Across six rural Michigan counties, the “MI Babies” project will employ strategies that lead to early identification of pregnant women with high-risk substance use, build work-force capacity to confidently and competently provide substance use screening and treatment to pregnant women, and leverage technology to expand access to evidence-based substance use screening, treatment, and prevention approaches that result in improved outcomes for mothers and infants.
Rural Michigan is disproportionately impacted by NAS. The six rural counties targeted by this project (Arenac, Bay, Gladwin, Iosco, Ogemaw, and Oscoda) have NAS incidence rates that are two- to three-times greater than state-level rates, coupled with severe shortages of mental health and primary care providers. Through the “MI Babies” project, we will partner with a federally-qualified health center, a regional community mental health authority, and two district health departments that serve this population through Women, Infants & Children (WIC) programs, Title X Family Planning Clinics, and Maternal/Infant Services. Designated targets include healthcare professionals within these settings who provide care to women who are seeking family planning services, prenatal care, and pregnancy/early childhood services, including physicians, nurse practitioners, physician assistants, social workers, and community enablers (n = 699). Through these efforts, we will reach 20,605 women of reproductive age over the project lifetime. To accomplish this, we will partner with a peer recovery organization to provide SBIRT training in these rural organizations, using simulations and “virtual patients” to improve providers’ confidence, competence, and readiness to implement SBIRT. We will leverage technology to improve access to substance use treatment for women across a continuum of care, beginning with preconception and extending beyond childbirth. Using a hub-and-spoke model, we will launch a Perinatal SUD Project ECHO to enhance workforce capacity to provide substance use treatment locally, where it is most needed. To further expand treatment options in our rural catchment area, we will employ computer-based treatment for cognitive behavioral therapy (CBT4CBT), an evidence-based approach with demonstrated efficacy for reducing or eliminating problematic and high-risk substance use. By building community coalitions across the 6-county region, the “MI Babies” project will create opportunities to impact women before, during, and after pregnancy to prevent substance-exposed and NAS-related morbidity and costs. We expect to see improvements in the following outcomes as a result of the “MI Babies” project: NAS awareness, SUD screening rates, SUD treatment engagement and retention, early and consistent prenatal care, and number of providers who have initiated buprenorphine waiver training. We anticipate reductions in NAS rates, NAS-related hospitalizations/costs, and opioid overdose deaths among women during the peripartum period.