Addressing the deep-rooted inequities identified by community members requires re-evaluating the health care experience from the ground up. But that doesn’t necessarily mean starting from scratch. ELEVATE is integrating an established substance use disorder (SUD) perinatal care model into Sacred Circle, a local health system operated by the Confederated Tribes of Goshute. The center is testing whether the SUD clinic could make the difference between life and death for some mothers.

In operation since 2017, the SUPeRAD perinatal SUD clinic integrates expertise from obstetricians, social workers, pharmacists, psychiatrists, addiction specialists, recovery services, and peer support. Research shows this multidisciplinary approach lowers rates of preterm birth, neonatal length of stay, and rates of positive toxicology at delivery. What’s more, having a one-stop shop for health care reduces access issues and keeps patients engaged. As a result, they’re more likely to continue medications for SUD over the long term. Maintaining treatment is critical since studies show that even though 80% of mothers voluntarily cease substance use during pregnancy, 50% of those that do not have health care or other support resume substance use after delivery.

Folding the multidisciplinary care model into an environment that a community already trusts may give mothers the culturally sensitive, evidence-based care they need. “The goal is to take the model to them, not to change the people that they’re seeing,” says Torri Metz, MD, the center’s principal investigator and associate professor of obstetrics and gynecology at U of U Health. “Instead, we’ll train the people that they’re seeing to implement this same type of model.”