participate with clinicians in making complex, in-the-moment medical decisions over time. She operationalized this expanded paradigm into easy-to-understand, person-centered programs (i.e., PREPARE for YOUR Care for patients and PREPARE for THEIR Care for caregivers) that use video stories to teach people how to identify and communicate their medical preferences and to make informed medical decisions. The candidate has received ongoing R01 and other funding to test the efficacy of these programs in primary care settings. This K24 proposal will provide the candidate with protected time to expand her research in a new direction. Grounded in implementation science frameworks and community-engaged research, the candidate will conduct research to adapt the PREPARE programs with and for PMCI and caregivers and test the acceptability of a new delivery model of online, livestreaming, facilitated group classes. The candidate will also continue to develop her formal mentoring program with plans for the recruitment, selection, development, and evaluation of mentees who will become leaders in aging research. She will work with each mentee to establish an individualized 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 the University of California, San Francisco (UCSF). She will leverage her leadership positions at UCSF and nationally to recruit mentees interested in aging research and ACP.