A Program of Interdisciplinary Clinical Services Research to Reduce Disparities in Access to Care: What Works, What Would Advance the Program Kathleen Ell School of Social Work

Funding and Interdisciplinary and Community Collaborators National Cancer Institute, National Institute of Mental Health, Centers of Disease Control and Prevention National Cancer Institute, National Institute of Mental Health, Centers of Disease Control and Prevention K. Ell, PI K. Ell, PI USC Oncology: D. Quinn, MD, L. Muderspach, MD, C. Russell, MD USC Oncology: D. Quinn, MD, L. Muderspach, MD, C. Russell, MD USC Psychiatry & Behavioral Science: B. Quon, MD, I. Lagomasino, MD; U Washington: M. Dwight-Johnson, MD, W. Katon, MD, J. Unützer, MD USC Psychiatry & Behavioral Science: B. Quon, MD, I. Lagomasino, MD; U Washington: M. Dwight-Johnson, MD, W. Katon, MD, J. Unützer, MD USC Endocrinology: A Harmel, MD, R. Mathur, MD USC Endocrinology: A Harmel, MD, R. Mathur, MD USC Anesthesiology: A. Ryan, MD USC Anesthesiology: A. Ryan, MD USC Pharmacy: J. Hay, PhD (Economics); M. Schoenbaum, PhD (RAND) USC Pharmacy: J. Hay, PhD (Economics); M. Schoenbaum, PhD (RAND) Medical Anthropology: L. Palinkas, PhD (SSW) Medical Anthropology: L. Palinkas, PhD (SSW) Biostatistics: B. Xie, PhD (SSW), J. Mintz, PhD (UCLA) Biostatistics: B. Xie, PhD (SSW), J. Mintz, PhD (UCLA) SSW: L. Cabassa, PhD SSW: L. Cabassa, PhD Community Clinical Research Collaborators: M. Royball, MD, (Roybal Cl), S. Leung, MD, (El Monte Cl), N. Gibbs, MD (Kaiser), M. Hoffing, MD (Desert Medical Group), S. Guller, MN (Sunplus Home Health) Community Clinical Research Collaborators: M. Royball, MD, (Roybal Cl), S. Leung, MD, (El Monte Cl), N. Gibbs, MD (Kaiser), M. Hoffing, MD (Desert Medical Group), S. Guller, MN (Sunplus Home Health) Research Training/Mentoring: NIH Minority Supplements to parent grants: I Lagomasino, MD, M. Aranda, PhD, K. Sanchez, PhD, A. Wells, Doctoral Student Research Training/Mentoring: NIH Minority Supplements to parent grants: I Lagomasino, MD, M. Aranda, PhD, K. Sanchez, PhD, A. Wells, Doctoral Student

Treatment and Clinical Services Research Efficacy designed to establish the effect of service or treatment Efficacy designed to establish the effect of service or treatment Effectiveness – test care delivered across broad range of populations in “real world systems”, can include anthropologic, cultural competency and cost-effective studies Effectiveness – test care delivered across broad range of populations in “real world systems”, can include anthropologic, cultural competency and cost-effective studies Practice – clinical epidemiology, quality of care, dissemination, cost-utility studies Practice – clinical epidemiology, quality of care, dissemination, cost-utility studies Health systems – organization, financing, resource allocation, utilization, and outcomes Health systems – organization, financing, resource allocation, utilization, and outcomes

Interdisciplinary Opportunities Illustrated by a Conceptual Framework of Clinical Services Research

Current Incentives and Resources Needed to Advance Interdisciplinary Research Favorable Funding Environment: NIH Roadmap Favorable Funding Environment: NIH Roadmap Overarching Aims: Fundamental discovery and translation - building blocks of biological systems, facilitating and training interdisciplinary research teams, re-engineering the clinical research enterprise and training the clinical research workforce, and facilitating translational research Overarching Aims: Fundamental discovery and translation - building blocks of biological systems, facilitating and training interdisciplinary research teams, re-engineering the clinical research enterprise and training the clinical research workforce, and facilitating translational research Recent PAs: Developing Centers for Innovation in Services and Intervention Research (Exploratory Center P20; PAR ); Biobehavioral Methods to Improve Outcomes Research (PA ); Advanced Centers for Innovation in Services and Intervention Research (PAR ) Recent PAs: Developing Centers for Innovation in Services and Intervention Research (Exploratory Center P20; PAR ); Biobehavioral Methods to Improve Outcomes Research (PA ); Advanced Centers for Innovation in Services and Intervention Research (PAR ) RFAs: Institutional Clinical and Translational Science Award (CTSA) (RFA-RM ); Planning Grants for Institutional CTSAs (RFA-RM ) RFAs: Institutional Clinical and Translational Science Award (CTSA) (RFA-RM ); Planning Grants for Institutional CTSAs (RFA-RM ) NIH research training initiatives NIH research training initiatives

Major Government and Private Foundation Reports Identifying Need and Pathways to Success Major Government and Private Foundation Reports Identifying Need and Pathways to Success USC Facilitating Factors USC Facilitating Factors Consistent with Strategic Plan Consistent with Strategic Plan Already Demonstrated Successful Centers/Programs Already Demonstrated Successful Centers/Programs Established Links to Community Health Systems and Community Partnerships Established Links to Community Health Systems and Community Partnerships Health Collaborative Health Collaborative Resources Needed Resources Needed Incentives for senior investigators to take time from what they are doing to advance an interdisciplinary effort Incentives for senior investigators to take time from what they are doing to advance an interdisciplinary effort Faculty Mentoring/Training, e.g., time and opportunity to work with existing successful investigators, programs Faculty Mentoring/Training, e.g., time and opportunity to work with existing successful investigators, programs Developmental Funding, e.g., pilot and supplementary studies Developmental Funding, e.g., pilot and supplementary studies