# Project STEPuP: A prenatal provider education and training program to improve medication-assisted treatment use during pregnancy and maternal and child health outcomes

> **NIH NIH R01** · MAGEE-WOMEN'S RES INST AND FOUNDATION · 2024 · $591,815

## Abstract

Topic DAT18-06: The prevalence of opioid use disorder (OUD) during pregnancy has quadrupled over the
past decade, as have maternal and neonatal morbidity and mortality related to substance use. Medication-
assisted treatment (MAT) use during pregnancy reduces adverse outcomes and is the recommended,
evidence-based practice (EBP) for OUD treatment during pregnancy. Despite this, 40% of pregnant women
with OUD do not receive MAT. Currently, there are no effective strategies to expand MAT access and
availability for pregnant women, especially in rural, low-resource settings where maternal opioid use is
disproportionately high. As an initial step to address this gap, we engaged key stakeholders across a large
health system in Pennsylvania to determine barriers and facilitators to expanding treatment services in high
need, low-resource obstetric settings. Our stakeholders identified a critical need for a women-centered, low-
resource, sustainable, provider-level intervention to facilitate the adoption of MAT in obstetric settings.
Therefore, our objective in this application is to test the effectiveness of a prenatal provider education and
training program designed to facilitate the adoption of EBP for OUD during pregnancy called Project STEPuP
(Substance abuse Treatment and Education during Pregnancy and Postpartum). Project STEPuP, grounded in
preliminary and pilot work conducted by our research team, has 4 components designed to address barriers to
MAT and EBP adoption: 1) a “hub and spoke,” remotely-supported provider education and training program, 2)
addiction teleconsultation support, 3) case management and telepsychiatry support, and 4) a partnership with
health system administrators and payers to address administrative and reimbursement related needs. To
achieve this objective, we will conduct a cluster-randomized clinical trial across 12 obstetric sites in
Pennsylvania and New York. Outcomes among 870 patients will be assessed during pregnancy, at delivery
and through 1 year postpartum. Our central hypothesis is that Project STEPuP will facilitate EBP adoption,
increase MAT utilization and improve health outcomes among pregnant and postpartum women with OUD and
their children. Specifically, we aim to: 1) create organizational readiness to facilitate Project STEPuP
implementation; 2) assess the effect of Project STEPuP on provider adoption of EBP for OUD during
pregnancy; and 3) evaluate the effect of provider adoption of EBP on maternal and child health outcomes. Our
research is significant by addressing the substantial knowledge gap of how to increase MAT use in pregnancy
and innovative by examining the role that prenatal providers can play in expanding treatment access.

## Key facts

- **NIH application ID:** 10837724
- **Project number:** 5R01DA049759-05
- **Recipient organization:** MAGEE-WOMEN'S RES INST AND FOUNDATION
- **Principal Investigator:** Marian Patricia Jarlenski
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $591,815
- **Award type:** 5
- **Project period:** 2020-07-15 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10837724

## Citation

> US National Institutes of Health, RePORTER application 10837724, Project STEPuP: A prenatal provider education and training program to improve medication-assisted treatment use during pregnancy and maternal and child health outcomes (5R01DA049759-05). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10837724. Licensed CC0.

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