Focus on Urban Health

$56.8 Million for Advancing Urban Health


Story by Alana Klein Prisco
Photos by Philip Channing


A 35-year-old African-American male with sickle cell  anemia, a chronic blood disease, suffers a stroke in his downtown Los Angeles home. He does not have access to a specialty care facility for adults with sickle cell disease.

A 4’6” eight-year-old boy weighing 90 pounds has been diagnosed with diabetes. He lives in a pocket of East Los Angeles where 97 fast food restaurants exist within in a four-mile radius. Neither he nor his family has been educated on the importance of proper nutrition and exercise.

A 45-year-old woman who lives near a freeway − a hotbed for air pollutants like car exhaust − has developed a chronic cough and chest pain. Her two children, who love to play outdoors, have experienced shortness of breath and wheezing and are at risk for developing asthma.

These are people who suffer from some of the health issues plaguing our urban communities.

Health care is more than taking a pill. Armed with a $56.8 million grant from the National Institutes of Health, researchers at USC, along with a host of academic, clinical and community partners in central Los Angeles, will work to gain knowledge that they can translate rapidly to improved health for diverse populations living in urban areas.

FIRST IN l.A. The prestigious Clinical and Transla- tional Science Award, which will be distributed over the next five years, is the first such award funded in Los Angeles. It supports the expanded Los Angeles Basin Clinical and Translational Science Institute (CTSI), which was established in 2006 to promote scientific discoveries and their application in real-life settings and to improve public health and health care.

Faculty from eight USC schools and Children’s Hospital Los Angeles are partnering with Kaiser Permanente Southern California, the L.A. County health system, the Community Clinic Association of L.A. County and more than 30 community health organizations in greater Los Angeles to address the specific needs of the urban and diverse patient populations found in USC’s backyard, the Los Angeles Basin. Clinical activities also take place at USC University Hospital, USC Norris Cancer Hospital and Doheny Eye Institute.
 
“The CTSA is the pivot point on which new clinical research growth will turn,” says Keck School of Medicine Dean Carmen A. Puliafito, M.D., M.B.A. For example, the CTSA will foster new clinical programs in such areas as biomedical ethics, clinical informatics and outcomes research. 

With this award, USC joined a consortium of 55 academic health centers in 28 states and the District of Columbia that are developing new ways to advance medical research in many disease areas and conditions, including cancer, mental illness, neurological disorders, cardiovascular disease, diabetes and obesity.

Sidebar: What is Translational Medicine?

Sidebar: Putting Urban Health First



Funded by Clinical and Translational Science Awards, members of the consortium share a common vision to reduce the time it takes for laboratory discoveries to become treatments for patients, to engage communities in clinical research efforts and to train clinical and translational researchers.

“It’s a very competitive process to get funding at this level. We’re excited to have this opportunity to bring different people, departments, schools and institutions together to improve health,” says Thomas A. Buchanan, M.D., principal investigator and director of the CTSI. He is also associate dean for clinical research at the Keck School of Medicine of USC.

USC competed for the award against 38 other institutions. Only nine institutions received grant awards this year, and the NIH has stated that it plans to implement a maximum of 60 Clinical and Translational Science Awards overall.

The broad interdisciplinary scope of the program and the community-wide participation produced what Puliafito calls “an extraordinarily strong grant application.” The application received a score of 12 on a scale of 10 to 90, where 10 is a perfect score.

USC set itself apart from the competition by articulating the institute’s commitment to serving a diverse and urban population and forming unique local partnerships. “We positioned our CTSI as not only an institute focused on health research, but also as a partnership among some of the largest providers of health care in Los Angeles. We are working collaboratively with others on campus and off campus, using L.A. as a real world laboratory to address issues that are important to the community here,” Buchanan says.


“The outcome of the Clinical and Translational Science Institute is expected to be better health and wellbeing for the people of
California – a direct link to the goals of The California Endowment. We are pleased to partner with USC and other health and
community organizations in this innovative approach to translating research findings directly into better health for members of our urban community.”
– Robert K. Ross, M.D., President and CEO, The California Endowment

“We’re thrilled to partner with the CTSI in expanding the boundaries and possibilities of biomedical research. The moving image, whether in the form of film, television, animation or interactive media, is an incredibly powerful tool for reaching patients and doctors in the community, and influencing attitudes, beliefs and behaviors toward healthier lives.”
− Elizabeth Daley, Ph.D., Dean, USC School of Cinematic Arts



FASTER PACE  The CTSI’s ultimate mission is to connect basic scientists to clinical and community researchers and practitioners to accelerate the pace at which laboratory discoveries are translated into practice.

“It can take 20 years for the knowledge of a new discovery to get into general practice,” says Michele Kipke, Ph.D., associate CTSI director for community engagement and professor in the departments of Pediatrics and Preventive
Medicine at the Keck School of Medicine. “That’s just too long if you think of how quickly science evolves. What was effective 20 years ago is antiquated now.”

While the CTSI has already been successful at launching community research and interdisciplinary projects on a small scale, large-scale funding from the new NIH award will open the doors to development of a premier clinical and translational institute with the potential for a very large impact on health research and care.

“The Clinical and Translational Science Award provides the funding we need to expand to full capacity,” says Buchanan.

The CTSI has four main goals for this award. The first is to create an integrated academic environment that promotes and supports clinical and translational research. Eight schools – Medicine, Pharmacy, Engineering, Social Work, Law, Education, Cinematic Arts and Dentistry – are actively involved in the institute, as well as USC University Hospital and USC Norris Cancer Hospital. The CTSI provides a variety of resources and services that support interdisciplinary research and translation to clinical care.

Sidebar: CTSI Partners, CTSI Internal Oversight Board


The second goal of the CTSI is to develop new translational teams and projects. Using priorities aligned with the Keck School of Medicine strategic plan and the health needs of the surrounding community, the institute is developing and providing pilot funding to interdisciplinary teams to conduct basic, clinical and community research.

Some interdisciplinary projects are currently under way. For example, leveraging talent from the health sciences, engineering, cinema and informatics, faculty members have developed an interactive computer game that helps autistic children better interact on an emotional level, one of the deficits of those with the disorder.

“We’re not only developing innovative treatments, but also creating interactive ways (beyond what a health sciences enterprise would typically do) to achieve our goals,” says Carlos Pato, M.D., associate CTSI director for research development and chair of the Department of Psychiatry and Behavioral Sciences at the Keck School.

The third goal of the CTSI is to expand USC’s network of professionals conducting clinical and translational research. Resources are being applied to training new basic and clinical researchers in team science. Two new training programs will support predoctoral students, postdoctoral associates and junior faculty as they pursue training in translational research. The CTSI also is developing Web-based educational materials that will be accessible to faculty, trainees, staff and community partners.

“We want to train people to work in an environment where scientists and clinicians form teams to address important health problems, informed by the needs of our communities,” Buchanan says. “It is a paradigm shift that will require new skills to complement traditional scientific knowledge and training.”


“The Community Clinic Association of los Angeles County is excited to work with USC on its Clinical and Translational Science Institute. We look forward to working with USC on bridging the gap between community services and academia. The CTSI provides a structure through which we can learn  from each other.”
− Brian Nolan, CEO, Community Clinic Association of L.A. County

“This is a significant award that is going to further our goal of becoming los Angeles’ premier academic medical center. The research this money is funding will help train the next genera- tion of physicians and scientists, advance medical research, and translate our discoveries into better treatments for our patients. We will be seeing the positive effects of this clinical award for decades to come.”
−  Mitch Creem, M.H.A., Chief Executive Officer, USC University Hospital and USC Norris Cancer Hospital




ULTIMATE REQUIREMENT  The fourth goal is to share research findings with care providers, health organizations and policy makers. “This step is the ultimate requirement for translation,” Buchanan says. “This is why we have such a broad partnership of institutions and health organizations in the CTSI. Our partnership provides us with a real opportunity to improve people’s health.”

Currently, the CTSI has 30 community partners from a diversity of organizations, ranging from health practitioners from major health networks to nonprofits that help shape government policy. Many of these groups focus on a particular disease, demographic or cause.

“They are the eyes and ears of our community. They let us know what the health issues are, which can sometimes be different from what the academic community perceives them to be,” says Buchanan.

With three advisory groups in place that comprise community-based organizations, health care providers and USC faculty, respectively, the CTSI stays on top of the health priorities facing the community.

For example, in one quarterly meeting, a community partner brought up the issue of health literacy and the challenges that arise when a patient cannot understand how to manage his or her care because of a language barrier.

“This is complicated when you live in Los Angeles, where many different languages are spoken and where there are enormous disparities in peoples’ levels of education,” Kipke says. “How we receive information is often filtered through a cultural lens. You can’t hand people who can barely read the same literature you would give to someone with a high school diploma.”

As more and more local organizations are learning about the CTSI’s mission, they want to get involved. The center is also proactively reaching out to “people who are working in our communities that are in a position to take a leadership role in helping us improve the health of this population,” Kipke says. She expects to sign on more partners in the near future. •


“As a partner of CTSI, we collaborate and have a voice  to strategically plan together. As a member of several other collaborations, I was mostly impressed with  the diversity of this partnership, university, hospitals, other nonprofits and grassroots groups who have their pulse on their particular communities. We are honored to participate.”
− Sandra Figueroa Villa, Executive Director, El Centro del Barrio

“The creation of the CTSI is a matter of ethical, as well  as practical importance. Beyond looking at the ethics of clinical trials, the research ethics program within the CTSI aims to promote our ethical commitment to health research that truly makes a difference in people’s lives.”
−  Alexander Capron, L.L.B., Scott H. Bice Chair in Healthcare, Law and Ethics, USC Gould School of Law; Professor of Law and Medicine, Keck School of Medicine of USC


Sidebar: Translational leaders of Tomorrow



CTSI Leadership



PRINCIPAL INVESTIGATOR AND CTSI DIRECTOR

Thomas A. Buchanan,

M.D., associate dean for clinical research, professor of Medicine and chief of the Division of Endocrinology & Diabetes, professor of Obstetrics & Gynecology and Physiology & Biophysics, Keck School of Medicine of USC

ASSOCIATE CTSI DIRECTORS
Michele Kipke,

Ph.D., professor of Pediatrics and Preventive Medicine, Keck School, and Children’s Hospital Los Angeles

Carlos Pato,
M.D., Franz Alexander Professor and chair of Psychiatry, Keck School 

OFFICE Of COMMUNITY ENGAGEMENT

Director - Michele Kipke
,
Ph.D., professor of Pediatrics and Preventive Medicine, Keck School, and Children’s Hospital Los Angeles

OFFICE Of RESEARCH DEVELOPMENT

Director - Carlos Pato
,
M.D., Franz Alexander Professor and chair of Psychiatry, Keck School

CENTER FOR SCIENTIFIC TRANSLATION

Director - Roberta Diaz Brinton
,
Ph.D., R. Pete Vanderveen Chair in Therapeutic Discovery and Development, Professor of Pharmacology and Pharmaceutical Sciences, Biomedical Engineering and Neurology, School of Pharmacy

CENTER FOR HUMAN STUDIES

Director - Fred Sattler
,
M.D., professor of Medicine and Biokinesiology and chief of Infectious Diseases, Keck School

CENTER FOR BIOMEDICAL INFORMATION SCIENCES

Director - Carl Kesselman
,
Ph.D., professor of Industrial and Systems Engineering, USC Viterbi School of Engineering

CENTER FOR EDUCATION, TRAINING AND CAREER DEVELOPMENT

Director - Jonathan M. Samet
,
M.D., M.S., professor and Flora L. Thornton Chair, Department of Preventive Medicine, Keck School  

REGULATORY KNOWLEDGE AND SUPPORT PROGRAM

Director - Frances Richmond
,
Ph.D., professor of Clinical Pharmacy and Pharmaceutical Economics, School of Pharmacy, and director, Clinical and Regulatory Science, Alfred E. Mann Institute for Biomedical Engineering at USC

RESEARCH ETHICS PROGRAM

Director - Alexander Capron
,
L.L.B., University Professor, Scott H. Bice Chair in Healthcare, Law and Ethics, USC Gould School of Law, and Professor of Law and Medicine, Keck School
University of Southern California University of Southern California
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