Archive for the ‘Nursing & Health Sciences’ Category

President’s Research Impact Award

Tuesday, April 23rd, 2013

Presidential Impact Award

A team of University of Maine graduate students and their faculty adviser Jennifer Middleton are the recipients of the 2013 President’s Research Impact Award for the research project “What Happens Next? Examining Child Protection Outcomes in a Cohort of Opioid-Exposed Infants.”

Alison Mitchell, Meagan Foss, Leah Agren, Jenifer Koch and Middleton won the annual President’s Research Impact Award at the 2013 GradExpo where Mitchell presented the project. The award is given to a graduate student and adviser who best exemplify the UMaine mission of teaching, research and outreach. The $2,000 award will be split among the grad students and their adviser.

The community-engaged research project, part of a research methods series for the Master in Social Work curriculum, is being conducted by the graduate students in collaboration with Middleton.

“The Graduate Student Leadership and I created this award last year to recognize the high-quality research of University of Maine graduate students occurring in so many academic areas across the campus,” says UMaine President Paul Ferguson. “I wanted to specifically recognize the research that has tangible impact for our state with the potential to make a difference — in this case, in the lives of some of Maine’s youngest citizens. This is an outstanding example of the research excellence that a land grant university offers to the people it serves.”

Though the population of infants born with prenatal opioid exposure in the Greater Bangor region is growing — from 23 in 2003 to 183 in 2012 — little is know about what happens to the infants after they leave Eastern Maine Medical Center, Mitchell says.

The project aims to clarify what happens, from a child welfare system perspective, after the infant is discharged. The team plans to explore rates and reasons families with opioid-exposed infants become subsequently involved with child protective services through the Office of Child and Family Services, or OCFS, at the Maine Department of Health and Human Services.

Currently, there are no other studies tracking the child protection outcomes of opioid-exposed infants in Maine, Mitchell says, and the project represents the first attempt to share data between EMMC and OCFS.

“Winning this award is enormously gratifying,” says Mitchell, noting that the project is a team effort. “Social workers in general aren’t particularly recognized for their research very often so for that it’s really exciting.”

The project was proposed to Middleton by EMMC contact Mark Moran, a graduate of UMaine’s Master’s in Social Work Program who works with families of substance-exposed infants.

There has been a significant increase in the number of drug-exposed babies born in Maine, from 165 in 2005 to 667 in 2011, and Maine’s opiate addiction rate is also the highest in the country per capita at 386 per 100,000 as opposed to the national average of 45 per 100,000, according to data collected by the research team.

The Bangor area, which is home to three methadone clinics and a hospital equipped to handle drug-exposed infants, has a concentration of opioid-exposed births compared to more rural areas. Drug-exposed babies who are delivered in regional hospitals get transferred to EMMC for treatment, Mitchell says.

When a substance-exposed infant is born at or transferred to EMMC, the hospital makes a notification and sends it to OCFS, she says.

“All of those infants in our cohort were already in the OCFS database so what this project is trying to do is just match cases,” Mitchell says.

By using the name and birth date of the drug-exposed infants from the EMMC record and having OCFS run a query on the infants one year from their birth date, the team was able to see if the child showed up in protective services’ database again, Mitchell says.

“It really is a three-way partnership,” Mitchell says of the involvement of the UMaine School of Social Work graduate students, EMMC and OCFS. “Each of the partners has had quite a bit of influence in shaping how the project has evolved.”

From their data collection, the team has determined that 68 percent of their sample does not show up again in child protection, while 32 percent showed up as having an open case with OCFS within their first year.

The students expect to receive information from the hospital on the severity of the 60 cases once the hospital eliminates identifying information and clears the data for release.

In the remaining weeks of the semester, the students will conduct statistical analyses. Agren and Koch will graduate in May 2013, while Mitchell and Foss, who are scheduled to graduate next year, will continue to do analyses over the summer once they find out where the cases fall in terms of severity.

Mitchell says she believes one of the reasons the project won the President’s Research Impact Award is because it’s a community-engaged partnership.

During the course of the class, the region received a $4 million federal grant for the Penquis Regional Linking Project, a five-year effort aiming to enhance the network of over 25 agencies in the Penobscot and Piscataquis counties supporting trauma-informed services for substance-exposed children and their families. Middleton is the lead researcher and co-director of evaluation for this project.

The team members think their research will help the agencies in the project reach their goal, and Mitchell says they have already received positive feedback from project members.

“What Happens Next?” also aims to generate knowledge useful in advancing local practice and policy efforts and pave the way for future collaborations.

“The primary aim is right in the title, ‘What happens next?’” Mitchell says. “The goal of the study is to see if we can figure out what happens from a child protective perspective and to establish those precedents of how to come together as a service-providing community.”

Contact: Elyse Kahl, 207.581.3747

Helping Substance-exposed Youngsters

Monday, November 19th, 2012

Substance Abuse

New $3.9 million social services project to improve the well-being and safety of the youngest victims of substance abuse

In Penobscot and Piscataquis counties, children ages 5 and under whose families are struggling with substance abuse will have improved well-being and safety, and a better chance of staying in or returning to their own homes rather than remaining in foster care under a five-year, $3.9 million project led by the Bangor-based Families And Children Together (F.A.C.T.), the University of Maine School of Social Work, and a coalition of community organizations and agencies.

The Penquis Regional Linking Project: Building Quality Services for Rural and Frontier Communities will receive $797,405 annually for five years from the Administration for Children and Families, Children’s Bureau’s Promoting Safe and Stable Families program. The effort will involve at least 25 area service agencies, led by F.A.C.T. and Beverly Daniels, the executive director of F.A.C.T. Jennifer Middleton, a UMaine assistant professor of social work, is the lead researcher on the project and co-director of evaluation.

“I am especially excited about this project because it is an exciting step toward establishing important community-university partnerships and addressing an issue of paramount importance to our region of the state,” says Middleton, who joined the UMaine School of Social Work faculty in 2011.

“Through the implementation of a trauma-informed system of care and the utilization of other evidence-based practices, this project has the potential to strengthen the system of care for families affected by substance abuse, helping parents and caregivers access important resources and reducing the isolation and stigma often experienced by these families,” says Middleton, who will team in the project’s evaluation with Len Kaye, a UMaine professor of social work and director of the Center on Aging.

The project will address a particularly critical need in the Penquis region of the state — Penobscot and Piscataquis counties, and the Penobscot Nation, say the project coordinators. Maine has the highest opiate addiction rate per capita in the country at 386 per 100,000, compared to 45 per 100,000 for the U.S. and 131 for New England, according to Middleton. In addition, a recent and growing problem is the use of bath salts; of the state’s 152 bath salts overdoses in 2011, 30 percent were in Penobscot County.

The high opiate rate has resulted in a sharp increase in the number of babies born with intrauterine exposure to drugs, note the researchers. The statewide number has jumped from 165 babies affected in 2005 to 667 in 2011. Of those, 173 were opiate-exposed. At Eastern Maine Medical Center, the primary birthing hospital in the Penquis region, a third of all drug-exposed infants in Maine — 195 substance-affected newborns — were treated in 2011. And the numbers continue to climb significantly in the Penquis region: The first two quarters of 2012 statistics regarding substance-exposed infants at EMMC show a 20 percent projected increase for this year, compared to 2011, Middleton says.

The newly funded Penquis Regional Linking Project is a “community engaged” research project and one of the first of its kind in the nation to implement and evaluate a trauma-informed system of care for substance-exposed infants and their families.

A program, agency or system that is trauma-informed is aware of the widespread impact of trauma and understands potential paths for healing. It recognizes the signs of trauma in clients, staff and others touched by the system, and responds by integrating knowledge about trauma into policies, procedures and practices. Specifically, a trauma-informed approach reflects a cultural change among service providers, reflected in the shift of asking, “What happened to you?” rather than “What’s wrong with you?” The principles of trauma-informed care are especially applicable when working with families struggling with substance abuse, as a large majority of these families have a history of trauma and adverse childhood experiences.

In the Linking Project, a specially trained “navigator” will partner with families dealing with substance abuse issues to assess their strengths and needs, build formal and informal supports, and reduce barriers to accessing resources. Services will include individualized and group prenatal and parenting education, access to substance abuse screening, and assistance with transportation.

With such services in place, the youngest children in families struggling with substance abuse will not only be safer, but have a better chance of staying with their families and reducing their foster care system involvement, according to the project coordinators. Initially, an estimated 500 children up to age 5 and their parents or caregivers will receive navigator services, outreach and referral services, parenting education and trauma-informed family support.

Across the country, people are recognizing the profound impact of trauma on individuals, families and society, according to the researchers. The largest and most widely recognized epidemiological study on the prevalence of childhood trauma and its impacts on health and well-being over the life span is the Adverse Childhood Experiences (ACE) study conducted jointly by the Centers for Disease Control and Kaiser Permanente. More than 17,000 Kaiser HMO members completed a confidential survey, reporting surprising high levels of adverse childhood experiences: Physical abuse (28 percent); sexual abuse (22 percent); emotional abuse (11 percent); living with a person who is depressed, suicidal, or diagnosed with a mental illness (17 percent); having a drug addicted or alcoholic family member (27 percent); witnessing domestic violence against the mother (13 percent); loss of a parent to death or abandonment, including divorce (23 percent); incarceration of a family member (6 percent); and physical (19 percent) and emotional (15 percent) neglect. Their “ACE scores” were then correlated with a wide range of physical health, behavioral health and social conditions.

There were two major findings of the ACE study. First, ACEs are very common: 70 percent of subjects had one or more ACE, 25 percent had two or more, and one in six had four or more. Second, the impact of ACEs is cumulative: There is a significant positive relationship between adverse childhood experiences and a very wide range of adverse outcomes, including depression, hallucinations, panic and anxiety, flashbacks and dissociation, multiple somatic problems, sleep problems, impaired memory, smoking, obesity, suicide, self-injury, alcoholism and drug use, eating disorders, heart disease, autoimmune disease, lung cancer, chronic obstructive pulmonary disease, asthma, liver disease, skeletal fractures, sexually transmitted diseases, HIV/AIDS, and early death. The correlations between ACE scores and health and social problems in adulthood are very strong. Adverse childhood experiences affect adult health and well-being in two ways: They have a direct impact on the neurological development of the child, and they pre-dispose the individual to the use of coping strategies or behavioral adaptations that can cause physical and emotional problems.

The Linking Project will dovetail into the existing Penquis District Linking Partnership to build a family-focused, integrated trauma-informed service system to mitigate the negative effects that substance abuse has on children and families. The Linking Partnership was created approximately one and a half years ago as a regional network of healthcare organizations, child welfare organizations, social service agencies, kinship care service providers, substance abuse treatment providers, public health agencies, institutions of higher learning including UMaine and the University of New England, and three offices in the Maine Department of Health and Human Services: Substance Abuse, Child and Family Services and the Family Drug Court Project.

The Linking Project will enhance the partnership by collaborating with the Sanctuary Institute, a national agency based in Yonkers, N.Y., that helps organizations implement the trauma-informed, whole-system organizational approach known as the Sanctuary Model. Furthermore, the Linking Project will be informed by a national trauma advisory council, consisting of key trauma experts from across the country, selected by project coordinators for their unique expertise regarding trauma-informed care, participatory action and qualitative research methods, and measurement of trauma-informed systems change. All service delivery implementation and project evaluation efforts will also be informed by consumers, namely parents and kinship providers of substance exposed infants in the Penquis Region.

In addition to UMaine and F.A.C.T., other partnering agencies in the Linking Project include: Eastern Maine Medical Center; the Penobscot Nation; Wellspring Substance Abuse and Mental Health Services, Bangor Public Health Nurses; Maine Department of Health and Human Services, Office of Child and Family Services; Maine Department of Health and Human Services, Office of Substance Abuse; Maine Academy of Pediatrics; Maine Families; Maine Touchpoints Project; Helping Hands with Heart; Charlotte White Center; Acadia Hospital; Children’s Developmental Services; Children’s Growth Council; and WINGS.

Grants by the Administration for Children and Families, Children’s Bureau’s Promoting Safe and Stable Families program were awarded to regional partnerships that provide, through interagency collaboration and integration of programs and services, activities and services designed to increase the well-being of, improve permanency outcomes for, and enhance the safety of children who are in out-of-home placements or are at risk of being placed in out-of-home placements as a result of a parent’s or caretaker’s substance abuse. The National Child and Family Services Improvement and Innovation Act (Pub. L. 112-34) includes a new targeted grants program (section 437(f) of the Act), that directs the Secretary of Health and Human Services to reserve a specified portion of the appropriation for regional partnership grants to improve the well-being of children affected by substance abuse.

Contact: Jennifer Middleton, (207) 581-2408; Beverly Daniels, (207) 941-2347

UMaine Economic Analysis Finds Obese Youth Could Cost Maine $1.2 Billion

Monday, November 5th, 2012

obesityThe medical costs of obesity for the current cohort of children and adolescents in Maine could reach an estimated $1.2 billion over the next 20 years, according to a new study by a University of Maine economist.

UMaine professor of economics Todd Gabe’s study suggests that the incidence of obesity is likely to increase from 7.8 percent of Maine’s kids and teens to an estimated 25.7 percent as they grow into adults.

“We’ve all heard about the nationwide obesity epidemic,” says Gabe, “and these figures bring the problem — especially the challenge facing our children as they become adults — closer to home.”

In his study, Gabe used statistics from the U.S. Centers for Disease Control and Prevention, and data on upward of 2,000 school-aged children in Maine, compiled by physical education teachers in 18 schools across the state.

The data on schoolchildren was collected during the last three years as part of ongoing research in the UMaine College of Education and Human Development, led by physical education professors Steve Butterfield and Robert Lehnhard, with statistician Craig Mason, kinesiology and physical education master’s graduate Sarah Livingstone, and exercise science graduate student Aaron Runner.

The physical education research team began collecting fitness data on Maine schoolchildren after training physical education teachers in the use of a standardized periodic fitness test called PACER (Progressive Aerobic Cardiovascular Endurance Run), designed by the Cooper Institute.

The physical education project, funded in part by the Betterment Fund in Maine, is one of the first of its kind in the nation, Butterfield says, and could become a national model for quantifying the extent and cost of obesity.

“A project combining exercise science and economics helps us examine an important issue facing our state, and it’s a good example of the growing interdisciplinary research happening at UMaine,” Mason says.

Last year, the medical costs of obesity for all age groups in Maine were an estimated $452.7 million, with most of these costs due to adult obesity.

The concern, say Butterfield and Lehnhard, is that obese children and adolescents are much more likely than their non-obese peers to become obese adults, when the medical costs are very high.

“If anything, these cost numbers are conservative,” says Gabe, whose study was funded, in part, through a partnership between the Maine Association for Health, Physical Education, Recreation and Dance; the Maine Department of Education; and UMaine’s College of Education and Human Development.

“These are medical costs related to obesity, and do not count indirect costs due to early mortality or morbidity. Other studies have uncovered non-medical costs from reduced workforce productivity that are more expensive to the economy than the medical costs of obesity,” Gabe notes.

Contact: George Manlove, (207) 581-3756 or

Kaye Comments in USA Today Magazine Story

Tuesday, April 10th, 2012

Comments from Len Kaye, director of the University of Maine Center on Aging, were included in an article on lifestyles and longevity in the April 2012 issue of USA Today Magazine. Kaye says a sense of optimism and well-being can lead to positive long-term health effects.

Contact: George Manlove, (207) 581-3756

Kaye Interviewed for Social Work Today Article

Monday, March 26th, 2012

Len Kaye, director of the University of Maine Center on Aging, was interviewed for an article on caregivers in the March/April issue of Social Work Today Kaye discussed the large population of male caregivers, whose numbers are generally underestimated, he said.

Contact: George Manlove, (207)581-3756

Center on Aging Study to Gauge Impaired Driving Downeast

Friday, February 3rd, 2012

The University of Maine Center on Aging is working with healthcare and social service providers and the public to determine to what degree impaired driving among older adults in Washington County is a hazard.

Impaired driving includes any condition that compromises an individual’s ability to drive a motor vehicle safely, and ranges from impaired vision to impaired decision-making due to medication, alcohol or substance abuse, according to Center on Aging research associate David C. Wihry.

“The study is to essentially scope the issue of impaired driving among older adults in Washington County in terms of how community members and professionals there view the issue, what they know about it, how important they think it is to address, as well as practical suggestions that they have for addressing the issue,” Wihry says. “In the report we are putting together, there will be suggestions for both exploring the issue further and ideas for interventions. So it is a combination of determining how much of an issue it is, as well as determining possible areas for further study and strategies for intervention.”

The Center on Aging and UMaine School of Social Work recently received a small grant from the U.S. Department of Health and Human Services via the Maine Center for Disease Control and Prevention and Community Health and Counseling Services in Bangor. The funding continues the project, “Washington County Older Adult Impaired Driving Project,” which started in 2010. The Center on Aging conducted focus groups in four Washington County communities to better understand both public and professionals’ perceptions on the issue, and consider suggestions for addressing them.

The Center is now broadening the survey population with electronic and telephone interviews to get more information. A report on the findings is due out this winter.

Contact: David C. Wihry, (207) 262-7928

Op-ed Notes Social Work Research

Thursday, January 26th, 2012

Sandra Butler, a UMaine social work professor, was noted in a Bangor Daily News op-ed about childless adults on MaineCare for her research into the population served by the MaineCare Childless Adults Waiver program. Butler did the research, which included interviewing a small subset of people who receive MaineCare through the program, for a report sponsored by Maine Equal Justice Partners.

Contact: Jessica Bloch, 207-581-3777

UMaine Researcher Noted in Story on Welfare Study

Tuesday, January 10th, 2012

A Bangor Daily News report on a study about childless adults on MaineCare included a mention of Sandra Butler, a UMaine social work professor who interviewed seven participants for the study, which found more than 40 percent of childless adults covered through MaineCare are older than 45 and many have serious medical conditions. The study was prepared by Maine Equal Justice Partners, an advocacy group for the poor. Butler’s contribution was also noted in a release on the InsuranceNewsnet magazine website.

Contact: Jessica Bloch, 207-581-3777

Kaye Interviewed for TV 7 Report on Elderly, Legal Needs

Monday, January 9th, 2012

Len Kaye, professor of social work and director of the UMaine Center on Aging, was interviewed for a Channel 7 (WVII) evening news report Jan. 6 about a recent study by the center on the legal needs of Maine’s older adults. Kaye said older people continue to need legal advice on health insurance and social services eligibility and protection from scams.

Contact: George Manlove, (207) 581-3756

Insurance News Website Notes Survey of Older Adults’ Legal Needs

Wednesday, January 4th, 2012

A UMaine news release about a new Center on Aging study that found aging Mainers’ legal needs continue to rise at a time when low-cost or free legal aid is scarce was carried by the website Insurance News. Study authors Len Kaye, the Center on Aging director and a UMaine social work professor, and Jennifer Crittenden, a researcher at the center, wrote that they use the survey to develop ways to reach under-served populations.

Contact: Jessica Bloch, 207-581-3777