Project Summary/Abstract
Opioid Use Disorder (OUD) during pregnancy in the US is increasing at alarming rates. Effective
psychosocial and substance use screening is vital to advance research and care for mothers with or
without OUD since psychosocial characteristics are known to contribute to prenatal health behaviors, to
medication-assisted treatment adherence, and consequently, to birth outcomes. Yet, despite
recommendations for comprehensive universal psychosocial and substance use screening, there are
professional, social, and technical barriers which hinder the systematic application of these
recommendations. The current project will evaluate, modify, and digitize a novel, multipurpose, brief, self-
report screening tool: the Profile for Maternal Opioid Treatment Effectiveness (PROMOTE). The
PROMOTE was developed by a multidisciplinary team of clinicians and researchers and captures
theoretically and clinically pertinent psychosocial and substance use risk factors (e.g. socio-demographic
variables, stress, interpersonal violence, social support, substance abuse severity and craving, and
treatment motivation) which can affect pregnant women with or without OUD. Systematically assessing
these vulnerabilities facilitates Screening, Brief Intervention, and Referral to Treatment (SBIRT) by health
care providers. The PROMOTE was recently implemented in Stony Brook University prenatal outpatient
clinics including a specialized program for women with OUD. The aims of this project are to confirm and
enhance the scientific validity and clinical efficacy of the PROMOTE screening tool. In Phase 1, to evaluate
the validity of the PROMOTE, we will: 1a) prospectively evaluate construct and criterion validity of the
PROMOTE compared with established full-length instruments completed by 90 women without OUD and
90 women with OUD; 1b) evaluate the predictive validity (accuracy of OUD detection) of the PROMOTE
among 1,000 patients; 1c) qualitatively assess the acceptability and content validity of the PROMOTE (in
English or in Spanish). In Phase 2, we will refine the PROMOTE based on patient response. In Phase 3,
we will pilot a digital version of the PROMOTE. In this phase, using a community-based participatory
approach, we will involve affected stakeholders, including patients, office staff, and care providers.
Improving treatment and health outcomes of pregnant women is a national imperative. Findings will
enable refinement of the PROMOTE and its use so that subsequent to this project it can be disseminated to
prenatal, addiction, and integrated care settings to facilitate collection of vital clinical and research data and
to support SBIRT. Additionally, we will propose a large scale, multicenter project utilizing the refined,
digitized PROMOTE to investigate biobehavioral and psychosocial mechanisms that contribute to physical
health and well-being among all pregnant women with or without OUD and their offspring.
