CADENCE: Continuous and Data-Driven Care

Prime Institution: University of South Florida

Maternal opioid use disorder (OUD) is the leading cause of maternal mortality in the first year after delivery and contributes to out-of-home placements in the child welfare system. Medication for opioid use disorder (MOUD) is the primary standard of treatment; however, access to MOUD and prenatal care is limited and fragmented. Insufficient data integration also makes it difficult to identify mother-infant dyads requiring care. In this project, investigators will create an interactive data dashboard for maternal, neonatal, and infant outcomes for pregnancies affected by opioid use disorder, pilot an integrated Continuous and Data-Driven Care (CADENCE) Program in a health system, evaluate clinical outcomes and implementation using the dashboard, and assess costs. Primary outcomes include mothers’ engagement in treatment and number of neonates with neonatal withdrawal syndrome requiring pharmacologic treatment. The program is expected to improve maternal, neonatal, and infant outcomes and decrease racial inequities.

Headshot of Tanner Wright

Dr. Tanner Wright

Dr. Tanner Wright is a board-certified general pediatrician at University of South Florida who works as a Neonatal Hospitalist at Tampa General Hospital specializing in the care of infants with in-utero exposure to medications and/or substances and is the Medical Director of the PEDI (Promoting Early Developmental Interventions) Clinic at Mary Lee’s House, a collaboration with the Healthy Start Coalition where parent-child dyads with elevated social risks are followed. He is a subject matter expert for the American Academy of Pediatrics "Maternal- Infant Health and Opioid Use Collaborative," and an invited technical consultant for the United Nations Office on Drugs and Crime (UNODC). Dr. Wright works closely with treatment centers and community resources to advocate on behalf of families affected by substance use. His research endeavors have led to multiple NIH clinical research sub-awards and CDC grants for work with caregiver-infant dyads affected by opioid use. As Director of the University of South Florida Center for Families Impacted by Substance Use (USF CFISU), he is involved in many efforts aimed to improve the outcomes for families in his care.

Jen Jennifer Marshall

Jennifer Marshall, PhD, CPH, USF Health, MPI

Dr. Marshall, MPI of CADENCE (Continuous And Data-drivEN CarE), is an Associate Professor at the University of South Florida (USF) College of Public Health, Chiles Center, teaching courses in Maternal and Child Health, Community Partnerships and Advocacy, and Community-based Research Methods and Program Evaluation. She serves as Interdisciplinary Faculty Lead and is also Director of Research and Evaluation and Director of Outreach for the NIOSH-funded Sunshine Education, Research and Training Center for occupational safety, health, and wellness. Leading Florida’s HRSA-funded Maternal, Infant, and Early Childhood Home Visiting evaluation since 2013 and the statewide Early Childhood Comprehensive Systems Impact Project evaluation (funded for 10 years), she conducts interdisciplinary public health systems research assessing perinatal support and infant mortality prevention programs; family-centered care and access to services for women, families, and children; mental health programs; and Florida’s Early Childhood Courts. Dr. Marshall’s research interests stem from over 30 years of experience working with community programs that support perinatal women’s health, underserved communities, and parents of young children with special health care needs. Areas of expertise include mixed-methods, community-based, participatory research, and program evaluation. Dr. Marshall has worked with the Florida Birth Defects Registry and USF Birth Defects Surveillance Program for 10 years as lead for community-based research on systems of care and family supports, including Zika virus epidemic response, the COVID-19 pandemic, and hurricane preparedness. Dr. Marshall has conducted several studies with Dr. Fryer on access to prenatal care, including assessing access to treatment and prenatal care for women with opioid use disorder in Florida.