Perinatal Subtance Use Research and Advocacy at Mass General
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Ongoing 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.
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.
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.
Equity in Perinatal Substance Use Testing (Retrospective Chart Review)
This retrospective chart review will examine variations in toxicology testing among women who obtain prenatal care in Massachusetts, to better understand when toxicology tests are utilized and for whom.
Davida Schiff, MD, MSc – Dr. Schiff is a general academic pediatrician and health services researcher focused on understanding how substance use in pregnant and parenting women impacts the health of children and families. She is the Medical Director of the HOPE Clinic, a multidisciplinary program caring for women and families with substance use disorder from the time of conception through the first two years postpartum.
Dr. Schiff completed her undergraduate training at Columbia University, medical training at the Boston University School of Medicine, pediatrics residency in the Boston Combined Residency Program at Boston Medical Center and Boston Children’s Hospital, general pediatrics research fellowship at Boston Medical Center, and master’s program in health services research from the Boston University School of Public Health.Her research is focused on improving care for families affected by substance use.
Edwin Raffi, MD – Dr. Edwin Raffi is a board certified psychiatrist at the Massachusetts General Hospital’s Center for Women’s Mental Health, and the MGH HOPE clinic and an Instructor in Psychiatry at Harvard Medical School. He completed his psychiatry residency training at Harvard Medical School’s South Shore Adult Psychiatry Residency Program and his fellowship in Perinatal and Reproductive Psychiatry at the MGH Center for Woman’s Mental Health.
Dr. Raffi’s areas of interest and/or research include:Perinatal and Reproductive Psychiatry, Addiction & Substance Use Disorders, Geriatric Psychiatry, Trauma, Mind Body Medicine, Health and Technology.
Jessica Gray, MD – Jessica Gray is a dually board certified family medicine physician and addiction specialist in the departments of Medicine at Massachusetts General Hospital (MGH) and Pediatrics in Massachusetts General Hospital for Children (MGHfC). She is associate program director for the MGH Addiction Medicine Fellowship and clinical director of the HOPE Clinic at MGH, where she cares for women with substance use disorders and their families from time of conception through the first two years postpartum. She also sees patients at the MGH Bridge Clinic, a low-threshold outpatient substance use disorder treatment clinic.
Dr. Gray is passionate about caring and advocating for marginalized populations and supporting clinicians and others who care for patients with substance use disorders. Dr. Gray’s publications can be found here.
Kate MacMillan, MD, MPH – Dr. Kate MacMillan is a board certified pediatrician paracticing at MGHfC, Good Samaritan Medical Center, and St. Elizabeth’s Medical center. Sarah completed her masters in public health and medical training at the Geisel School of Medicine at Dartmouth. Dr. MacMillan’s publications can be found here.
Sarah Bernstein, MD – Dr. Sarah Bernstein is a board certified maternal fetal medicine specialist at Massachusetts General Hospital, obstetrical director of the MGH HOPE clinic, co-director of the MGH Diabetes in Pregnancy Program, medical director of the MGH obstetrics clinic and an instructor at Harvard Medical School.
Dr. Bernstein’s areas of interest and/or research include: The diagnosis and management of fetal growth restriction, optimizing care for pregnant women with substance use disorders and diabetes in pregnancy
Gina Liu, MSc – Gina completed her undergraduate degrees in Statistics and Computational Biology at the University of Pennsylvania. She then received her Master’s in Evidence-Based Social Intervention and Policy Evaluation at the University of Oxford, specializing in gun violence research. She is currently a medical student in the HMS Pathways program, with hopes to integrate social epidemiology research as part of her future clinical career.
Kathleen Koenigs, BA – Kathleen is currently a fourth year at Harvard Medical School. She gained experience caring for patients with complex medical and psychosocial needs while working as a case manager at Boston Health Care for the Homeless Program after graduating from Harvard College. In medical school, she engaged in advocacy and research to benefit patients with substance use disorders, leading the Student Coalition on Addiction to advance harm reduction policies on the state and federal level, and publishing a study characterizing polysubstance use at a needle exchange program. Kathleen is applying into Ob/Gyn and hopes to pursue a career in maternal-fetal medicine specializing in addiction care. She is excited to be part of the PRISM team studying toxicology consent practices at time of labor and delivery.
Sam Cohen, MD – Sam is a pediatric resident at MGH, volunteering his time and support on various PRISM Projects. He earned his medical degree from the University of California, San Francisco. Sam’s areas of interest in research involve the intersection of early education and medicine to promote public health.
Clinical Research Coordinators
Erin Work, BA – Erin holds a Bachelor’s Degree in Gender, Sexuality, and Feminist Studies from Middlebury College where she performed research on the consumption of food and drugs during pregnancy for her undergraduate thesis. She previously worked in research for Massachusetts General Hospital’s Neuroscience Statistics Research Laboratory in the Department of Anesthesia, Critical Care and Pain Medicine. She hopes to pursue a career at the intersection of reproductive health and harm reduction.
Moira Nolan, BA – Moira earned her BA in psychology and sociology at American University where she gained interest in studying the social and political factors effecting pregnant and parenting individuals. Since graduating she has worked within women’s health research, most recently joining the PRISM team to serve as a research coordinator for the MOMs clinical trial. Within the coming years Moira plans to apply to Certified Nurse Midwife programs.
Interns & Volunteers
Ella Kim – Ella is a pre-med student majoring in Biology and Psychology at Wesleyan University (Class of 2022). As a Research Intern at the HOPE clinic, Ella has conducted retrospective chart review, coding manual refinement, and data entry using REDCAP. She is interested in how social determinants impact physical and mental health, particularly among disadvantaged women and their families. She hopes to become a physician specializing in addiction medicine. In her spare time, Ella enjoys her volunteer work at Massachusetts General Hospital as a patient escort, and playing on the volleyball team at Wesleyan.
Heather Jamieson – Heather will be earning her BA in biology with a specialization in cellular, molecular biology and genetics, and psychology at Boston University in the spring of 2021. Through her courses she became interested in public health and clinical research. Her sophomore year she joined a lab focused on Alzheimer’s Disease research, and during her junior spring she joined the HOPE Clinic as a chart review volunteer. In the upcoming year, Heather hopes to go to graduate school to study microbiology as it relates to human health.
Joseph Distefano, BS/MPH – Joseph is a BS/MPH candidate in the 4 + 1 Dual Degree Program at Boston University Sargent College and Boston University School of Public Health, where he studies Health Science. His passion for social justice has informed his study of public health and desire to address social inequities in healthcare. He has recently joined the PRISM team as a research volunteer, assisting with chart review on the Equity in perinatal substance use testing, reporting, and healthcare utilization project. In the next few years, Joseph plans on attending medical school.
Lily Gulledge – Lily is a junior at Harvard College studying History and Science and Global Health and Health Policy, where she was first introduced to the importance of the social determinants of health. She enjoys assisting the HOPE Clinic with patient chart review because it provides insight on the practicalities of this important sphere of medical care. After graduation, Lily hopes to apply to health policy MD-PhD programs and improve rural health outcomes in her home state of Alabama.
Serra Muftu – Serra is currently a senior at Tufts University majoring in biology where she gained an interest in patient-centered research that informs more equitable health outcomes, especially in reproductive health. She joined the PRISM team as a student researcher working on a qualitative research project that studies experiences with pregnancy and MOUD. In the future, Serra hopes to attend medical school.
Clinical Advisory Team
- Julia Reddy, MPH
- Katie Raftery
- Latisha Goullaud
Past Team Members
Ann Herrin, RN – Ann earned her BS in Nursing at the University of Miami School of Nursing. Immediately after graduation she moved to Kotzebue Alaska to work with the native Inupiaq population. This started her journey into working with underserved and at-risk populations. Ultimately this led her into research during the early years of the AIDS Clinical Trials. From there she participated in research for osteoporosis and menopause and Alzheimer’s disease. She joined the PRISM team to serve as the Research Nurse for the MOMs Clinical Trial. Ann has recently left the PRISM team and moved to Austin Texas with her husband Steve.
Carly Eiduson, BA – Carly earned her BA in Biology and Community Health at Tufts University. She spent much of her undergraduate experience working as an Emergency Medical Technician and conducting research on health disparities, resource allocation, and decision making in the setting of organ transplant. She is particularly interested in the patient-provider relationship and team based healthcare. Carly is currently employed as a clinical research coordinator in the Department of Anesthesia, Critical Care and Pain Medicine at MGH where her research focuses on reducing opioid use and side effects for patients undergoing various surgeries through the use of local anesthetics as an alternative. She has joined the PRISM team to serve as a volunteer to further understand and research how to better care for patients using a team based model.
Naomi Dulit-Greenberg – Naomi is a soon-to-be graduate of Tufts University, where she is studying Psychology and Spanish. Through her internships and classes, she became interested in promoting healthy child development and ending cycles of trauma, particularly for children in foster care. Last summer, she interned at the HOPE Clinic at MGH, and discovered how interconnected substance use is with mental and physical health. After graduating, she hopes to pursue either a career in medicine or Psychology.
Sara Meyers – Sara is a medical student at Case Western Reserve University in Cleveland, Ohio, and has previously spent a summer in Boston working on research. After graduating from Kenyon College, Sara worked at BWH for two years prior to starting medical school. Sara loves biking, eating ice cream, going for walks, and listening to podcasts!
Shayla Partridge, BA – Shayla earned a BA in the History of Science with a secondary in Global Health & Health Policy at Harvard College. During her undergraduate career, she was also involved in health activism that included access to medicine efforts related to global HIV/AIDS as well as leading sexual health education workshops in under-resourced high schools. Her senior thesis explored the social and historical meanings of substance-exposed newborns throughout the twentieth century, which led her to her current passion for working with families affected by substance use. Shayla has worked with the HOPE Clinic for two years, first as a Program & Research Coordinator, and now working full time as a researcher on qualitative projects related to dyadic care models and experiences of pregnant and postpartum people taking medications for opioid use disorder (MOUD). She will be attending Yale School of Nursing in Fall of 2020 to pursue becoming a Family Nurse Practitioner.
If you have an interest in perinatal substance use research and are interested in joining PRISM, please contact Moira Nolan at Mnolan@mgh.harvard.edu.