PCPH Seed Grants Research Funding
UPCOMING SEED GRANT DEADLINES
July 19, 2019 - October 18, 2019
About Seed Grants
In order to facilitate development of research among Clinician Educators in the division, we now fund up to nine $5,000 grants per year. Application cycles happen three times a year – in the spring, summer and fall quarters. These awards are used to fund pilot research work by faculty looking to develop their research skills and background. Applications for Seed Grants are reviewed and awarded by the faculty leaders of the Evaluation Sciences Unit (ESU). For more information, email Mae Verano, PCPH research admin, at firstname.lastname@example.org.
All Clinician Educator faculty members within Stanford Division of Primary Care and Population Health at any faculty level are eligible to apply. Applicants MUST be affiliated with PCPH in order to be eligible.
Up to $5,000 may be requested for research or project related fees. Because of the small size of the grants, PI salaries, professional memberships, etc. are not permissible uses of seed grants.
Proposals can be for a quality improvement project, a small research study, or a request to supplement a larger study. There are two major criteria for an application’s success:
- Ability to clearly articulate their research question, methods, and analytic plan. Applicants should be able to provide evidence of their study's importance and feasibility in regards to scope, funding provided, and stakeholder support. It is clear that thought has been put behind the project’s study aims and design.
- Demonstrates how the proposed project supports the applicant’s career development. Applicant is invested in the opportunity to develop research skills and to develop further expertise in topic. Proposed plan is intentional about building research experience.
Applicants for Seed Grants are required to touch base with ESU faculty leaders to receive feedback and support in developing the quality of their research. To schedule a consultation meetings, please email Mae Verano at email@example.com with your request:
- For Awarded Proposals: After notice of award, you will be contacted to set up a meeting with ESU faculty leaders. This meeting is meant to serve as a planning and feedback session to help shape awarded proposals into feasible reasearch with reasonable scope and quality study design.
- For Non-Awarded Proposals (Optional): For those whose proposals were not awarded, an optional post-submission consultation with ESU faculty leaders is available to discuss areas of improvement and to provide guidance should the applicant resubmit their proposal in a future submission cycle.
As the Principle Investigator of the awarded study, CEs are expected to present results in some form of academic output after study closeout-- e.g. an academic seminar, a scientific poster, a published paper or manuscript. ESU faculty leadership can provide guidance during award period on the feasibility of the various possibilities for presentation.
Seed Grant Awardees
The Feasibility and Acceptability of an Online Educational Program on Opioid Tapering for Patients on Chronic Opioids
Korina De Bruyne, MD
Studies are increasibly showing that opioids are no better at controlling pain than other medications or modalities, but are associated with mugh higher risk. Yet, 17% of Americans are still prescribed yearly. Stanford's division of Primary Care and Population Health has 518 patients currently on long term opioids, of which 106 are on doses higher than 90 Morphine Equivalent daily doses -- a dose above which risk for opioid overdose quadruples and the risk of developing opioid use disorder rises. Stanford Primary Care has implemented a new policy that such patients will be tapered over the course of months to years. Dr. De Bruyne will be developing a patient facing opioid tapering video in collaboration with the Stanford CME office to present to patients, and will assess the feasibility and acceptability of the online educaitonal video. She will analyze the effect the video has on patient knowledge of risk vs. benefit of opioid therapy and opioid tapering -- with particular attention to patient facilitators and barriers to tapering.
Assessing the Outcomes of the Geriatrics-Trauma Clinical Pathway
Matthew Mesias, MD
As part of the getriatrics-trauma clinical pathway, the inpatient geriatrics team consultes on all patients over the age of 65 who are admitted to the inpatient trauma service. Consultations focus on delirium prevention/management, fall prevention, osteoporosis evaluation, advance care planning, and discharge planning. This clinical pathway, implemented in 2018, is evaluating for improvements in inpatient outcomes. Dr. Mesias was awarded a PCPH Seed Grant for his study to better understand what happens to patients after discharge from the geriatrics-trauma clinical pathway in hopes of improving overall care and consult recommendations, as well as improving communication with primary care providers. Dr. Mesias will be assessing the patient outcomes of current living situation, number of hospitalizations or ED visits since discharge, adherence to recommendations, evaluation for fall prevention/osteoporosis, and caregiver overall perspective. Through a mixed methods approach, Dr. Mesias hopes this baseline dataset can be the foundation for future geriatric QI initiatives.
Medical Group Visits for Stress/Anxiety
Maria Juarez-Reyes, MD PhD
The prevalence of anxiety disorders in urban primary care settings has been estimated at 19.5% with 41% of these patients reporting no current treatment. Patients with anxiety disorders also have a high rate of co-morbidity with physical symptoms, medical and psyciatric conditions. Integrating mindfullness interventions into a Medical Group Visit format has been used for managing both pain and MH conditions, but there is sparse literature on the effectiveness of this approach for patients with stress and anxiety. Dr. Juarez-Reyes' intervention was to develop a 6 week educational and mindfullness MGV in primary care for patients with stress and anxiety and evaluate pre and post vitals, depression and anxiety scores.
Ergonomic Injuries and Enhancements of the Stanford IR Suite (EIE-SIRS project)
Rajan Puri, MD MPH
The Interventional Radiology service is an integral component of the Vascular Center at Stanford. It provides minimally invasive catheter based radiological procedures to patients for diagnostic evaluation and/or therapeutic intervention. However the physical tasks of laboratory employees expose these critical players in patient care to a variety of unique ergonomic risk factors. Dr. Rajan Puri was awarded a PCPH Seed Grant to assess, identify and hopefully improve the process of musculoskeletal pain/injury related ergonomic standards among employees at SHC. He will look to see if certain repetative limb movements and wearing of personal protective equipment in the Stanford IR department leads to occupational work injuries.
Analyzing the Feasibility of a Multidisciplinary Team-based Care Intervention at Stanford Primary Care
Shreya Shah, MD & Anuradha Phadke, MD
Hypertension affects over 100 million people in the US and treatment to improve high blood pressure reduces the risk of cardiovascular disease and all-cause mortality. Among patients treated for hypertension in the US in 2016, a substantial portion had inadequately controlled systolic blood pressures. Team-based care strategies are the most effective for blood pressure control, with everage reductions in systolic blood pressure. Self-monitorying of blood pressure has also been recommended by the new 2017 ACC/AHA Hypertension Guidelines to help for confirmation and management of hypertension. Drs. Shah and Phadke were awarded a PCPH Seed Grant to analyze the feasibility of a team-based care intervention aimed at improving blood pressure control among patients at Stanford Primary Care clinics. Their multi-component intervention includes an educational session, team-based care, and telemonitorying with pharmacist remort medication titration -- which will be assessed to determine their feasibility, acceptability to care team members, acceptability to patients, and relative impact on improving clinic and home blood pressures.
Evaluation of an Intimate Partner Violence Screening in a VA Women's Health Clinic
Meenadchi Chelvakumar, MD MPH
It is estimated that one out of every three women will report abuse or violence victimization from an intimate partner at some point in their lifetime. Women, compared to men, are considerably more likely to experience an IPV-related physical injury and are the victimes of 70% of IPV-related homicides. Several risk factors put veteran women at increased risk of experiencing IPV such as post-traumatic stress disorder and multiple deloyments. Primary care clinics have been shown to be ideal environments to screen women for IPV. In Spring 2017, Dr. Chelvakumar developed and implemented a pilot screening protocol for IPV int he Women's Health Center of the Palo Alto VA to be delivered to all primary care patients once a year by their primary care providers. Dr. Chelvakumar was awarded an PCPH Seed Grant to evaluate the results of the screening using a mixed methods approach to improve the protocol and implementation efforts moving forward.
Evaluation of SPACE, an SHC Intervention to Promote Faculty Leadership & Wellness
Eva Weinlander, MD
Burnout among Stanford Primary Care faculty is nearly 40%*. The 9 month Making SPACE program in the Dept. of Medicine was created to mitigate burnout and promote wellness among faculty -- providng a safe and supportive monthly gathering/training for participating faculty to develop skills, behaviors, and attitudes that contribute to physical, emotional, and professional wellbeing. To date 46 DOM faculty have taken place in the first two cohorts. Dr. Weilander was awarded a PCPH Seed Grant to leverage the diverse expertise of the SPACE team members to evaluate the broad impact of SPACE on measurable outcomes that affect participants, their patients, and the organized settings in which they work.
* Statistic from the Stanford 2016 Physician Wellness Survey by Dr. Mickey Trockel
Evaluation of the 2018 Flu Outreach Bulk Communication
Amelia Sattler, MD
As part of SHC's participation in the Centers for Medicare & Medicaid Services' Merit-based Incentive Payment System, a multi-disciplinary team promoted flu vaccinations among patients through a bulk-ordering and bulk-communication strategy conducted through Epic. In 2018, 164,453 electornic messages were sent to patients, 38,131 of those read were primary care patients . Of those patients, 38% sent a response back-- creating an enormous amout of work for coordinators and providers who had to then resolve the responses. Dr. Sattler was awarded a PCPH seed grant to conduct a qualitative analysis of the patient response messages to identify themes and inform improvements of the current bulk message content and function, with the ultimte goal of decreasing the quantity of patient response messages in 2019.
Effect of an Electronic Best Practice Alert on 25(OH) Vitamin D Testing
Doris Chen, MD
Dr. Chen received a seed grant in 2017 to evaluate whether an electronic best practices alert when ordering 25-OH vitamin D testing is an effective way to reduce unnecessary testing. Stanford Health Care has incorporated the Choosing Wisely guidelines into Epic to help providers follow recommendations from this campaign. Dr. Chen will also review data from provider interactions with the Choosing Wisely prompt to understand the most common reasons for physicians ordering 25-OH Vitamin D levels despite interruptive prompts. The seed grant funded statistician support which came from Evaluation Sciences Unit.
Improving Rates of Advanced Care Planning Documentation in EPIC
Marina Martin, MD, MPH
Dr. Martin received a seed grant in 2017 to improve the Stanford Senior Care Clinic's Advanced Care Planning documentaiton in Epic. Patients in her clinic have high health crisis and mortality rates, yet documentation around Advanced Care Planning and completing Advanced Directive and Physician's Orders for Life-Sustaining Treatment forms has been inconsistent. The study will improve this Epic documentation. The seed grant funded an Advanced Care Plannign course and the costs of video filming and editing. ESU assisted with study design help and reimbursements.
Improving Population Health Management in the Resident Clinic
Maja K Artandi, MD
In every day patient care it is challenging to complete the health maintenance requirements for a patient since the acute presenting symptoms are more important to the patient and the physician. Many centers nationwide are struggling with the problem of how to address their population health management and how to improve their population health data. To solve this problem, Dr. Artandi studied whether using premedical students in the role of patient advocates would improve the population health data. She designed a course for premed students where they would take care of a patient panel as health-advocates, during which each student would have a panel of about 60 patients with the goal of improving the population health data for these patients. The course equiped students with the skills to provide patient health education and to improve patients’ health maintenance through clinic - and telephone encounters.
Safe Reduction of Chronic High Dose Opioid & Benzodiazepine Prescribing in the Primary Care Setting
Angie Chen, MD
Opioids and benzodiazepines are commonly prescribed together and are known to cause deadly respiratory depression when taken together. Despite physician acknowledgment of this widespread prescription drug problem and the strong support for clinical and regulatory interventions, there is still evidence that a small percentage of physicians are only slightly if at all concerned about diversion, and about a third of physicians still believe interventions to reduce prescription opioid misuse will hamper patients receiving pain treatment. The purpose of Dr. Chen's study is three-fold: 1) Identify physician outliers who need guidance in reducing long term chronic opioids, and opioid with benzodiazepine co-prescribing, 2) Identify barriers to safe opioid and benzodiazepine prescribing and appropriate referrals to substance use disorders treatment, and 3) Help increase confidence in managing patients on chronic opioids and benzodiazepines while mitigating physician fatigue around complex pain and addiction patients within a busy primary care practice.
Primary Care Skill Set Series
Baldeep Singh, MD
Dr. Singh received a seed grant to develop a clinical skills workshop for joint injections using artificial joint models to enhance clinical skill sets for faculty, residents and students. His study will develop pre- and post-surveys to assess confidence and reduced referral rates, and will use workshop training with models for skill set enhancement. The seed grant funded multiple joint models needed for the workshop. ESU assisted with study design help and reimbursements.
Diet and Physical Activity Intervention Pilot Study in the Philippines
Julieta Gabiola, MD
Dr. Gabiola received a seed grant to demonstrate the overlal efficacy of a text messaging intervention in disseminating health information and improving blood pressure management in hypertensive patients in Pampanga Province, Philippines. Dr. Gabiola is interested in how adding technology and using social support can help to manage blood pressure. The seed grant will fund blood pressure monitors and salary support for a statistical analyst. ESU supported with study design help.
Feasibility and Effectiveness of Physical Therapy via Telemedicine
Steven Lin, MD
Dr. Lin received a seed grant to study the feasibility of offering patients an option to pursue physical therapy via telemedicine in order to increase access and adherence to it. For this pilot study, Stanford Family Medicine will offer a select group of patients the option of receiving physical therapy via telemedicine rather than at an in-person physcial therapy clinic. Dr. Lin hopes to understand if offering this option will help patients better access and adhere to treatment. The seed grant will fund multiple subscriptions to digital services to enable the telemedicine encounters. ESU has helped with study design, IRB approval, and reimbursements.
Career Transitions in Academic Medicine
Felicia Hui, MD
Dr. Felicia Hui's ultimate goal was to help physicians maintain generativity and productivity in the face of career transitions. Transitions are inevitable and spurred by both professional and personal changes, and are often unexpectedly challenging. An academic medical career may include serial stages (e.g., training to 1st position) that continue into retirement. However, little advice is given on how to move smoothly through each stage. There is little written about academic medical transitions and how one copes. Dr. Hui explored how Stanford University School of Medicine faculty experience and cope with career transitions. She conducted a pilot study to interview faculty at various stages of their careers who had a transition in the last year and developed a survey to characterize these issues more broadly among Stanford faculty.
Virtual Health Education within the Family Medicine Core Clerkship
Rika Bajra, MD
Virtual communication is rapidly becoming an integral part of health care delivery. Telemedicine offers the potential for increased health care access, especially in underserved/rural populations, as well as improved patient satisfaction, and enhanced coordination of care. However, there are distinct communication challenges with virtual visits compared to face-to-face visits. Medical schools have not yet fully incorporated a virtual health curriculum to prepare graduates for this challenge. Dr. Bajra's was awarded a seed grant to develop a Needs Assessment survey that would lead to a comprehensive and longitudinal curriculum to teach students advanced virtual communication skills. In the preclinical years, students learn fundamentals of effective communication such as building rapport and assessing and maintaining engagement virtually. Building on this foundation, Dr. Bajra's study focused evaluating clerkship students comfort levels with clinical assessment skills, while recognizing limitations and common pitfalls of virtual encounters.
Hypertension in Kenya
Megan Mahoney, MD
Dr. Mahoney received a seed grant to supplement funding for a previously funded population-based epidemiologic study to determine prevalence of hypertension and other cardiovascular risk factors in a rural region of Kenya. The seed grant funded blood pressure cuffs, urinalysis test strips, and recruitment and training of enumerators. ESU helped with reimbursements.
Korina De Bruyne, MD
Dr. DeBruyne received a seed grant to investigate how knowledgeable patients are about current data on the risks associated with long-term opioid use and options available for opioid reduction and cessation. She also investigated whether a balanced, evidence based educational intervention for patients on chronic opioid therapy will increase knowledge of these issues. The seed grant funded educational materials. ESU provided IRB protocol application and help with reimbursements.
Stanford University 25 - Physical Exam Skills
Maja Artandi, MD
Dr. Artandi received a seed grant to study if a physical diagnosis curriculum for residents and attendings in the outpatient setting accompanied by hands-on training increases the confidence and comfort of the physicians performing the exam. The seed grant helped finance participant incentives and a research assistant. ESU provided IRB protocol application, survey coordination, and statistical support.
Sandra Tsai, MD
Dr. Tsai received the seed grant to fund weight management group classes for participants for her study in pregnant women with excessive gestational weight gain. She tests the effectiveness of a 3-6 month mobile texting intervention in aiding postpartum weight loss in women who exceeded the recommended threshold for weight gain in pregnancy. The seed grant funded participant incentives and technology for web meetings. ESU helped Dr. Tsai with research administration, survey management and reimbursements.