Program Overview

Each year, United Health Foundation ranks each state's health status using 81 different measures of health outcomes and social determinants of health from 30 unique data sources.¹ Within those measures, Mississippi ranked worst (#50) in food insecurity, per capita income, unemployment, and its economic hardship index. The state also ranked 49th in rates of preventable deaths, teen births, clinical care, and poverty, 48th in income inequality, and 46th in percentage of residents who are unemployed.¹

Importantly, as is generally true throughout the U.S., Mississippi is appreciating more fully the interconnections between SUD and IPV among pregnant and postnatal women, and recognizing the need to screen and treat for both. Mississippi's mental health and SUD providers need to be trained to screen and refer for treatment those women suffering from IPV. Concomitantly, Mississippi's community-based service providers for pregnant and postpartum women suffering from IPV need to be trained to screen and refer patients for SUD. With this application, we are proposing to do just that.

The University of Mississippi Medical Center (UMMC) and its partners, (1) Mississippi Coalition Against Domestic Violence (MCADV), (2) Converge: Partners in Access (Converge), (3) Mississippi Coalition Against Sexual Assault (MSCASA), (4) Mississippi State Department of Health (MSDH), (5) Community Health Center Association of Mississippi (CHCAMS), and (6) University of Mississippi's Center for Research Evaluation (CERE), propose to establish the SUD and IPV among Mississippi's Moms: Initiative to Prevent and Treat (SIMM Initiative). The remaining sections of this project narrative describe our plans for developing, implementing, and evaluating the work of the SIMM Initiative.

The SIMM Initiative has identified seven goals:

• Goal 1: Establish and implement a pilot project that incentivizes SUD providers treating pregnant and postpartum women in Mississippi to be trained on identifying and addressing IPV.
• Goal 2: Develop and implement an SUD training program for Mississippi's community-based IPV staff members that focuses on pregnant and postpartum women.
• Goal 3: Based on feedback from recipients of initial SUD and IPV training programs, revise as necessary, and disseminate widely best practices for managing co-occurring IPV and SUD among pregnant and postpartum women.
• Goal 4: Develop and implement statewide plan for integrating IPV and SUD protocols across healthcare settings.
• Goal 5: Provide technical assistance to community-based IPV programs to better accommodate the needs of pregnant and postpartum women with SUD.
• Goal 6: Develop and disseminate a disparity impact statement on Mississippi's pregnant and postpartum women at risk for co-occurring SUD and IPV.
• Goal 7: Monitor, evaluate, and continuously improve the programs and services offered by the SIMM Initiative.

Mississippi has the highest prevalence of any physical intimate partner violence, as well as before pregnancy, and second highest during pregnancy, according to the Centers for Disease Control and Prevention.

Often unreported, intimate partner violence affects as many as 50 percent of young, single, poor, minority pregnant women, said SIMM principal investigator Dr. Lei Zhang, and substance use disorder providers aren't necessarily trained to provide the needed resources.

"Bridging these gaps through an integrated approach undergirded by community partnership will hopefully provide the necessary wrap-around support for those struggling with IPV, SUD and new motherhood, empowering them to take the steps to secure their health, safety and a better future for themselves and their families," said Dr. Michelle Owens. "We also want to strengthen the ability of providers to identify and readily assist those individuals who are victims or at risk of IPV."

1. 2022 Senior Report State Rankings. https://www.americashealthrankings.org/learn/reports/2022-senior-report/state-rankings

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