Of Science and Service

by Phil Saken

How three new NIH-supported projects will support mothers and homeless youth in Ohio

For the first time in its history, the College of Nursing this year ranks tenth in the nation in National Institutes of Health (NIH) funding of colleges of nursing. Behind that ranking is a wide array of research projects that demonstrate our commitment to nursing science and to serving our community and the world. Here is a glimpse into three newly funded projects designed to support vulnerable populations in Ohio.

Homeless youth and opioid addiction

Recent United States estimates indicate that one in 30 adolescents (ages 13-17) and one in 10 young adults (ages 18-25) experience homelessness each year. To complicate matters, homeless youth are disproportionately affected by the opioid epidemic, with reported rates of opioid use up to 79%. 

College of Nursing Professor Jodi Ford, PhD, RN, FAAN, serves as one of two principal investigators on an interdisciplinary team supported by a five-year, $6.9 million project from the NIH/National Institute on Drug Abuse's Helping to End Addiction Long-term (HEAL) initiative. The study is titled, “Building Social and Structural Connections for the Prevention of Opioid Use Disorder among Youth Experiencing Homelessness: A Randomized, Controlled Trial Examining Biopsychosocial Mechanisms.” Ford is working with principal investigator Natasha Slesnick, PhD, from the College of Education and Human Ecology and founder of Star House, the only drop-in center in Columbus serving youth experiencing homelessness.

“Our research, and that of others, shows that exposure to adverse childhood and life experiences is linked to irregular patterns of cortisol, a primary stress hormone, and high levels of inflammation in the body,” said Ford, who is also assistant director of the Martha S. Pitzer Center for Women, Children and Youth and director of the college’s Stress Science Lab. “That phenomenon may contribute to depression and death by suicide, as well as substance use, often used to reduce symptoms of psychological distress.”

Ford said the project will document how evidence-based interventions targeting substance use, as well as connections to community services and safe and supportive people and places, can help prevent opioid and other substance misuse in Columbus’ population and across the country. 

In this project, the research team will train the therapists and youth advocates at Star House to implement evidence-based interventions, including a motivational substance use and mental health intervention as well as an advocacy intervention focused on linkage to community and social supports. 

“Our goal is to test the real-world effectiveness of the interventions individually and in combination to understand which is most effective in preventing opioid use disorder and other substance use and in improving mental health outcomes as well as homelessness,” Slesnick said. “We also will conduct the first cost-benefit analysis on this approach, which has not been done before. Knowing the cost of the interventions will help agencies plan for their adoption. Our goal is for this work to have practical benefit to those serving youth across the country.” 

Postpartum primary care

Assistant Professor Shannon Gillespie, PhD, RN, (’12 MS, ’15 PhD) calls improving the care of mothers and infants “a deeply personal and meaningful endeavor.” She is one of two principal investigators on a study of how models of postpartum primary care affect the health of mothers and infants during the first year after childbirth, which is funded by a new five-year, $3.8 million grant from NIH/National Institute of Nursing Research.

Gillespie is working with a team including principal investigator Seuli Brill, MD, FAAP, FACP, an associate professor in the College of Medicine, on the randomized controlled study, “The mom and infant outcomes study: A trial of perinatal outpatient delivery systems” (the MOMI Study). This study aims to produce critical data toward addressing pregnancy-related illness and death, which has more than doubled over the last 20 years, particularly among minoritized and low-income populations.

Together, this transdisciplinary team will compare two approaches to maternal and infant care during the year after childbirth, particularly among mothers and infants who are transitioning out of high-risk pregnancy. While the approaches both offer the standard components of primary care, they differ based on how patients are scheduled, how healthcare providers communicate, how the health history informs care and how referrals are made. If successful, findings from this clinical trial will be disseminated through the Ohio Care Innovation and Community Improvement Program and the state’s Federally Qualified Health Center network.

“By critically considering how care is delivered, we hope to address the alarming and persistent socioeconomic, racial and ethnic disparities in pregnancy-related illness and death witnessed in nations such as the United States and improve overall maternal and infant health outcomes,” Gillespie said.

Gillespie will also partner with College of Nursing colleagues Amy Mackos, PhD, associate clinical professor and director of biomedical research; research assistant professor Nathan Helsabeck, PhD; clinical research nurse Ana Wong, RN, BSN; and laboratory technician Erik Ferrin on a new five-year, $2.3 million project dubbed PROMIS: “Prenatal Immunomonitoring in Spontaneous Preterm Birth Prevention.” This project funded by the NIH/National Institute of Child Health and Human Development will seek to test new ways to predict and prevent early birth using early pregnancy blood samples.