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.

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.

Use of Involuntary Civil Commitment for Substance Use Disorder Among Perinatal and Reproductive-Aged Individuals in Massachusetts

Using the Massachusetts Department of Public Health Public Data Warehouse, a statewide linked administrative database, this project will examine the use of involuntary civil commitment (ICC) for substance use disorder among reproductive-aged women in Massachusetts from 2014–2022. We will compare ICC rates during prenatal, postpartum, and non-perinatal periods and assess differences in sociodemographic, substance use, and mental health characteristics across reproductive stages.

Promoting Research with Mothers receiving OUD Treatment; a focus on Equity (PRoMOTE)

This study centers the experiences of women of color with opioid use disorder who are participating in the National Institute on Drug Abuse Clinical Trials Network (CTN)-0080 Medication Treatment for Opioid Use Disorder in Expectant Mothers (MOMs) trial. Through interviews with participants and research staff, the study explores factors that influence starting and continuing medication for opioid use disorder (MOUD), as well as trial enrollment and retention. Using a mixed-methods approach, findings from interviews are combined with survey data and site- and state-level information to better understand how race, equity, stigma, and discrimination shape care experiences. The goal is to identify practical opportunities to improve engagement, reduce structural barriers, and promote more equitable perinatal substance use disorder care.