President’s Research Impact Award Winners Examine Child Protection Outcomes of Opioid-Exposed Infants

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