About

Lee Sanders is a professor in the Department of Pediatrics at Stanford University, specializing in General Pediatrics. His role involves teaching and research within the Human Biology program at Stanford, contributing to the academic community through his expertise in pediatrics. His work is part of a broader faculty effort to advance understanding in human biology and pediatrics, supporting undergraduate education and research initiatives at Stanford.

Research topics

• Medicine
• Psychology
• Physical therapy
• Pediatrics
• Demography
• Environmental health
• Internal medicine
• Political Science
• Pedagogy
• Immunology
• Medical emergency
• Psychiatry
• Chemistry
• Endocrinology
• Food science
• Animal science
• Applied psychology
• Biology
• Family medicine
• Medical education
• Nursing
• Gerontology

Selected publications

• Are Low-Income, Diverse Mothers Able to Meet Breastfeeding Intentions After 2 Months of Breastfeeding?

  UNC Libraries · 2025-07-15

  articleOpen access

  <strong><em>Background:</em></strong> Little is known about intended breastfeeding duration of women who initiate breastfeeding. We describe the association between intended and actual breastfeeding duration among low-income, diverse mothers who report maintaining breastfeeding for the first 2 months postpartum. <strong><em>Materials and Methods:</em></strong> We included mothers (64% Hispanic, 17% non-Hispanic black) participating in Greenlight, a cluster randomized childhood obesity prevention trial, who were providing breast milk at the 2-month preventive service visit and reported intended breastfeeding duration at this visit. Breastfeeding status was assessed at subsequent visits, up to 24 months. Poisson regression with a robust variance estimator was used to estimate risk ratios and 95% confidence intervals for meeting breastfeeding intentions. Covariates included race/ethnicity, income, receiving benefits from the Special Supplemental Nutrition Assistance Program for Women, Infants and Children (WIC), education, age, employment, depression, maternal obesity, U.S. born, whether infant was first born, and study site. <strong><em>Results:</em></strong> Median intended breastfeeding duration was 11.5 months (interquartile range [IQR]: 6-12) and median actual breastfeeding duration was 8.6 months (IQR: 4-14) (<em>n</em>&thinsp;=&thinsp;349). Approximately half (49%) met intended breastfeeding duration. Breastfeeding duration differed based on milk type provided at the 2-month visit in that mothers providing mostly or only breast milk had increased likelihood of meeting breastfeeding intentions. Regardless of milk type provided at 2 months, the longer a mother intended to breastfeed, the less likely she was to meet her breastfeeding intentions. <strong><em>Conclusions:</em></strong> In this diverse sample of women less than half met breastfeeding intentions despite maintaining breastfeeding for 2 months. Understanding factors that prevent mothers from attaining intended breastfeeding duration is critical to improving breastfeeding outcomes, especially in low income and ethnic minority populations.

  PublisherDOI

• Assessing Diet Quality in a Racially and Ethnically Diverse Cohort of Low‐income Toddlers

  UNC Libraries · 2025-07-03

  articleOpen access

  BACKGROUND: Low-income racially and ethnically diverse children are at higher risk for obesity compared with their counterparts; yet, few studies have assessed their diet quality. OBJECTIVE: The aim of the study was to evaluate the diet quality of a racially and ethnically diverse cohort of 2-year-olds using the Healthy Eating Index (HEI)-2010. METHODS: We used 24-hour dietary recall data from caregivers of toddlers (24-34 months) at 4 pediatric resident clinics that participated in the Greenlight Study to calculate compliance with the Dietary Guidelines for Americans (DGA) using total HEI score (range 0-100) and 12 component scores. RESULTS: Participants (n = 231) were mostly Hispanic (57%) or non-Hispanic black (27%) and from low-income families. Mean HEI-2010 score was 62.8 (standard deviation [SD] 10.5). Though not significant, Hispanics had the highest HEI score. Toddlers of caregivers without obesity, older than 35 years and born outside the United States had higher HEI scores. Most had high HEI component scores for dairy, fruit, and protein foods, but few achieved maximum scores, particularly for whole grains (13%), vegetables (10%), and fatty acid ratio (7%). CONCLUSIONS: Despite scores reflective of DGA recommendations for fruit, dairy and protein foods, toddlers in this diverse sample had low quality diets as measured by the HEI, driven largely by low component scores for whole grains, vegetables, and ratio of unsaturated to saturated fatty acids.

  PublisherDOI

• Linking deliveries to newborns using nationwide Medicaid data

  BMC Medical Research Methodology · 2025-10-24

  articleOpen access

  Linking mothers to their newborns in health records is crucial for understanding the impact of policies, programs, and medical treatments on intergenerational health outcomes. While previous studies have used shared identifiers for linkage, such data are often unavailable in Medicaid records due to privacy concerns. Existing algorithms are not sufficiently flexible to accommodate Medicaid data from all states and from both Medicaid Analytic Extract (MAX) and Transformed Analytical Files (TAF) data systems. We present a scalable framework and linking algorithm that connects deliveries and infants without relying on names, addresses, or linkage to vital records. First, we confirm our ability to identify newborn beneficiaries and deliveries resulting in live birth across states and over time by comparing our findings to the total number of Medicaid births recorded in the National Vital Statistics System (NVSS). Second, we confirm that our algorithm accommodates variations in Medicaid records over time and across states for MAX and TAF data, supporting matches at different levels of stringency. Finally, we assess the extent to which our algorithm is effective across demographic groups. Using data from all 50 states over 9 years, our algorithm linked 11.68 million mother-infant dyads, covering 68% of Medicaid-enrolled infants, over 30% of all U.S. infants. Our linked cohort is approximately representative of the broader population of Medicaid beneficiaries on key observable characteristics including race and ethnicity, age, gender, and region. However, linked beneficiaries are more likely to be white and from the Midwest or Northeast relative to those we are unable to link. Despite substantial variation in the nature of Medicaid data across states and over time, it is possible to identify family units in all states between 2011 and 2019 without linking claims to vital records. This algorithm will facilitate research on social determinants of health and the intergenerational effects of medical interventions and public policy.

  PublisherOA PDFDOI

• Behavioural components and delivery features of early childhood obesity prevention interventions: intervention coding of studies in the TOPCHILD Collaboration systematic review

  International Journal of Behavioral Nutrition and Physical Activity · 2025-02-05 · 6 citations

  reviewOpen access

  BACKGROUND: Early childhood obesity prevention interventions that aim to change parent/caregiver practices related to infant (milk) feeding, food provision and parent feeding, movement (including activity, sedentary behaviour) and/or sleep health (i.e. target parental behaviour domains) are diverse and heterogeneously reported. We aimed to 1) systematically characterise the target behaviours, delivery features, and Behaviour Change Techniques (BCTs) used in interventions in the international Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration, and 2) explore similarities and differences in BCTs used in interventions by target behaviour domains. METHODS: Annual systematic searches were performed in MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, and two clinical trial registries, from inception to February 2023. Trialists from eligible randomised controlled trials of parent-focused, behavioural early obesity prevention interventions shared unpublished intervention materials. Standardised approaches were used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials. Validation meetings confirmed coding with trialists. Narrative syntheses were performed. RESULTS: Thirty-two trials reporting 37 active intervention arms were included. Interventions targeted a range of behaviours. The most frequent combination was targeting all parental behaviour domains (infant [milk] feeding, food provision and parent feeding, movement, sleep health; n[intervention arms] = 15/37). Delivery features varied considerably. Most interventions were delivered by a health professional (n = 26/36), included facilitator training (n = 31/36), and were interactive (n = 28/36). Overall, 49 of 93 unique BCTs were coded to at least one target behaviour domain. The most frequently coded BCTs were: Instruction on how to perform a behaviour (n[intervention arms, separated by domain] = 102), Behavioural practice and rehearsal (n = 85), Information about health consequences (n = 85), Social support (unspecified) (n = 84), and Credible source (n = 77). Similar BCTs were often used for each target behaviour domain. CONCLUSIONS: Our study provides the most comprehensive description of the behaviour change content of complex interventions targeting early childhood obesity prevention available to date. Our analysis revealed that interventions targeted multiple behaviour domains, with significant variation in delivery features. Despite the diverse range of BCTs coded, five BCTs were consistently identified across domains, though certain BCTs were more prevalent in specific domains. These findings can be used to examine effectiveness of components and inform intervention development and evaluation in future trials. TRIAL REGISTRATION: PROSPERO registration no. CRD42020177408.

  PublisherOA PDFDOI

• Key takeaways from Stanford’s symposium on AI for Data Science

  Journal of Clinical and Translational Science · 2025-01-01

  articleOpen access

  Abstract Numerous symposia and conferences have been held to discuss the promise of Artificial Intelligence (AI). Many center on its potential to transform fields like health and medicine, law, education, business, and more. Further, while many AI-focused events include those data scientists involved in developing foundational models, to our knowledge, there has been little attention on AI’s role for data science and the data scientist. In a new symposium series with its inaugural debut in December 2024 titled AI for Data Science , thought leaders convened to discuss both the promises and challenges of integrating AI into the workflows of data scientists. A keynote address by Michael Pencina from Duke University together with contributions from three panels covered a wide range of topics including rigor, reproducibility, the training of current and future data scientists, and the potential of AI’s integration in public health.

  PublisherOA PDFDOI

• Parental Perspectives on the Impact of the COVID-19 Pandemic on Infant, Child, and Adolescent Development

  UNC Libraries · 2025-03-18

  articleOpen access

  OBJECTIVE: The purpose of this study is to understand how families from diverse sociodemographic backgrounds perceived the impact of the pandemic on the development of their children. METHODS: We used a multimethod approach guided by Bronfenbrenner's Ecological Systems Theory, which identifies 5 developmental systems (micro, meso, exo, macro, and chrono). Semistructured interviews were conducted in English or Spanish with parents living in 5 geographic regions of the United States between July and September 2021. Participants also completed the COVID-19 Exposure and Family Impact Survey. RESULTS: Forty-eight families participated, half of whose preferred language was Spanish, with a total of 99 children ages newborn to 19 years. Most qualitative themes pertained to developmental effects of the microsystem and macrosystem. Although many families described negative effects of the pandemic on development, others described positive or no perceived effects. Some families reported inadequate government support in response to the pandemic as causes of stress and potential negative influences on child development. As context for their infant's development, families reported a variety of economic hardships on the COVID-19 Exposure and Family Impact Survey, such as having to move out of their homes and experiencing decreased income. CONCLUSION: In addition to negative impacts, many parents perceived positive pandemic-attributed effects on their child's development, mainly from increased time for parent-child interaction. Families described economic hardships that were exacerbated by the pandemic and that potentially affect child development and insufficient government responses to these hardships. These findings hold important lessons for leaders who wish to design innovative solutions that address inequities in maternal, family, and child health.

  PublisherDOI

• Artificial intelligence–powered 3D analysis of video-based caregiver-child interactions

  Science Advances · 2025-02-14 · 9 citations

  articleOpen accessCorresponding

  We introduce HARMONI, a three-dimensional (3D) computer vision and audio processing method for analyzing caregiver-child behavior and interaction from observational videos. HARMONI operates at subsecond resolution, estimating 3D mesh representations and spatial interactions of humans, and adapts to challenging natural environments using an environment-targeted synthetic data generation module. Deployed on 500 hours from the SEEDLingS dataset, HARMONI generates detailed quantitative measurements of 3D human behavior previously unattainable through manual efforts or 2D methods. HARMONI identifies longitudinal trends in child-caregiver interaction, including child movement, body pose, dyadic touch, visibility, and conversational turns. The integrated visual and audio analysis further reveals multimodal trends, including associations between child conversational turns and movement. Open-sourced for large-scale analysis, HARMONI facilitates advancements in human development research. HARMONI achieves 63 to 80% consistency on key attributes with human annotators on SEEDLingS and 84 to 93% consistency on videos taken from a laboratory setting while achieving >100 times savings in time.

  PublisherDOI

• National Birth Outcomes and Care Utilization for Infants of Emergency Medicaid Eligible Parents

  2025-05-31

  preprintOpen access

  Medicaid births represent nearly 40% of all births nationwide and in states such as Oregon and California, births covered by Emergency Medicaid (EM) are 20-30% of all Medicaid births. EM provides restricted/limited benefits coverage for life-threatening conditions, including labor and delivery care for individuals who are otherwise ineligible for Medicaid because of immigration status. Despite EM-covered populations experiencing social and economic disadvantage, prior research on outcomes has included select states, such as Oregon, South and North Carolina, and Texas. This study uses national data to compare health outcomes for infants born to individuals receiving EM and non-EM coverage.

  PublisherDOI

• COVID-19 vaccine hesitancy among low-income, racially and ethnically diverse US parents

  UNC Libraries · 2025-04-30

  articleOpen access
  PublisherDOI

• Good Friends and Good Neighbors: Social Capital and Food Insecurity in Families with Newborns

  UNC Libraries · 2025-10-19

  articleOpen access
  PublisherDOI

Recent grants

• NIH Grant U54CA153705

  NIH · $3.4M · 2017

• SCH:INT Collaborative Research: Intelligent Information Sharing: Advancing Teamwork in Complex Care

  NIH · $1.6M · 2016–2022

• NIH Grant R01HD059794

  NIH · $6.7M · 2019

Frequent coauthors

• Susan A. Everson‐Rose

  University of Minnesota

  693 shared

• Kimberly M. Henderson

  Mayo Clinic

  693 shared

• Yori Gidron

  University of Haifa

  677 shared

• Cari J. Clark

  Emory University

  677 shared

• Peter Allebeck

  Institute for Health Metrics and Evaluation

  650 shared

• Laura Rodriguez‐Murillo

  Columbia University Irving Medical Center

  523 shared

• Olveen Carrasquillo

  508 shared

• Rany M. Salem

  University of California, San Diego

  505 shared

Education

• MPH, Epidemiology

  University of California Berkeley

  2000

• MD

  Stanford University School of Medicine

  1994

• BA, History of Science

  Harvard University

  1990