The USF College of Public Health is saying farewell to one of its esteemed faculty members, Dr. William Sappenfield, a USF Distinguished Professor and director of the Florida Perinatal Quality Collaborative (FPQC) and the Chiles Center, both housed within the college and dedicated to cutting-edge research and education promoting the health and well-being of women, children and families.

Sappenfield, a pediatrician and epidemiologist who focuses on maternal and child health, retires after serving the college for 12 years. “That’s the longest I’ve been anywhere in my career,” he noted.

Sappenfield says what he’ll miss most about his time at the COPH is the people—the students, faculty, staff and leaders. “I have had the chance to work with outstanding people,” he noted.

And they will undoubtedly miss him as well.

“It was both an honor and a privilege to work with Bill,” said Bobbi Rose, an alum of the college who also served as conference coordinator for USF Health. “He is, WITHOUT FAIL, supportive, super smart, available, ethical and caring—for his colleagues, staff, students and the community at large. We need more Bill Sappenfields in this world!”

Amy Phillips, doctoral student and alum of the college, echoes those sentiments.

“As a new master’s student in 2013, I remember meeting one-on-one with Dr. Sappenfield and he insisted I call him Bill—never Dr. Sappenfield (to this day, I still don’t know that I ever have, lol),” Phillips, currently a COPH doctoral student, recalled. “He also shared his journey to leadership with my Maternal and Child Health Leadership Scholar cohort. I am grateful for the opportunity to know and learn from him!”

Natalie Preston, director of the college’s Office of Engagement and Constituent Relations, also values the knowledge she gleaned from Sappenfield.

“I appreciate that Bill always made me feel like we were equals,” Preston said. “He was very approachable and personal. My son was quite sickly as a toddler and elementary school kid. I reached out to Bill on many occasions for his medical insight as a pediatrician. He always received me warmly and explained options in a manner that was easily understood by a non-medical professional. His demeanor is as warm and bright as his smile! Without question, I will miss him. Hopefully his best life is coming in retirement!”

Sappenfield said some of the highlights of his time at the college have been becoming a faculty member, impacting lives and careers via teaching and mentoring, leading, promoting and revitalizing the Chiles Center and fully developing the FPQC, a group that significantly impacts the health and health care of mothers and infants in Florida.

What’s next for Sappenfield as he heads off into retirement?

“Deciding what I want to do when I grow up,” he said. “That’s going to take me some time to figure out! The college has paid me to do what I so much enjoy doing.”

Here, a pictorial look back at Sappenfield’s 12 years with the college:

Story by Donna Campisano, USF College of Public Health

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A team of researchers led by USF College of Public Health (COPH) doctoral student Justin Swanson has found that although people under age 65 born with birth defects make up just 4.1% of inpatient hospitalizations, their medical treatment accounts for nearly 8% of total hospitalization costs.

The study, “Inpatient Hospitalization Costs Associated with Birth Defects Among Persons Aged <65 Years — United States, 2019,” was published in July in Morbidity and Mortality Weekly Report.

Swanson, a PhD student concentrating in epidemiology, was lead author. His co-authors were COPH professors Drs. Russell Kirby, Jason Salemi and Jean Paul Tanner, as well as researchers from the Centers for Disease Control and Prevention and the University of Utah.

According to the study, approximately 3% of infants are born each year in the U.S. with birth defects (ones affecting the heart are most common). What’s more, birth defects are the leading cause of infant mortality.

Perhaps not surprisingly, the cost of medical treatment related to birth defects can be astronomical over the span of a lifetime.

“By our conservative estimate, the cost of inpatient hospitalizations associated with birth defects was $22 billion in 2019,” Swanson reported. “This is an objectively large chunk of the nation’s total inpatient hospitalization costs, and it falls disproportionately on individuals with birth defects.”

While the researchers didn’t look at why that is, they theorize that the increased cost burden may be attributed to the number and types of services required to diagnose and treat birth defects. They also note that keeping track of such statistics is important, as knowing where costs are high helps health care professionals and policymakers better allocate financial resources in the future.

“Birth defects research (especially those involving the cost component) requires continual assessment and refinement of techniques. Our hope was to inform and assist policymakers, researchers and providers with the strategic use of health care resources,” Swanson said. “Our work finds and reinforces the fact that individuals with birth defects are disproportionately burdened by inpatient hospitalization costs, which is just one aspect of morbidity associated with these disorders.”

Story by Donna Campisano, USF College of Public Health

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Dr. Russell Kirby, a USF Distinguished Professor and perinatal epidemiology expert at the USF College of Public Health, has been honored with a mentoring award that bears his name.

Kirby became the first-ever recipient of the Russell S. Kirby Mentoring Award, presented by the National Birth Defects Prevention Network (NBDPN).

“The award,” says the NBDPN, an international group of individuals dedicated to birth defects surveillance, research and prevention, “is given to an individual who has demonstrated an outstanding commitment to mentoring, advising and building supportive environments for colleagues in the field of birth defects surveillance, research and prevention.”

The NBDPN said it presented the award in Kirby’s honor for his years of supporting the growth of birth defects programs, as well as for mentoring students, staff and other professionals.

“I was very honored to receive the award, which I did not expect,” Kirby said. “I knew that the new award was being created and would be named in my honor, but I did not anticipate I would be its first recipient.”

Kirby estimated he’s mentored “hundreds” of students and professionals on birth defects—their prevalence and prevention—over the years.

“While at USF, in addition to approximately 20 maternal and child health concentration students each year, I have sat on 36 dissertation and thesis committees, serving as major/co-major professor for 21 students,” Kirby noted. “I have also mentored numerous faculty members at USF and other universities around the country, and I have worked with program staff at birth defects surveillance programs in many states. I helped establish programs in Rhode Island, Delaware, Minnesota and Oregon, and I worked closely on projects with colleagues in Colorado, Texas, Michigan and New York. This has been in addition to my leadership for the Birth Defects Surveillance Program at USF.”

Kirby said he feels an obligation to his peers and his profession to act as a mentor to those interested in the study of birth defects.

“Mentoring is what it’s all about,” he said. “Just as others supported me in my education and early career, I feel I owe it to pay it back. Mentoring is very rewarding and generates lifelong connections and friendships that transcend our daily work.”

Story by Donna Campisano, USF College of Public Health

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According to a new study led by USF College of Public Health (COPH) PhD student Zailing Xing, premature menopause (defined as menopause occurring before age 40) increases the risk of all-cause death by 53 percent and reduces lifespan by nearly two years compared to women without premature menopause.

The study, “Premature Menopause and All-Cause Mortality and Life Span Among Women Older Than 40 Years in the NHANES I Epidemiologic Follow-Up Study: Propensity Score Matching Analysis,” was

co-authored by COPH professors Drs. Amy Alman and Russell Kirby and published in July in the Journal of Women’s Health.

The female hormone estrogen, Xing noted, can have a protective effect on the body, helping to protect women from cardiovascular disease, bone loss and high cholesterol. What’s more, said Xing, the drop in estrogen that occurs with premature menopause can lead to emotional distress, anxiety, depression and reduced quality of life.

 “All of these may contribute to the shortened lifespan of women with premature menopause,” she said.

While premature menopause and its connection to mortality have been studied extensively, Xing, who is concentrating in epidemiology, said the study’s use of a statistical method known as propensity score matching analysis (PMS), makes the results more convincing.

“By matching individuals with similar propensity scores, the exposed and unexposed groups become more comparable, making the study design closer to randomized experiments,” she explained. “The application of this method strengthens the persuasiveness of our findings.”

Xing said studying the physical and mental effects of premature menopause emphasizes a woman’s need for comprehensive care and support to help navigate the challenges associated with early menopause.

“Premature menopause can significantly impact a woman’s reproductive and psychological well-being,” Xing said. “Studying the effect of premature menopause on mortality and lifespan sheds light on physical health outcomes and addresses broader aspects of women’s health and quality of life.”

Story by Donna Campisano, USF College of Public Health

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Nearly six percent of infants in this country are hospitalized for an infection before they ever reach their first birthday.

Could a mother’s exposure to certain metals during pregnancy play a role in causing—or even preventing—those infections?

According to Dr. Catherine Bulka, a USF College of Public Health assistant professor who specializes in environmental and molecular epidemiology, the answer is yes.

She recently presented research showing that metals, which accumulate in and pass through the placenta, can disrupt or bolster an infant’s immune function, thereby impacting susceptibility to infections. She presented the research at the first-ever meeting of the International Society for Environmental Epidemiology’s North America Chapter (ISEE NAC).

The ISEE NAC promotes scientific research on environmental health, particularly environmental epidemiology.

“Our results showed that exposures to arsenic, a toxic metalloid, in utero, were associated with a greater risk of fever during infancy, but exposures to manganese, an essential nutrient obtained from dietary sources, counteracted that risk,” Bulka said. “Manganese is present in whole grains and vegetables. Extremely low and extremely high dietary intakes of manganese can lead to deficiency or toxicity. Our results were consistent with the idea that there is a ‘just right’ amount that provides health benefits.”

Bulka noted that some metals (in the right amounts) are hypothesized to suppress an infant’s immune system are arsenic, cadmium and lead. Those that are hypothesized to stimulate the immune system are chromium and manganese.

While Bulka and her colleagues didn’t look at how metals affect a mom-to-be or the pregnancy, per se, she said certain metals are known to be reproductive hazards.

“We know from other studies that arsenic, cadmium and lead are reproductive toxicants,” Bulka said. “Exposures have been linked to preterm birth, low birth weight, gestational diabetes, gestational hypertension, preeclampsia and other issues.”

Avoiding all harmful metals isn’t possible, but Bulka advised limiting exposure when possible.

“Cigarette smoking is a source of metal exposure, so pregnant people should avoid smoking, including exposing themselves to secondhand smoke,” she noted. “Contaminated drinking water is also a concern, especially for individuals who use private wells, as these are not nationally regulated for their metal content. Private well owners should make sure to test their water for metals, and if they are found to be at toxic levels, there are filters that can be installed to reduce exposures. And as far as exposures through food, I would suggest pregnant people eat a varied, well-balanced diet.”

Bulka noted it’s important to remember that environmental exposures don’t happen in a vacuum.

“Studying combinations of metal exposures better reflects reality,” she said. “I think my research has two implications: One, we need to be considering the role of environmental chemicals in infectious diseases and two, modifying dietary intakes or using dietary supplements may offer solutions in terms of reducing the toxic effects of environmental chemical exposures.”  

Story by Donna Campisano, USF College of Public Health

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August is National Breastfeeding Month

The American Academy of Pediatrics, World Health Organization (WHO) and UNICEF all recommend that infants be breastfed exclusively for the first six months of life.

Yet, according to WHO, fewer than half are.

Part of the problem, say breastfeeding advocates like Mirine Richey, a USF College of Public Health DrPH student, is the robust and sometimes misleading advertising of breast-milk substitutes to new moms.

It’s been estimated that the marketing tactics inflate the expected use of infant formula, part of which was the driver for the shortages in the U.S. in 2022.

In an effort to stem the problem and encourage more breastfeeding, WHO developed the International Code of Marketing Breast-milk Substitutes in 1981. The code established international policies and regulations regarding the advertising of formula, bottles and other breast-milk substitute products.

But those policies are often ignored or violated.

In June, Richey took part in the first Global Congress on the Implementation of the International Code of Marketing Breast-milk Substitutes held in Geneva, Switzerland.

The Congress

During the three-day congress, delegates from 130 countries met to share knowledge and strategies to end what WHO calls the “unethical” marketing of breast-milk substitutes. Some of that “unethical” marketing, said Richey, includes formula companies using paid social media “influencers” to promote the use of their products.

“The meeting was intended to address implementation challenges for those countries, such as the U.S., where the code does not even have partial implementation,” said Richey, a certified lactation consultant who works at Florida State University in a research faculty position. “During the 2022 U.S. infant formula crisis, I gave several presentations and talks on the lack of oversight in the U.S. and the barriers to breastfeeding. I submitted a statement to WHO when they issued their call for a congress meeting. The call was looking for academics, policymakers and public health leaders from each UN member country. I applied as an academic, as the majority of my doctoral research and work centers around breastfeeding and policy.”

Working to Curb False Advertising

After listening to reports of the latest research and international perspectives, Richey and the other delegates were divided into regional groups and tasked with developing ways to overcome code implementation barriers.

The congress, said Richey, had its highs and lows. For example, without a U.S. government representative at the gathering, policy changes were not able to move forward.

“The infant formula lobby is incredibly powerful in our country, and it will take bipartisan political and public health leadership to move the needle,” Richey commented. “We are behind many of our contemporaries in this realm.”

But there is some good news.

The five U.S. delegates at the congress work for a variety of academic and nongovernmental organizations and remain dedicated to participation, Richey said. They’ve also formed a small but determined workgroup.

“I am truly inspired to overcome implementation barriers to breastfeeding health policy,” she said. “While most countries have only adopted some of the guidelines, WHO wants to encourage full implementation, and I can see promise in a move to adopt some of the key elements in the U.S., such as enforcing safe and truthful marketing and restricting direct consumer marketing.”

Story by Donna Campisano, USF College of Public Health

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Candace Webb, a USF College of Public Health (COPH) graduate, drew inspiration from the ‘80s sitcom “The Cosby Show.” 

“I was really impacted by seeing representation of two black professional parents on TV. I always wanted to go into medicine and was always really interested in science and human biology.” 

While a student at Tampa’s King High School, Webb volunteered at Tampa General Hospital as a Red Cross candy striper. 

“I loved patient care—the teamwork and communication between providers. And I really liked the clinical environment.”  

Through a fortunate discovery in the library at King, Webb found a program that allowed her to work in the labs at USF’s Morsani College of Medicine. It was a program that gave minority high school students an opportunity for mentoring and exposure to biomedical research. It was a formative experience that propelled her to pursue a biochemistry major at the University of Florida (UF). 

In her first year at UF in 2000, Webb experienced her mother’s untimely passing from complications related to HIV.  

“It was Thanksgiving Day, and it was traumatic and tragic,” Webb remembered. “Her experience made me ask questions like, ‘Why are African American families disproportionately impacted by a preventable condition like HIV? Why are children of African American women being orphaned in America at higher rates – especially when there’s highly effective treatment available?’ This introduced me to health care disparities, health inequities and how the health insurance system is tied to employment. My mom was caught in that gap period where employers hold initiation of benefits for six months. She passed away in that period of time. That is what drives me now and also what led me to public health.”   

It was during her time at UF that she noticed something. 

“I started seeing that the people who were doing the work that I cared about all had MPH at the end of their names,” Webb said. “I told myself, ‘I need to learn more about this MPH degree,’ and so I shifted from wanting to treat one person to wanting to treat communities and to affect systems.” 

Webb subsequently earned her MPH with a concentration in maternal and child health from the COPH in 2006.  

Driven by her personal experiences and a desire to create change, Webb said she embarked on a path that combined her scientific background with her passion for public health. In 2018, Webb was presented with the USF COPH Outstanding Alumni Award, which is given to alumni who demonstrate—as judged by their former professors and current colleagues—exceptional dedication and improvement to public health. 

Currently, Webb holds a position in the Health Resources and Services Administration (HRSA) as the chief of the Adolescent Health Branch in the Maternal and Child Health Bureau.  

“ I think HRSA is one of the best places to work in the federal government and especially in the U.S. Department of Health and Human Services,” Webb commented. “Equity has been at the core of our mission. While other organizations have broader missions, ours is squarely on underserved and rural communities, people living with HIV, maternal and child health populations and the health workforce.”  

Drawing from her own experiences, Webb offered advice and recommendations to current students and young alumni who aspire to make their mark on the world. She emphasized the following key points: 

• Stay connected: “Maintaining strong connections is essential. I am still connected to individuals I met during my time at USF. And I’m friends with folks who went to USF at different times than I did. The program’s quality and the caliber of its graduates are evident in the strong network of USF alumni. It truly feels like being part of a family.” 
• Broaden your connection: “Join organizations like the American Public Health Association, be an active member and engage with different sections, interest groups and caucuses.” 

Alumni Fast Five:

What are you reading recently? “I recently started reading ‘My Dear Comrades,’ by Sunu P. Chandy, a social justice activist and civil rights attorney who works at the National Women’s Law Center. The book of poems weaves together her personal experiences as a woman of color and her legal and activist work. It provides a refreshing contrast to my daily technical reading. I’m also reading “The Boy, The Mole, the Fox, and The Horse” by Charlie Mackesy.

What did you dream of becoming when you were young?
“I’ve always been interested in science, medicine, dance, and culture so I dreamt of being a physician (an OB-GYN or a pediatrician), a medical geneticist, or a member of the Alvin Ailey American Dance Theater.”

Where would we find you on the weekend?
“You will likely find me covering a performance at The Kennedy Center for the Performing Arts in Washington, DC for The Rogers Revue, at a book talk or book festival, Latin dancing (salsa, bachata), enjoying brunch with friends, or playing with my rescue kittens Lucky and Nigel.”

What superpower would you like to have?
“I would love to be able to communicate and connect with more people meaningfully. So, it would be cool to be a hyperpolyglot (proficient in more than 6 languages)!”

What’s your all-time favorite movie?
“There are so many. A few are Love and Basketball, Dirty Dancing, Happy Feet, Up, and The Sound of Music.”

Bonus! What podcasts are you listening to? “Loretta Ross, a remarkable human rights activist, has a TEDx talk on the ‘Calling in Culture.’ It emphasizes the importance of fostering understanding rather than calling people out. I also love Michelle Obama’s podcast, ‘The Light We Carry.’ The former First Lady explores themes of resilience, hope and personal growth, inspiring listeners to reflect on their own journeys and find light in challenging times.” 

Story by Liz Bannon, USF College of Public Health 

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Haley Maxwell’s interest in public health began when she served as a scribe for a urogynecologist who had a public health degree in addition to a medical one.

“I loved the way she practiced medicine because she treated each person individually, according to their conditions,” said Maxwell, who graduated USF’s College of Public Health (COPH) in 2021 with an MPH. “Whenever patients with complex medical issues came into the office, she kept a positive attitude and was committed to providing the best care that she could. During my time as a scribe, I decided to investigate MPH programs. On my first day of classes at the COPH, I knew this program was exactly what I needed. Public health is committed to understanding the reason behind health issues and how to prevent them from happening in the future.”

While it was a doctor who inspired Maxwell to pursue her MPH, it was a documentary about medical procedures performed on enslaved African women that got her interested in her concentration—maternal and child health.

“The practices that were performed still have underlying medical consequences for African American women today, especially in regard to the maternal mortality rate,” said Maxwell, who graduated Virginia Commonwealth University in 2018 with a B.S. in health sciences and a minor in chemistry. “I was completely shocked by this information. I felt the need to make a difference.”

Maxwell said she decided on the COPH because of its solid reputation and its maternal and child health concentration. She said that from the get-go she was inspired by the COPH faculty, particularly Assistant Professor Dr. Ronee Wilson.

“I remember meeting her during orientation and learning that her research correlated with my interest in African American maternal mortality,” Maxwell commented. “Also, I was fortunate enough to have her as my mentor during the Maternal and Child Health Scholar Program from 2020-2021. It was so inspiring to have my check-ins with her because she remained professional, positive and attentive toward our work together.”

While a student at the college, Maxwell served as a graduate research assistant, a maternal and child health scholar and president of the Public Health Student Association. In 2021, USF Health named Maxwell Student Leader of the Year. “I can confidently say that I am so glad I chose USF because it challenged and prepared me for the profession,” she said.

Like many public health students graduating in the midst of the pandemic, Maxwell’s first public health job was investigating COVID-19 cases, recording symptoms, exposures, close contacts, etc.

From there, she pursued her maternal child health passion, recently completing a prestigious Oak Ridge Institute for Science and Education (ORISE) fellowship with the federal government’s Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program, working on fatherhood initiatives.

“The ORISE fellowship gave me a wider perspective about MIECHV programs around the United States,” she said. “I was able to review awardee reports and developed a fatherhood analysis about the MIECHV programs with fatherhood initiatives.”

Maxwell is currently seeking an MS in medical sciences at Morehouse School of Medicine with plans to enter medical school in 2024.

“The COPH has an amazing program that prepared me for the public health profession,” she said. “Thanks to the coursework, volunteering, research and leadership roles, I have a greater understanding of the public health field. I can combine my research and public health foundational skills to analyze and evaluate public health issues. The COPH is an environment filled with opportunity, collaboration and faculty who want to see you succeed!”

Alumni Fast Five

What did you dream of becoming when you were young?

A physician

Where would we find you on the weekend?

I am either trying out a new restaurant or in the comfort of my own apartment.

What is the last book you read?

“Medical Apartheid,” by Harriet A. Washington

What superpower would you like to have?

Invisibility

What’s your all-time favorite movie?

“Friday After Next”

Story by Donna Campisano, USF College of Public Health

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Oral pre-exposure prophylaxis (PrEP) is about 99 percent effective in reducing the risk of contracting HIV from sex, but that’s only if it’s taken daily. When users forget, lack motivation for taking a daily pill or experience barriers to getting the drug, risk goes up.

An implantable, biodegradable PrEP device, currently in clinical trials, may address those problems. But what will it take for health care providers (HCPs) to prescribe it and women to use it?

To help understand, Morgan Brown, a USF College of Public Health DrPH student in Advanced Practice Leadership, and colleagues from Population Services International (PSI) and Eastern Virginia Medical School, surveyed female sex workers and HCPs in South Africa, which has the highest number of people living with HIV globally.

They decided to focus on women, said Brown, because some of the study sample already had experience with implantable devices. Likewise, some of the HCPs also were familiar with prescribing implantable contraceptives.

“We hoped that use of an implantable product comparable to implantable contraceptives would provide some frame of reference to respondents,” said Brown, who at the time of the study worked for PSI but currently is a data and learning specialist at Q2 Impact, an international company based in Virginia that addresses global issues. Brown supports monitoring and evaluation efforts of a USAID Feed the Future award.

Their study, “End-user research in support of long-acting systemic antiretroviral delivery systems: insights from qualitative research with providers and target users in South Africa,” was published in the journal BMC Infectious Diseases in December.

So, what did both prescribers and users want to see in an implantable PrEP device?

“Overall, the device needs to be highly effective, offer long-lasting protection and result in minimal adverse side effects,” Brown noted.

The women in the study expressed a high degree of willingness to try the device, citing that they liked the convenience and dissolvability of the implant. HCPs liked it for the same reasons, but some worried that it could increase promiscuity and noted that it didn’t protect against sexually transmitted infections.

Marketing the product—which consists of four pellets, bigger than a penny but smaller than a matchstick—properly will be key to its success, Brown noted.

“Overall awareness of PrEP was very low in this study, so we as public health practitioners need to do a better job of communicating PrEP’s availability and effectiveness, both in its current form and when other forms like the implant become available,” Brown explained. “The main benefit of implantable PrEP is that it removes the adherence barrier of traditional, oral PrEP, which must be taken daily,” she added. “By removing end-user barriers and making it easier for people to protect themselves, this could be a massive win in the fight against HIV.”

Story by Donna Campisano, USF College of Public Health

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Faculty across several disciplines at USF Health earned National Institutes of Health funding to streamline prenatal, obstetric, pediatric, treatment, behavioral and community health care for patients with opioid use disorder.

Called CADENCE (Continuous and Data-Driven Care), the new program will better serve pregnant patients and new parents, as well as their infants, as they navigate the care they need for managing opioid dependence.

Co-principal investigators for the HD2A R61/R33 grant are Kimberly Fryer, MD, MSCR, assistant professor in the Department of Obstetrics and Gynecology in the USF Health Morsani College of Medicine, and Jennifer Marshall, PhD, CPH, associate professor in the USF Health College of Public Health, and fellow in the Lawton and Rhea Chiles Center.

The primary aim of the new program is to streamline the integration of four “clinics” – or areas that patients might typically access separately. By streamlining these disciplines, care and scheduling will be more coordinated and holistic, and health outcomes of the parent and baby could greatly improve.

The four USF Health clinics being streamlined include office based opioid treatment (OBOT), the maternal family medicine prenatal/obstetric clinic, the PEDI pediatrics clinic, and behavioral health/mental health service.

A “secret shopper” study led by Dr. Marshall a year ago found that only about 20 percent of over 1000 attempts for pregnant women with Medicaid experiencing opioid use disorder were able to set appointments for prenatal care, indicating that many providers may hesitate to take these patients because they do not have the capacity or know how to connect their patients to the addiction treatment critical to helping these patients succeed in caring for themselves and their babies.

By bringing the four primary disciplines together, patients will have access to integrated, continuous, care that will improve maternal engagement in recovery or treatment for maternal opioid use disorder at delivery, neonatal outcomes, and timely referral to early intervention.

The new CADENCE includes two components: a data stage that will create in the first two years an interactive data dashboard that tracks maternal, neonatal, and infant outcomes for pregnancies affected by opioid use disorder and pilot the CADENCE program within USF Health and Hillsborough County; and an implementation stage in the third, fourth and fifth years that will focus on measuring improvement in clinical outcomes at the program level using the data from the dashboard and assessing the implementation and costs of the CADENCE program.

This program of integrated, continuous, care will be rapidly refined using a data-driven approach towards improving maternal engagement in recovery or treatment for maternal opioid use disorder at delivery, neonatal outcomes, and timely referral to early intervention.

A long-term aim of the project is to develop a model that can be shared throughout Florida and at other academic medical programs to help pregnant women in their communities.

Reposted from USF Health Blog

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