Developing a strategy bundle to prepare, implement, and scale integrated perinatal opioid use disorder care in healthcare systems

The National Institute on Drug Abuse awarded Hennepin Healthcare Research Institute $193,320 on July 1, 2026, under the Drug Use and Addiction Research Programs (CFDA 93.279) to support development of a mentored career development award (K01) focused on improving behavioral healthcare for mothers with opioid use disorder, their children, and families.

The award funds a five-year research initiative through June 30, 2031, based in Minneapolis, Minnesota. The investigator will develop a strategy bundle to prepare, implement, and scale integrated perinatal opioid use disorder care within healthcare systems, targeting the hundreds of thousands of U.S. women with opioid use disorder who are pregnant or parenting children up to age five. Integrated care—a multidisciplinary team providing substance use, mental and medical healthcare, social work, peer recovery, and doula services—has demonstrated effectiveness for this population but faces implementation barriers due to historical service fragmentation and organizational inertia.

The award supports three training goals: establishing expertise in applied implementation research in health systems including electronic health record data management; developing comprehensive knowledge in multilevel implementation strategies; and building competency in dissemination and implementation science. The research builds on the investigator's clinical background treating substance use in families and prior implementation science experience integrating behavioral health into medical settings.

Abstract

The overarching goal of this mentored career development award (K01), responsive to PAS-22-206, is to support me in my development as an independent investigator focused on improving behavioral healthcare for mothers, their children and families. The proposed study focuses on the hundreds of thousands of U.S. Women with opioid use disorder (OUD) who are pregnant or parenting children up to age 5 ("mothers with OUD"), a critical period of development for children and elevated motivation for OUD recovery in mothers. OUD severely impairs a person's ability to function as a healthy parent and thus continues generational trauma and challenges that could be mitigated with treatment. Yet, mothers with OUD face significant punishment (child custody loss, involuntary commitment) and therefore avoid healthcare engagement and OUD treatment. However, these consequences have been lessening as more professionals recognize the benefits of harm reduction and trauma-informed approaches; IT is time to better engage mothers with OUD in appropriate care. Integrated care, a multidisciplinary team that provides substance use, mental, and medical healthcare; social work; peer recovery and doula services, has been shown to be the most effective approach for mothers with OUD, but IT is difficult to implement due to historical inertia keeping these services separate and other barriers. Research supporting effective implementation is needed. This innovative proposal will build on my strong clinical background treating substance use in families and my research experience with implementation science and integrating behavioral health into medical settings. IT will support me in achieving three training goals: 1) establish expertise in applied implementation research in health systems including EHR data management and usage, 2) establish expertise in comprehensive perinatal addiction services and 3) develop competency in multisite clinical and implementation trials methodology. These skills will allow me to achieve the following study aims: 1) develop a feasible multi-level implementation strategy bundle for integrated care for mothers with OUD by piloting and adapting implementation strategies at hennepin healthcare, 2) develop a micro-theory of implementing integrated care for mothers with OUD by interviewing key informants at successful programs, and 3) finalize the implementation protocol for a future multisite implementation trial with prospective sites. My expert mentoring team includes two addiction medicine physicians, one specialized in substance use in pregnancy (jones) and the other an experienced clinical trialist and PI of a nida CTN node (bart); a psychologist with expertise in clinical and implementation trials related to substance treatment within healthcare systems (japuntich), and an implementation scientist with experience implementing substance use treatment across the VA healthcare system (hagedorn). Additional advisors in perinatal psychiatry (KIM) and biostatistics (langworthy), and institutional resources, mean i will have the full support and knowledge needed to successfully complete my training and study aims and achieve R01-level funding to conduct a multisite trial.