Awardee Anisha Patel, MD

Awards:

Joint Pilot & Feasibility with Stanford Diabetes Research Center (2019)

Arline and Pete Harman Endowed Faculty Scholar (2018-2021)

Total Award Amount: $350,000

MCHRI impact: Pilot & Feasibility funding from SDRC and MCHRI enables Dr. Patel and her team to study the impact of water stations installed at 10 sites throughout San Francisco in addition to a new soda tax. Meanwhile, the MCHRI Faculty Scholar Award allows her to study the cost-effectiveness and health impacts of promoting fresh water intake in elementary schools. Obesity reduction is the target for both projects.

“With both of these grants, I’ve had the opportunity to go onto the broader Stanford campus and find people who are working in similar areas, but with totally different expertise,” Dr. Patel says.

The Faculty Scholar award supports 25 percent of her time for research and career development, and Dr. Patel has used it to network with investigators outside the School of Medicine. Recently, she’s been working closely with Szu-chi Huang, PhD, Associate Professor of Marketing at Stanford Business School, to design signage related to water promotion.

Improved water access in San Francisco neighborhoods: In 2017, 19 new public water hydration stations were installed in neighborhoods across San Francisco, the result of a partnership between the City and County of San Francisco, community groups, and the University of California, San Francisco, UCSF. (Dr. Patel is an affiliate faculty in the Philip R. Lee Institute for Health Policy Studies at UCSF.) Delivering free and safe water to communities is a way to counter rising rates of obesity and diabetes.

Dr. Patel and her team are analyzing data from 30 sites across the Bay—10 sites with the new water stations as well as 20 other sites (10 in San Francisco and 10 in Oakland) with older fountains.

Both San Francisco and Oakland have enacted a soda tax, whereby revenue collected from the tax can be allocated for community health and wellness efforts.

Dr. Patel hypothesized that the 10 San Francisco sites with the new water stations would have a greater impact on obesity reduction as compared to the other sites that benefited only from the soda tax.

This summer, her team visited the sites. They stayed at each for about four hours to observe foot traffic.

“We’re looking to see what people are drinking in the parks, so what kind of beverages they had in their hand or were carrying with them and if they used the water fountains or stations,” Dr. Patel says.

She says her team observed modest increases in water intake throughout the city thanks to the stations. More results are forthcoming.

Water First program in Bay Area schools: Through an ongoing R01—dubbed Water First—through the National Heart, Lung, and Blood Institute, Dr. Patel has led a clean drinking water initiative at 26 low-income elementary schools in the Bay Area.

Funding provided for a comprehensive intervention at 13 of the schools. Dr. Patel’s team installed water stations in cafeterias and playgrounds. They gave cups and reusable water bottles to students at these schools and created a six-month health education campaign with class lessons, homework assignments, and even a water-inspired performance led by a local singer-songwriter. The intervention targeted fourth graders.

She and her colleagues now aim to investigate the changes in what students are drinking and obesity over time within students at schools that received the intervention. They also will compare the data collected at schools that received the intervention with data collected at 13 control schools.

The Faculty Scholar Award will help to specifically measure the cost of the Water First program against the rate of change in consumption of water and other beverages and overall health. She and her team have been able to tease out the cost of each component of the program.

“We’re finding that a lot of schools are actually installing water stations throughout California. But the curricular parts are harder to implement,” says Dr. Patel, noting the resources it takes to train teachers.

Early analysis shows the intervention is successful in that kids are drinking more water. The caveat—having a vessel is important.

“We found that if students don’t have a water bottle or don’t have a cup they actually don’t drink much water,” she says. “Cups are actually a barrier for a lot of schools because they would need to purchase them and compost or recycle them. Most of the schools are encouraging students to bring reusable bottles.”

A pediatrician’s approach to diabetes research: Dr. Patel employs community-based participatory research methods, meaning she works with communities to address what’s most important to them. For example, kids were the ones who told Dr. Patel and her team they wanted access to water at lunchtime. Their comments were the genesis of the Water First program.

Many times, communities will also act as research partners, contributing to all phases of study design and implementation. Some may even serve as co-investigators on grants or collaborate on research publications.

Dr. Patel has been working closely with the Sugary Drinks Distributor Tax Advisory Committee in San Francisco, and Mayor London Breed has listened to the committee’s recommendations. Breed recently announced that the city’s fiscal budget for the next two years will direct $22.4 million in soda tax revenue toward programs promoting children’s health and wellness.

“The thing I love about working with community partners is they know how to get the information out there to people who are going to change things,” Dr. Patel says.

BY LAURA HEDLI

Laura Hedli is a writer for the Division of Neonatal and Developmental Medicine in the Department of Pediatrics and contributes stories to the Stanford Maternal and Child Health Research Institute.