Active Research Projects

Improving Treatment Engagement and Adherence to Optimize Outcomes for Opioid-Exposed Mother-Infant Dyads

Funded by the National Institute on Drug Abuse (NIDA K23DA048169), this study aims to aim to better understand the factors that impact engagement in treatment, adherence to medications, and attitudes towards medications for opioid use disorder (MOUD) among pregnant, postpartum, and parenting women. This mixed-methods study aims to quantitatively examine how medication adherence impacts maternal and child health utilization and outcomes and qualitatively explores beliefs, attitudes, interpersonal and structural barriers and facilitators to treatment engagement and adherence in order to develop a pharmacotherapy promotion intervention.

Family Engagement Project

The PRISM team is leading the Family Engagement Project 2.0, with the support the Massachusetts Health Policy Commission (HPC), to continue to support hospitals in developing their ability to engage families impacted by substance use disorders, identify potential sources of inequitable care, incorporate the family voice in local improvement efforts and create supportive spaces to elicit the perspective of families with lived experience.

Medication Treatment for Opioid Use Disorder in Expectant Mothers (MOMs)

Funded by the National Institute on Drug Abuse (NIDA) Clinical Trials Network, the MOMs study is a randomized control trial (CTN- 0080) evaluating the impact of two different types of buprenorphine treatment for opioid use disorder in pregnant women. The MOMs trial seeks to compare the effectiveness of sublingual buprenorphine to a long-acting injectable formulation, CAM2038. The MOMs study will follow the health of mother and baby through pregnancy up to one-year post-partum. This multisite trial will enroll 300 participants nationally, with 25 participants recruited locally at MGH.

Retrospective Cohort Study of Substance-Exposed Dyads at MGH and in the MGH HOPE Clinic

The MGH HOPE Clinic is an outpatient clinic for pregnant and parenting women with substance use disorders, their children, and their partners that opened in April 2018. The HOPE Clinic provides integrated and coordinated care across many disciplines including Pediatrics, Addiction, Psychiatry, Social Work, Obstetrics, and recovery coaching. This retrospective review of mother-infant dyads impacted by substance use disorders across MGH will examine the unique challenges these families face, and explore how the model of multidisciplinary, integrated care for the dyad provided by the HOPE Clinic has affected health and other outcomes among these patients. A case-control study will analyze psychiatric and substance use history and severity, prenatal care engagement, delivery outcomes, infant and child health, as well as measures of healthcare utilization across care settings, comparing deliveries to women who engaged in the HOPE Clinic compared to women with substance use disorder who have not engaged in this clinic.

Pilot Feasibility of Infant Respite Care for Mothers With Substance Use Disorders in Residential Settings

This pilot program collaborates with the New England Doula Support company, two residential treatment programs, and the Department of Children and Families to provide overnight infant respite care for dyads currently residing in residential treatment programs. The primary aim of this mixed methods study is to evaluate the feasibility and acceptability of night respite care in residential settings. The secondary aims will examine the extent to which provision of respite care results in improved maternal and infant outcomes including maternal exhaustion, mental health, substance use treatment retention, parenting-self efficacy, decreased unscheduled healthcare utilization, and reducing filings for parental abuse and neglect.

Patients Perspectives on Discussing Safety and Ongoing Substance Use While Parenting

Using qualitative methodology, this project aims to use focus groups with postpartum women with substance use disorder to assess patient attitudes towards ongoing non-prescribed substance use while parenting. Often overlooked, patient perspectives on how clinicians assess child safety in the setting of using substances while parenting will be critical to inform patient-centered clinical polices in the HOPE clinic.

Toxicology Consent Practices

Using semi-structured qualitative interviews with clinicians and birthing people who underwent toxicology testing at the time of delivery, this project aims to investigate the impact of toxicology testing during pregnancy on birthing people; clinician attitudes and practices around toxicology testing during pregnancy; as well as barriers and facilitators to obtaining consent for toxicology testing at delivery. Findings will be used to develop evidence-based guidelines to support practices that ensure equitable care for birthing individuals and families.