2022 Updates

Yuki Hebner

Yuki is a PhD Candidate at UCLA in Cellular and Molecular Biology, with a focus on Gene Regulation, Epigenomics and Transcriptomics. She received a BA and MA in Molecular Biology and Biochemistry from Wesleyan University, conducting research into genetic mechanisms. In addition to her work in the lab, Yuki serves as President of the Science Policy Group at UCLA and co-founded and directs the Neuroscience Communication Seminars at the UCLA Brain Research Institute. Beyond academia, she is also engaged in scientific publishing as an Editor of Knowing Neurons, science communication as a published author of policy memos in the Journal of Science Policy & Governance, and public outreach as a volunteer with numerous community organizations. At CIAPM, she will support the Impact Assessment project, among others.

Dr. George Slavich is featured for this month’s Investigator Spotlight.

1. What are the major goals of your project, and how does the project address health impacts of Adverse Childhood Experiences (ACEs) and advance equity in California?

The overarching aim of this project is to harness the power of cutting-edge tools from psychology, immunology, multi-omics, and translational bioinformatics to identify social, molecular, and immunological processes that can be targeted to mitigate toxic stress effects and enhance personalized resilience in California.

To address our overarching aim, we are conducting a highly collaborative, multi-site demonstration project in which we are monitoring the stress levels and physiologic and biological functioning of more than 700 adults using state-of-the-art tools for life stress and Adverse Childhood Experiences (ACEs) assessment, mobile/smartwatch physiologic assessments, non-invasive blood microsampling, proteomics, metabolomics, lipidomics, immune protein assessments, electronic health record mining and analysis, and translational bioinformatics. In addition, we are developing a personalized online biopsychosocial resiliency training program, a Personal Health Dashboard, and a stress tracking website, which will display real-time estimates of stress burden at the city, state, and country level to predict stress-related health events and inform policymakers and health officials across California and the world.

Our goal with this project is to help reduce the substantial disparities in human health and those attributable to ACEs and toxic stress, which are one of the most costly, burdensome, and deadly social and medical challenges that we face today.

2. What are the most exciting project accomplishments or developments so far?

We are excited about the launch of the California Stress, Trauma, and Resilience (CAL STAR) Network. This is an amazing collaboration among scientists, academic institutions, healthcare providers, and public health advocates in California. Our main goal is to connect innovative research, public engagement, and leadership development to enhance resilience, promote community health and well-being, and prevent and mitigate toxic stress and health inequities caused by ACEs. As part of this work, we are developing a Massive Open Online Course (MOOC) on stress, health, and resilience, and we will soon be launching the CAL STAR Research Training Program, which will help trainees advance their conceptual and technical knowledge of topics related to stress, health disparities, multi-omics research, and precision medicine. Our website just went live, and we hope folks will reach out and join us in this important work.

3. How do projects funded by CIAPM differ from those funded by other sponsors?

I think the biggest difference between CIAPM projects and those funded by other sponsors is the direct focus on translating cutting-edge science into practice. By requiring each CIAPM project team to have clinical and/or community partners, CIAPM is helping ensure that the taxpayer dollars that are spent supporting cutting-edge science in California will translate into better health and wellbeing for the great people of this state. All too often, amazing projects that are funded by other sponsors yield incredible breakthroughs that are never translated into better health or health care. That's why we are so honored and proud to be supported by CIAPM. We really want our work to have an immediate and positive impact on the health and wellbeing of the people of California, and we simply cannot think of a better way to accomplish this important goal than to work with this amazing organization.

CAL STAR Network Launch

A major milestone was met by ACEs Lead PI Dr. Slavich and his team at UCLA, Los Angeles County Department of Health Services, Stanford University, and UCSF when they launched the California Stress, Trauma, & Resilience (CAL STAR) Network this summer. CAL STAR is a collaboration among scientists, academic institutions, healthcare providers, and public health officials and advocates focused on enhancing resilience, promoting community health and well-being, and preventing and mitigating toxic stress and health inequities in California related to ACEs. For more information visit https://calstarnetwork.org/.

The Governor's Office of Planning and Research is hiring for two positions! OPR is looking for a full-time Communications Specialist & Administrator and a half-time Communications & Administrative Student Intern to work with the CIAPM.

Both roles work closely with staff and external leaders from industry, academia, health care, and community-based organizations, as well as officials from the Newsom Administration.

Applications close October 2. Follow the links for more information and to apply. For any questions about the positions, contact Julianne McCall. For questions about the application process, contact Joanna Sledge.

The final state budget passed by the legislature in June and signed by the Governor includes $19.25 million to launch two new projects led by CIAPM: a $10 million depression research program and a $9.25 dollar five-year interagency project to boost representation in biomedical research. Requests for proposals will launch as early as this fall.

Dr. Manali Patel is featured for this month’s Investigator Spotlight.

1. What is the major goal of your project, and how does the project address the benefits and use of Precision Medicine in cancer research?

The major goal of our project is to reduce cancer disparities in Monterey County by focusing on the integration of precision medicine education and care delivery across the continuum of cancer. We designed a multi-level intervention that integrates community health worker-led educational approaches for precision cancer care delivery, clinician engagement, and clinic and health system process changes to ensure equitable receipt of precision cancer care. We hope to improve patients’ understanding of precision medicine and enhance evidence-based cancer care among low-income and Latinx adults.

2. What are some of the most exciting project accomplishments or developments so far?

The most exciting project accomplishments thus far have been the development, adaptation, and implementation of a novel approach to ensuring evidence-based precision cancer care delivery in our target population. With guidance from our community advisory board, we have designed, implemented, and are now testing an intervention which integrates community health workers into cancer care delivery after diagnosis, prioritizes cancer screening and genomic testing throughout the continuum of the disease. Along the way we have identified several barriers to evidence-based cancer care delivery, such as food insecurity and other complications from social determinants of health. We’re addressing these barriers by developing and testing new interventions with county partners such as the Monterey County Food Bank.

3. How do projects funded by CIAPM differ from those funded by other sponsors?

First, the premise for achieving equity was built into CIAPM’s RFP, differing from any other cancer-related precision-medicine award opportunity. This laser focus on underrepresented populations in precision medicine was unique in that it recognized that while precision cancer care improves clinical outcomes for some populations with cancer, it can also exacerbate existing disparities.

Second, CIAPM required engagement with community partners. From our prior work, we know that community engagement inevitably leads to more effective, acceptable, and sustainable approaches, and with CIAPM’s encouragement we have continued to adapt our project based on community input

Finally, the partnership with the Governor’s Office of Planning and Research provides us with a direct opportunity to inform policy and sustain change. The engagement by the CIAPM staff and the integration of our results into potential policy change is crucial given that cancer health equity is truly a policy issue. We are thankful for the award and the opportunity to make meaningful changes in the way that precision cancer care is delivered in the state.

Find us at PMWC 2022

Don’t miss the many representatives of the CIAPM network, including Advisors, researchers, community partners, and staff who will deliver talks, moderate panels, emcee sessions, and host booths throughout the three-day conference.

CIAPM will be showcased in its own session on Thursday, June 30 at 1:00pm at the Track 4 stage, featuring PIs from the Cancer Disparities and Adverse Childhood Experiences research programs: Dr. William Kim from UCSD and Dr. Michael Synder from Stanford University.

CIAPM Co-Director Dr. Julianne McCall will also moderate a stellar panel on Tuesday, June 28 at 3:45 at the Track 1 stage: “Past, Present, and Future: How will we manage the next pandemic?” The panel features California State Health Officer Dr. Tomás Aragón, CIAPM Advisor and Stanford University Chief of Pediatric Infectious Diseases Dept. Dr. Yvonne Maldonado, Former President of the Fred Hutchinson Cancer Research Center Dr. Lawrence Corey, and UCSF Dept. of Medicine Chair Dr. Robert Wachter.

Stop by our booth #A201 at the main hall entrance to meet CIAPM staff and learn more about our forthcoming RFPs on depression research and equitable participation in research.

View attendance announcement

Full conference information

CIAPM 2021 Annual Report Released

CIAPM’s 2021 Annual Report was released on May 17, 2022. The report covers the year’s major accomplishments including:

  • Advances made by our cancer disparities and ACEs research teams.
  • The substantial revitalization of CIAPM’s California Precision Medicine Asset Inventory.
  • The activities of the Precision Medicine Advisory Council including the Data Integration and Equitable Consent Working Groups.

On May 17, CIAPM shared highlights of the report with a public briefing.

View 2021 Annual Report briefing

In this CIAPM Investigator Spotlight, we feature Dr. Ariane Marie-Mitchell, Associate Professor of Preventive Medicine and Pediatrics at Loma Linda University. Since 2021, Dr. Marie-Mitchell and her team have worked on her CIAPM-funded project, A Multi-Component Intervention to Strengthen Families and Build Youth Resilience.

What are the major goals of your project, and how does the project address health impacts of Adverse Childhood Experiences (ACEs) and advance equity in California?

The major goal of this project is to foster partnerships between pediatricians, community health workers and parenting educators to improve the delivery of vital information and resources to a diverse population of families with ACEs. All partners will be trained with an evidence-based method that strengthens families and builds youth resilience. A second major goal is to use biological, psychological, and social data from a large cohort of children to evaluate whether our intervention reduces signs of toxic stress and improves child health outcomes, health care utilization, and school performance.

Our clinic is located in San Bernardino County, a region of California that is challenged by high rates of both poverty and ACEs. Along with these risk factors are higher-than-average rates of substantiated child abuse cases, substance use deaths, and chronic diseases. We’re hoping that our intervention will be an efficient and scalable model for pediatric preventive care that improves health and psychosocial outcomes for families with ACEs, in addition to reducing disparities by socioeconomic status and race/ethnicity.

A unique feature of CIAPM funding is the opportunity to combine a community intervention with a basic science research. Other sources of funding often focus on either community programs or biological research, but rarely both.
Ariane Marie-Mitchell, MD, PhD, MPH

How is the work that CIAPM funds different from the work being funded at the federal level?

A unique feature of CIAPM funding is the opportunity to combine a community intervention with a basic science research. Other sources of funding often focus on either community programs or biological research, but rarely both. Because of the unique nature of the CIAPM funds, we are creating primary care and community-level partnerships which will directly benefit the families served, and we are conducting a rigorous biological, psychological, and social evaluation. Our results will serve to guide the implementation of similar interventions in other communities, and to advance scientific understanding of the biology of adversity and resilience.

What are the most exciting project accomplishments or developments so far?

We have developed and refined a bilingual curriculum for pediatricians, community health workers, and parenting educators that translates the scientific knowledge about ACEs and resilience into useful information, skills, and resources for families. Approximately 1500 families with ACEs have been counseled by our 65 trained pediatric providers, and over 300 families have been referred to our community partners. We have also navigated some of the challenges of information sharing across different organizations and have begun building an infrastructure that will be available to partners beyond the duration of this project.

CIAPM Investigator Spotlight: Dr. Elad Ziv

In our first CIAPM Investigator Spotlight, we feature Dr. Elad Ziv, MD, Professor of Medicine and member of the Helen Diller Family Comprehensive Cancer Center and the Institute for Human Genetics at UC San Francisco. Since 2019, Dr. Ziv and his team have worked on his CIAPM-funded project, Addressing Disparities in Breast Cancer in Latinas: A Multi-Tiered Approach.

What are the major goals of your project, and how does the project address cancer health disparities in California?

This project is focused on understanding the genomic variants affecting breast cancer risk and progression among Latinas. Latina women are one of the largest demographic groups in California and breast cancer is the most common cancer in this group, like women from every population. However, we know a lot less about breast cancer in Latina women. Our project seeks to identify the inherited genetic variants that affect Latinas’ risk of developing cancer. We are also studying genetic changes in Latinas’ breast tumors, which may affect the way breast cancer progresses and could also affect treatment outcomes. Very little work of this kind has been done in this population.

The project team is also working with community-based organizations to help educate Latina women in the community about hereditary breast cancer. We encourage women to learn about their risk, to discuss the possible need for genetic testing with their doctors, and to get tested if appropriate. So the disparities we are trying to address are mostly disparities in knowledge: lack of knowledge in the medical community about how inherited genes and novel genetic changes affect breast cancer risk, progression, and treatment in Latinas, and lack of knowledge in the community about genetic risk.

Latina women are one of the largest demographic groups in California...[v]ery little work of this kind has been done in this population...CIAPM's funding is allowing us to recruit a large number of women who are not currently represented well in existing datasets.
Elad Ziv, MD

How is the work that CIAPM funds different from the work being funded at the federal level?

First, federal granting agencies often assume that research participants have already been recruited and consented, and that samples have been collected prior to applying for funding. However, scientists have not yet recruited enough Latinas and women from other non-European ancestries to have the large sample sizes that are needed for genetic studies in specific populations. CIAPM’s funding is allowing us to recruit a large number of women who are not currently represented well in existing datasets. Second, at the federal level it is not expected, emphasized, or understood that genetic studies should involve community partners. Community partnerships and the extensive educational component of our project are part of the fabric of the study, and CIAPM’s funds are being used to build new relationships between scientists and the communities they serve.

What are the most exciting accomplishments or developments so far?

We have added over 900 samples from Latina women with breast cancer to existing datasets. This is making a big impact by improving sample size for discovery, and we are beginning to identify previously-unknow genetic variants that affect breast cancer risk in this population. We have also learned a tremendous amount by building collaborations with community organizations. CIAPM has allowed us to bring together a new group of bright, creative, and motivated scientists and leaders from organizations across California in pursuit of a common goal, which is also a noteworthy accomplishment.

Governor Newsom Proposes $19.3M for Precision Medicine

On January 10, Governor Newsom released his 2022–2023 state budget proposal, the California Blueprint. Included is a $19.3M allocation for CIAPM: $10M for research to improve prevention, diagnosis, and treatment of depression with a focus on underserved populations, and $9.3M to create a cross-sector network of state agencies, nonprofits, and universities with the goal of boosting representation in biomedical research.

This proposal sets in motion a months-long period of negotiations with the Legislature that will conclude with a budget bill passed by both the Senate and the Assembly, signed by the Governor, and enacted July 1, 2022.

Budget Goal: Addressing Depression With Precision

The current trial-and-error approach to depression treatment can be costly and dangerous, potentially subjecting patients to prolonged suffering, significant side effects, and debilitating changes to medication regimens.

"The lack of reliable biomarkers for depression and suicidality makes diagnosis and treatment metrics difficult across cultures, genders, age, and other factors. Precision medicine techniques like pharmacogenetics can increasingly offer physicians modern tools to accurately identify which patients will benefit from a given therapeutic," said Clara Lajonchere, PhD, Chair of the California Precision Medicine Advisory Council.

COVID-19 continues to devastate community-wide mental health. New research is urgently needed to increase clinical and social options to combat the current and anticipated surge in depression, especially in underserved communities.

Using the principles of precision medicine to address depression involves harnessing the power of computational analytics, next-generation genetic sequencing, and data sharing and aggregation to provide interventions that are tailored to a specific patient, instead of an "average patient."

The 2018 report Precision Medicine: An Action Plan for California identifies depression as an area in which precision medicine research can benefit patients in the short and long term.

These depression research funds would be competitively granted to research institutions that partner with community groups and/or county clinics that provide services to Californians that suffer from depression at disproportionate rates. As with previous CIAPM RFPs, research teams must be co-hosted by at least one academic research institution and one nonprofit community/patient organization.

Budget Goal: Equitable Inclusion in Biomedical Research

Diversity in all its forms is one of California's greatest assets. So too is the state's world-class biomedical research ecosystem, pushing the boundaries of science in service of health and wellbeing. Not all Californians have benefitted equally, however, from cutting-edge innovations. Disparities continue to grow for patients in rural settings, communities of color, for those with disabilities, and others. One of the many upstream explanations is the lack of representation in research. Simply put, folks who are not engaged in research studies may not be able to see themselves in the results.

The Governor's proposed budget includes $9.3M to increase representation in biomedical research so that scientific advances better reflect California's diversity. CIAPM will lead an interagency collaboration to develop best practices, create informational materials, and host events to raise awareness and strengthen participation among underrepresented communities in research studies.

"The Governor's vision of a California for All necessitates cross-sector leadership across our state's scientific landscape to pursue health equity as the primary focus. Until researchers embrace the full range of social, physiological, economic, cultural, geographic, and other determinants of health, current disparities are likely to persist. As the Governor's long-range and strategic planning office, we are excited to lead this effort to advance health and medical strategies that work for all Californians," commented Sam Assefa, MCP, Director of the Governor's Office of Planning and Research.

2021 Updates

Redesigned California Precision Medicine Asset Inventory Launches

In partnership with Lawrence Berkeley National Lab in 2019, CIAPM developed an interactive database of resources (or assets) related to advancing precision medicine in California. Entries include research labs, community-based and professional organizations, projects, datasets, private companies, public agencies, and more. The purpose of the Asset Inventory is to foster connections between these expansive networks with a searchable, interactive mapping tool that allows users to find the people, organizations, and projects in California that are of interest to them.

This summer CIAPM redesigned the Asset Inventory to improve the user experience. The core functions are unchanged: users can filter assets by organization type, organization activity, and health topic, or use a search bar to find more specific terms not captured in the general filters.

New or improved features:

  • Users can easily add or update information about their organizations
  • Search results display in a scrollable, easy-to-read list
  • Details automatically display when an asset on the list or map is selected
  • Filters are more pronounced and easier to switch on/off
  • Downloadable search results

CIAPM staff also produced a quick explainer video to introduce the Asset Inventory and provide an overview of the features.

View the new Asset Inventory

New ACEs Awards Announced

The 2021-22 California State Budget, signed by Governor Newsom on June 28, 2021, expands the state's investment in preventing and treating Adverse Childhood Experiences (ACEs) by $12.4 million to drive innovative, community-driven research. This additional funding will support seven collaborative demonstration projects total across the state for three years, building on the first round of awards announced by the California Initiative to Advance Precision Medicine (CIAPM) in March 2021.

This critical investment is part of Governor Gavin Newsom's broad-based California Comeback Plan to transform California’s behavioral health system for children and youth into an innovative, prevention-focused system with early, targeted screenings and intervention. It is also a key priority of California Surgeon General Dr. Nadine Burke Harris, who aims to cut ACEs and toxic stress in half within a generation. Advancing the science of ACEs is a core element of the state's sweeping approach to explicitly address childhood trauma and toxic stress through complementary investments that extend resources and support evidence-based practices at the doctor’s office, schools, and social services across California's communities. All seven ACEs demonstration projects begin this summer as part of CIAPM, in partnership with the Office of the California Surgeon General.

"If we're going to reduce the burden of ACEs and toxic stress in a generation, we need research to inject fresh, ambitious ideas into the health care pipeline so our clinicians, social workers, and other frontline providers have a modern set of options to prevent, diagnose, measure, and treat the health impacts of ACEs and toxic stress," said California Surgeon General Dr. Nadine Burke Harris, MD, MPH. "Precision medicine is how we get there: moving from a one-size-fits-all system to an individualized approach that harnesses technology and data to address the root causes of health and social conditions, not just symptoms. In California, not only are we investing in cutting-edge research, we're also making sure that diverse communities play a role in accelerating the research agenda in a manner and direction that serves all Californians."

Research teams are co-led by academic research institutions and one or more community- or county-based organizations that serve individuals with ACEs. The new projects are listed below.

  • Systems-based, Multidisciplinary Assessment of Adversity and Toxic Stress for Individualized Care (The SYSTEMAATIC Project) – Stanford University; Center for Youth Wellness
  • Advancing a Precision Population Health Approach to ACEs to Reduce Health Disparities – UC San Diego; San Diego County Behavioral Health Services; Scripps Mercy Hospital Chula Vista; Community Information Exchange - 211 San Diego; Rady Children's Hospital; University of San Diego; San Diego State University; YMCA of San Diego County
  • Identifying Social, Molecular, & Immunological Processes for Mitigating Toxic Stress & Enhancing Personalized Resilience – UCLA; The Scripps Research Institute; UCSF; Los Angeles County Depart. of Health Services

2020 Annual Report Released

The Governor's Office of Planning and Research is pleased to announce the release of CIAPM's 2020 Annual Report to the California Legislature.

In a year defined by a pandemic, a national reckoning over racial injustice, and increasing climate-related disasters including devastating wildfires and several months of extreme heat, CIAPM continued to lead and participate in wide-ranging, cross-agency efforts to further medical sciences, elevate community partnerships, and engage experts in helping to shape the next chapter of health and wellbeing in a modern era of scientific and inclusive leadership.

CIAPM staff have prepared this report to showcase 2020 programmatic and project highlights, which include:

  • Advancing the State's response to COVID-19 by contributing time and expertise as members of the Governor's COVID-19 Testing Task Force and the Governor's Future Opportunities Task Force
  • Establishing and convening the California Precision Medicine Advisory Council, in coordination with the Senate, Assembly, and California Health and Human Services Agency
  • Launching two Advisory Council working groups focused on 1) integrating data about Social Determinants of Health into electronic health records, and 2) engaging with underrepresented communities to increase participation in biomedical research
  • Co-authoring and supporting the release of the first-ever California Surgeon General's Report
  • Adding to OPR's capacity to address systemic racism by participating in the Capitol Collaborative on Race and Equity, and continuing to fund research that directly addressed health disparities
  • Expanding programmatic communications and outreach with a new monthly newsletter and public-facing resources on our website
  • Engaging the wider precision health community by speaking at national and international conferences and participating on panels

The full report is available to download. Briefings on the report were delivered to the legislature and stakeholders on June 17, available to view here.

California Legislature Allocates $12.4 Million for ACEs Research

On June 14, the California State Legislature passed a state budget that includes Governor Newsom’s proposed $12.4 million investment to expand CIAPM's ACEs research program. The investment will build on the first round of awards announced in March 2021, to launch a total of seven demonstration projects across the state. All projects begin this summer. The Governor has until the end of June to sign the budget bill.

California's economy is coming roaring back. With the largest surplus in California history, we're using this once-in-a-generation opportunity to create an economic recovery that will leave nobody behind.
Governor Gavin Newsom on June 14, 2021

More about CIAPM's ACEs research

The California Initiative to Advance Precision Medicine looks ahead and envisions future needs for a healthier, more equitable state. This includes supporting precision medicine research projects that will deliver effective clinical and community-based solutions within five years. ACEs and toxic stress pose the sort of cross-cutting challenges that impact nearly all health departments and communities. And as the state emerges from the COVID-19 pandemic, the need continues to grow for next-generation prevention, detection, and treatments to address ACEs, toxic stress, and affiliated health conditions.

CIAPM Welcomes Graduate Student Interns

Following a competitive application process with many extremely well-qualified candidates, CIAPM is thrilled to bring aboard two new graduate student interns: Jessica Lumian and Affad Shaikh. Their primary project is building an updated California Precision Medicine Asset Inventory, with an improved user interface and greater functionality. The current Asset Inventory will remain accessible through this phase of development.

Jessica Lumian

Jessica Lumian is pursuing a PhD in Microbiology at the University of California, Davis in the Earth and Planetary Sciences department. She holds a bachelor's degree in Biochemistry and Molecular Biology from Michigan State University. Her thesis research focuses on environmental tolerance mechanisms of Antarctic cyanobacteria using a variety of bioinformatics techniques. She enjoys promoting data availability and reproducibility in scientific research and has served as a prior instructor for The Carpentries, a non-profit organization dedicated to teaching fundamental computational skills and fostering an inclusive data science community. She also assists with the organization of science outreach events through STEM for Girls at UC Davis and is interested in increasing science literacy for all ages. In addition to her graduate work, Jessica studied the accessibility of dialysis treatment centers in California using geographical and statistical analyses. She is enthusiastic about contributing to work promoting equity and accessibility in healthcare.

Affad Shaikh

Affad Shaikh is a business-oriented Data Scientist who recently completed dual master's degrees in Business Administration and Information Systems and Technology from Claremont Graduate University. He earned his bachelor's degree from the University of California, San Diego in International Studies and is currently finishing a Data Fellowship with The Data Incubator. He looks for solutions and uncovers stories that inform strategy and decision making, and he combines design thinking with a collaborative, multidisciplinary approach. His motivation is to be of service, and to that end he is currently a Board Secretary for the Interfaith Movement for Human Integrity, a California non-profit dedicated to advocating and serving marginalized communities at the intersection of immigration detention and criminal justice. Prior to his graduate studies, Affad built up the Civil Rights department in the Greater Los Angeles office of the Council on American and Islamic Relations, a national non-profit.

Governor Newsom's California Comeback Plan Supports CIAPM Research

As part of the Governor’s California Comeback Plan, CIAPM would receive $12.4 million to further the science of Adverse Childhood Experiences (ACEs) by supporting community-driven precision medicine projects focused on treating and preventing ACEs with scalable approaches. A total of seven collaborative research teams across the state would receive funding: expansion of the four inspiring projects announced in March, and initiation of three additional projects. These projects were selected and ranked from 39 original applications by CIAPM’s world-class, out-of-state Expert Selection Committee.

The challenges of addressing ACEs exist along a pipeline. At one end are health care and service providers responding to children and adults with acute and serious needs, bolstered by California's first-in-the-nation efforts to enhance ACEs screening and referral systems. At an earlier end of the pipeline are researchers and communities carefully studying the prevalence and physiological impacts of ACEs and toxic stress in diverse regions, developing innovative and cross-cutting strategies for preventing, detecting, and treating ACEs.

CIAPM exists at this earlier stage of research and looks ahead to visualize future needs for a healthier, more equitable state. To reach those goals, we set in motion competitively selected research projects that will deliver more effective clinical and community-based solutions within five years and well beyond.

Watch Governor Newsom's press conference on the budget via the Governor's YouTube channel. The Health and Human Services Summary and full budget proposal are also available online.

Redesigned CIAPM Website Launches

On April 22 CIAPM launched a redesigned website. The rollout was part of a larger website update for the Governor’s Office of Planning & Research. In addition to the educational content discussed below, the new site is easier to navigate and better highlights our funded projects, cross-agency partnerships, news and updates, and members of our staff, the California Precision Medicine Advisory Council, and Expert Committees.

We are also delighted to launch brand new content, including a primer on precision medicine and a curated resource library of external information for all audiences. In the near future we plan to add playlists of our favorite informative videos about precision medicine, public health, and other related topics, and a continuously updated list of relevant external funding opportunities.

Browse the primer for answers to questions like How does precision medicine affect me? and How will data change health care? If you are a researcher, teacher, student, or community member, there are additional resources that have been carefully curated with you in mind.

We will continue to update the resources to capture new developments and represent diverse voices in the field. If there is a link or topic you would recommend including on the webpage, please share it with us.

California Precision Advisory Medicine Council Working Groups Launch

February marked the kickoff for both of the Council's working groups. Each is focused on addressing specific health disparities: integrating social determinants of health data into electronic health records, and creating a framework for an equitable consent process that brings more undderrpresented minority groups into medical research.

The first meeting of the Data Integration working group took place on February 8. The group discussed several existing efforts to standardize social determinants of health for electronic health records, and possible partnerships and synergies between public, private, and nonprofit organizations. The Data Integration group is chaired by Hakan Sakul, PhD, who is a Vice President and Head of Diagnostics at Pfizer.

A traditional medical record doesn't give a health care practitioner a complete picture of the many factors that contribute to a patient's health and wellness. Risk factors such as food or housing insecurity have an enormous impact on a person's health, but at present there is no consensus about the best way for health professionals to capture, assess, store, or access data about social drivers of health so that the information can be used in clinical decision making. We're looking forward to connecting with partners across the state and country to break down data integration barriers for the benefit of Californians.
Dr. Hakan Sakul
Chair, Data Integration Working Group

The first meeting of the Equitable Consent working group took place on February 19. The members contributed ideas on the development of an equitable framework for the informed consent process that takes place in the course of research on human subjects, and strategized how to maximize the impact of the project. The group is chaired by Kenneth Kim, MD, a physician who is the founder and Chief Medical Officer for Ark Clinical Research.

Part of the reason health disparities persist is that the communities experiencing disparities have historically been preyed upon by medical researchers, so they are understandably reticent to participate in research that may benefit them. It's the responsibility of the researchers to reach out to minority groups that are currently underrepresented in medical research, learn from them their reasons why they may hesitate to participate, and work with those communities on strategies to build trust between researchers and potential research subjects. A step in that direction is to design an equitable framework for the informed consent process so that it is accessible to a wider array of potential participants.
Dr. Kenneth Kim
Chair, Equitable Consent Working Group

Each working group will meet every other month, and meetings will be open to the public. Check the Meetings page for agendas and registration details.

Setting a Statewide Research Agenda for Disaster Resilience

The California Council on Science & Technology (CCST) engaged CIAPM in an agenda-setting workshop on February 18 as part of their new Disaster Resilience Initiative, an effort to bridge science and technology experts with state policymakers. Sharing the virtual panel with California Health and Human Services Assistant Secretary Marko Mijic and Assemblymember Dr. Bill Quirk, CIAPM Co-Director Dr. Julianne McCall presented to deans, chief science officers, chief innovation officers, professors, and other experts representing California's world-class research institutions, including CIAPM Advisor Dr. Bonnie Maldonado. Discussion about the most pressing policy and research challenges in our state touched on the digital divide, an impending mental health crisis, rampant public health misinformation, economic strains, workforce development, and data infrastructure. Policy Fellows Aiyana Emigh Cortez and Hyunsoo Gloria Kim contributed to post-panel discussions and exercises.

2020 Updates

First-ever California Surgeon General's Report Released

The first-ever California Surgeon General’s Report was released, titled Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health. This report was co-authored by CIAPM Co-Director Dr. Julianne McCall, with contributions from Co-Director Dr. Shannon Muir, former Science Fellow Dr. Ken McCullough, and Policy Fellow Gloria Kim, design by Science Communications Specialist and Administrator Megan Varvais, and reference management by Policy Fellows April Booth and Aiyana Emigh Cortez.

The 438-page report is a product of experts across specialties and geographic areas. Organized around primary, secondary, and tertiary prevention strategies, the report includes stand-alone summaries for various sectors, including health care, education, early childhood, justice, and social services.

California Surgeon General Dr. Nadine Burke Harris presented key findings from the report in a public webinar, recorded and accessible here.

We at CIAPM were honored to partner with the Office of the California Surgeon General to develop this important resource and look forward to continuing to advance the science of ACEs with the announcement of awardees of our ongoing Request for Proposals for ACEs research in March.

Key Steps to Reduce Racial Cancer Disparities Include Supporting Minority Scientists, Diversifying Medical Schools and Clinical Trials

Former CIAPM Advisor John Carpten, PhD, addressed Congress this month as the Chair of the inaugural AACR Cancer Disparities Progress Report 2020, published September 16 by the American Association of Cancer Research. In his presentation to Congress and a recent interview for the American Journal of Managed Care (AJMC), he discussed the root causes of racial inequality in cancer care, how inequality in research leads to disparities in outcomes and mortality, and how cancer researchers can change these circumstances.

By diversifying the cohort, we learn more about the efficacy of the therapy, or perhaps the toxicity profile...by diversifying trials, we help everyone. The whole concept of interdisciplinary and transdisciplinary research will probably be part of the answer. And we have to break down the barriers, break down the walls, and break down the silos, and begin to work together and come up with novel study designs that bring to bear various disciplines to address these issues.
Dr. John Carpten

Dr. Carpten is the Chair of the Department of Translational Genomics at the University of Southern California (USC) and co-leads the Translational and Clinical Sciences Program at the USC Norris Comprehensive Cancer Center. Dr. Carpten was a member of the Precision Medicine Advisory Committee, which produced the 2018 report Precision Medicine: An Action Plan for California.

Further reading: AACR Cancer Disparities Progress Report 2020

Former CIAPM Investigator Celebrates Anniversary of Major Genome Breakthrough

This summer, the National Human Genome Research Institute celebrated 20 years since Dr. David Haussler and his team at UC Santa Cruz uploaded the first working draft sequence of the human genome. Not long after, the UCSC Genome Browser was released, enabling graphical visualization of the data. The framework continues to provide researchers the opportunity to contribute their findings for others to use. Since its release, the UCSC Genome Browser has been used extensively, nearing 40,000 citations in the literature.

In the early days of the pandemic, Dr. Haussler's team worked to adapt the UCSC Genome Browser to provide researchers around the world with a common platform to access the latest molecular data characterizing the SARS-CoV-2 genome and proteins. Scientists can use the community resource to analyze how the virus has mutated, compare the genome with other coronaviruses, and upload their own findings to further shared understanding. A manuscript was recently posted with full details.

Dr. Haussler is the Scientific Director of the UC Santa Cruz Genomics Institute and was one of CIAPM's first grantees in 2015.

California Precision Medicine Advisory Council Holds First Meeting

The California Precision Medicine Advisory Council (CPMAC) held its first meeting on May 12 and 15, 2020. Both sessions were virtual. The Council selected Clara Lajonchere, PhD to be Chair and Keith Yamamoto, PhD for Vice Chair. Dr. Lajonchere is the Deputy Director of the Institute for Precision Health at UCLA's David Geffen School of Medicine. Dr. Yamamoto is Vice Chancellor for Science Policy and Strategy at UCSF.

Information about the CPMAC's meetings, including minutes, can be found on the Meetings page.

CIAPM-Supported Research Advances Pandemic Response

Sequencing the Virus

A CIAPM grant recipient is using the techniques he refined and expanded as a Principle Investigator to sequence viral genomes from hundreds of COVID-19 patients, informing health officials of how the virus is mutating and spreading around the world. Charles Chiu, MD, PhD, an infectious disease physician and professor of laboratory medicine at University of California San Francisco, received the grant in 2015 for his project “Precision Diagnosis of Infectious Diseases.” Dr. Chiu conducted the research in collaboration with four other Universities of California, the Department of Public Health, a number of California-based companies, and other partners.

Read more in the press:

Identifying Lesser-Known Symptoms of COVID-19

New research from Dr. Brennan Spiegel, MD and a Wuhan-based medical team sheds light on a lesser-known form of COVID-19. While the coronavirus pandemic continues to unfold, doctors and scientists around the world are rapidly developing diagnostic tests, searching for possible treatments, testing vaccine candidates, and caring for patients using every medical tool and technique available. Those critical efforts depend on a comprehensive understanding of how COVID-19 impacts all patients, not just the majority. Dr. Spiegel serves as Director of Health Services Research at the Cedars-Sinai Health System in Los Angeles and is a 2017 CIAPM grant recipient for research in cardiology and remote biosensors.

While the most prevalent and threatening symptoms of COVID-19 are respiratory, the research team found that some patients with a more mild form of the disease experience gastrointestinal problems before or entirely without any of the commonly associated symptoms, like fever, cough, and shortness of breath. Such patients tend to be diagnosed later than others, and are at-risk of spreading the virus for days without suspecting they would test positive for the disease.

Read the pre-published study made available by the American Journal of Gastroenterology and national press coverage:

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Julianne McCall
Julianne McCall is the Co-Director for the California Initiative to Advance Precision Medicine.