Krista Harrison, PhD

Associate Professor

Geriatrics

Krista Harrison, PhD, is an Associate Professor in the Division of Geriatrics and the Philip R. Lee Institute for Health Policy Studies (IHPS). Her research aims to mitigate suffering by improving models of care & policies for older adults living with, dying from, and grieving neurodegenerative diseases and other serious illnesses. She uses quantitative data to examine population-level needs and generate qualitative and mixed-methods data to inform the development of policy recommendations or gerineuropalliative interventions for community-dwelling people with dementia and care partners.

Dr. Harrison completed her PhD in health policy and bioethics at the Johns Hopkins Bloomberg School of Public Health; postdoctoral training in aging research and implementation science at UCSF, and an Atlantic Fellowship for Equity and Brain Health at the Global Brain Health Institute. Before joining UCSF, Dr. Harrison was an executive leader at a large nonprofit community-based hospice and palliative care organization. Dr. Harrison's currently serves as co-lead of the Vulnerable Aging Research Core of the Claude D. Pepper Older American Independence Center.

Education
05/2021 - Diversity, Equity and Inclusion Champion Training, University of California
Atlantic Fellow, 2019 - Equity in Brain Health, Global Brain Health Institute, UCSF
T32 Fellowship, 2017 - Aging Research, University of California
Certificate, 2016 - Implementation Science, University of California
PhD, 2013 - Bioethics, Health Policy & Management, Johns Hopkins Bloomberg School of Public Heath
AHRQ NRSA, 2010 - Health Services Research, Johns Hopkins Bloomberg School of Public Health
BA, 2004 - Biology, English, Williams College
2002 - Biology, English, Oxford University
Honors and Awards
  • Junior Faculty Visiting Professor Program in Geriatric Palliative Care, University of North Carolina, 2024
  • GeriPal Mentor of the Year, UCSF Geriatrics and Palliative Care Fellowship, 2021
  • UCSF Philip R. Lee Institute for Health Policy Studies Emerging Scholar Exchange Program, University of Pennsylvania Leonard R. Davis Center, 2020
  • NIA Mentored Research Scientist Development Award (K01), National Institute on Aging, 2019-2024
  • 2019 UCSF MSTAR Research Mentor Award, UCSF Medical Students Training in Aging Research (MSTAR), 2019
  • CTSI KL2 Career Development Award, University of California San Francisco, 2018-2021
  • Pilot Awards for Global Brain Health Leaders, Alzheimer's Association/Global Brain Health Institute, 2018-2020
  • NPCRC Junior Faculty Career Development Award, National Palliative Care Research Center, 2018-2020
  • Hellman Fellows Program, University of California San Francisco, 2018-2020
  • UCSF Claude D. Pepper Older Americans Independence Center (OAIC) Research Scholar, University of California San Francisco, 2017-2019
Publications
  1. Bock MA, Macchi ZA, Harrison KL, Katz M, Dini M, Jones J, Ayele R, Kutner JS, Pantilat SZ, Martin C, Sillau S, Kluger B. Does a novel community-based outpatient palliative care intervention for Parkinson's disease and related disorders improve care? Qualitative results from patients and care partners. Palliative medicine 2024. PMID: 38267836


  2. Allison TA, Gubner JM, Harrison KL, Smith AK, Barnes DE, Covinsky KE, Yaffe K, Johnson JK. Music engagement as part of everyday life in dementia caregiving relationships at home. The Gerontologist 2023. PMID: 38158775


  3. Guterman EL, Kiekhofer RE, Wood AJ, Allen IE, Kahn JG, Dulaney S, Merrilees JJ, Lee K, Chiong W, Bonasera SJ, Braley TL, Hunt LJ, Harrison KL, Miller BL, Possin KL. Care Ecosystem Collaborative Model and Health Care Costs in Medicare Beneficiaries With Dementia: A Secondary Analysis of a Randomized Clinical Trial. JAMA internal medicine 2023. PMID: 37721734


  4. Li J, Bancroft H, Harrison KL, Fox J, Tyler AM, Arias JJ. Out-of-Pocket Expenses for Long-Term Care by Dementia Status and Residential Setting Among US Older Adults. Journal of the American Medical Directors Association 2023. PMID: 37863109


  5. Aldridge MD, Hunt LJ, Harrison KL, McKendrick K, Li L, Morrison RS. Health Care Costs Associated With Hospice Use For People With Dementia In The US. Health affairs (Project Hope) 2023. PMID: 37669483


  6. Harrison KL, Boyd N, Ritchie CS. Toward Gerineuropalliative Care for Patients with Dementia. The New England journal of medicine 2023. PMID: 37632464


  7. Hsu KY, Cenzer I, Harrison KL, Ritchie CS, Waite L, Kotwal A. In sickness and in health: Loneliness, depression, and the role of marital quality among spouses of persons with dementia. Journal of the American Geriatrics Society 2023. PMID: 37539784


  8. Hunt LJ, Gan S, Smith AK, Aldridge MD, Boscardin WJ, Harrison KL, James JE, Lee AK, Yaffe K. Hospice Quality, Race, and Disenrollment in Hospice Enrollees with Dementia. Journal of palliative medicine 2023. PMID: 37010377


  9. Radcliffe KG, Halim M, Ritchie CS, Maus M, Harrison KL. Care Setting Transitions for People With Dementia: Qualitative Perspectives of Current and Former Care Partners. The American journal of hospice & palliative care 2023. PMID: 36730920


  10. Harrison KL, Garrett SB, Gilissen J, Terranova MJ, Bernstein Sideman A, Ritchie CS, Geschwind MD. Developing neuropalliative care for sporadic Creutzfeldt-Jakob Disease. TO REMOVE 2022. PMID: 35239456


  11. Harrison KL, Cenzer I, Smith AK, Hunt LJ, Kelley AS, Aldridge MD, Covinsky KE. Functional and clinical needs of older hospice enrollees with coexisting dementia. Journal of the American Geriatrics Society 2022. PMID: 36420734


  12. Sideman AB, Gilissen J, Harrison KL, Garrett SB, Terranova MJ, Ritchie CS, Geschwind MD. Caregiver Experiences Navigating the Diagnostic Journey in a Rapidly Progressing Dementia. Journal of geriatric psychiatry and neurology 2022. PMID: 36412170


  13. Harrison KL, Cenzer I, Ankuda CK, Hunt LJ, Aldridge MD. Hospice Improves Care Quality For Older Adults With Dementia In Their Last Month Of Life. TO REMOVE 2022. PMID: 35666964


  14. Harrison KL, Ritchie CS, Hunt LJ, Patel K, Boscardin WJ, Yaffe K, Smith AK. Life expectancy for community-dwelling persons with dementia and severe disability. TO REMOVE 2022. PMID: 35357694


  15. Trandel ET, Lowers J, Bannon ME, Moreines LT, Dellon EP, White P, Cross SH, Quest TE, Lagnese K, Krishnamurti T, Arnold RM, Harrison KL, Patzer RE, Wang L, Zarrabi AJ, Kavalieratos D. Barriers of Acceptance to Hospice Care: a Randomized Vignette-Based Experiment. TO REMOVE 2022. PMID: 35319086


  16. LaHue SC, Escueta DP, Guterman EL, Patel K, Harrison KL, Boscardin WJ, Douglas VC, Newman JC. COVID-19 severity and age increase the odds of delirium in hospitalized adults with confirmed SARS-CoV-2 infection: a cohort study. TO REMOVE 2022. PMID: 35227231


  17. Ankuda CK, Kotwal A, Reckrey J, Harrison KL, Ornstein KA. The Experience of Homebound Older Adults During the COVID-19 Pandemic. TO REMOVE 2022. PMID: 35167063


  18. Naasan G, Boyd ND, Harrison KL, Garrett SB, D'Aguiar Rosa T, Pérez-Cerpa B, McFarlane S, Miller BL, Ritchie CS. Advance Directive and POLST Documentation in Decedents With Dementia at a Memory Care Center: The Importance of Early Advance Care Planning. Neurology. Clinical practice 2022. PMID: 36157620


  19. Shafir A, Ritchie CS, Garrett SB, Bernstein Sideman A, Naasan G, Merrilees J, Widera E, Flint L, Harrison KL. "Captive by the Uncertainty"-Experiences with Anticipatory Guidance for People Living with Dementia and Their Caregivers at a Specialty Dementia Clinic. TO REMOVE 2022. PMID: 35124641


  20. Harrison KL, Garrett SB, Halim M, Sideman AB, Allison TA, Dohan D, Naasan G, Miller BL, Smith AK, Ritchie CS. "I Didn't Sign Up for This": Perspectives from Persons Living with Dementia and Care Partners on Challenges, Supports, and Opportunities to Add Geriatric Neuropalliative Care to Dementia Specialty Care. Journal of Alzheimer's disease : JAD 2022. PMID: 36245375


  21. Ornstein KA, Ankuda CK, Leff B, Rajagopalan S, Siu AL, Harrison KL, Oh A, Reckrey JM, Ritchie CS. Medicare-funded home-based clinical care for community-dwelling persons with dementia: An essential healthcare delivery mechanism. TO REMOVE 2021. PMID: 34936087


  22. Eaton England AL, Ritchie CS, Mickler A, Perissinotto CM, Garrigues SK, Leff B, Sheehan OC, Harrison KL. Attitudes of Homebound Older Adults and their Caregivers toward Research and Participation as Research Advisors. The Gerontologist 2020. PMID: 33216908


  23. Boyd ND, Naasan G, Harrison KL, Garrett SB, D'Aguiar Rosa T, Pérez-Cerpa B, McFarlane S, Miller BL, Ritchie CS. Characteristics of people with dementia lost to follow-up from a dementia care center. International journal of geriatric psychiatry 2021. PMID: 34590336


  24. Hunt LJ, Harrison KL, Covinsky KE. Instead of wasting money on aducanumab, pay for programs proven to help people living with dementia. Journal of the American Geriatrics Society 2021. PMID: 34480351


  25. Allison TA, Gubner JM, Oh A, Harrison KL, Pham K, Barnes DE, Johnson JK, Covinsky KE, Smith AK. Meaningful Activities and Sources of Meaning for Community-Dwelling People Living with Dementia. Journal of the American Medical Directors Association 2021. PMID: 34481793


  26. Harrison KL. Making Space for Grief in Academia. JAMA 2021. PMID: 34427597


  27. Oh A, Allison TA, Mahoney K, Thompson N, Ritchie CS, Sudore RL, Harrison KL. Front-Line Hospice Staff Perceptions of Barriers and Opportunities to Discussing Advance Care Planning With Hospice Patients and Their Families. Journal of the American Medical Directors Association 2021. PMID: 34391713


  28. Bernstein Sideman A, Harrison KL, Garrett SB, Naasan G, Dementia Palliative Care Writing Group , Ritchie CS. Practices, challenges, and opportunities when addressing the palliative care needs of people living with dementia: Specialty memory care provider perspectives. Alzheimer's & dementia (New York, N. Y.) 2021. PMID: 33969177


  29. Harrison KL. The Hidden Curriculum Of Hospice: Die Fast, Not Slow. Health affairs (Project Hope) 2021. PMID: 33939517


  30. Hunt LJ, Harrison KL. Live discharge from hospice for people living with dementia isn't "graduating"-It's getting expelled. Journal of the American Geriatrics Society 2021. PMID: 33855701


  31. Leff B, Sheehan OC, Harrison KL, Eaton England A, Mickler A, Basyal PS, Garrigues SK, Schuchman M, Perissinotto C, Garrett SB, Ritchie CS. A Home-Based Care Research Agenda by and for Homebound Older Adults and Caregivers. Journal of applied gerontology : the official journal of the Southern Gerontological Society 2021. PMID: 33792428


  32. Mickler AK, Leff B, Eaton England A, Garrigues SK, Schuchman M, Perissinotto C, Ritchie CS, Harrison KL, Sheehan OC. Understanding the Daily Experiences and Perceptions of Homebound Older Adults and Their Caregivers: A Qualitative Study. Journal of applied gerontology : the official journal of the Southern Gerontological Society 2021. PMID: 33522364


  33. Harrison KL, Leff B, Garrigues SK, Eaton England AL, Perissinotto CM, Sheehan OC, Mickler AK, Basyal PS, Ritchie CS. Virtual Research Stakeholder Groups with Isolated Homebound Elders and Caregivers: Lessons Learned Relevant to Research during Pandemics. Journal of palliative medicine 2021. PMID: 33395555


  34. Dressler G, Garrett SB, Hunt LJ, Thompson N, Mahoney K, Sudore RL, Ritchie CS, Harrison KL. "It's Case by Case, and It's a Struggle": A Qualitative Study of Hospice Practices, Perspectives, and Ethical Dilemmas When Caring for Hospice Enrollees with Full-Code Status or Intensive Treatment Preferences. Journal of palliative medicine 2020. PMID: 33237830


  35. Allison TA, Oh A, Harrison KL. Extreme Vulnerability of Home Care Workers During the COVID-19 Pandemic-A Call to Action. JAMA internal medicine 2020. PMID: 32749452


  36. Hunt LJ, Garrett SB, Dressler G, Sudore R, Ritchie CS, Harrison KL. Goals of care conversations don't fit in a box': Hospice Staff Experiences and Perceptions of Advance Care Planning Quality Measurement. Journal of pain and symptom management 2020. PMID: 33096214


  37. Harrison KL, Kotwal AA, Smith AK. Palliative Care for Patients With Noncancer Illnesses. JAMA 2020. PMID: 33048142


  38. Leff B, Sheehan O, Bhatnagar S, Harrison KL, Barrows RC, Ritchie CS. To What Extent Are the Centers for Medicare & Medicaid Services 2019 MIPS Quality Measures Inclusive of Home-Based Medical Care? Annals of internal medicine 2020. PMID: 32423352


  39. Bernstein A, Merrilees J, Dulaney S, Harrison KL, Chiong W, Ong P, Heunis J, Choi J, Walker R, Feuer JE, Lee K, Dohan D, Bonasera SJ, Miller BL, Possin KL. Using care navigation to address caregiver burden in dementia: A qualitative case study analysis. Alzheimer's & dementia (New York, N. Y.) 2020. PMID: 32377557


  40. Sheehan OC, Ritchie CS, Garrett SB, Harrison KL, Mickler A, Eaton England AL, Sharma Basyal P, Garrigues SK, Leff B. Unanticipated Therapeutic Value of the Patient-Centered Outcomes Research Institute (PCORI) Stakeholder Engagement Project for Homebound Older Adults. Journal of the American Medical Directors Association 2020. PMID: 32376106


  41. Harrison KL, Leff B, Altan A, Dunning S, Patterson CR, Ritchie CS. What's Happening at Home: A Claims-based Approach to Better Understand Home Clinical Care Received by Older Adults. Medical care 2019. PMID: 31876645


  42. Harrison KL, Allison TA, Garrett SB, Thompson N, Sudore RL, Ritchie CS. Hospice Staff Perspectives on Caring for People with Dementia: A Multisite, Multistakeholder Study. Journal of palliative medicine 2020. PMID: 32130076


  43. Harrison KL, Bull JH, Garrett SB, Bonsignore L, Bice T, Hanson LC, Ritchie CS. Community-Based Palliative Care Consultations: Comparing Dementia to Nondementia Serious Illnesses. Journal of palliative medicine 2020. PMID: 31971857


  44. Portacolone E, Halpern J, Luxenberg J, Harrison KL, Covinsky KE. Ethical Issues Raised by the Introduction of Artificial Companions to Older Adults with Cognitive Impairment: A Call for Interdisciplinary Collaborations. Journal of Alzheimer's disease : JAD 2020. PMID: 32250295


  45. Candrian C, Furuno JP, Kavalieratos D, Harrison KL. Collaboration Makes Us Better: Time to Increase Equity in the Science of Hospice and Palliative Care. Journal of palliative medicine 2019. PMID: 31794371


  46. Possin KL, Merrilees JJ, Dulaney S, Bonasera SJ, Chiong W, Lee K, Hooper SM, Allen IE, Braley T, Bernstein A, Rosa TD, Harrison K, Begert-Hellings H, Kornak J, Kahn JG, Naasan G, Lanata S, Clark AM, Chodos A, Gearhart R, Ritchie C, Miller BL. Effect of Collaborative Dementia Care via Telephone and Internet on Quality of Life, Caregiver Well-being, and Health Care Use: The Care Ecosystem Randomized Clinical Trial. JAMA internal medicine 2019. PMID: 31566651


  47. Harrison KL, Ritchie CS, Patel K, Hunt LJ, Covinsky KE, Yaffe K, Smith AK. Care Settings and Clinical Characteristics of Older Adults with Moderately Severe Dementia. Journal of the American Geriatrics Society 2019. PMID: 31389002


  48. Rosa TD, Possin KL, Bernstein A, Merrilees J, Dulaney S, Matuoka J, Lee KP, Chiong W, Bonasera SJ, Harrison KL, Kahn JG. Variations in Costs of a Collaborative Care Model for Dementia. Journal of the American Geriatrics Society 2019. PMID: 31317539


  49. Kestenbaum MG, Harrison K, Masi D, Kuhl EA, Muir JC. Use of auditing and feedback in an outpatient hospice setting: Quality and pharmacoeconomic oversight. Journal of pain and symptom management 2019. PMID: 31247213


  50. Verma A, Smith AK, Harrison KL, Chodos AH. Ethical Challenges in Caring for Unrepresented Adults: A Qualitative Study of Key Stakeholders. Journal of the American Geriatrics Society 2019. PMID: 31059129


  51. Harrison KL, Hunt LJ, Ritchie CS, Yaffe K. Dying With Dementia: Underrecognized and Stigmatized. Journal of the American Geriatrics Society 2019. PMID: 30908605


  52. Ritchie CS, Leff B, Harrison K. Response to Letter to the Editor "Caregiver Assessment Is Critical to HBMC". Journal of the American Medical Directors Association 2019. PMID: 30879949


  53. Casey JJ, Harrison KL, Ventura MI, Mehling W, Barnes DE. An integrative group movement program for people with dementia and care partners together (Paired PLIÉ): initial process evaluation. Aging & mental health 2019. PMID: 30744387


  54. Bernstein A, Harrison KL, Dulaney S, Merrilees J, Bowhay A, Heunis J, Choi J, Feuer JE, Clark AM, Chiong W, Lee K, Braley TL, Bonasera SJ, Ritchie C, Dohan D, Miller BL, Possin KL. The Role of Care Navigators Working with People with Dementia and Their Caregivers. Journal of Alzheimer's disease : JAD 2019. PMID: 31322558


  55. Ritchie CS, Leff B, Garrigues SK, Perissinotto C, Sheehan OC, Harrison KL. A Quality of Care Framework for Home-Based Medical Care. Journal of the American Medical Directors Association 2018. PMID: 30056010


  56. Harrison KL, Taylor HA, Merritt MW. Action Guide for Addressing Ethical Challenges of Resource Allocation Within Community-Based Healthcare Organizations. The Journal of clinical ethics 2018. PMID: 29916829


  57. Hunt LJ, Lee SJ, Harrison KL, Smith AK. Secondary Analysis of Existing Datasets for Dementia and Palliative Care Research: High-Value Applications and Key Considerations. Volume 21 of Issue 2. Journal of palliative medicine 2017. PMID: 29265949


  58. Petrillo LA, Dzeng E, Harrison KL, Forbes L, Scribner B, Koenig BA. How California Prepared for Implementation of Physician-Assisted Death: A Primer. Volume 107 of Issue 6. American journal of public health 2017. PMID: 28426307


  59. Harrison KL, Dzeng E, Ritchie CS, Shanafelt TD, Kamal AH, Bull JH, Tilburt JC, Swetz KM. Addressing Palliative Care Clinician Burnout in Organizations: A Workforce Necessity, an Ethical Imperative. Volume 53 of Issue 6. Journal of pain and symptom management 2017. PMID: 28196784


  60. Harrison KL, Adrion ER, Ritchie CS, Sudore RL, Smith AK. Low Completion and Disparities in Advance Care Planning Activities Among Older Medicare Beneficiaries. Volume 176 of Issue 12. JAMA internal medicine 2016. PMID: 27802496


  61. Harrison KL, Taylor HA. Healthcare resource allocation decisions affecting uninsured services. Volume 30 of Issue 8. Journal of health organization and management 2016. PMID: 27934550


  62. Harrison KL, Connor SR. First Medicare Demonstration of Concurrent Provision of Curative and Hospice Services for End-of-Life Care. Volume 106 of Issue 8. American journal of public health 2016. PMID: 27310352


  63. Harrison KL, Taylor HA. Organizational values in the provision of access to care for the uninsured. Volume 7 of Issue 4. AJOB empirical bioethics 2016. PMID: 28781981


  64. Harrison KL, Boyden JY, Kalish VB, Muir JC, Richardson S, Connor SR. A Hospice Rotation for Military Medical Residents: A Mixed Methods, Multi-Perspective Program Evaluation. Volume 19 of Issue 5. Journal of palliative medicine 2016. PMID: 27139524


  65. Kamal AH, Harrison KL, Bakitas M, Dionne-Odom JN, Zubkoff L, Akyar I, Pantilat SZ, O'Riordan DL, Bragg AR, Bischoff KE, Bull J. Improving the Quality of Palliative Care Through National and Regional Collaboration Efforts. Volume 22 of Issue 4. Cancer control : journal of the Moffitt Cancer Center 2015. PMID: 26678966


  66. Davis MS, Harrison KL, Rice JF, Logan A, Hess B, Fine PG, Muir JC. A Model for Effective and Efficient Hospice Care: Proactive Telephone-Based Enhancement of Life Through Excellent Caring, "TeleCaring" in Advanced Illness. Volume 50 of Issue 3. Journal of pain and symptom management 2015. PMID: 25896105


  67. Harrison KL, Errett NA, Rutkow L, Thompson CB, Anderson MK, Ferrell JL, Freiheit JM, Hudson R, Koch MM, McKee M, Mejia-Echeverry A, Spitzer JB, Storey D, Barnett DJ. An intervention for enhancing public health crisis response willingness among local health department workers: a qualitative programmatic analysis. Volume 9 of Issue 2. American journal of disaster medicine 2014. PMID: 25068938


  68. Barnett DJ, Thompson CB, Semon NL, Errett NA, Harrison KL, Anderson MK, Ferrell JL, Freiheit JM, Hudson R, McKee M, Mejia-Echeverry A, Spitzer J, Balicer RD, Links JM, Storey JD. EPPM and willingness to respond: the role of risk and efficacy communication in strengthening public health emergency response systems. Volume 29 of Issue 6. Health communication 2013. PMID: 23799806


  69. Harrison KL, Farrell RM, Brinich MA, Highland J, Mercer M, McCormick JB, Tilburt J, Geller G, Marshall P, Sharp RR. 'Someone should oversee it': patient perspectives on the ethical issues arising with the regulation of probiotics. Volume 18 of Issue 2. Health expectations : an international journal of public participation in health care and health policy 2012. PMID: 23279082


  70. Geller G, Harrison KL, Rushton CH. Ethical challenges in the care of children and families affected by life-limiting neuromuscular diseases. Volume 33 of Issue 7. Journal of developmental and behavioral pediatrics : JDBP 2012. PMID: 22947883


  71. Harrison KL, Geller G, Marshall P, Tilburt J, Mercer M, Brinich MA, Highland J, Farrell RM, Sharp RR. Ethical Discourse about the Modification of Food for Therapeutic Purposes: How Patients with Gastrointestinal Diseases View the Good, the Bad, and the Healthy. Volume 3 of Issue 3. AJOB primary research 2012. PMID: 22773953


  72. Mercer M, Brinich MA, Geller G, Harrison K, Highland J, James K, Marshall P, McCormick JB, Tilburt J, Achkar JP, Farrell RM, Sharp RR. How patients view probiotics: findings from a multicenter study of patients with inflammatory bowel disease and irritable bowel syndrome. Volume 46 of Issue 2. Journal of clinical gastroenterology 2012. PMID: 21716123


  73. Mathias CB, Freyschmidt EJ, Caplan B, Jones T, Poddighe D, Xing W, Harrison KL, Gurish MF, Oettgen HC. IgE influences the number and function of mature mast cells, but not progenitor recruitment in allergic pulmonary inflammation. Volume 182 of Issue 4. Journal of immunology (Baltimore, Md. : 1950) 2009. PMID: 19201896


  74. Marvin M, O'Rourke D, Kurihara T, Juliano CE, Harrison KL, Hutson LD. Developmental expression patterns of the zebrafish small heat shock proteins. Volume 237 of Issue 2. Developmental dynamics : an official publication of the American Association of Anatomists 2008. PMID: 18161059


  75. Bryce PJ, Mathias CB, Harrison KL, Watanabe T, Geha RS, Oettgen HC. The H1 histamine receptor regulates allergic lung responses. Volume 116 of Issue 6. The Journal of clinical investigation 2006. PMID: 16680192