# CEREMONY: Culturally Engaged REcovery - MOms connected through Native community

> **NIH NIH U54** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2024 · $627,394

## Abstract

ABSTRACT: PROJECT 1 CEREMONY
Pregnant and postpartum American Indian and Alaska Native people (Native mothers) face a more than two-
fold higher risk of maternal mortality compared to non-Hispanic White mothers. Deaths related to substance
use (SU) and mental health conditions reflect a leading cause of preventable maternal mortality,
including among Native mothers, making these conditions a strong target for reducing maternal mortality
and morbidity. The Utah Maternal Mortality Review Committee (MMRC) has identified access to substance use
disorder (SUD) treatment including medication for opioid use disorder (MOUD), mental health care, improved
social support, decreased stigma against SUD, and care coordination, particularly in the postpartum period
(when the majority of deaths occur) as actionable intervention points. The objective of our study, Culturally-
Engaged REcovery – MOms connected through Native CommunitY (CEREMONY), is to adapt evidence-based
perinatal care models that integrate pregnancy and postpartum care with SU/SUD treatment and care to meet
the needs of Native mothers. With our partners at Sacred Circle Clinic, a federal Tribal Contract clinic operated
by the Confederated Tribes of the Goshute Reservation, we are uniquely poised to respond to the expressed
needs of Native mothers and stakeholders, who identified a lack of culturally-integrated SUD care as a
significant gap in perinatal care for Native mothers. We will do this by building upon the strong, evidence-
based foundation of our University of Utah integrated perinatal SUD clinic called Substance Use and
Pregnancy – Recovery, Addiction, and Dependence (SUPeRAD). The SUPeRAD model directly addresses the
actionable intervention points identified by the MMRC to prevent SUD-related maternal deaths, but is not
specifically adapted to Native mothers’ needs. The rationale for this study is that there is a critical knowledge
gap in the adaptation and implementation of integrated perinatal SUD care specifically for Native
mothers. The CEREMONY study will fill this gap by adapting the SUPeRAD clinic model to the needs of
Native mothers using the validated ADAPT-ITT adaptation framework, informed by human centered design
and community-based participatory research (Aim 1); and then testing the adapted, culturally-integrated
perinatal SUD care intervention at Sacred Circle Clinic using a Hybrid Type 1 effectiveness-implementation
study (Aim 2a&b). The Hybrid Type 1 design will provide important, reliable data on the clinical effectiveness of
culturally adapted perinatal SUD care for Native mothers (Aim 2a) while also producing novel data on the
implementation process (Aim 2b). Successful completion of these Aims will provide implementation and
training protocols that can be used to guide adaptation and implementation of culturally-adapted perinatal SUD
care in other settings across the US. Our study is innovative and significant because it employs strong
community engagement princip...

## Key facts

- **NIH application ID:** 10908713
- **Project number:** 5U54HD113169-02
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Michelle Precourt Debbink
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $627,394
- **Award type:** 5
- **Project period:** 2023-08-17 → 2030-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10908713

## Citation

> US National Institutes of Health, RePORTER application 10908713, CEREMONY: Culturally Engaged REcovery - MOms connected through Native community (5U54HD113169-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10908713. Licensed CC0.

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