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.

Research Focus Areas

Research Collaborations

Program Summary

Social, environmental, and behavioral factors are strong predictors of health and disease and contribute to social inequalities in health. The Spectrum Population Health Sciences Pilot Grants Program is intended to stimulate novel research that can advance our understanding of how environments, policies and programs impact population health and social inequalities in health. Research projects sponsored under this program 1) focus on a social, economic, community or environmental factor and its influence on health, 2) have implications for reducing social inequalities in health, and 3) demonstrate a means of translating research into impact. Projects involving multidisciplinary teams, particularly those that span the seven Stanford schools, are highly encouraged.

For prospective applicants coming from a non-population health background, we encourage you to use this opportunity to incorporate new population health collaborations, data sources, and theories into your proposals. All prospective applicants should review the projects of our previously awarded grantees (included lower on this page) as well as the CDC’s Social Determinants of Health Toolkit to get a sense of the types of research being prioritized for this funding opportunity. Unfortunately, we are not able to fund foreign projects at this time. Please also note that clinical trials as defined by the NIH are not eligible.

Spectrum PHS Pilot Grantees & Projects

2023

Melissa Franco

The impact of expanding Medicaid to undocumented children in California

Grantees: Melissa Franco, Ph.D. Student in Health Policy, admitted Autumn 2021 Immigration Policy Lab Student

Adrienne Sabety, Assistant Professor of Health Policy

Most undocumented children in the United States are uninsured, potentially adversely affecting health outcomes. This proposal seeks to understand the impact of expanding access to Medicaid for undocumented children in California. We will estimate how many additional children gained coverage in response to the expansion of Medicaid to all children, regardless of documentation status (State Bill 75, implemented May 2016). We will then estimate the effect of gaining access to Medicaid on all-cause child and adolescent mortality and identify subgroups where the effects were largest.

Adrienne Sabety

Ashley Griffin

Promoting Equitable Use of Remote Monitoring Devices and Patient-Generated Health Data

Grantees: Ashley Griffin Postdoctoral Research Fellow, Health Policy

Donna Zulman, Associate Professor, Division of Primary Care and Population Health, Department of Medicine

The U.S. health care system is at a pivotal stage in the expansion of digital health given proliferation of digital devices and recent regulatory and technical groundwork that enables patients to track and access their health information remotely. These innovations and progress have given rise to an abundance of data created and recorded by patients outside of the clinical setting, but digital health disparities prevent patients of all backgrounds and abilities from being able to engage with these devices. This project will evaluate a national initiative by the Department of Veterans Affairs (VA) to 4 distribute tablets and remote monitoring devices (blood pressure cuff, pulse oximetry device, weight scale, thermometer) to veterans with barriers to accessing in-person care. Leveraging a mixed-methods design, we will examine the use of and experience with remote monitoring devices among a cohort over 150,000 patients, of which 8,500 received a remote monitoring device, to inform strategies for technology engagement programs and equitable distribution of devices to a population of patients who face social and digital inequities.

Donna Zulman

Esther John

Air pollution, social determinants of health, and timing of pubertal development

Grantee: Esther John, Professor (Research) of Epidemiology and Population Health and of Medicine (Oncology)

Polycyclic aromatic hydrocarbons (PAH) are endocrine-disrupting chemicals and a major component of ambient fine particulate matter (PM2.5). We previously measured urinary PAH metabolite concentrations in 779 samples provided by 359 girls aged 6-16 years from the San Francisco Bay Area and found that higher metabolite concentrations were associated with earlier onset of puberty. In this pilot study, we will assess correlations of zip code-level ambient concentrations of PM2.5 (wildfire-specific and total) with urinary PAH metabolite concentrations and contextual SDOH. We will assess whether PM2.5 concentrations are associated with the timing of pubertal milestones such as thelarche, pubarche, and menarche.

MK Quinn

Inequities in family engagement in the NICU

Grantees: MK Quinn Postdoctoral Scholar, Neonatal and Developmental Medicine

Jochen Profit Professor Department of Pediatrics (Neonatology)

Families’ engagement in NICU care facilitates holding, skin-to-skin care, and human milk feeding. A family’s presence in the NICU and these interventions improve neonatal survival, long term infant development, and parental mental health. However, there are many disproportionate structural barriers faced by marginalized families when visiting the NICU. These parents are less likely to have access to paid family leave, childcare, transportation, and may encounter language barriers. This creates a disparity in the ability of parents to visit their infants, leading to decreased health benefits for parental mental health and infant survival and development. Few studies have characterized these structural barriers and evaluated how they affect infant and parental disparities and outcomes. We plan to conduct a multicenter survey of parents with preterm infants in the NICU, in order to first understand the prevalence of these barriers and investigate whether these barriers are experienced more by historically excluded groups. The results of this study will be used to design policy interventions to ensure families can engage in their preterm infant’s care, and ultimately, reduce inequities and improve preterm health outcomes.

Jochen Profit

Thomas Robinson

Developing a risk tool with clinical measures and multi-omics to predict dyslipidemias in low-income, Latino children with overweight or obesity: Analysis of a 4-year prospective cohort

Grantee: Thomas Robinson, The Irving Schulman, M.D. Professor of Child Health, Professor of Medicine (Stanford Prevention Research Center) and, by courtesy, of Epidemiology and Population Health

Nicole Gladish, Postdoctoral Fellow Epidemiology & Population Health

Jennifer Li-Pook-Than, Research Associate, Genetics Department

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among Latino individuals in the US, affecting nearly half of Latino adults. Risk factors such as dyslipidemia, high glucose levels, and high BMI are prevalent among Latinos, and early intervention is crucial. Low-income, racial/ethnic minority populations are often under-represented and the last to benefit from research on new biomedical technologies. This study proposes to use a unique, deeply, and broadly characterized 4-year longitudinal cohort of low-income, high-risk, Latino youth to counter this norm. With data from the Stanford GOALS trial of low-income Latino children in northern California, this study will use extensive anthropometric, physiological, behavioral, psychological, socio-cultural, and comprehensive omics profiling to identify predictive markers of multifactorial dyslipidemia (MD) in children, utilizing standard and machine learning methods to assess the predictability of clinical measures and multi-omics profiles individually and in combination. Additionally, we will investigate the association between modifiable psychosocial and behavioral measures and MD predictors over time to inform potential interventions. These findings could contribute to reducing CVD risk disparities by guiding personalized risk profiling and interventions.

Nicole Gladish

Jennifer Li-Pook-Than

Roshni Sahoo

Leveraging multi-modal surveys for robust prediction of health indicators

Grantees: Roshni Sahoo, Ph.D. Student in Computer Science, School of Engineering admitted Autumn 2020

Stefan Wager, Associate Professor of Operations, Information, and Technology Graduate School of Business

The central goal of this work is to leverage the complementary aspects of online and offline survey data to generate high-resolution estimates of health indicators that are robust to sampling bias. We propose a procedure that uses multi-modal survey data to learn robust models for predicting health indicators from individual-level covariates. We will apply this procedure to a set of five health-related indicators that span different domains (mental health, COVID-19 vaccination, smoking status, hypertension, and food security), assessing which health indicators are most severely affected by sampling bias in online surveys. In addition, we will quantify improvements in subgroup accuracy (including educational attainment, income, race/ethnicity, and urban/rural residence) achieved by applying our procedure, compared to standard methods.

Stefan Wager

Suzanne Tamang

Identifying environmental determinants of chronic rheumatic disease flares

Grantee: Suzanne Tamang, Assistant Professor of Medicine (Immunology and Rheumatology)

We seek to develop an integrated dataset that will improve our understanding of the impact air pollution has on the development and progression of spondyloarthritis (SpA), a subtype of inflammatory arthritis. Our plan is to perform a descriptive epidemiological study using PM2.5 as an example inhalant exposure and SpA disease activity as the outcome of interest. We will graph the longitudinal trend of PM2.5 exposure during the time period (daily, weekly, monthly, yearly), and then chart spondyloarthritis flares that occur during this time. The VA data are uniquely positioned to enable robust, reproducible and innovative scientific discoveries into SpA due to a new publicly sourced environmental determinants of health database that is linked to Veterans Health Administration electronic health records, and PULSAR, a multi-site SpA registry. Our work can help improve our understanding of the population health burden of climate change and support the clinical management of chronic rheumatic diseases associated with air pollution.

Britni Wilcher

Improving Behavioral Healthcare Access: A 30-Year Health and Economic Impact Microsimulation

Grantees: Britni Wilcher, Postdoctoral Scholar, Health Policy

Alyce Adams, Stanford Medicine Innovation Professor and Professor of Epidemiology and Population Health, of Health Policy

US spending to treat adults with mental disorders reached $106.5 billion in 2019 and continues to grow even though many individuals do not receive appropriate care (Soni 2022). Teletherapy has been touted as an equalizer with the potential to reduce barriers to access behavioral health care in specialty care deserts, however the digital divide continues to lock some vulnerable populations out of virtual care. The proposed pilot project will lay the foundation for estimating the Future Adult (dynamic microsimulation) Model which will identify the 30-year impact of distributing video-enabled tablets to VA patients – a policy intervention targeting the digital divide – on mental health and economic outcomes. Drawing on a unique dataset that is well-suited for identifying socioeconomic groups, the long-term study result will (1) illustrate the complex interaction between social determinants and mental health over time as well as (2) inform strategies to reach vulnerable populations lacking access to behavioral health services.

Alyce Adams

2022

Shalmali Bane

The contribution of multi-level factors to racial disparities in cesarean birth: California 2007-2018

Grantees: Shalmali Bane, PhD candidate in Epidemiology and Clinical Research

Suzan Carmichael, Professor Department of Pediatrics and Obstetrics and Gynecology

There is substantial variability in the rate of cesarean section by social factors, including race/ethnicity and socioeconomic disadvantage. These disparities persist after adjustment for individual-level factors, and there is limited investigation on how multi-level factors, such as neighborhood or hospital factors, may influence these disparities in cesarean section rates. The aim of this project is to assess the contributions of multi-level factors to disparities in cesarean rates, using linked vital statistics and maternal discharge data from California during 2007-2018. Given the high, possibly medically unnecessary, cesarean rate and prevalent disparities, this knowledge is crucial to inform structural interventions and policies to prevent the most vulnerable populations from experiencing disproportionate adverse maternal health outcomes, and better inform the planning of their reproductive futures.

Suzan Carmichael

Anjali Dixit

Epidemiology and Economics of California Wildfire Smoke and Allergic Disease in Children

Grantees: Anjali Dixit, Postdoctoral Scholar, Anesthesiology, Perioperative and Pain

Laurence Baker, Professor of Health Policy, Department of Health Policy; Freeman Spogli Institute and Stanford University School of Medicine

Allergic disease, including both asthma and atopic dermatitis, is a highly prevalent, burdensome, and costly problem for children and their families in the United States. Children with asthma undergoing surgery are at increased risk of life-threatening respiratory complications associated with exposure to general anesthesia. Racial and ethnic disparities in the prevalence and treatment of allergic disease are well- documented. As the climate crisis in California continues, with more frequent and destructive annual wildfires, existing racial disparities in pediatric allergic disease may be exacerbated. We therefore aim to investigate the association between wildfire smoke and pediatric allergic disease, focusing on asthma and atopic dermatitis, through a lens of 1) racial equity, 2) economic burden, and 3) safety of surgical care. We will address these associations via a novel linkage of Medi-Cal data – which is uniquely suited to our research questions given its breadth and inclusion of a large proportion of children in California, many of whom are Black, Hispanic, or Asian – with both a national hazard mapping system to detect wildfire smoke plumes and the Environmental Protection Agency’s Air Quality dataset. We will draw from our inter- disciplinary expertise in methodology and clinical subject matter and will apply sophisticated epidemiologic and econometric approaches to reduce confounding and isolate causal effects. Our work will have important impacts on clinical care and health policy and is particularly salient given the ongoing climate crisis in California and its exacerbation of known inequities in child health.

Laurence Baker

Helen Kissel

Race, Provider Experience, and Maternal Health in the US

Grantees: Helen Kissel, Ph.D. Student in Economics, admitted Autumn 2019 Student Employee, Economics

Heidi Williams, Professor of Economics

In this project, we ask: does racial heterogeneity in the patient population at a physician’s training location impact his/her ability to treat patients of different races? We focus on the specialty of obstetrics and gynecology. The population health challenge motivating this project is the racial gap in maternal mortality in the US. Our goal is to provide practicable lessons on how provider training might be designed to reduce this growing health inequality.

Heidi Williams

Aditya Narayan

Examining the causes and consequences of exit and return to homeless shelters

Grantees: Aditya Narayan, MD Student, expected graduation Winter 2026, School of Medicine

David Chang, Clinical Assistant Professor, Medicine

Homeless shelters are crucial in facilitating effective interventions to reduce the health disparities faced by people experiencing homelessness and helping them return to permanent housing – however, poor retention in shelters severely limits the effectiveness of these shelter-based interventions. There has been minimal scholarship exploring the socio-demographic and health-related factors which lead to sustained homelessness and poor retention in shelter settings. Our project is novel in leveraging social epidemiological approaches alongside qualitative methods to study the factors associated with shelter retention and returns to homelessness in California. We seek to leverage our research findings to craft effective interventions through collective and community-engaged partnerships with local shelter networks.

David Chang

Rebecca L. Tisdale

Virtually Decided: Social, Economic, and Institutional Predictors of Virtual Cardiology Care Use

Grantees: Rebecca L. Tisdale, Postdoctoral Scholar, Health Policy, Epidemiology and Population Health

Donna Zulman, Associate Professor, Division of Primary Care and Population Health, Department of Medicine

Virtual specialty care is a promising solution to the access crisis caused by specialty care deserts, the absence of specialists in geographic regions, and compounded by pandemic-associated care disruptions—but one that risks exacerbating a “digital divide” between those with and without access to specialty care. The proposed project, leveraging expertise across the clinical and social sciences, aims to understand the individual- and facility-level characteristics that affect access to virtual specialty care use, with cardiology as an example field. Drawing on a database of 400,000 cardiology patients—one of the largest populations in which to study these questions—we will examine utilization of virtual cardiology care and how social, economic, and institutional predictors of virtual cardiology care use have evolved over the first two years of the COVID-19 pandemic. As virtual specialty care was used only rarely prior to March 2020, this analysis serves to characterize the early implementation phase of virtual cardiology care provision, and thereby inform future virtual specialty care efforts critical to extended access to high-quality specialty care to all.

Donna Zulman

Wenyun Zuo

Spatial and Temporal Variation in Age at Death in the US

Grantees: Wenyun Zuo, Basic Life Res Scientist, Biology

Shripad Tuljapurkar, The Dean and Virginia Morrison Professor of Population Studies, Professor Biology Department

There is considerable interest in how SES/race/ethnicity determines mortality. This proposal uses new county data for the US work and exploits a decomposition of total variance into variance between groups vs. variance within groups to examine whether differences between spatial units can be aggregated over space, and whether they are predictive over time.

Shripad Tuljapurkar

Tainayah Thomas

Exploring strategies to effectively measure and address the effects of structural racism on diabetes prevention: A Mixed-Methods Approach

Grantee: Tainayah Thomas, Assistant Professor, Department of Epidemiology and Population Health

Structural racism is pervasive and contributes to health inequities. Upstream policies at the state and local level form the foundation upon which downstream inequities in social risk factors and health outcomes exist. Therefore, there is a critical need to explore strategies to address the upstream policies that support structural racist practices while also assessing and addressing the downstream risk factors that contribute to poorer diabetes health outcomes for low-income communities of color. The proposed mixed-methods project seeks to utilize state and local data to comprehensively evaluate the distribution of upstream and downstream social risk factors, operationalize and measure structural racism using novel data sources, and contextualize the effects of structural racism on diabetes outcomes through key informant interviews with relevant stakeholders.

2021

Giacomo Benini

The Invisible Threat: The Health Risks of Natural Gas Flaring and Venting

Grantees: Giacomo Benini, Postdoctoral Research Fellow, Department of Energy Resources Engineering; and Adam Brandt, Associate Professor of Energy Resources Engineering and Senior Fellow at the Precourt Institute for Energy

Cleaner than coal, more abundant than oil and less dangerous than nuclear, natural gas represents the promise for a transition to a cleaner energy mix. However, recent studies have drawn attention to the health risks associated with reservoir emissions caused by the combustion (flaring) and the leakages (venting) of unsold gas, and geographical proximity to gas and oil wells. Surpassing spatial contiguity, our project brings into the analysis the intensity of flaring and venting, as well as their interaction on a US national scale. To do that, we will layer Skytruth Global Flaring, the TROPOspheric Monitoring Instrument, two free access satellite datasets, the Rystat ShaleWell Cube, a commercial dataset providing self-reported flaring and venting, with the SMART Behavioral Risk Factor Surveillance System (BRFSS) City and County Data and the Optum claims data.

Adam Brandt

Marshall Burke

Health impacts of pollution that infiltrates indoors

Grantees: Marshall Burke, Associate Professor of Earth System Science and Senior Fellow at the Freeman Spogli Institute for International Studies, at the Woods Institute for the Environment and at the Stanford Institute for Economic Policy Research; and Lynn Hildemann, Professor of Civil and Environmental Engineering

A vast literature studies the detrimental impact of outdoor air pollution on health, but Americans spend ~90% of their time indoors. Disparities in the home and work indoor environments could affect how ambient pollution infiltrates indoors for different groups, but such differences remain unquantified and, thus, total pollution exposure disparities remain poorly understood. Here, we combine four large-scale datasets on housing characteristics, air leakage rates, remote-sensing-based pollution exposures, and birth outcomes to estimate pollution infiltration for every household in the US. We then use these data to characterize local-level disparities in overall exposure to total PM2.5 and to wildfire-derived PM2.5, for both outdoor concentrations and the amount that infiltrates indoors, and study whether variation in infiltration rates moderates the relationship between wildfire smoke exposure and preterm birth in a large CA birth cohort.

Lynn Hildemann

Jonathan Yong Lee

Trust Wars: Identifying Common Rhetorical Strategies and Evaluating their Causal Effect on Trustworthiness Perceptions of Public Health Institutions

Grantee: Jonathan Yong Lee, Clinical Instructor, Psychiatry and Behavioral Sciences Ph.D. Student in Health Policy, admitted Summer 2018

Public health institutions face a growing challenge of maintaining public trust in the face of constant attacks on their trustworthiness from a variety of sources and media channels. Yet, little is known about the effectiveness of specific rhetorical strategies aimed to promote distrust in public health institutions and the most effective ways in which they can respond. This project aims to fill this gap in knowledge in two ways: 1) First, I will use natural language processing techniques to systematically identify common rhetorical strategies used to attack or defend source trustworthiness in the public health information arena; 2) Drawing on insights from behavioral economics, I will conduct two online survey experiments evaluating the causal effects of the above identified rhetorical strategies, which will help identify institutional vulnerabilities and the most effective ways for institutions to respond. The findings of this project will help improve our understanding of the causes of, and potential solutions for, declining trust in public health institutions, which disproportionately affects the health outcomes of socioeconomically disadvantaged communities.

Stephanie Leonard

Identifying Opportunities to Improve Health Inequities for Pregnant People using National Claims Data

Grantees: Stephanie Leonard, Instructor, Obstetrics & Gynecology - Maternal Fetal Medicine; Member, Maternal & Child Health Research Institute (MCHRI); and Deirdre Lyell, Professor Obstetrics and Gynecology; Associate Director, Division of Maternal-Fetal Medicine and Obstetrics; Director, Program in Placental Disorders; Medical Director, Labor and Delivery; Director, Maternal-Fetal Medicine Fellowship

Maternal health inequities are a top public health priority, but have remained pervasive and persistent in the U.S. An urgent need exists for research that advances our understanding of these disparities to inform effective approaches. This study aims to determine what racial/ethnic, socioeconomic, and geographic disparities exist in severe maternal morbidity (SMM) in the U.S., independent of comorbidities, and what clinical practices contribute to disparities in SMM. This will be a cohort study using contemporary national pregnancy-related claims data collected by Medicaid and commercial insurance companies. This project will overcome previous major research limitations, facilitate new partnerships across disciplines, and generate evidence that will be highly informative for the growing number of initiatives aiming to advance maternal health equity.

Deirdre Lyell

Alice Milivinti

A Healthy Surrogate: Predicting Long-Run Effects from Short-Run Policies

Grantees: Alice Milivinti, Postdoctoral Research Fellow, General Internal Medicine, Primary Care and Population Health; and Susan Athey, Economics of Technology Professor, Graduate School of Business; Senior Fellow at the Stanford Institute for Economic Policy Research and Professor, by Courtesy, of Economics

The effects of social and health policies unfold over a recipient’s lifetime. However, their evaluation is often limited to short-run experimental data. A compelling solution for life-cycle evaluations are the so-called surrogate indices, which identify short-term health responses best linked to long-term outcomes, while overcoming the statistical limitations typical of a single surrogate. This project will develop a surrogate health index of short-term indicators to evaluate the impact of social policies on longer-term health outcomes. By exploiting random calendar variations on the provision of the Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP) benefits recorded in the National Longitudinal Survey of Youth 1979, we will link short-term benefits with longer-term outcomes. This project is among the first contributions to a Library of Early Indicators for Social Science for the impact of socio-economic policies on health.

Susan Athey

Francis Pearman

Gentrification, Displacement, and Child Health: Evidence from National Data

Grantees: Francis Pearman, Assistant Professor, Graduate School of Education; and Lily Steyer, PhD Student in Education

Exposure to neighborhood disadvantage has long been known to adversely affect children’s physical and mental health. Far less is understood about what happens to children’s health when disadvantaged neighborhoods gentrify. Using national longitudinal data from the Panel Study of Income Dynamics (PSID) and Fragile Families and Child Wellbeing Study (FFCWS) and rigorous quasi-experimental methods, this study will examine how neighborhood gentrification and residential displacement impact children and adolescents' physical and mental health. Specifically, we will assess whether gentrification drives changes in rates of asthma, lead exposure, high body mass index, or internalizing and externalizing behaviors among children and adolescents. We will further investigate the extent to which the effects of gentrification on children and adolescents' physical and mental health are explained by their families' residential displacement. At a time of rising gentrification across the United States, our project will produce generalizable knowledge about whether and how urban redevelopment matters for the health of children and adolescents residing in gentrifying neighborhoods.

Lily Steyer

Gabrielle Wong-Parodi

Evaluating the Effectiveness of Interventions on Reducing Wildfire Smoke Exposure and Health Risks in Low-Income Hard-to-Reach Communities in the San Francisco Bay Area

Grantee: Gabrielle Wong-Parodi, Assistant Professor, Department of Earth System Science; Center Fellow, Stanford Woods Institute for the Environment

In the American West, wildfire smoke exposure increasingly threatens the health of low-income hard-to-reach (i.e., non-English speaking) communities. Few studies have been done to assess the impact of technology and communications-based interventions on reductions in exposure to wildfire smoke and associated health risks, especially among low-income hard-to-reach populations in a behaviorally realistic context. This 2-phase pilot study will determine the effectiveness of affordable interventions (air sealing, portable air filters, native-language messaging) to reduce wildfire smoke exposure and health risks among low-income communities with a high proportion of non-English speaking households. The results of this study will identify affordable and actionable intervention steps for individuals and communities, and inform policies, programs, and risk communication strategies that are behaviorally realistic for the hard-to-reach communities local organizations, governments, and agencies serve.

2020

Anneke Claypool

Prioritizing effective interventions to eliminate disparities in COVID-19 outcomes among marginalized populations

Grantee: Anneke Claypool, PhD Candidate, Department of Management Science and Engineering

Marissa Reitsma, PhD Candidate, Department of Health Policy

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.

Marissa Reitsma

Robert Fairchild

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

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.

Jacqueline Ferguson

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

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.

Zong Huang

Effects of expanding financial access to medically-assisted treatments for opioid dependence

Grantee: Zong Huang, PhD Student, Department of Economics

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.

Allison Kwong

Access to Subspecialty Care for Alcohol-Associated Liver Disease

Grantee: Allison Kwong, Instructor, Department of Medicine, Division of Gastroenterology & Hepatology

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.

Cesar Vargas Nunez

Investigating the Impact of COVID-19 on Healthcare Inequities and Public Attitudes

Grantee: Cesar Vargas Nunez, PhD Candidate, Department of Political Science

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.

Pablo Paredes

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

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).

Michele Patel

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

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.

Jenny Suckale

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

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.

Past Funding Cycles

2023

Applications Due: February 28, 2023 | 11:59 PM (Pacific Time)
Information Session: January 24, 2023 | 2:00 PM - 3:00 PM (Pacific Time)
- Slide Presentation
- Zoom Session Recording

2022

2021

2020

Page Contents

The 2023 Spectrum PHS Pilot Grants Info Session

Contact Us

We look forward to hearing from you.

For questions regarding scope of the proposal, criteria for awards or the review process, contact Eileen Bernabe, Associate Director Research Programs, Center for Population Health Sciences: StanPopHealth@stanford.edu.

For questions regarding the application process and requirements, contact Ellen Orasa at eorasa@stanford.edu.