Projects to Advance Integrative Health Equity throughout the Osher Center FY25-26

Crowd-sourcing innovative ideas to support and improve access to integrative health through cross-program collaboration to benefit the Osher Center for Integrative Health community.

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Enhancing Equity in Long COVID Management Through Integrative Medicine Education

Submitted by Carla Kuon on April 10, 2025 - 6:26pm Last revised by Carla Kuon on May 27, 2025 - 5:38pm.
Project Idea Status: 
Open

 

Names of Project Lead(s) and Key Team Members

  • Project Lead: Carla Kuon, MD; University of California at San Francisco (clinic, education)
  • Supervisor: Dr. Kavita Mishra
  • Key Team Members:
    • Michael Peluso, MD, MPh, MHS; Zuckerberg San Francisco General Hospital (clinic, research)
    • Nikki Gentile, MD, PhD; University of Washington (education and research)
    • Kathryn Hansen, ANP-BC; Vanderbilt University
    • Iman Majd, MD, LAc; University of Washington
    • Aiko Bailey, LAc; University of Washington
    • Wu-Hsun Tom Yang, ND, LAc; University of Washington
    • Other collaborators from the Long COVID Interest Group (affiliated with the International Congress on Integrative Medicine and Health).

Project Description: (1 page maximum)

Project significance and innovation: Higher prevalence of Long COVID has been associated with female gender, Hispanic origin, the presence of a disability, low socioeconomic status, nonurban residence, and other factors. 1-4 These populations face higher rates of infection, limited access to specialized care, and prolonged disability, economic hardship, and productivity loss. Lack of familiarity with integrative medicine approaches—effective for managing symptoms such as fatigue, brain fog, persistent pain, and emotional stress—among clinicians further limits exposure to these helpful modalities, exacerbating existing health disparities.

This project addresses these disparities by increasing access to integrative care through evidence-informed educational resources in English and Spanish. Deliverables include (1) Flipped classroom modules with REDCap pre- and post-training evaluations to measure changes in clinician knowledge, confidence, and competency, and (2) creation of patient-facing video content with Spanish captioning for patients with Long COVID describing dietary changes, supplement use, pacing, addressing post-exercise fatigue, mind/body techniques, symptom management (3) patient-facing printable materials in both Spanish and English, published online at the Osher website for widespread access.

Video Content : A set of 3, 50-minute videos will be created for patients in English (with English and Spanish captions), addressing the following holistic health interventions detailed below.

  1. Nutrition: The anti-inflammatory diet and the low-histamine diet will be explained in detail.  Dietary modifications of autoimmune conditions are addressed. The five “superfoods” will be explained: anti-inflammatory vegetables, antioxidant-rich foods, omega-3-rich foods, spices, and cooked mushrooms.  Additionally, avoidance of inflammatory foods such as sugar, processed meats, and dairy will be detailed. 
  2. Supplement /nutraceutical use: Correcting low vit D and iron stores, use of mitochondrial supplements such as riboflavin, L-carnitine, Quercetin, fish oil, magnesium, and use of NAC or glutathione antioxidants will be explained. Use of LDN will be explained.
  3. Exercise: Post-exertional malaise can be addressed via pacing, restorative recumbent exercise according to Dysautonomia International Protocols.
  4. Mind-body: Techniques to address dysautonomia and runaway stress, including a 4-7-8 breath experiential, mindfulness, guided imagery, and gentle yoga, will be discussed. Vagal toning exercises and emerging evidence for TVNS (transcutaneous vagal nerve stimulation) will be discussed.

Patient-facing educational materials:

A set of 3 patient-facing educational handouts will be created in both English and Spanish to accompany the video content, detailing the four holistic interventions detailed above. Of note, these interventions are covered in the Osher Long COVID Group Medical visit (LC-GMV) series.  Once published, they would be available to patients in ZSFGH and also to Osher patients,  including those enrolled or waiting to enroll in the LC-GMVs at Osher. 

Clinician-facing educational materials:

A set of two 60-minute educational videos for clinicians will be created in English with English captions for the hearing impaired, followed by a brief knowledge assessment via Educational Technology Services (ETS). REDCap pre- and post-surveys will be built into the educational activity. Findings from piloting the resources via REDCAP surveys would factor back into the design and development of the additional physician educational materials, which could include development of future handouts and online resources.  One example of non-integrative online resources can be seen in the following center site: https://med.stanford.edu/long-covid-care-reach.html

By piloting these resources through UCSF in Collaboration with San Francisco Zuckerberg General Hospital, and the University of Washington Osher Centers and Long COVID clinics, this initiative aims to improve access to integrative medicine for underserved populations, inform future education projects, and enhance health equity across programs.

Clinician-facing video content, along with associated knowledge assessments, will be submitted for CME accreditation as an enduring activity. The accrediting entity is yet to be determined and will depend on cost associated with submitting the final video product. The team is currently exploring options including the UW and the American Academy of Family Physicians (AAFP). A request for 2-3 CME credits will be made for the video package and supporting materials.

Project Timeline, Feasibility, and Anticipated Impact:

Project Timeline: The proposed project is feasible within the 12-month timeline and aligns with the Osher Collaborative’s mission to advance integrative health equity through education. Collaborators bring multidisciplinary expertise to develop evidence-informed, accessible materials for diverse clinical settings.

Q1: Development of patient-facing video content and patient-facing handout materials

Q2: Editing of video content and finalizing patient-facing handouts. Translating handouts into the Spanish Language and adding Spanish captions on videos.

Q3: Creation of CME content for physicians. This would include video creation and REDCap pre- and post-surveys.

Q4: Optimizing and finalizing CME content creation. Publishing all content onto the Osher Collaborative Website.

Dr Kuon, Director of UCSF’s Long COVID OPTIMAL clinic and co-investigator in the Long COVID Care AHRQ Network, is a leading expert in clinical care for Long COVID. She provides international expertise in the clinical management of Long COVID and as creator of UCSF’s group medical visits, is an expert in developing and delivering protocolized care in a group setting. 

Dr. Peluso, Director of Zuckerberg San Francisco General’s Long COVID Clinic, Division of HIV, Infectious Diseases and Global Medicine, UCSF, is a clinician and researcher in long COVID through the LIINC (Long-term Impact of Infection with Novel Coronavirus). He provides expertise in Long COVID research.  He is the PI on the Long COVID Care AHRQ Network.

Dr. Gentile, UW Osher Center faculty, Co-Director of the UW Long COVID Clinic and Co-PI in the Long COVID Care Network, provides national expertise and a mechanism for broad dissemination to communities disproportionately impacted by Long COVID. She is currently designing a CME program for physician education on Long COVID. The team’s combined expertise ensures the creation, piloting, and dissemination of resources to address clinician and patient education gaps in integrative care. 

 

Impact:

  1. Clinicians: Increased knowledge and confidence in applying integrative techniques to manage Long COVID, improving access for underserved and marginalized populations.
  2. Patients: Empowerment through actionable education, addressing gaps in care and tailoring resources for adults, children, and disadvantaged groups.

This collaboration strengthens health equity by improving access to integrative care for Long COVID patients across diverse communities.

 

Total Budget Requested: $20,000

 

References

1. National Center for Health Statistics. U.S. Census Bureau, Household Pulse Survey, 2022–2024. Long COVID. Generated interactively. Accessed August 1, 2024. https://www.cdc.gov/ nchs/covid19/pulse/long-covid.htm

2. Sweis JJG, Alnaimat F, Esparza V, et al. From acute infection to prolonged health consequences: understanding health disparities and economic implications in Long COVID worldwide. Int J Environ Res Public Health. 2024;21(3):325. doi:10.3390/ ijerph21030325

3. Shah DP, Thaweethai T, Karlson EW. Sex differences in Long COVID. JAMA Netw Open. 2025;8(1):e2455430. doi:10.1001/ jamanetworkopen.2024.55430

4. Vahratian A, Saydah S, Bertolli J, Unger ER, Gregory CO. Prevalence of post-COVID-19 condition and activity-limiting post-COVID-19 condition among adults. JAMA Netw Open. 2024;7(12):e2451151. doi:10.1001/jamanetworkopen.2024. 51151

 

Supporting Documents: 
File small_dei_grant_proposal_submission_draft_5.27.25.docx
File small_dei_grant_budget.docx

Comments

Ariana Jostad-Laswell - April 21, 2025 - 11:17am

This is an exciting project! What are the integrative approaches that you will highlight in the materials created? Will the patient-facing materials be available in multiple languages?

Carla Kuon - April 21, 2025 - 3:15pm

Thanks Ariana!  Integrative approaches include dietary changes, like the anti-inflammatory or low histamine diet, and some anti-inflammatory supplements which have been helpful like Quercetin, fish oil, D, C, correcting low iron, etc.  Then adding mind/body components like breathwork, vagal exercises, etc.  

The idea of adding patient-facing materials is a great thought.  I am able to translate those into Spanish and will definitely add to the list of deliverables. Thanks!

Dorothy Chiu - April 23, 2025 - 3:14pm

Your study details a great double-pronged clinician & patient-centered approach to increase IHE for patients with Long COVID. I'm especially intrigued by the nutritional management piece!

Curious how findings from piloting the resources that will be created through this initiative might factor back into the design and development of the materials - especially thinking about the videos, which might be harder to edit and/or reshoot footage for? Also curious if all integrative approaches that you mentioned would each have a CME-statement as well as video and educational materials in English & Spanish? or, are videos the educational materials?

Carla Kuon - April 30, 2025 - 9:10am

The educational materials would include handouts in English and Spanish, as well as videos. Though videos would be in English, we can add caption translations in Spanish.  The video production is the most expensive part of the grant (about 7-8k) so producing another set of videos in Spanish would depending on the funding received though this might be possible if additional funding is received. 

In terms of piloting the resources, fortunately, I have received a lot of feedback from the GMVs and have already edited and improved the handouts based on patient feedback. So hopefully there wouldn't be too many changes in the video content.  I can see a scenario where additional videos could be produced in the future if there is a need.

Julia Burns - April 23, 2025 - 4:08pm

Great proposal, Carla! If you plan to film video content in SF, I recommend using Educational Technology Services (ETS). They provide affordable, in-house video services for UCSF. You can view their rates here: https://edtech.ucsf.edu/video-production. 

Carla Kuon - April 30, 2025 - 9:11am

This is amazing Julia!  Would you like to be an advisor for this project?  I would love to include you!

Yvette Coulter - April 23, 2025 - 7:04pm

This proposal is a fantastic initiative to tackle health disparities in Long COVID care by boosting access to integrative medicine through educational resources. The partnership between UCSF, ZSFG, and the University of Washington looks promising, combining different areas of expertise to create really practical, evidence-based materials. It’s great to see a focus on training clinicians and educating patients, with resources available in Spanish and English (Thanks, Ariana, for highlighting this!). 

Could you share a bit more about how you’ll structure the pre- and post-training evaluations for clinicians? I’m curious about the metrics you’ll use to measure changes in their knowledge, confidence, and competency.

Carla Kuon - April 30, 2025 - 9:12am

Nikki Gentile has been creating CME content through the U. of Washington, so it would be in collaboration with them.  I will need to ask her these more granular details, and get back to you on this.  

Jenifer Matthews - April 24, 2025 - 10:19pm

It would be great to have resources for parents navigating this for their kids/teens as well!

 

Carla Kuon - April 30, 2025 - 9:14am

Thanks Jen!  Yes, I think the recc's overall would remain the same, though I imagine more support for parents in how to encourage dietary changes in kids/teens would be wise, I agree. 

Marliese Warren - April 30, 2025 - 2:57pm

From Perry Lang:

I tend to like projects with both a top down (train the trainers) and bottoms up (support the patients) approach. This project has both.  I also like the collaboration with Zuckerberg San Francisco General Hospital. 

Carla Kuon - May 6, 2025 - 6:45pm

Thank you Perry, I agree that collaboration with ZSFGH is important. They just started a Long COVID clinic and improving resources for this patient population is key in the expansion effort. 

Cooking for Life: Offering Virtual Nutrition-Focused Cooking Classes to Osher Community Care Fund Patients

Submitted by Danica Cowan on April 18, 2025 - 7:53am Last revised by Danica Cowan on May 30, 2025 - 8:37pm.
Project Idea Status: 
Open

*Please note, our project activities evolved slightly between phase 1 and phase 2 with feedback. Phase 2 includes an updated description of proposed activities, deliverables, and staffing. Phase 1’s original submission is preserved below for transparency.

Project Significance and updated Statement of Project Feasibility and Anticipated Impact, including the Osher Community: Poor diet poses a significant barrier to integrative health equity. Culinary medicine is the evidence-based application of food and cooking to medicine such that patients are empowered to make healthful dietary decisions for disease treatment and prevention. From years of patient care experience, providers including our project leads have observed that a substantial proportion of Osher patients, particularly those eligible for our Community Care Fund, struggle to adhere to critical dietary recommendations. Interest in bringing culinary medicine to our UCSF Osher Center for patients and providers has been long-brewing and this opportunity will strengthen our internal capacity (e.g., in staff skills, resources, connections with relevant Osher Collaborative and UCSF partners like the Food Equity and Justice Program) to provide or restart a menu of culinary medicine programming at the Center. Previously, our project lead helped establish the Vouchers4Veggies program at Osher before funding sources changed. Our project co-lead helped launch the first culinary medicine program for patients in ambulatory care at UCSF. Our research lead is experienced in quantitative, qualitative, and mixed methods data collection and analysis as well as public health nutrition. Successful completion of this project will instill valuable cooking skills to more under-resourced members of our Osher patient population, hopefully inspiring better health. 

*Updated* Project Description and Deliverables (d):This project will host a series of live, quarterly virtual patient “cook-along” workshops (d1) and also create a resource library of 5-6 short-form (1-2 minute) videos for patients on basic cooking skills and nutrition education (d2). These activities will be led by experienced Osher providers Danica Cowan and Linda Dulong. They will be informed by a short, targeted patient needs assessment to identify prominent barriers to dietary change in our Osher patient population to address. We will team up with UCSF Educational Technology Services to edit the videos, restart Vouchers4Veggies to support groceries/food and ingredient sourcing for patients, and collaborate and coordinate with UCSF and the Osher Collaborative's existing network of staff and programming already working in the areas of food equity and culinary medicine to augment our efforts. This grant will also kickstart other resources at Osher to support cooking amongst patients, including establishing a spice pharmacy (d3), cooking appliance/equipment library (d4), and cookbook library (d5). We will also assess program feasibility and acceptability as well as examine changes in cooking skills, culinary knowledge, and basic dietary intakes.

*Updated* Project Team Members/Roles: Danica Cowan, MS, RD; Integrative Dietitian - Culinary Medicine Lead;  Linda Dulong, MSN, ANP-C; Integrative Nurse Practitioner - Culinary Medicine Co-Lead;  Dorothy Chiu, PhD, MSPH; Postdoctoral Fellow - Research Lead;  Julia Burns, MA; Communications Specialist; Osher Administrative Staffperson TBD - Project Administrator. Kavita Mishra, Deborah Caldwell, and Maria Chao provide release time.

Project Innovation: Virtual culinary medicine workshops and videos are an innovative strategy to teach cooking and nutrition effectively and sustainably. They bypass logistical challenges of in-person activities and allow participants to cook and learn in their regular cooking spaces. Patients can ask questions as they figure out how to apply lessons in their individual contexts and even topics like taste, smell, and appearance can be interactively addressed as a group. People often struggle to translate what they learned during an appointment to home – the virtual format jumps that hurdle and brings the provider to their kitchen/cooking space. Additionally, this project will help solidify professional culinary medicine networks for Osher providers.  

Project Timeline:

Phase 1, Preparation (July-Sept 2025): Needs Assessment, Plan Cookalong Workshops and Videos, Set up Distribution for Veggie Vouchers, Spices, Cooking Equipment/Cookbook Library

Phase 2, Implementation (Oct-April 2026): Film Videos, Run Quarterly Workshops

Phase 3, Evaluation (May-June 2026): Analyze Data, Tweak Offerings per Feedback

Total Budget Requested: $20,000

 

Phase 1 Proposal Project Description: Poor diet poses a significant barrier to integrative health equity.  Dietary change is a critical  component of an effective integrative care plan, but many Osher patients lack foundational cooking skills and culinary knowledge to facilitate these changes via cooking tasty and healthful meals. Thus, it is often very challenging for Osher patients to fully adhere to their dietary recommendations. This is especially a concern for Osher patients eligible for the Community Care Fund. Here, additional barriers to eating healthfully often include a lack of equipment and ingredients. This project will address the barriers above by partnering with 18 Reasons to pilot 2 rounds of virtual cooking classes, as well as build up resources at Osher to support cooking such as a spice bank and cooking appliance library. We will also assess program feasibility and acceptability as well as examine changes in cooking skills, culinary knowledge, and basic dietary intakes.

Phase 1 Statement of Project Feasibility and Anticipated Impact:18 Reasons is a well-established SF based non-profit that provides in person and virtual nutrition-oriented cooking classes to many underserved individuals and families in the Bay Area. Since 2017, 18 Reasons has partnered with various UCSF groups and Linda Dulong, team member on this project, worked with them while she was a provider in WHPC. Successful completion of this project will instill valuable cooking skills to more under-resourced members of our Osher patient population, hopefully inspiring better health. Additionally, this project will kickstart the ability of Osher providers to provide culinary medicine programming to its patient population. Culinary medicine is the evidence-based application of food and cooking to medicine such that patients are empowered to make healthful dietary decisions for disease treatment and prevention.  Project outcomes such as the cooking appliance library, spice bank, and information collected from the evaluation component will also help inform and improve future iterations of this offering.

 

 

 

 

 

 

 

 

 

Supporting Documents: 
PDF icon osher_ihe_small_grant_culinary_medicine_budget_3.pdf

Comments

Ariana Jostad-Laswell - April 21, 2025 - 11:24am

A spice bank sounds like such a creative idea--how would it work?

Danica Cowan - April 24, 2025 - 1:29pm

I think spice pharmacy might be a better description.  

Yvette Coulter - April 23, 2025 - 7:08pm

This is wonderful! I love the spice bank idea- would this be like the bulk bins at Berkeley Bowl or little samples to send out along with recipes and instructions? 

If you need student involvement to help with the rollout, I would be happy to connect you with the Culinary Medicine student interest group.

Danica Cowan - April 24, 2025 - 1:28pm

I think it could almost work like a spice pharmacy (maybe that's a better term), where participants can request which spices they want, we portion them out, and they could pick them up at visits, or they could be sent with their produce boxes for that week's class. 

It would be great to connect with the Culinary Medicine interest group!

Kennedy Blevins - April 24, 2025 - 1:53pm

I had a similiar question to Ariana. I was curious how individuals would access the appliance library and what infrastructure would be in place to make sure the appliances are returned? This would be a great resource.

Danica, I love that the cooking videos are something that can be sustainable for Osher long term and that this project involved community partnership.

Furuther the potential for Osher providers to learn culinary medicine sounds like a great idea and I am sure it would be highly sought after. I hope to learn more about your ideas for this programming.

Danica Cowan - April 25, 2025 - 1:15pm

The appliance library wouldn't be self checkout.  We'd need to work with our admin team to monitor. I will coordinate with them to figure out how both the "spice pharmacy" and "applicance library" would work logistically. 

Marliese Warren - April 30, 2025 - 2:54pm

From Perry Lang:

Laudable goal. I have questions about who the potential partners would be. I also have reservations about “virtual” only. Sampling or tasting is important. Will the program provide food boxes with ingredients for the cooking demonstration and lesson?

Dorothy Chiu - May 2, 2025 - 4:03pm

Danica can add more, but in previous conversations, she had relayed to me the virtues of this program's virtual model. While the "in person" format definitely has the advantages of enabling tasting and sampling as you say, virtual cooking/culinary medicine lessons allow participants to cook in their regular cooking location - using their own kitchen equipment, spices, and spaces! And, it enables them to ask questions in real-time as they learn techniques and figure out how to apply it in their individual contexts. This can help with implementation and sustainability of the lesson as, many times, people can learn in the classroom, but struggle when they need to translate what happened there to their own space at home. The virtual format here recognizes the existence of that hurdle and finds a way to effectively address it head on.

This project will partner with 18Reasons for the cooking lessons and they do provide participants with most if not all ingredients needed before hand. Danica and the Osher team will help provide additional support through the spice pharmacy, cooking appliance library, and education and troubleshooting as needed. Thanks!

Movimiento Juntos: A Mind-Body Class for Spanish-speaking Patients with Chronic Pain

Submitted by Ariana Jostad-Laswell on April 18, 2025 - 2:06pm Last revised by Ariana Jostad-Laswell on May 30, 2025 - 11:38am.
Project Idea Status: 
Open

Project Title: Movimiento Juntos: A mind-body skills class for Spanish-speaking people living with chronic pain

 

Brief Project Description:

Chronic pain is one of the most common causes of disability and suffering in the United States. Non-medication treatments including integrative therapies are recommended (instead of or along with pain medications), but such treatments are not widely available to people with limited English proficiency or lower-income people. Our team conducts research on the Integrative Pain Management Program, which 12-week integrative group medical visits in English and Spanish, in partnership with San Francisco Health Network. Currently, ongoing support after the program is available in English only. Spanish-speaking participants have urged our team to provide longer-term integrative health and social support. This project would pilot an in-person, Spanish-language public class that provides peer support and mind-body practices for chronic pain management. The group will be located at the Osher Center and will be open to the public, including Spanish-speaking Osher Center patients and Mount Zion primary care patients.

 

Brief Statement of Project Feasibility and Anticipated Impact:

Osher Center researchers and San Francisco Health Network have collaborated on integrative chronic pain care and related research for >10 years, with multiple versions of an Integrative Pain Management Program in English, and recent development of a 12-week Spanish language program (59 participants enrolled to date). Spanish-speaking participants have directly requested ongoing, in-person support beyond the 12-week program, and all program facilitators are interested in contributing to an ongoing class. To evaluate the class, we will invite participants to complete brief surveys about their chronic pain and related symptoms, as well as social support and program satisfaction. Mind-body practices and social support are known to help reduce chronic pain and pain-related symptoms, while external stress is known to worsen chronic conditions. We are confident that this group would support the wellbeing of Spanish-speaking Latine immigrants during a time of exacerbated stress due to policy change, while serving a model for ongoing group programming after short-term interventions.

 

Deliverables:

Our project aims to pilot a free, drop-in public class at the Osher Center providing mind-body practices for chronic pain management in Spanish. Classes will meet weekly for 90 minutes from September through May. This class will be open to the public, and recruitment will focus on Spanish-speaking Osher Center patients, San Francisco Health Network patients participating in Osher Center-affiliated research, and primary care patients from the UCSF Division of General Internal Medicine clinic at Mount Zion.

 

Impact on Osher Center Community:

The Osher Center clinic is serving a rising number of Spanish-speaking patients and is uniquely situated to expand access to integrative therapies for chronic pain management in multiple languages.Our project will include collaboration between Osher Center researchers, clinicians, and public classes team, as well as external partners. This program will benefit the overall Osher Center and Mount Zion community in several ways:

  • provide language-concordant access to integrative health services for Spanish-speaking patients at Mount Zion clinics
  • encourage cross-program collaboration within the Osher Center
  • increase awareness of the Osher Center among Spanish-speaking communities and organizations in San Francisco.

 

Team Members and Roles

Project Lead: Samuel Solis

Project Advisor: Ariana Thompson-Lastad

Lead teacher: Zoë Elena

Advisory team Members (guest speakers, support navigating Osher Center processes):

  • San Francisco Health Network: Ann Dallman, Sebastian Melo, Naomi Schoenfeld
  • OCIH Clinic: Fatima Barragan, Carla Kuon
  • OCIH research: Christa Fernando, Maria T Chao, Denise Ruvalcaba
  • OCIH public classes team: Anita Botello Santoyo, Julia Burns, Selena Chan, Jen Shea
  • OCIH finance team: Calvin Tse

Total Budget Requested: $20,000

 

Project Significance and Innovation

Mind-body practices and social support are known to benefit chronic pain and pain-related symptoms (e.g., mental health, sleep). Integrative care can include support from practitioners, and guidance on daily practices such as nutrition, movement, and coping with pain. In San Francisco 11.7% of residents speak Spanish as their primary language. However, this community often lacks access to integrative health care due to financial, physical, and language-related barriers to care.

Movimiento Juntos, a drop-in Spanish-language class for people with chronic pain, will be taught by a bilingual yoga and mindfulness teacher (Zoë Elena), with recruitment and administrative coordination from a bilingual Osher Center staff member (Samuel Solis). Zoë has experience teaching Spanish-speaking people with chronic pain and works closely with Sammy on the Integrative Pain Management Program. Guest speakers from the Osher Center and San Francisco Health Network will be invited to present on pain-related topics such as anti-inflammatory nutrition, mindfulness practices, and acupressure. Resources shared with participants for home practice will include Spanish-language videos created by the OCIH HOME project. To evaluate the class, participants will be invited to provide feedback on the program as well as complete brief surveys about their chronic pain and overall health (at their initial participation, 3 months into participation, and end of 9-month pilot).

Timeline (06/30/2025- 06/30/2026)

  • Jun-Jul 2025: Grant Awarded, kickoff meeting, planning class and evaluation, scheduling facilitators and guest speakers, translating consent forms or other materials
  • Aug 2025: Participant recruitment
  • Sept 2025-May 2026: Run weekly group at Osher Center, collect survey data
  • May-Jun 2026—Analyze evaluation data, write final report

Name of the supervisor who has provided release time: Julia Wu (for Samuel Solis)

Supporting Documents: 
File project_budget_justification.docx

Comments

Dorothy Chiu - April 23, 2025 - 2:00pm

This project would definitely fill a gap in services offered at Osher and provide significant support for a community that is undergoing more precarious times. Wondering if zoom or online options would also be offered and/or if the ongoing support groups would be limited to those completing the 12-week GMV series? Curious if current evaluation components look at benefits to the social networks (family members, friends, community members) of the GMV participants?

Christa Fernando - April 23, 2025 - 5:19pm

We got a lot of feedback from patients specifically preferring in-person services, but a virtual option would definitely expand access! We have a virtual version of this program in English already so the framework is there. Also this would be open to patients who didn't do the original GMV series (as that part of the study has more exclusion criteria). Our current surveys do look at social support (specifically who their support network is, do they feel like they have someone to reach out to...etc). Wondering if there are any specific benefits of social networks you were thinking of looking at? thanks for your thoughts!

Dorothy Chiu - April 24, 2025 - 1:47pm

That's great you all can build on the English virtual framework if you all go that route! 

I was curious about social networks thinking about extended benefits of participating in the ongoing support groups to family and friends - for example on children with parents who are less burdened by pain and/or have emotional support through the group, and/or on friends with whom participants might share information/strategies, etc. they learn in group that could also help them. Imagining a sort of benefit "wave" :)

Ariana Jostad-Laswell - April 24, 2025 - 4:12pm

I love this idea--it's definitely something we hear about in qualitative analysis of existing pain groups

Julia Burns - April 23, 2025 - 4:16pm

Great proposal! You mention that the group will off educational materials and resources. Will the identified team members be responsible for creatin new materials or translating exisiting materials? If you'd like to include translation services in the budget, you might consider partnering with UC Davis Translational Services. They were recommended to me by another comms colleague at UCS. Here is where you can learn more: https://health.ucdavis.edu/interpreting-services/written-translation

If you are looking to include videos of mind-body practices, you can ask the HOME team to use their videos. We are working on culturally relevant videos in Spanish and Cantonese. They should be ready by Fall 2025.

Ariana Jostad-Laswell - April 24, 2025 - 4:14pm

Thanks Julia! We would love to use the HOME videos as ways for participants to practice at home. Our team has created new materials & translated them for our existing pain groups, and would be exploring what additional written materials participants would find most useful (if any).

Yvette Coulter - April 23, 2025 - 7:13pm

This sounds like an amazing way to enhance Osher Center services and foster continued collaboration between Osher Center researchers and the San Francisco Health Network. It’s inspiring to see this initiative addressing specific requests from participants and responding to their long-term support needs. This will not only enhance their well-being but also serve as a valuable model for future programs.

Marliese Warren - April 30, 2025 - 2:51pm

From Perry Lang:

Pain management is important. I also like the idea of partnering with the San Francisco Health Network. It is great that this program will address a community need. 

Jhia Jackson - May 30, 2025 - 12:24pm

Love that the title has spanish words in it -- I feel like it already signals a bit of the culture expansion having this program at Osher would bring. Seeing more variety of patients in the building sparks more creativity and motivation, even as a research fellow.

Kennedy Blevins - June 5, 2025 - 1:18pm

This is such a great proposal that will address a critical gap in services at Osher. I am curious if you plan to use the class for English-speaking individuals as a model to ensure ongoing support past the award period for the class for Spanish-speaking individuals?

Narrative Medicine Writing Workshops for LGBTQIA+ Community

Submitted by Julia Burns on April 18, 2025 - 2:49pm
Project Idea Status: 
Open

In response to the federal attacks on queerness, especially the well-being and safety of trans people, I propose a pilot writing workshop series that uses narrative medicine techniques to foster whole-person healing within the local LGBTQIA+ community. This could be specific for queer youth, or for all ages. 

Narrative medicine emphasizes the power of storytelling to promote empathy, reflection, and agency in health journeys. This project extends narrative medicine into the realm of integrative health, where physical, emotional, and spiritual well-being are interconnected. Participants will engage in guided writing exercises focused on themes of resilience, identity, embodiment, and healing. Workshops will incorporate mindfulness practices, trauma-informed facilitation, and opportunities for collective reflection.

This project aligns with the principles of integrative health equity by creating an accessible, community-centered space for healing that values lived experience as a form of knowledge. It also lays the groundwork for future research: participants' narratives could inform a qualitative study exploring the impacts of narrative practice on perceived well-being, connection, and self-advocacy in intersectional health contexts.

Funding will support program development, writing retreat space, facilitator honoraria, and stipend for community partners/exerts. If successful, this model could be adapted to serve other marginalized communities.

Comments

Ariana Jostad-Laswell - April 21, 2025 - 11:24am

What a very timely project. Curious if you are already in contact with UCSF clinicians, researchers, etc focused centrally on LGBTQ+ health. Since it's such a tough time for many people's funding, availability of roles with stipends might be especially appreciated!

Julia Burns - April 23, 2025 - 4:45pm

Not yet, but I would look for guidance from the Transgender Care Team—including Maddie Deutsch, MD—to suggest facilitators and help promote these workshops. 

Dorothy Chiu - April 23, 2025 - 1:53pm

This is an important and great idea, especially now, agree! Is there a target number of groups you would hope to host through this? Also, is there utility in and/or room for incorporating an evaluation component in this vision? 

Julia Burns - April 23, 2025 - 4:46pm

I would love to partner with some of our researchers to develop and evaluation to help measure impact, if possible. I think we should pilot one group of 10-12 people and then create a reoccuring series.

Dorothy Chiu - April 25, 2025 - 11:18am

happy to chat about or brainstorm options in this space if helpful!

Christa Fernando - April 23, 2025 - 5:05pm

I love to social support aspect here alongside the self-reflection! Wondering who facilitators would be and how they would be trained in narrrative medicine? Also it seems like facilitators might not need to be healthcare providers necessarily but maybe social workers or counselors. Also wondering if there is a school partnership that would support this for a youth-focused group...

Yvette Coulter - April 23, 2025 - 7:21pm

This proposal is incredibly timely and addresses a critical need within the LGBTQIA+ community. The idea of using narrative medicine techniques to foster healing is both innovative and impactful.

By focusing on resilience, identity, embodiment, and healing, the workshops promise to create a supportive space where participants can explore and affirm their experiences. The integration of mindfulness and trauma-informed practices is particularly thoughtful.  It’s exciting to see a project that honors lived experiences and offers a pathway for healing and empowerment. 

Kennedy Blevins - April 24, 2025 - 2:02pm

Julia, what an innovative idea. Thank you for sharing. Would you be open to sharing the materials you use for the pilot of this program and your insights with other Osher center personelle after you finish? A reoccuring series also sounds like a great idea.

I think it might be really great to make this specific to youth. What age groups were you thinking?

Marliese Warren - April 30, 2025 - 2:48pm

From Perry Lang:

I am intrigued at the notion of Narrative Medicine, which I know very little about. If funded, LGBTQ participants must be diverse ethnically, socially and economically. I would also be curious about the role of applicable biblical stories (Paul’s thorn in his side) and universal teaching stories (Chinese farmer and his horse) which highlights that what seems initially bad can turn out to be beneficial and vice versa.    

Improving Access to Integrative Health Research for Underrepresented Cancer Survivors

Submitted by Anand Dhruva on April 18, 2025 - 5:06pm Last revised by Anand Dhruva on May 30, 2025 - 8:28pm.
Project Idea Status: 
Open

Project Lead: Anand Dhruva (Education Program)

Key Team Members: Patty Moran, Maria Chao, Rick Hecht (Research Program)

Brief Project Description:  A majority of integrative health research has included well educated, high income, White patient populations. This project proposes addressing language, logistical, and literacy barriers to improve research recruitment in diverse populations. This will supplement an existing study testing the multi-site feasibility of an Ayurvedic medicine intervention compared to health education. A key goal of that study is to recruit underrepresented patients (i.e., patients currently poorly represented in integrative health research). We recently conducted qualitative interviews with underrepresented patients to identify barriers to participation. Underrepresented patients felt that more time and explanation is needed to describe study participation. Participants identified logistical barriers to participation (e.g., transportation, parking) and for some technological barriers. Language barriers may also play a role (e.g., English as a second language). In this IHE small grant, we propose to test impact of addressing the above identified barriers on study participation among underrepresented patients.

Brief Statement of Project Feasibility and Anticipated Impact: Underrepresented patient populations are poorly represented in research studies, which limits their access to integrative health practices and negatively affects the quality of research. Our prior qualitative work provides a clear direction for the proposed work in this grant. By addressing barriers to participation, we will be able to contribute to the literature on ways to improve inclusion of underrepresented patients in integrative health research. The results of this work may inform the design and implementation of other integrative health research – especially projects involving complex whole systems of medicine. This project can be completed by June 30, 2026 as this aligns with our recruitment timeline for the existing study. The project involves members of the UCSF Osher Center Research and Education Programs and faculty and staff at zSFG. More broadly, this advances research on Ayurvedic medicine, a historically marginalized system of medicine.

Total Budget Requested: $20,000

Supporting Documents: 
File Proposal
File Budget

Comments

Ariana Jostad-Laswell - April 21, 2025 - 11:22am

This is such an important direction for supporting inclusive participation in clinical trials. What kinds of barriers are you expecting to address and how, with these funds?

Dorothy Chiu - April 23, 2025 - 1:48pm

Agree, the lessons learned from executing this initiative will no doubt contribute to future integrative health trials! Also agree it would be interesting to learn more about the barriers that have been identified as good targets for this intervention  - but also if it seems like it's many barriers on top of each other that contribute to someone not participating in the trial - or if there is a main barrier to attack?  Also, is there a target number of patients to recruit and/or attempt to address the barriers for? Curious also if the likelihood of participating in ayurvedic trials differ by medical condition, and/or if that would impact the target population for this as well?

Anand Dhruva - April 24, 2025 - 6:37pm

Hi Ariana and Dorothy,

Thanks for these comments and questions. As you know, this is a complex area where there has been significant research. Many barriers are difficult to overcome. As it relates to this work, we are aiming to stay within the framework of our prior work with this patient population. Our qualitive research has helped to identify a few areas that we would like to target with the proposed research. For example, we know that there is a distrust of the medical system due to many factors, including a history of coercion and "experimentation" on people of color by the biomedical system. This is real and something that we have to overcome since we are operating in the framework of biomedicine (even if we are trying to shake up that framework with our research). On a practical level, this means being able to spend more time with prospective participants to explain the research and having specific areas to cover in that conversation. Our qualitative work has suggested directions for those conversations.

Anand

Marliese Warren - April 30, 2025 - 2:46pm

From Perry Lang:

The goal is lofty, but I want to know more about the cost per participant, particularly as it relates to removing or addressing barriers of transportation (i.e. taxi vouchers, parking stipends), or technological (i.e. new equipment). I would also like to know more about the existing study and participants. 

Anand Dhruva - May 23, 2025 - 12:20pm

Hi Perry, Thanks for these comments. We will address them and provide more details in these areas in our phase 2 proposal. Anand

Program Evaluation of Mindful HEART: Healing and Embodied Awareness to Recover from Trauma

Submitted by Kennedy Blevins on April 18, 2025 - 5:42pm Last revised by Kennedy Blevins on May 30, 2025 - 5:43pm.
Primary Author: Selena Chan
Project Idea Status: 
Open

UCSF Osher Center Key Team Members:  

Kennedy M. Blevins, PhD | Project Lead | Postdoctoral Research Fellow 

Selena Chan, DO|Collaborator | Integrative Psychiatrist, Associate Director of Clinical Programs 

Nichole Proffitt, SEP, CMT-P|Collaborator | Integrative Mindfulness Instructor 

Shelley R. Adler, PhD | Project Advisor | Director, UCSF Osher Center 

Project Description: Mindful HEART, is an innovative five-week public course offered through the University of California, San Francisco (UCSF) Osher Center clinic and designed for individuals in the recovery stages of trauma. The program’s development—from conceptualization to delivery— has been shaped by the combined expertise of a somatic experiencing practitioner and an integrative psychiatrist, as well as feedback from UCSF Mindfulness Based Stress Reduction class participants, who highlighted the need for greater capacity at the Osher Center for those navigating trauma recovery. The proposed IHE project proposal aims to evaluate the Mindful HEART program through feedback from Mindful HEART class participants.  
 
Feasibility: The first Mindful HEART course offering (MH-1) is currently running May-June 2025, and a second iteration of Mindful HEART (MH-2) is planned for September-October 2025. The course instructor, Nichole Proffit, will invite 10 MH-1 students to provide course feedback through individual interviews, informing the development of the second course offering. The program lead, Dr. Kennedy Blevins, will lead the evaluation by conducting interviews and asking questions via questionnaires to elicit feedback from past participants. For adaptive refinement of the Mindful HEART program, it is necessary to evaluate more than learner satisfaction and other typical factors assessed in program evaluation. This evaluation will focus not only on class participants’ learning outcomes on key Mindful HEART objectives, but also their application of these principles in daily life. Lastly, strategies and tools developed for the evaluation of Mindful HEART will be made available to inform the formal evaluation of other Osher Center public classes. 
 
Significance: The Kirkpatrick model is an effective framework for evaluating learning outcomes in training settings (Kirkpatrick, 1998). This framework is appropriate for this application since Mindful HEART aims to teach skills for those in trauma recovery. The Kirkpatrick model includes four levels: (1) reaction, which measures participants’ immediate feedback and satisfaction; (2) learning, which assesses the extent to which participants gained knowledge and skills; (3) behavior, which evaluates whether participants are applying their learned knowledge and skills in their work; and (4) results which determines the impact of the training on organizational goals, outcomes, and effectiveness. Levels 1 (reaction) and 2 (learning) will be addressed by inviting participants from MH-1 to participate in interviews following completion of the MH-1 course. These interviews will assess the impression of the course (reaction), which is typically evaluated by the Osher Center following public classes, but will also go to the next level of understanding what individuals learned from the Mindful HEART program (learning), including suggestions for how the program could be improved to support delivery and learning. Next, the Mindful HEART program will be refined based on MH-1 participant feedback and incorporated for MH-2. Those enrolled in MH2 will be invited to complete survey questions before the beginning of the MH-2 course and after the completion of the MH2 course to assess what skills individuals gained (learning) and will be invited to participate in post-course interviews two weeks after MH-2 to understand whether individuals are applying their skills following the Mindful HEART course (behavior). Evaluation and refinement of the Mindful HEART program will support the class's future offerings and create lasting protocols for Osher public class evaluation in an effort to improve capacity for the UCSF Osher Center to support integrative health equity (results). 
 
Innovation: The proposed project aligns with this call’s goal of improving integrative health equity by addressing the need for a program specifically focused on those in trauma recovery at the UCSF Osher Center. Seventy percent of adults globally report at least one trauma experience (Benjet et al., 2016). Typically, mindfulness-based programs focus on re-establishing a sense of safety following trauma (Herman, 1992, Chapter 8). However, there is a need for programs focused on trauma recovery (Kelly & Garland, 2017) that integrate psychotherapeutic and mindfulness approaches (Williston et al., 2021). The Mindful HEART program taps directly into this need, focusing on mindful and somatic-based approaches to trauma recovery. Further, while many course-based evaluations stop at level 1 or 2 of the Kirkpatrick model (Holtschneider & Park, 2019), this project will address all four levels of program evaluation to improve the Mindful HEART program and ensure this program evaluation has a lasting impact. While delivery of the program is funded through class tuition, support for further refinement and evaluation of Mindful HEART is needed to ensure the program has far-reaching benefits for the Osher Center.  
 
Impact: The proposed project contributes to the Osher Center’s broader evidence-informed, trauma-recovery efforts while building professional and personal communities of wellbeing and creating infrastructure to improve integrative health equity at the UCSF Osher Center. This effort can help assess potential pathways for clinical integration, instructor training, and future research across Osher Center programs.  
 
Collaboration: This project fosters collaboration across the clinic, education, research, and administration programs and is strengthened by the team’s diverse integrative health equity expertise, spanning educational evaluation, experiential group programming, and direct care of individuals in trauma recovery. 

 

Project Timeline: 

May – June 2025 

  • Nichole Proffitt will lead MH-1 from May to June 2025. 

  • Drs. Selena Chan and Kennedy Blevins will participate in MH-1 as class participants. 

June – July 2025 

  • Nichole Proffitt will invite class participants to provide feedback on the class. 

  • Kennedy Blevins will gather feedback from MH-1 program participants through interviews with participants to inform MH-2 program delivery. 

July – September 2025 

  • Kennedy Blevins will compile feedback and share with Nichole Proffitt and Selena Chan to guide refinement of MH-2 based on feedback from MH-1 participants. 

  • Nichole Proffitt and Selena Chan will refine Mindful HEART based on participant feedback. 

September – October 2025 

  • Kennedy Blevins will survey 10 incoming MH-2 course participants from the course registration list on expectations for the course and key learning objectives one week prior to MH-2. 

  • Nichole Proffitt will lead MH-2 from September to October 2025. 

October – December 2025 

  • Kennedy Blevins will invite the same 10 MH-2 participants to interview two weeks after the course and ask them to complete post-class evaluation surveys to assess changes in key course and learning objectives after delivery of MH-2. 

December 2025 – February 2026 

  • Kennedy Blevins will compile feedback and responses from MH-2 participants and share with Nichole Proffitt and Selena Chan. 

February – March 2026 

  • Nichole, Selena, and Kennedy will share participant insights from the program evaluation with the overall UCSF Osher Center community (e.g., at case conference and/or other internal Osher meetings). 

March – July 2026 

  • Selena Chan and Kennedy Blevins will develop lasting protocols for meeting the needs of Osher patients with complex mind-body trauma histories. 

  • Selena Chan and Kennedy Blevins will develop lasting protocols for the evaluation of Osher Center public classes and training. 

 

References: 

Benjet, C., Bromet, E., Karam, E. G., Kessler, R. C., McLaughlin, K. A., Ruscio, A. M., Shahly, V., Stein, D. J., Petukhova, M., Hill, E., Alonso, J., Atwoli, L., Bunting, B., Bruffaerts, R., Caldas-de-Almeida, J. M., de Girolamo, G., Florescu, S., Gureje, O., Huang, Y., Lepine, J. P., … Koenen, K. C. (2016). The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychological medicine, 46(2), 327–343. https://doi.org/10.1017/S0033291715001981 

Herman, J. L. (1992). Trauma and Recovery: The Aftermath of Violence – From Domestic Abuse to Political Terror. Basic Books. 

Holtschneider, M. E., & Park, C. W. (2019). Simulation and Advanced Practice Registered Nurses: Opportunities to Enhance Interprofessional Collaboration. AACN advanced critical care, 30(3), 269–273. https://doi.org/10.4037/aacnacc2019157  

Kelly, A., & Garland, E. L. (2016). Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results From a Stage I RCT. Journal of clinical psychology, 72(4), 311–328. https://doi.org/10.1002/jclp.22273 

Williston, S. K., Grossman, D., Mori, D. L., & Niles, B. L. (2021). Mindfulness interventions in the treatment of posttraumatic stress disorder. Professional Psychology: Research and Practice, 52(1), 46. https://doi.org/10.1037/pro0000363 

Supporting Documents: 
File mindful_heart_evaluation_-_budget_overview_5.30.25.docx

Comments

Dorothy Chiu - April 23, 2025 - 1:28pm

This is sounds like a great project to diversify, extend, and enhance offerings at Osher for important populations!

Curious if the Mindful HEART program is structured to have similar groups (e.g., women, men, by race/ethnicity, age, etc.) in class with each other, or is it more that folks are in recovery from trauma? Also, would the funding requested through this grant be aimed at running a second course of Mindful HEART, or be focused on conducting a mixed methods evaluation of the pilot course that's running now to inform the second and/or future iteration(s) of Mindful HEART? 

Kennedy Blevins - April 24, 2025 - 2:15pm

Thank you Dorothy for your support and thoughtful question. The later of your comment is our plan -- to use funding to conduct a mixed methods evaluation of the Mindful HEART program. Participants from the pilot program will be invited to participate in focus groups, which will inform the next and future itterations of the Mindful HEART program. Further program evaluation will be coducted on the second iteration of the Mindful HEART program with existing feedback in mind.

The Mindful HEART program was created to be open access for those self-identified trauma recovery based on Osher MBSR and other public class participant feedback stating a need for this type of programing. We will definitely consider participants' thoughts and feelings around specitic affinity groups during the evaluation stage.

Marliese Warren - April 30, 2025 - 2:43pm

From Perry Lang:

The topic of trauma is timely, especially in this era of political shifting.  I would need to know more about the 5-week Mindful Heart course and whether it discusses individual traumas and institutional or systems trauma. Moreover, I don’t know if the course explores the link between individual and institutional traumas; trauma coping verses trauma recovery.   

Kennedy Blevins - May 1, 2025 - 10:31am

Dear Perry, thank you for your question. Individuals in the Mindful HEART program self-identify whether they have experienced physical or emotional trauma, however, this is not limited to non-institutionalized trauma. Rather, the program focuses on processing the impact of trauma whether individual or institutional. The program evaluation will help us address this important nuance in trauma experiences by working with those specifically in trauma recovery to integrate and process their trauma experience(s) rather than cope. However, improved coping may be a byproduct of the program that we can investigate during our program evaluation. 

Kennedy Blevins - May 1, 2025 - 1:11pm

Dear Perry, I also wanted to add that we recognize that institutional barriers exist and contribute to trauma. In that vein, access to the course is free for those who are supported by the community care fund, which supports individuals from socioeconomically disadvantaged backgrounds in the San Francisco Bay Area to participate in classes and treatment at the Osher Center.

The instructor, Nichole, also has 1 on 1 private interviews before the course to determine if additional professional mental health support is needed for particpant's self-identified trauma. In this way, this course is a complement to professional health care by allowing for the opportunity to address trauma recovery as a team.

Carla Kuon - June 3, 2025 - 9:50am

Love the innovation to increase access for trauma care, this addresses a long-standing gap in care.  Is this course covered by insurance or a paid course?  

Kennedy Blevins - June 4, 2025 - 6:49am

Thank you for the support. Great question! The class is funded by tuition. Those interested in class participation are encouraged to apply for the Community Care Fund (CCF). The public classes only scholarship covers class tuition even if individuals are not being seen by a clinician and those who have been recently seen by the clinic can apply to the CCF financial assistance program so long as they have clinican oversight. Both of these pathways are avenues eligible participants can use to get support to cover the cost of the Mindful HEART course.

How to CHA-cha!: Equipping San Francisco Youth with Complementary Health Approaches and Strategies for their Mental Health and Well-Being

Submitted by Dorothy Chiu on April 18, 2025 - 8:59pm Last revised by Dorothy Chiu on May 31, 2025 - 12:08am.
Project Idea Status: 
Open

*Content has been updated based on feedback/comments and reorganized its information to fit the suggested structure, but the original submission is below for transparency. 

Description of Project: 

This project will support an academic-community collaboration between members of the Osher community and Community Well to create educational content on complementary health approaches (CHAs) to support youth mental health and well-being through a participatory action-inspired approach. Community Well is a SF Excelsior District (District 11)-located community-based holistic health center experienced in supporting the health of its diverse, under-resourced community and has a successful history working within SF public schools. Youth (n=30-40, age 12-18) will be recruited from 3 SFUSD middle and high schools to discuss mental health care and CHA knowledge/usage in focus groups. Findings will inform the creation of short, tailored, and youth-oriented educational materials (e.g., digital handouts, social media posts) on CHAs (e.g., how-to instruction, local area resources) addressing identified needs to support youth use/access of CHAs for mental health. Materials will be field-tested before community-wide dissemination.

Project Deliverables: Short, tailored, and youth-oriented educational materials (e.g., digital handouts, social media posts) covering 5-10 CHAs (as informed by focus groups) in terms of how-to instruction, local area resources, etc.

Project Significance: Youth mental health is in crisis. As existing mental health services struggle to meet current demands, CHAs offer promising, youth-approved solutions (Cunningham et al., 2021). Many CHAs have growing evidence-bases for mental health and are practices youth can engage in independently. For example, mind-body techniques (e.g., meditation, guided imagery, self-expression via art and words, forest bathing) have been linked to increased mental well-being, happiness, and emotional regulation in youth, as well as reduced stress and depressive symptoms (Aalsma et al., 2020; Keller et al., 2023; Nagpal and Radliff, 2024). Yet, youth CHA usage remains low, especially for those of color and low income. Barriers to engagement include limited CHA access and low health literacy (Clayton-Jones et al, 2021). Mindfulness may foster positive psychological outcomes in many ways, including eliciting self-compassion, positive mind states, and lower psychological distress (Keng et al., 2011; Inwood et al., 2018; Creswell et al., 2019; Crosswell et al., 2023), as well as via the “stress buffering framework” wherein “regulatory” brain activity is increased while “reactivity” pathways are decreased (Creswell et al., 2019), so modulating physiological stress responses (e.g., the HPA axis) to support resilience and health (Creswell et al., 2019; Creswell et al., 2014).

Anticipated Impact, including on the Osher Community: Successful completion of this project will result in educational content (e.g., digital downloads, social media posts) that can empower youth to use and access CHAs to support their mental health and well-being, so promoting integrative mental health equity. Content/materials will be disseminated to youth tapped for focus groups and may extend also to the general youth population attending public schools in SF and the larger Bay Area as well as youth seen at Osher. The academic-community collaboration formed here could catalyze similar and more partnerships of this variety for youth mental health programming and beyond as well.

Project Innovation: Youth participatory action approaches are increasingly recognized as an effective means for community health promotion for youth, including for mental health, given its ability to amplify and empower youth voices (Smith et al., 2024). This project will utilize this innovative strategy to harness diverse SF public school youth perspectives and inform the comprehensive development of educational content that will help promote mental health through CHAs. It will also create a novel partnership between the community and integrative academic clinical and research staff to tackle a critical public health issue. 

Timeline:

July-Aug 2025: Project Planning and Preparation

Aug-Sept 2025: Youth Recruitment at 3 SFUSD school sites (2 high schools, 1 middle school)

Oct-Dec 2025: Conduct Focus Groups, Start Data Analysis

Jan-March 2026: Finish Data Analysis, Creation of Educational Content

April-May 2026: Youth testing of Educational Content and Revision Based on Youth feedback

May-June 2026: Dissemination of Educational Content through Youth-friendly Channels

Team Members and Roles

Dorothy Chiu, Osher Research Project Lead

Jennifer Moran, Community Well Co-Founder and Community Lead

Fatima Barragan, Integrative Pediatrician - will provide project oversight and guidance

Julia Burns, Communications Specialist - will support the development and creation of youth-friendly content and dissemination strategies through youth-friendly channels.


Total budget request: $13,500.

 

---------------------------------------------

phase 1 submission, fyi, for reference:

Project Lead: Dorothy Chiu

Key Team Members: Jennifer Moran (Community Well), others welcome/pending.

Project Description:

Youth mental health is in crisis. As existing mental health services struggle to meet current demands, complementary health approaches (CHAs) offer promising solutions. Many CHAs have evidence-bases for mental health and are practices youth can engage in independently. Yet, youth CHA usage is low, and lower in youth of color and low income. Barriers to engagement include low knowledge of and access to CHA and low health literacy. Hyperlocal factors likely play a role, though are understudied. This project seeks to conduct focus groups among local and/or underserved youth to better understand knowledge, attitudes, and barriers surrounding CHA usage. Based on focus group findings, tailored educational material(s) will be created to provide instruction, local area resources, and other key information to support youth in their use/access of CHAs for mental health. Possible editorial input from Osher’s expert providers will be pursued, and materials will be youth field-tested before community-wide dissemination.

 

Statement of Project Feasibility and Anticipated Impact: 

The project lead honed her qualitative skills throughout graduate and postdoctoral training and previously crafted public health educational materials for diverse youth audiences. SF’s Community Well is a community-based holistic health center with expertise in supporting health and well-being in diverse, under-resourced communities. The project lead and Community Well have collaborated on grants and share professional interests. (Please note the team welcomes more team members with interests in health communications/graphic design and integrative pediatrics/mental health!)

Project completion will entail creation of a youth-oriented, expert-reviewed, and disseminable booklet that provides actionable information on how youth can engage in CHAs (e.g., meditation, acupressure, nature therapy, etc.) for mental health promotion. Content will also address common needs and concerns and include local resources for support. Empowering youth with CHAs will promote integrative health equity. Anticipated benefits are expected for youth seen at Osher and UCSF and living in the San Francisco Bay Area.

Estimated budget: $15,000.

Supporting Documents: 
PDF icon chacha budget pdf

Comments

Ariana Jostad-Laswell - April 21, 2025 - 11:20am

Community Well & Osher seem ideally positioned for more collaboration. What ages of youth are you aiming to recruit for this project?

Dorothy Chiu - April 23, 2025 - 1:08pm

thanks, Ariana! I was thinking 6th graders and up through high school (so maybe age 12-18) and writing the booklet an 8th grade reading level.

and, yes - agree! I think Community Well's philosophies are well-aligned with Osher's. Hope this may be a way to spark collaboration! 

Julia Burns - April 23, 2025 - 4:28pm

Hi Dorothy -- great proposal! I'd love to be involved with this project. I'm interested in learning what content and channels resonate with youth, and I could help with the development of materials.

Dorothy Chiu - April 24, 2025 - 12:33pm

Thanks! - I would love your communications expertise, Julia! Welcome! 

Great point about finding content and channels that resonate with youth - I had originally been thinking along more traditional lines of dissemination for the booklet (e.g., through Osher and zSFGH waiting rooms/providers that are youth facing, SFUSD health professionals (e.g., school nurses, health teachers, administrative offices), through Community Well and their events/contacts with other community-based organizations, etc.), but it would definitely behoove "reach" to push content and/or ways to access the booklet through social media and other means that reach youth directly!

Dorothy Chiu - April 25, 2025 - 11:38am

also, considering the diverse youth that Community Well serves as well as those in the SFUSD community, it would make sense to have translations of the booklet available - spanish for sure, and can explore other options. It's nice to know there's a translation service/resource at UC Davis!

Jenifer Matthews - April 24, 2025 - 10:12pm

Great idea! Any thought on partnering with local schools?

Dorothy Chiu - April 25, 2025 - 12:00pm

thanks, Jen!

Yes, schools would be key! Offering the materials once done to San Francisco Unified School District had definitely come to mind, and it would be nice to find ways to work with them more - for example, to identify integrative strategies (e.g., nature therapy, acupressure, diet/nutrition, art/music therapy, breathwork) that would be particularly appealing/fitting to youth as well as to learn of barriers that might exist that would be pragmatic to address in what we develop. Some piloting could also happen with students in addition to what Community Well could do with their base. (Community Well is a technical assistance partner with San Francisco's Dept of Child, Youth, and Their Families so they have been working at some SFUSD sites that way.)

It'd also be great to reach out to Oakland Unified and Berkeley Unified and others as well, for dissemination at least, if not more... I I have a couple of contacts for some of these already so could start there. I am envisioning the final product to provide a section listing Bay Area/local resources that youth and families could tap into as needed.

 

as the materials are being developed as well to make sure it's in line with known needs.

 

Marliese Warren - April 30, 2025 - 2:36pm

From Perry Lang:

Intriguing idea.  However, I would need to know more about CHA (complementary health approach) evidence-based methodologies. I would also like to know more about recruitment goals, plans and numbers of participants.   

Dorothy Chiu - May 2, 2025 - 11:47am

Thank you Perry! and, yes, you raise important points.

For recruitment goals, plans, and numbers of participants, we would aim to recruit 30-40 diverse youth across San Francisco and surrounding Bay Area to participate in brief and targeted focus groups of about 2-3 people each in the Fall. (Per the literature on sample size estimates for qualitative studies to reach saturation, a minimum of 30 should be adequate [Hennick and Kaiser, 2022; Sharma et al., 2024]). Community Well would help lead recruitment efforts as would other community-based organizations as needed. For later stages of the project (Spring 2026), a subset of youth that participated in the focus groups would be asked to review the developed materials. Community Well would help lead those efforts as well. 

For the evidence base for various CHAs to support youth mental health -- Yes! it is ever expanding and increasing, which is super exciting and what motivates this project. For example, a primary study of forest bathing (contemplative time in nature-based settings often coupled with a structured walk) in 16-18 year olds observed increased their mental well-being and happiness and reduced stress (Keller et al., 2023). Another study amongst teens with depression found they viewed mind-body techniques (e.g., guided imagery, meditation, mindful eating, self-expression via art and words) to be helpful and acceptable means to treat depression symptoms (Cunningham et al., 2021). Relatedly, a systematic review of mindfulness or yoga-based school interventions in youth age 11-18 found generally consistent benefits on self-management and emotional regulation (Nagpal and Radliff, 2024). Ways by which mindfulness may foster positive psychological outcomes include the elicitation of self-compassion, perspective shifts, acceptance skills, positive states of mind, emotion regulation, lower perceived stress and psychological distress, and enhanced psychological well-being attributable to being in a restorative state of “deep rest” (Keng et al., 2011; Inwood et al., 2018; Creswell et al., 2019; Crosswell et al., 2023) Also, through the stress buffering framework, mindfulness practices may 1) increase functional activity in the prefrontal cortex via the “regulatory” pathway while 2) decreasing functional connectivity in the amygdala or body’s stress alarm via the “reactivity” pathway. (Creswell et al., 2019) Together, this modulates activation of the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal-medullary (SAM) axis to increase stress resilience and support mental (and physical) health. (Creswell et al., 2019; Creswell et al., 2014).

Marliese Warren - April 30, 2025 - 2:40pm

I like this idea and love the collaboration with Community well.  I'm curious about additional potential partnerships with organizations that work with youth such as LYRIC or Umoja Health.

Dorothy Chiu - May 2, 2025 - 11:52am

Thanks Marliese! Yes, for sure - it would be great to reach out to more community organizations with experience or priorities serving youth for this. Thanks for putting LYRIC and Umoja on my radar! It looks like their service areas don't really overlap with Community Well's and also extend into San Mateo and other parts of SF and Oakland, potentially enabling access to more youth. 

Possible avenues of collaboration include: We could explore ways to partner -- like Community Well, maybe they could help source more focus group participants who could bolster the identification of integrative strategies of interest as well as unique practice barriers that we could then be sure to address in the material(s) we develop through this. The community-based orgs could also recruit youth to serve as test audiences for the material(s) to help refine readability, clarity, presentation, appeal, etc. and get it "youth-approved". Translation to other languages could also be explored if identified as a need. Last, working with more community partners could help broaden dissemination of this project as well!

This is just a start though, and it'd be nice to explore ways to collaborate and/or expand partnerships with discussion with Community Well too.

 

Early Autism Intervention for at Risk Children

Submitted by Marliese Warren (UCSF Osher Center for Integrative Health) on April 19, 2025 - 9:52am
Primary Author: Sanford Newmark
Project Idea Status: 
Open

  1. Description of project (150 words) 

 This proposal seeks funding to launch an early intervention initiative for children with autism from underserved communities, by bridging a partnership between Osher Center and ZSFG. Research shows children from low-income, and minority backgrounds are diagnosed up to 2.5 years later than their peers, significantly delaying access to therapy during critical developmental windows. Barriers include limited healthcare access, cultural stigma, and provider shortages. Early intervention can improve communication, social skills, and long-term independence, yet disparities persist. Through integrative care, family-centered support, and culturally informed outreach, this program aims to reduce treatment delays and improve clinical outcomes to bridge the gap in care and give every child a stronger start. 

  1. Deliverables 

Focused outreach and treatment of a limited number of patients during the first year.

 

  1. Impact on Osher Center Community 

  1. List of team members and their roles 

Project leads: Sanford Newmark, MD and Fatima Barragan, MD 

Comments

Ariana Jostad-Laswell - April 21, 2025 - 11:18am

This seems like an important way to expand the pediatric care that is available through Osher so that more safety-net patients can access care. Would this be a way to bring SFGH patients to Osher to receive care? Or offering expanded services at SFGH?

Fatima Barragan - May 28, 2025 - 6:13pm

Great question Ariana, it would be both! Increase referral to Osher and treatment of Autism children at ZSFG. 

Dorothy Chiu - April 23, 2025 - 1:03pm

this project is very interesting and agree, important! I'm curious how the project and funds would be used to achieve the deliverables of outreach and treatment and how/which integrative strategies would be applied? I imagine there are many possible routes that could be taken!

Fatima Barragan - May 28, 2025 - 6:16pm

Hi Dorothy, thank you for your comments and questions. For outreach, our hope is to increase awareness of community autism resources w/in SF. For treatments, we would focus on the use of Leucovorin and other evidence based supplements. 

Christa Fernando - April 23, 2025 - 5:00pm

This is an exciting project! I am also curious what 'focused outreach and treatment' would look like. Will this be a program that providers refer their patients to or a public program? I'm also curious if a group medical visit model might be helpful here especially for caregiver support...

Fatima Barragan - May 28, 2025 - 6:18pm

Hi Christa! We considered a GMV model and that may be something we look into for future projects. This would be a program that providers can refer their patients to for now. 

Yvette Coulter - April 23, 2025 - 6:59pm

 Fostering a partnership between the Osher Center and SFGH is truly fantastic, as it could harness the strengths of both institutions to offer comprehensive and integrative care for children with autism.

However, several questions arise regarding the specifics of service delivery:

  • In what form will the collaboration between the two institutions take? Will it involve referring patients to the Osher clinic or expanding services directly at the family health center? 
  • If expanded services at SFGH are envisioned, what would this entail? Would it involve establishing a General Medical Visit (GMV) model or adding clinic shifts and additional providers? 

I am excited to learn more!

Fatima Barragan - May 28, 2025 - 6:25pm

Hi Yvette,  

The collaborations between the two institutions will include Dr. Newmark and myself (in my ZSFG role) triaging and treating patients either at ZSFG or Osher depending on our availability. We expect there to be an increase in referral to Osher Center for autsim, specifically for more medically complex cases. 

Regarding the expanded services, we would designate clinic slots at our Clinica Buena Vida for autistic pts. This would allow us to increase access to Autism specific Integrative Medicne txt modalities.  

Thank you for your great questions!

Marliese Warren - April 30, 2025 - 2:27pm

From Perry Lang, Osher Center Community Advisory Council Member-

Awesome goal.  The deepening partnership between Osher and ZSFG holds great potential, enhancing the lives of poor patients with the benefits of Osher. I would like to know more about evaluation and measuring success. 

Fatima Barragan - May 28, 2025 - 6:30pm

Hi Perry, 

Our goal is to measure success by comparing pre-and post intervetion Autism specific referral numbers to both the Osher and Clinica Buena Vida. We will evaluate pts for clinical sxs improvement post integrative medicine interventions. We will also add a short survey for parents to complete post visit.  

Thank you for your interest and support! 

Bridging Early Autism Intervention Through Integrative Medicine for Underserved Children

Submitted by Sanford Newmark on May 30, 2025 - 3:08pm
Primary Author: Fatima Barrigan
Project Idea Status: 
Open

Project Description (150 words max):

This proposal seeks funding to launch an early autism intervention initiative for children from underserved communities by establishing a partnership between the UCSF Osher Center for Integrative Health and Zuckerberg San Francisco General Hospital (ZSFG). Children from low-income and minority backgrounds are often diagnosed with autism up to 2.5 years later than their peers, delaying access to critical early interventions which could have a substantial positive effect on their future development. Barriers include limited healthcare access, cultural stigma, and provider shortages. This initiative will provide integrative, family-centered care at both Osher and ZSFG to reduce delays and improve developmental outcomes. Through targeted outreach, evidence-based supplement interventions, and culturally informed education, this pilot aims to increase early referrals, support families, and offer equitable access to integrative pediatric autism care.

Deliverables (Year 1):

  • Provide integrative autism evaluations and care for an initial cohort of underserved patients.
  • Designate clinic slots at ZSFG’s Clinica Buena Vida for autism-specific care.
  • Provide referrals and guidance to help families access available support such as ABA, speech, and occupational therapy
  • Increase referrals to the Osher Center for more complex autism presentations.
  • Develop and distribute culturally relevant educational materials for families.
  • Track and evaluate referral trends, symptom improvements, and caregiver satisfaction through surveys and chart reviews.

Impact on Osher Center Community:

  • Expands Osher’s reach to  increase our services to  low-income and historically underserved pediatric populations.
  • Strengthens Osher’s partnership with ZSFG, promoting integrative medicine equity across UCSF campuses.
  • Builds a model for integrative autism care within safety-net systems, with potential for future scale-up.
  • Supports Osher’s mission to innovate and lead in equitable, whole-person pediatric care.

Team Members and Roles:

  • Dr. Sanford Newmark, MD (Osher Center) – Project Co-Lead. Provides integrative autism evaluations at Osher and supports development of care protocols.
  • Dr. Fatima Barragan, MD (ZSFG & Osher Center) – Project Co-Lead. Coordinates patient triage and treatment at ZSFG, leads outreach, and supervises care delivery.
  • Clinica Buena Vida Support Staff – Assist in patient scheduling, follow-up, and interpretation needs.
  • Osher Pediatric Integrative Medicine Team – Collaborate on evaluation metrics, supplement guidance, and educational materials.
Supporting Documents: 
File Budget