Research Projects

Research projects at ZSFG Division of General Internal Medicine

Kirsten Bibbins-Domingo, MD

All of Us Research Program National Sexual and Gender Minority (SGM) Engagement Network
San Francisco General Hospital Foundation
The major goal of this grant is to engage SGM communities in the All Of Us Precision Medicine Initiative.

Role: Principal Investigator

Hypertension Management in Minority and Low Income Populations
NIH NIDDK                                                                              
This proposal seeks to develop effective hypertension control interventions in safety-net settings caring for race/ethnic minority patients with complex co-morbid conditions including chronic kidney disease and diabetes, and to use computer simulations to evaluate these interventions for their population impact on disparities.  This proposal enhances the career development of the PI, while allowing her to develop a rich training environment for junior investigators from a range of disciplines.
Role: Principal Investigator 

SF State BUILD: Enabling Students to Represent in Science
NIH/NIMHD
Goals: Collaborative efforts between UCSF CVP and SFSU to enhance the academic qualifications of the underrepresented minority BUILD scholars and also promote faculty exchanges between the two institutions, thereby transforming both institutions, and strengthening the existing long-term partnership.
Role: Principal Investigator at UCSF

UCSF CTSI NRSA Training Core
NIH-NCATS 
The fundamental goal of the UCSF Clinical and Translational Science Institute TL1 Training Program is to provide pre-doctoral and post-doctoral fellows with the methodological, analytic, leadership, and team science skills required to conduct transformative clinical and translational research relevant to precision health.
Role: Principal Investigator

UCSF Research Implementation Sciences for Equity (RISE)
NIH/NHLBI
Goals: UCSF-RISE will provide outstanding didactic training, research experiences, and on-going research mentoring in ImS for URM faculty and senior fellows focused on cardiovascular or pulmonary disease research, leveraging the considerable expertise in training in ImS here at UCSF. These research skill building activities will be paired with an innovative career development program that includes critical activities of importance for this career stage (including manuscript and grant writing) delivered by successful, NIH-funded investigators who lead this project (including senior URM faculty) and drawing on the broader base of outstanding researchers in cardiovascular and pulmonary diseases at UCSF.
Role: Principal Investigator 

Alicia Fernandez, MD

Making a Difference in Real-World Bioethics Dilemmas
The Greenwall Foundation
The major goal of this project is to identify and resolve the emerging or unanswered bioethics problem in clinical care, biomedical research, public health practice, or public policy.
Role: Principal Investigator

Mentoring in the Context of Improving Care for Latinos with Diabetes
NIH/NIDDK
The major goals of this project are to support the expanded mentoring of early career investigators--from every level of the training pipeline--in clinical and health services research dedicated to improving outcomes for low-income Latinos with diabetes, and also support a research project on determining Latino diabetes patients' role in overcoming language barriers in health care.
Role: Principal Investigator

NIH Building Infrastructure Leading to Diversity (BUILD)
San Francisco State University
The major goals of this project are to establish networks to create opportunities for SF BUILD Scholars to engage in health equity research with diverse faculty at UCSF, and to enhance career development opportunities and collaboration for minority faculty through a cross-institutional forum at both UCSF and SF State.
Role: Co-Principal Investigator

UCSF Research in Implementation Sciences for Equity (RISE)
NIH/NHLBI
The major goals of this project are to train and sustain underrepresented minority (URM) fellows and junior faculty from across the US and Puerto Rico for long-term success in academic careers pursuing innovative research in cardiovascular or pulmonary diseases, and to prepare scholars to conduct innovative research and compete successfully for independent research funding.
Role: Principal Investigator

Valy Fontil, MD

Bring It Down San Francisco: Harnessing Cloud-Based Technology To Improve Hypertension Management In A Low-Income Underserved Population
National Institute of Health
The research objectives in this application builds on Dr. Fontil's previous work to: 1) examine provider-dependent (which are in part system-level factors) and  patient-dependent processes that may limit BP control in a low-income, racially diverse population, (2) model potential impact of optimizing these processes in a virtual population of Black patients at safety-net clinics, and (3) address two processes known to be problematic – imperfect medication intensification and inadequate visit frequency – by pilot-testing the feasibility of a technology-enabled HTN intervention (based on BID-SF) that helps doctors and patients collaborate on choosing best options for treatment intensification.
Role: Principal Investigator

Leigh Kimberg, MD

Aspire to Realize Improved Safety and Empowerment (ARISE)
DHHS Office of Women’s Health (OWH)
The study aims to transform the interpersonal violence (IPV) programs in 17 primary care clinics in the San Francisco Health Network by implementing sustainable collaborative interventions with leading community IPV and legal organizations in order to empower survivors of IPV and, ultimately, reduce IPV. We will evaluate the impact of ARISE on IPV care measures, patient safety behaviors and other secondary patient outcomes. ARISE will employ the RE-AIM framework to determine ARISE’s success, and assess its external validity and exportability.
Role: Principal Investigator

Margot Kushel, MD

Aging Among the Homeless:  Social Isolation, Function and Institutional Care
NIH/NIA
The major goal of this grant is to establish a cohort of 350 homeless adults aged 50 and older and examine geriatric conditions, health and healthcare outcomes through a life course perspective in order to improve the delivery of clinical services and align policies and programs with the needs of this high risk population.
Role:  Principal Investigator

Community Health (ECROP)
Examining the Consequences of Opioid Restrictions on Patients, Clinical Care, and Community Health
NIH 
We propose to conduct a qualitative study examining the consequences of reductions in opioid prescribing for chronic non-cancer pain (CNCP). The study will recruit CNCP patients with a history of substance use (past or current) who access healthcare in low income, safety-net clinical settings, their primary care clinicians, and community stakeholders. Study results will improve our understanding of the positive and negative consequences of reductions in opioid prescribing on patients, clinical care delivery and community health to inform clinical and policy recommendations.
Role: Co-Principal Investigator

Family-assisted Housing for Older Homeless Adults
NIH/NIA
The major goals of this grant are to use qualitative research methods and ethnography to understand barriers to and facilitators of re-housing older homeless adults (aged 50 and older) with members of their family, via in-depth interviews and ethnographic observations with older homeless adults, family members and key informants
Role:  Co-Principal Investigator

Mentoring Researchers in Aging in Vulnerable Populations
NIH/NIA
Dr. Kushel’s goals for this grant are to (1) Perform rigorous patient oriented research aimed at improving our understanding of aging in vulnerable populations, with a particular focus on older homeless adults; (2) Use her research as a platform for mentoring junior patient-oriented researchers in aging in vulnerable adults.
Role: Principal Investigator

PFS Housing First Initiative
Abode Services
The major goals of this grant are, in a randomized controlled trial, to assess outcomes (housing, health care utilization, use of social services) in chronically homeless adults randomized to permanent supportive housing versus usual care.
Role: Co-Investigator

Courtney Lyles, PhD

Engaging Diverse Patients in Using an Online Patient Portal
Agency for Healthcare Research and Quality
The major goals of this project are to employ qualitative and implementation science skills to understand barriers to electronic health records and to design a new approach to patient engagement and to apply these rigorous approaches within an integrated delivery system with a mature electronic system (Kaiser Permanente Northern California) and a safety net public hospital system currently implementing an online patient portal (San Francisco General Hospital, SFGH).
Role: Principal Investigator

Overcoming Health Disparities by Engaging Patients with the Personal Health Record, MYSFHEALTH
NIH / NLM
We have established a partnership between UCSF researchers and the San Francisco General Hospital (SFGH) Library to develop educational curricula to teach patients how to access their own health information in MYSFHEALTH, a new online personal health record within the city and county of San Francisco. Once the curriculum is finalized, we plan to test its effectiveness with a selected population of patients at SFGH and San Francisco Public Libraries.
Role: Principal Investigator

ASPIRE: Advancing Safety Process Innovation in Rheumatology
Agency for Healthcare Research & Quality
This grant proposal seeks to inform the development of eMeasures – including the Quality Data Model (QDM), Health Quality Measures Format (HQMF) and other structured coded terminologies   a new approach to quality measurement that uses automatically extracted EHR information to give clinicians and health systems information regarding specific patient safety problems. HIT-solutions such as eMeasures that can be applied across EHR data repositories serve as a foundation for a continuous learning health care system, as envisioned by the Institute of Medicine. The work proposed here builds the groundwork for further testing and nationwide dissemination of eMeasures to monitor and improve safety for those using high-risk medications in the ambulatory setting.
Role: Co-Investigator

Improving Diabetes and Depression Self-Management via Adaptive Mobile Messaging
NIH / NIDDK
This grant proposal seeks to develop and test a personalized motivational text messaging intervention to improve management of co-morbid diabetes and depression with an emphasis on low-income populations. The findings from this study will aid in the development and dissemination of mobile health tools for chronic illness management in diverse patients.
Role: Co-Principal Investigator

Tablet Research to Improve Understanding of Medications for People's Health (TRIUMPH)
Kaiser Foundation Research Institute
This proposal aims to design a tablet application in the waiting room to improve patient provider communication for complex patients with diabetes on many medications. We will design a simple-to-use tablet application that will educate patients about the importance of bringing up medication concerns at the beginning of the visit and collect current medication concerns that can be shared in real-time with providers during in-person visits.
Role: Co-Principal Investigator

Tech Allies
Little Brothers Friends of the Elderly
In partnership with Little Brothers Friends of the Elderly, the Tech Allies program aims to train older adults to learn to use a tablet in their home.  Specifically, isolated older adults are matched with a volunteer who provides one-on-one tablet training for at least 8 weeks. More information can be found here.

The Next Frontier in Diabetes Communication: Promoting Health Literacy in the Era of Secure Messaging
NIH / NLM
Limited health literacy places individuals at greater risk of type 2 diabetes and its complications, making limited health literacy a critical clinical and public health problem. As healthcare becomes increasingly dependent on electronic communications, patients with limited health literacy may have difficulty communicating by email with their clinician or understanding the clinician’s emailed replies or instructions. This proposal will use computational linguistics to examine how diabetes patients with a variety of health literacy levels interact with their clinicians via patient portals, will explore whether linguistic gaps between patients and clinicians are associated with diabetes outcomes, and will create a feedback tool to assist clinicians to better accommodate diabetes patients’ communication needs.
Role: Co-Investigator

Nynikka Palmer, DrPH, MPH

Constructing a Relational Bridge to Achieve High-Quality Prostate Cancer Care for African Americans
National Cancer Institute
This study aims to mitigate the perfect storm of complex treatment options and constraints in communication by constructing a relational bridge between low income African American men and equal prostate cancer treatment, using peer navigation as a means to foster trust and empowerment and optimize patient-centered communication and quality of care.
Role: Principal Investigator

Neda Ratanawongsa, MD

Improving medication decision-making by integrating adherence data in a safety net EHR
AHRQ
Through this K08 career development award, I work with my primary mentor, Dr. Dean Schillinger, to develop a career as an independent investigator in health informatics implementation research, focused on enhancing patient medication adherence, shared decision-making, and patient-important outcomes for safety net populations with chronic diseases, such as diabetes.

Urmimala Sarkar, MD

Building an Ambulatory Patient Safety Learning Laboratory for Diverse Populations: The San Francisco Ambulatory Safety CEnter for iNnovaTion (ASCENT)
PHS Agency for Healthcare Research & Quality
In outpatient health care settings like physicians’ offices, there are significant risks to patients’ safety, including delays in diagnosis and treatment which result in disease progression, preventable complications of treatment, and adverse drug events. Few systems exist to recognize and ameliorate such patient safety problems, and the overall aim is to design, develop, test, and evaluate innovative solutions to improve patient safety.
Role: Principal Investigator

Improving Survivorship Care for Diverse Cancer Patients Cared for in Safety-net Settings
NIH NCI
The goal of this mid-career development award is to strengthen Dr. Sarkar’s mentoring of early career researchers focused on cancer survivorship care in safety net settings serving diverse populations. In alignment with mentoring plans, mentored research activities will address gaps in survivorship care through root cause analysis, the role of survivorship care plans for diverse patients living with colorectal, prostate, and breast cancers, and the use of implementation science methods to initiate development of a health information technology-enabled care coordination tool informed by stakeholder input on challenges in post-treatment/ survivorship care.
Role: Principal Investigator

Influencing Cervical Cancer Prevention and Detection Online through Social Media
NIH NCI
This study is a mixed-methods approach to online social media and social networks for enhancing understanding of cervical cancer screening in order to optimize the spread of health messages and behaviors within online social networks.
Role: Principal Investigator

Investigating Failures of Notification and Monitoring in Outpatient Care: Safety Promotion Action Research and Knowledge (SPARK) Network
PHS Agency for Healthcare Research & Quality
The long-term goal of this research is to reduce adverse events and errors in outpatient health care. This project is focused on approaches to measure and characterize adverse events in result notification and ongoing monitoring for high risk health conditions in safety net health care systems that care for diverse patient populations, including low-income and race/ ethnic minority groups. We aim to measure the extent of disparities in patient safety in ambulatory care settings and ways to understand underlying reasons for these disparities.
Role: Principal Investigator           

Patient Safety Network and Web Morbidity and Mortality
PHS Agency for Healthcare Res & Quality
The goal is to maintain excellence of current PSNet and WebM&M websites while focusing on a series of enhancements to existing features and activities.  We seek to disseminate both sites to an broader audience, leveraging additional partnerships and collaborations, as well as new technological capabilities – both through social media and by optimizing the sites to be used on a variety of platforms. 
Role: Co-Investigator

The Health ePeople Resource for Mobilized Research
NIH NIBIB
We seek to create the Health ePeople Resource, a mobilized cohort and infrastructure to carry out research using mobile and digital technology as well as to study mobile health itself. The Resource will develop a cohort of 1,000,000 volunteer participants who have consented to provide data to the resource and participate in research. The Resource will also develop tools for researchers to rapidly conduct research using this cohort or collect new data on an existing cohort.
Role: Co-Investigator

Improving Diabetes and Depression Self-Management via Adaptive Mobile Messaging
PHS Agency for Healthcare Research & Quality

The goal is to use adaptive text messaging to help patients with both depression and diabetes increase their physical activity rates.
Role: Co-Investigator

Dean Schillinger, MD

The Next Frontier in Diabetes Communication: Promoting Health Literacy in the Era of Secure Messaging
NIH NLM 
Limited health literacy places individuals at greater risk of type 2 diabetes and its complications, making limited health literacy a critical clinical and public health problem. As healthcare becomes increasingly dependent on electronic communications, patients with limited health literacy may have difficulty communicating by email with their clinician or understanding the clinician’s emailed replies or instructions. This proposal will use computational linguistics to examine how diabetes patients with a variety of health literacy levels interact with their clinicians via patient portals, will explore whether linguistic gaps between patients and clinicians are associated with diabetes outcomes, and will create a feedback tool to assist clinicians to better accommodate diabetes patients’ communication needs.
Role: Principal Investigator

The HMO Research Network – University of California San Francisco Center for Diabetes Translational Research (CDTR)
NIH NIDDK; Kaiser Foundation Research Institute
The goal is to continue and expand the work of the Health Delivery Systems Center for Diabetes Translational Research, a collaborative partnership between the Kaiser Permanente Northern California’s Division of Research, HealthPartners Institute for Education and Research, Harvard Pilgrim Health Care Institute, and the University of California San Francisco.
Role: Site PI; Director of National Diabetes Safety Net Resource Program

Building an Ambulatory Patient Safety Learning Laboratory for Diverse Populations:The San Francisco Ambulatory Safety CEnter for iNnovaTion (ASCENT)
AHRQ
In outpatient health care settings like physicians’ offices, there are significant risks to patients’ safety, including delays in diagnosis and treatment which result in disease progression, preventable complications of treatment, and adverse drug events. Few systems exist to recognize and ameliorate such patient safety problems, and the overall aim is to design, develop, test, and evaluate innovative solutions to improve patient safety.
Role: Co-Investigator

Diabetes screening and care received by the mentally ill in an integrated system
NIH/NIDDK
The goal of this application: the first step toward attaining the long-term goal is to understand the diabetes monitoring and care received by racially and ethnically diverse populations with severe mental illness in an integrated care delivery system.
Role: Co-Investigator

Health Literacy Systems in the Safety Net: Lessons from Complex Care Management
NIH NINR
To provide an ethnographic description of the interactions, processes, and organizational arrangements of two chronic care programs that contribute to patients’ health literacy, retention in the clinical care system and fulfillment of their social and medical needs. As a result of this work, we will elaborate a conceptual framework linking organizational HL attributes to patient engagement.
Role: Co-Investigator

Implementing The Bigger Picture Campaign into Low-Income High Schools via the CATCH Program
James L Irvine Foundation Impact Fund
Through our CATCH intervention, The Bigger Picture will partner with SFUSD schools and collectively work towards “making heath a shared value." The CATCH intervention aims to improve health equity, build a culture of health among SFUSD participants and promote type 2 diabetes prevention. Our workshop programming and assemblies are rigorously designed to evaluate changes in high school students’ mindsets and expectations towards understanding the social and environmental drivers of type 2 diabetes among youth and youth of color.

Role: Co-Investigator

Improving Advance Care Planning by Preparing Diverse Seniors for Decision Making
NIH NIA
This project will determine the efficacy of a novel, patient-centered, multi-media website called PREPARE. PREPEARE is focused on preparing ethnically diverse, older adults to communicate their wishes with surrogate decision makers and clinicians and to make complex medical decisions over the course of serious and chronic illness. This project will result in a practical advance care planning guide that will be easy-to-use and disseminate and result in diverse, older adults who are prepared for complex medical decision making.
Role: Co-Investigator

Investigating Failures of Notification and Monitoring in Outpatient Care: the Safety Promotion Action Research and Knowedge (SPARK) Network
AHRQ
The overall goals of this proposal are to examine the epidemiology of patient safety in ambulatory care settings that care for diverse, low-income populations as follows; (1) to characterize the incidence and prevalence of specific safety gaps, by race/ ethnicity and language proficiency; (2) to gather in- depth, qualitative evidence about strategies that can improve safety and characterize disparities in patient safety; (3) to pilot-test patient safety monitoring methodologies in a diverse sample of five safety net health care systems; and (4) to develop a measurement and error investigation toolkit for dissemination amongst safety-net health care systems.
Role: Co-Investigator

Testing combinations of population interventions to encourage healthy eating
NIH NIDDK
In Aim 1, we will conduct a prospective evaluation of a population-wide SSB tax in both tax-affected and matched unaffected CA counties. We will identify changes to both beverage and food consumption and purchasing, food substitution patterns, spillover to neighboring areas, effects of marketing, and any regressive economic effects for low-income populations. The longer-term follow-up period enabled by our design will test the hypothesis that a SSB tax produces sustained declines in SSB consumption rather than merely short-term effects followed by a return to pre-tax consumption. Uniquely, we will then test complementarity between the tax and other interventions in Aims 2 and 3. In Aim 2, we will examine the complementarity of the SSB tax with a fruit and vegetable voucher program. Some SSB tax-affected and distant tax-unaffected counties have introduced fresh fruit and vegetable purchasing vouchers, which enable low-income families facing food insecurity to purchase fruits and vegetables at major supermarkets and corner stores in the area, not just at farmer’s markets. We will test the hypothesis, supported by our preliminary data that pairing the purchasing penalty of an SSB tax with a purchasing incentive of a fruit and vegetable voucher improves upon the modest effect of either intervention alone. In Aim 3, we will identify the complementarity between the SSB tax and a workplace SSB purchasing ban, implemented in some workplaces but not others during tax-affected and -unaffected periods.
Role: Co-Investigator

Research Training at the Confluence of Infectious and Non-Communicable Diseases in India
NIH Forgarty Intern’l Center
The goal of the 5-year Global Infectious Diseases (GID) training grant proposal is to establish a research and training program in India focused on the study of the interaction of infectious diseases with non-communicable diseases such as diabetes. Dr. Schillinger will serve on the NCD leadership team.

Hilary Seligman

Eat SF!
Hellman Family Collaborative Change
This grant allows implementation of EatSF!, a fruit and vegetable voucher program for low-income residents of San Francisco. Vouchers in the value of $20-40 per month are redeemable at local corner stores and participating grocery stores in a neighborhood-based vendor networkEatSF was been established in support of San Franciscos citywide goal of being hunger-free by 2020.
Role: Principal Investigator

Randomized Control Trial on Diabetes in Food Banks
Feeding America
The goal of this project is to evaluate the effectiveness of implementing diabetes monitoring, self-management support, primary care coordination, and diabetes appropriate food to improve glycemic control among food pantry clients with diabetes.  This study is implemented in collaboration with Feeding America, which holds the primary grant although Dr. Seligman functions as PI.
Role: Principal Investigator

Senior Medical Advisor and Lead Scientist
Feeding America
The major goal is lead the development and design of  Feeding America’s research agenda related to food insecurity, poverty, nutrition, health and other related social policies, and to support the translation, implementation and dissemination of research, community health and nutrition insights into policy strategies and initiatives.
Role: Principal Investigator

UCSF Prevention Research Center
Centers for Disease Control and Prevention
Two distinct projects: (1) Coordinating Center for the CDC’s Nutrition and Obesity Policy Research and Evaluation Network; (2) Implementation of nutrition policies through the Feeding America network of food banks by examining barriers to and opportunities for distribution of healthier foods, establishing policies and goals for produce distribution, and developing a protocol for food banks to monitor client dietary intake.
Role: Principal Investigator (supplement)

Designing Food Voucher Programs to Reduce Disparities in Healthy Diets
NIH/NHLBI
The major goal is to design, coordinate and maintain food voucher programs in order to reduce disparities in health diets. This multi-center, randomized, controlled trial examines strategies for supporting healthy dietary intake using incentive programs and estimates their impact on long-term development of cardiovascular disease.
Role: Co-Investigator

Wagahta Semere, MD

Caregiving for Patients with Diabetes in the Era of Online Patient Portals: Findings from the ECLIPPSE Study
NIH/NLM
This project aims to (1) To develop and validate a novel method for analyzing the content of secure messages (SMs) between patients with diabetes and their clinicians, in order to distinguish when a “proxy” (son/daughter, spouse, relative, parent, or other caregiver) communicates on behalf of the patient vs. when the patient self-generates the SM; (2) To characterize the prevalence and distribution of proxy (both formal and informal) SM use within patients’ SMs and examine the socio-demographic, communication and clinical characteristics of proxy versus non-proxy patients; (3) To compare the quantity, intensity, function, and content of SMs written by proxies vs. those of SMs written by non-proxies.
Role: Supplement Candidate                                  

Champion Providers
California H&W Dept of Health Care Services
The Champion Providers initiative builds on the pilot started in 2013 to harnesses the influence, power and respect of health care providers to build healthier communities. The program trains and supports motivated physicians and dentists throughout the state to add their professional influence and experiences to mitigate today's unprecedented obesity epidemic through policy, systems and environmental changes. By connecting physicians and dentists with their local health departments, community coalitions and other organizations, Champion Providers assist in addressing a range of local health concerns, ranging from access to healthy foods, increased opportunities for physical activity and other obesity prevention efforts, especially in low-income communities.
Role: Co-Investigator 

Planning for the Evaluation of Managed Long-Term Services and Support
California H&W Dept of Health Care Services
This project aims to report on the readiness of integrated 20110-2016 dataset to analyze transition into managed Long-Term Services and Support (LTSS) and this policy’s impact on the use of LTSS, acute and subacute services; report on the readiness of the managed care data for analyses of post-MLTSS outcomes comparing those in Cal Medi-Connect and those who are not; report on the compare the change in outcomes from pre- to post-LTSS for Seniors and Persons with Disability (SPD) beneficiaries who enroll in managed LTSS and compare these to the change in outcomes for a comparable time period for beneficiaries who do not enroll in managed LTSS.
Role: Co-Investigator

Vanessa Thompson, MD

Champion Providers
California H&W Dept of Health Care Services
The Champion Providers initiative builds on the pilot started in 2013 to harnesses the influence, power and respect of health care providers to build healthier communities. The program trains and supports motivated physicians and dentists throughout the state to add their professional influence and experiences to mitigate today's unprecedented obesity epidemic through policy, systems and environmental changes. By connecting physicians and dentists with their local health departments, community coalitions and other organizations, Champion Providers assist in addressing a range of local health concerns, ranging from access to healthy foods, increased opportunities for physical activity and other obesity prevention efforts, especially in low-income communities.
Role: Principal Investigator    

Maya Vijayaraghavan, MD

A Smoke-free Home Intervention in Supportive Housing
Tobacco Related Disease Research Program
In partnership with 6 large supportive housing agencies in the San Francisco Bay Area, we will examine the barriers to and facilitators of implementing smoke-free policies in supportive housing and develop and implement a brief intervention to increase adoption of smoke-free homes among tenants of supportive housing. 
Role: Principal Investigator

Risk perceptions, response to marketing, and poly-tobacco use among homeless
Resource Allocation Program, UCSF

The major goals of this project are to obtain information on poly-tobacco use among homeless adults to inform the U.S. Food and Drug Administration in its regulatory authority and in developing anti-tobacco messages to communicate the harms of tobacco use to homeless adults.
Role: Principal Investigator

Ending tobacco use in high risk, low income smokers
Tobacco Related Disease Research Program
This project develops a community practice-based research collaborative involving San Francisco’s safety-net primary care network and a large community-based behavioral health services provider, with the aim of more effectively addressing smoking in low income populations.
Role: Co-Investigator

SF-CAN Tobacco Task Force
University of California, San Francisco

SF CAN is a partnership involving the San Francisco Department of Health and UCSF Cancer Center investigators, designed to reduce cancer incidence in the San Francisco Community.  Dr. Vijayaraghavan is one of the co-leaders of Thread 1 of SF CAN, which addresses smoking in primary care, addiction treatment, and homeless service populations.
Role: Co-Investigator

Teach Together: 5A's Implementation and Fidelity in Urban and Rural FQHC's
NIH/NIDA

Although the 5A’s for smoking cessation is an accepted standard of care, national data show that most primary care providers fail to adhere to the full intervention guidelines. This NIDA-funded implementation science R01 tests the use of a hybrid delivery model for the 5A’s in primary care that could improve intervention fidelity, save clinician time, and still utilize the social influence of the provider. This model is being tested in a randomized-controlled trial at 3 UCSF primary care clinics. Primary outcomes include 5A’s fidelity and factors that influence the adoption of technology in medical settings.
Role: Co-investigator