October 19, 2021

Family Medicine research team awarded OVPR Anti-Racism Grant to investigate racial inequities in newborn drug screening

Funding will support their project, “Promoting racial equity in newborn drug testing: A justice-informed, participatory mixed methods study,”  also known as the Equity in Newborn Screening  Study (ENDS study)

A team of researchers based in the University of Michigan’s Department of Family Medicine have been awarded an anti-racism research grant from the Office of the Vice President for Research (OVPR), in partnership with the National Center for Institutional Diversity, for their project “Promoting racial equity in newborn drug testing: A justice-informed, participatory mixed methods study.”

The Equity in Newborn Drug Screening Study (also known as ENDS study) will examine trends in newborn drug testing by race and ethnicity at Michigan Medicine. The study will also explore patient-provider perspectives regarding newborn drug testing. Additionally, the study will use mixed methods, community-engaged, and justice-informed approaches to achieve the study aims.

The first-of-its-kind project at Michigan Medicine was spearheaded by U-M Family Medicine resident physicians Sebastian Schoneich, MD, Carol Shetty, MDand William P. Saunders, MD, MBA, and U-M medical student Tori Waidley with mentorship from family medicine faculty Lauren Oshman, MD, MPH, and Chris Frank MD, PhD. Kate McCabe, PhD, a recent postdoctoral fellow at UM Institute for Research on Women and Gender, will provide expertise in medico-legal responses to pregnant people with substance use disorders. Missy Plegue, MA (Lead Statistical Analyst, Family Medicine) will play a critical role in analyzing data generated from 27,000 pregnancies that occurred at Michigan Medicine from 2014- 2020.

The Anti-Racism Grant provides funding to expand the project’s scope and bring in additional team members for conceptual and methodological support, as well as management of research activities: Justine Wu, MD, MPH; Paul Chandanabhumma, PhD, MPH; Murphy Van Sparrentak, MSW; and Ananda Sen, PhD. The grant will also support the formation of a Participatory Council of community stakeholders who will advise the research team on decisions that affect the research process. 

“The ENDS Study is unique in that it was designed with anti-racism and community partnership frameworks in mind to ensure that our interventions do not reinforce institutionalized racism in our health care system” said Oshman, the lead faculty member on this project.

Michigan is one of 25 states that mandate health care professionals to report cases of newborn drug exposure to Child Protective Services. While these reports can facilitate patient referrals to drug treatment programs and social services, this process can also lead to serious emotional and legal repercussions for people and their families - including the termination of parental rights.

A prior landmark study in Florida reported that Black mothers and their children are more likely to be reported for prenatal drug use than their white counterparts, even when rates of drug use were similar between the groups. Professional organizations, including the American College of Obstetricians and Gynecologists, have raised concerns about policies that effectively criminalize substance use in pregnancy, including incarceration or threats of incarceration.

“The findings from the ENDS study will provide information that can inform models of care that seek to eliminate racial inequities through quality improvement efforts, clinical policies, and training of health care professionals,” added Wu, the grant’s principal investigator.

The ENDS Study was one of eight projects funded, and the only one awarded to a study team from Michigan Medicine, in the first cycle of OVPR Anti-Racism Grants.

The grants are a part of the Provost’s Anti-Racism Initiative, a university-wide campaign that aims to strengthen community engagement and capacity around work that addresses racial inequality, equity and justice in society.

For more information about the ENDS Study please contact [fammed-ENDSteam@med.umich.edu]