Supporting Our Families through Addiction and Recovery
For 10 years, BMC has helped pregnant women with opioid dependence through Project RESPECT (Recovery, Empowerment, Social Services, Prenatal Care, Education, Community, and Treatment). Offering treatment for substance use during pregnancy, Project RESPECT provides prenatal care, substance use recovery services, and behavioral health within a specialized prenatal care clinic.
Supporting our Families through Addiction and Recovery (SO FAR) will support these women, and their babies, after delivery. The baby will have its well-baby visits in the pediatric clinic and during that same appointment and in the same clinic, mom will receive her continued treatment for substance abuse. In addition, mom will be paired with a mentor, someone who has been in her shoes, to help her through the challenges of having a newborn and undergoing substance abuse treatment. Led by the Chief of Ambulatory Pediatrics, Eileen Costello, MD as well as pediatrician Davida Schiff, MD, we believe this model will improve the health of mother and baby, help decrease rates of substance use relapse, and promote positive parenting experiences. SO FAR brings together a multidisciplinary team including general pediatrics (Drs Costello, Schiff and Minear), developmental pediatrics (Dr Augustyn), neonatal and NAS expertise (Dr. Wachman), addiction medicine (Dr. Price), behavioral health (Dr Vibbert) and infectious disease (Dr Agarwal). The program will be thoroughly evaluated to determine the degree to which it changes mothers and infants health (e.g. relapse; breast feeding) and health service use (e.g. emergency department visit).
Brief PTSD Intervention in Primary Care
Adolescents and young adults who have experienced trauma often experience post-traumatic stress disorder, or PTSD. When not treated, PTSD can lead to a host of medical problems. In this program, an evidence-based model in adult medicine will be piloted for adolescents and young adults exposed to trauma. These patients will be enrolled in a three-session program that helps them manage their PTSD using a model called Brief Relaxation, Education, and Trauma Healing (BREATHE). The program will teach adolescents about trauma and its symptoms as well as ways to regulate their emotions through mindfulness and deep breathing. Led by an adolescent medicine provider Mandy Coles, MD and psychologist Lauren Ng, PhD, the program will adapt the adult intervention to be effective and relevant for diverse adolescents. The team will evaluate the degree to which the program lessens symptoms of traumatic stress and improves function and well-being.
Individual Education Plan (IEP) Clinic
Many children with Individual Education Plans (IEP) have related health issues. Whether ADHD, autism, Downs Syndrome, or a myriad of other diagnoses, it can be important for the health care provider and school to work together to ensure the best possible outcome for each student. In Boston, access to Developmental and Behavioral Pediatrics can be challenging due to a shortage of specialists. In the IEP Clinic, run by Soukaina Adolphe, MD and Ivys Fernandez, JD who specialize in delivering primary care to children with special needs, patients with IEPs will have a one-time appointment with the provider-specialist to review their IEP and medical history, and then be fast-tracked to a developmental and behavioral pediatric specialist.
Uniting Schools and Pediatricians to Promote School Readiness
Low-income children are less school ready than wealthier counterparts; schools, pediatrics and community agencies generally work in silos making helping families less effective. We will partner with educators, families and community agencies to pilot systems for enhanced communication that build comprehensive and individualized development plans for children that promote both health and school success.
Using Cultural Brokers to Improve Care Planning
Linguistic competence is not always synonymous with cultural sensitivity. Life experience and cultural beliefs shape families’ attitudes and opinions towards healthcare and need to be taken into consideration in developing appropriate shared plans of care. We are forming a multi-disciplinary team to develop and evaluate shared care plans for children with chronic conditions that reflect families’ values, culture and lived experience.
Caring for Parents within Pediatrics
Parents are more likely to seek care for their children then themselves; parental physical and mental health problems compromise child health. We will pilot and evaluate programs that support access for caregivers to mental health services within primary care pediatrics.
The Center will provide continuous learning opportunities to advance the development of providers, improve the systems they are working in and ultimately provide better care. The Center Fellowship supports the work of our early career faculty who are focused on the intersection of advocacy, public policy, social determinants and population health.
Lucy Marcil, MD, MPH
Dr. Marcil has joined our Department as the inaugural Fellow in the Center for the Urban Child and Healthy Family. Lucy completed medical school at the University of Pennsylvania School of Medicine and an Masters of Public Health from Johns Hopkins. During her pediatric residency in the Urban Health Track of the Boston Combined Residency Program, Lucy co-founded StreetCred, an innovative program offering financial services to the families we serve at BMC. StreetCred offers families the opportunity to complete their taxes and access anti-poverty programs while visiting their pediatrician’s office. In the 2017 tax season, StreetCred served over 400 families and returned more than $1,200,000 to patients served at BMC, the South End Community Health Center and Boston Health Care for the Homeless Program. In the Center for the Urban Child and Healthy Family, Lucy will devote her energies to expanding the scope of services provided by StreetCred and disseminating our model to other sites across the country.