ABSTRACT: The growing population of older adults with advanced cancer experiences significant public health problems, including steep declines in quality of life, receipt of care that does not reflect patients' values and preferences, and high rates of caregiver burden. Inadequate attention to patient priorities and age-related concerns (e.g., function, cognition, and social support)—contribute to morbidity in this population. The emerging field of geriatric palliative care seeks to address age-related concerns and align care with patient goals over the trajectory of chronic and serious illness. The overarching goal of this K24 proposal is to enhance the candidate's mentorship of students, fellows, and junior faculty pursuing geriatric palliative care research, with a particular focus on identifying unmet geriatric palliative care needs and developing and testing interventions to improve quality of life and goal-concordant care for older patients with advanced cancer. As a successful mid-career investigator with a track record of leading successful palliative intervention trials with seriously ill older patients, the candidate is well-positioned to mentor the next generation of aging researchers. This award will leverage an outstanding longitudinal dataset of over 400 audio-recorded `primary' palliative care visits with older patients with advanced cancer and longitudinal patient- and caregiver-reported outcomes to explore optimal geriatric palliative care intervention designs. The research aims are to (1) characterize communication about age-related concerns in primary palliative care visits with older adults with advanced cancer and their family caregivers; (2) identify missed opportunities for addressing age- related concerns in primary palliative care visits for older adults with advanced cancer and their family caregivers; and (3) refine a conceptual model for primary palliative care delivery that incorporates age- related concerns and can be optimized to improve quality of life for older adults with advanced cancer. The K24 award will provide protected time for the candidate to update and expand her mentorship program, building bridges between researchers in geriatrics, palliative care and oncology. She will leverage outstanding aging research and mentoring resources available at the University of Pittsburgh; learn new skills to foster inquiry, wellbeing and resilience among trainees; and create a Junior Faculty Visiting Professor Program for geriatric palliative care researchers. This proposal is significant and innovative because it will support new clinical investigators using novel mentoring techniques and develop pilot data to inform large-scale trials addressing deficiencies in quality of care for a burgeoning population of older adults with advanced cancer. It is highly feasible because the candidate is a committed mentor with ongoing R01 funding, from an outstanding research environment with strong geriatrics programs and a large po...