# Improving Treatment Engagement and Adherence to Optimize Outcomes for Opioid-Exposed Mother-Infant Dyads

> **NIH NIH K23** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $199,383

## Abstract

PROJECT SUMMARY:
The surge in the non-medical use of prescription opioids, heroin, and fentanyl is a critical public health
emergency affecting women of child bearing age and their families. Pregnancy can be a motivating time for
women with opioid use disorder (OUD) to engage in treatment, with pharmacotherapy (with methadone or
buprenorphine) and psychotherapy the recommended first line treatment. Pharmacotherapy adherence has
been associated with improved obstetric, infant, and maternal substance use outcomes at delivery. Yet
medication discontinuation in the postpartum period occurs at high rates, increasing the risk of relapse and
overdose. To date, however, interventions to support pharmacotherapy adherence among pregnant women
with OUD have shown mixed results, and few interventions have been aimed at postpartum women and
families. Therefore, the central objective of this mixed-methods study is to quantify how OUD pharmacotherapy
utilization impacts postpartum maternal-infant outcomes and qualitatively explore factors impacting treatment
adherence in order to develop a pharmacotherapy promotion intervention to improve the health of the opioid-
exposed mother-infant dyad. This project includes three main aims: (1) To analyze a linked, longitudinal,
administrative dataset from Massachusetts Department of Public Health to examine how duration of
pharmacotherapy engagement and type of pharmacotherapy received impact maternal and infant outcomes;
(2) To engage with a diverse group of stakeholders including postpartum women with opioid use disorder and
their families to qualitatively identify beliefs and attitudes and delineate interpersonal and structural barriers
and facilitators to treatment engagement and adherence to develop a pharmacotherapy promotion intervention;
and (3) Pilot test the pharmacotherapy intervention to improve treatment adherence among pregnant and
postpartum women with OUD assessing the feasibility and acceptability of the intervention. The findings from
this series of projects will fill an existing gap in a high priority research area within NIDA that will inform the
care of pregnant and postpartum women with OUD. The PI, Dr. Schiff, is an early-career clinician investigator,
pediatrician, and addiction medicine physician who will use this career development award to enhance her
skills in quantitative research including longitudinal analyses of complex public health datasets, qualitative
research with vulnerable populations, intervention development, and clinical trials design. Throughout the
award period, Dr. Schiff will work closely with a multidisciplinary mentorship and advisory team with expertise
in maternal-child health, addiction psychiatry, perinatal epidemiology, biostatistics, qualitative analysis,
intervention development, and clinical trials design to carry out her stated career objectives and specific aims.

## Key facts

- **NIH application ID:** 9894776
- **Project number:** 5K23DA048169-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Davida Schiff
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $199,383
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9894776

## Citation

> US National Institutes of Health, RePORTER application 9894776, Improving Treatment Engagement and Adherence to Optimize Outcomes for Opioid-Exposed Mother-Infant Dyads (5K23DA048169-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9894776. Licensed CC0.

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