Spectrum PHS Pilot Grants
A core function of PHS is to stimulate, facilitate, and conduct research on social determinants of health. Below you will find past and current research projects supported by PHS as well as a list of our collaborators. PHS also offers seed funding to Stanford researchers through the Spectrum PHS Pilot Grants Program. See below for past pilot projects and future funding opportunities. Contact us for more information about any of the projects or to be connected with the investigators.
2020 Spectrum PHS Pilot Grantees & Projects
Prioritizing effective interventions to eliminate disparities in COVID-19 outcomes among marginalized populations
Grantee: Anneke Claypool, PhD Candidate, Department of Management Science and Engineering
Summary: There is an urgent need for effective interventions to address disparities in COVID-19 outcomes among marginalized populations. This project will first identify drivers of disparities amenable to policy action through analysis of multiple streams of data. Using a Bayesian evidence synthesis approach, the project will then develop a microsimulation of the COVID-19 cascade of care for infected individuals. Finally, in consultation with local policymakers in California, the project will utilize this analytic framework to quantify the potential effects of candidate policies and interventions on reducing health disparities.
Assessing Disparities and Clinician Implicit Bias in the Use of Biologic Therapies to Treat Rheumatoid Arthritis
Grantee: Robert Fairchild, Assistant Clinical Professor, Department of Medicine, Division of Immunology
Summary: Rheumatoid arthritis (RA) affects up to 3 million adults and biologic disease modifying anti-rheumatic drugs (b-DMARDs) and oral Janus kinase inhibitors (JAK-i) have been transformative in RA management. The goal of this study is to determine whether b-DMARDs/JAK-i use in RA differs by patient race and ethnicity controlling for insurer in both a variable payer (Stanford Hospital) and single payer system (Palo Alto VA). Secondarily, the study will evaluate whether provider biases lead to disparities in b-DMARDs/JAK-I prescription using implicit bias survey testing. This will be the first study to evaluate b DMARD/JAK-i use in RA across race/ethnicity at a major academic center with a single payer government run hospital comparator, and the first to use implicit bias testing to identify possible provider biases in prescription behavior.
Virtual Disparities: Social, Economic, and Environmental Factors Associated with Telemedicine Use
Grantee: Jacqueline Ferguson, Postdoctoral Research Fellow, Center for Population Health Sciences, Department of Medicine
Summary: Standing at the intersection of social epidemiology, population health, and clinical care, this project aims to examine variation in Veterans’ use of virtual care across social, economic, and environmental factors. This work will harness a dataset of over 5.4 million Veterans Health Administration (VA) patients to identify combinations of demographic, social, and clinical characteristics that are associated with lower rates of telemedicine use before and during the COVID-19 pandemic. Results will begin to fill a critical gap in VA’s understanding of what combination of factors predict reduced access to care during this critical period of virtual care expansion. The project will serve as a catalyst for collaboration among longstanding population health researchers in the Departments of Epidemiology and Population Health, Sociology, and Medicine who have not had the opportunity to work together.
Effects of expanding financial access to medically-assisted treatments for opioid dependence
Grantee: Zong Huang, PhD Student, Department of Economics
Summary: This study will evaluate the effectiveness of medically-assisted treatments (MATs) as a solution to the opioid crisis. To do so, the study will investigate the extent to which the 2014 Medicaid expansion as part of the Affordable Care Act increased the financial accessibility of MATs. The study will compare states that opted into versus out of Medicaid expansion to determine if expansion led to an increase in buprenorphine and methadone utilization. It will then explore whether this translated into changes in opioid-related outcomes such as opioid overdose deaths.
Access to Subspecialty Care for Alcohol-Associated Liver Disease
Grantee: Allison Kwong, Instructor, Department of Medicine, Division of Gastroenterology & Hepatology
Summary: Alcohol-associated liver disease (ALD) is a growing public health burden in the United States and is now the leading indication for liver transplantation. This study will use the Optum datasets available through the PHS Data Core to study gender, sociodemographic, and geographic disparities in access to subspecialty care, liver transplantation, and substance abuse treatment for patients with alcohol-associated liver disease. The overall impact of this study is to identify gaps in the referral cascade for alcohol-associated liver disease and populations that are systematically disadvantaged in the current healthcare system. Results from this study will help target future community-and population-based interventions to improve access to multidisciplinary care for patients with ALD.
Investigating the Impact of COVID-19 on Healthcare Inequities and Public Attitudes
Grantee: Cesar Vargas Nunez, PhD Candidate, Department of Political Science
Summary: Six months after the first COVID-19 case in the US, it has become evident that minorities are suffering a disproportionate share of cases and deaths. Yet, the asymmetric impact of COVID-19 is not driven by biological factors but by political decisions that determine which individuals (and under what conditions) are eligible for healthcare. Immigrants, barred from most government healthcare programs, are left especially vulnerable. Fixing these inequities, however, requires action from policymakers who are unlikely to act unless doing so is popular with voters. While it has been argued that the ongoing pandemic has changed public attitudes towards healthcare expansion, there is limited evidence that confirms it. This project seeks to answer two interrelated questions. First, how have immigrants coped with the pandemic? Second, how has COVID-19 altered public attitudes towards healthcare access? To answer the former, this study will use social media advertisements to recruit a large sample of immigrants across the country and collect survey data on the impact of COVID-19 in their lives. The results will shed light on the experiences of immigrants with COVID-19, whether they were able to access necessary care, and how the pandemic has affected their mental health. To answer the second question, the study will use a set of survey experiments to measure the pandemic’s short and long-term effects on attitudes. The results of this study will contribute to scholarship on health inequities and inform policies to reduce them.
Personalized long-term stress management for COVID-19 distance learning
Grantee: Pablo Paredes, Clinical Assistant Professor, Department of Psychiatry and Behavioral Sciences and, by courtesy, Department of Epidemiology and Population Health
Summary: The COVID-19 pandemic has had devastating consequences on global mental health with a disproportionate burden on vulnerable populations. Requiring millions of adolescents to take on remote coursework with limited support systems is expected to impact their mental health. While stress responses are personal and contextual, common patterns are emerging including anxious scrolling (“doom scrolling”), overexposure to negative media, and lowered productivity due to procrastination on social media. This study will build Home SWEET School (HSS), a Chrome browser plugin that delivers stress and time management interventions tailored for adolescents, their parents, and teachers based on personal traits and preferences (e.g. personality, self-reported productivity), efficacy (i.e. stress reduction), and context (e.g.time online, location).
Optimizing behavioral obesity treatment using digital health for racial/ethnic minority populations
Grantee: Michele Patel, Postdoctoral Research Fellow, Stanford Prevention Research Center, Department of Medicine
Summary: Obesity disproportionately affects racial/ethnic minority populations, yet these groups are under-represented in behavioral weight loss treatment. Remotely-delivered digital interventions have the potential to broaden reach and minimize some of the traditional barriers to enrolling in these treatments. Self-monitoring, such as tracking dietary intake, is an effective behavioral approach that can be delivered remotely; however, it is unknown whether a detailed versus simplified diet tracking approach is most acceptable and effective among racial/ethnic minority groups. Using mixed methods, this project will first compare these two strategies in the context of a 3-month digital weight loss intervention among 40 racial/ethnic minority adults with overweight/obesity to determine feasibility and preliminary efficacy; then, qualitative interviews with 10 participants will gather feedback on acceptability of each self-monitoring approach as well as barriers to and facilitators of intervention engagement.
Understanding the health impacts of climate hazards on households on the brink of financial instability in the San Francisco Bay Area
Grantee: Jenny Suckale, Assistant Professor, Department of Geophysics
Summary: Climate change amplifies both the frequency and the intensity of natural hazards like fires and floods in the San Francisco Bay Area. Every household in the Bay Area will be affected by climate change, but to varying degrees depending on the social context. The goal of this study is to integrate understanding of the health impacts of climate-related hazards such as fires and floods on the physical and mental health of disadvantaged households in the San Francisco Bay Area into an upcoming two-year panel survey. We approach the problem through the normative view of scientific co-production to ensure the inclusion of different perspectives into the formulation of research questions and recruitment of survey participants.