# Project-003

> **NIH NIH P20** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2020 · $202,333

## Abstract

Multiple chronic conditions (MCC), defined as two or more co-occurring chronic conditions, occur frequently in
vulnerable adult patients such as those living in nursing homes or with end-stage renal disease. Vulnerable
adult populations with MCC have worse health outcomes and higher utilization of all types of health services
compared to those who do not have chronic conditions, and they are at higher risk of receiving inappropriate
and/or burdensome services (e.g., procedures, treatments, and hospitalizations) that are inconsistent with their
preferences. Medical complexity alone does not explain these differences; the issues vary on many
characteristics including race/ethnicity, acculturation, and living location. Furthermore, while most palliative
care is currently provided in acute care, it is recommended that interdisciplinary palliative care begin early for
any serious illness and be delivered across the continuum of health care settings. There are knowledge gaps
in key palliative care areas including how best to support symptom management, communication, and care
coordination; these knowledge gaps must be addressed to provide effective innovative interdisciplinary care
models in multiple health care settings for vulnerable adult patients with MCC to ensure they receive
appropriate care that is consistent with their preference . To address these gaps, the aims of the exploratory
P20 Center for Improving Palliative Care for Vulnerable Adults with MCC (CIPC) are to: 1) Develop a
sustainable infrastructure that supports interdisciplinary researchers to develop into transdisciplinary teams
that conduct biobehavioral, palliative care research across health care settings for vulnerable adults with MCC;
2) Develop new programs of biobehavioral, palliative care research for vulnerable adults with MCC led by
nurse scientists; 3) Enhance the knowledge and skills of participating investigators on transdisciplinary,
biobehavioral, palliative care research methods across health care settings for vulnerable adults with MCC and
disseminate new knowledge to relevant stakeholders; and 4) Evaluate the Center’s inputs, outputs, and
outcomes on an ongoing and annual basis and refine processes as needed. The CIPC is uniquely poised to
develop research capacity in this area. The partnership between Columbia University School of Nursing and
the Visiting Nurse Service of New York increases access of pilot project investigators to vulnerable urban
dwelling adults with MCC. The Enrichment Plan activities, which are informed by leading interdisciplinary
palliative care clinicians, along with support from the Pilot Administrative Core with vast scientific expertise
(e.g., mixed methods biobehavioral research in adults with MCC and biostatistics) and expert consultation with
the Palliative Care Research Cooperative, provide an excellent foundation in best practices for biobehavioral,
palliative care research. This foundation coupled with the robust research environment...

## Key facts

- **NIH application ID:** 9935170
- **Project number:** 5P20NR018072-03
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Dawn Dowding
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $202,333
- **Award type:** 5
- **Project period:** — → —

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9935170

## Citation

> US National Institutes of Health, RePORTER application 9935170, Project-003 (5P20NR018072-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9935170. Licensed CC0.

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