Funded Projects

Trainspotting: Fostering the Opioid Epidemic's Infants

Project Year

2026

City & State

Pensacola, Florida

Program Name

Resident

Topic

Health Disparities

Program Description

In Northwest Florida, a region deeply shaped by the legacy of pill mills, the opioid epidemic’s youngest victims face a critical gap in discharge education. From 2010-2012, 90 of the top 100 oxycodone-purchasing physicians in the U.S. practiced in Florida, followed by a shift to illicit fentanyl and rising rates of Neonatal Opioid Withdrawal Syndrome (NOWS). Escambia County, once a national epicenter of opioid prescribing, now reports one of the highest rates of NOWS in Florida.   13.1% of infants with NOWS end up entering the foster care, nearly ten times the rate of other newborns, and are less likely to be placed with kin. NOWS infants face higher rates of placement instability, largely because caregivers feel underprepared to handle withdrawal symptoms. Infants with NOWS have the highest 30-day emergency department revisit rate among all groups of medically complex newborns, over 25%.   While birth parents participate in bedside care, receive structured teaching and engage in discharge planning, foster parents often assume care only after discharge and therefore miss critical opportunities to learn feeding and soothing techniques. Furthermore, foster parents often receive incomplete medical and family histories, including details of maternal health conditions, and the type, timing and extent of prenatal substance exposure.  To address this gap, we propose a simple, scalable intervention: a series of short, accessible education videos and handouts designed specifically for foster parents receiving NOWS infants. Foster parents who have cared for NOWS infants will be identified with the help of hospital case management, and Northwest Florida Health Network, a nonprofit organization managing foster cases across the region. 2-3 virtual focus groups will be conducted with 3-5 of these experienced foster caregivers to explore perceived discharge education gaps and caregivers' preferences for content, format, and delivery.  Their input will drive the creation of approximately ten educational videos, each 5-10 minutes in length. A discharge toolkit with handouts summarizing the contents of the videos, pre and post-utilization surveys and printed QR codes that link to the educational videos will be handed to all foster parents receiving NOWS infants, approximately 2 every month, from the Studer Family Children's Hospital NICU. Pre-utilization surveys will be completed at discharge and post-utilization surveys will be submitted approximately 3 months after discharge. This will help us objectively evaluate the change in caregiver confidence, the extent of video usage, and the effect the videos had on unplanned healthcare utilization. NICU staff will provide feedback so we may assess feasibility, sustainability, and integration into the discharge workflow. Based on the feedback we will refine the content and upscale the project to include foster cases managed by Northwest Florida Health Network.  We anticipate this project will measurably boost foster parent confidence, which will lead to fewer emergency room visits and hospital re-admissions in the first 90 days after discharge. Ultimately, the project aims to strengthen the local safety net by stabilizing placements, reducing strain on overwhelmed emergency services, and providing a scalable model to support a uniquely vulnerable population.

Project Goal

To enhance caregiver confidence among foster parents receiving infants with NOWS by developing a sustainable educational videos and handouts designed around their specific needs and priorities, ultimately reducing preventable post‑discharge healthcare utilization.

Project Objective 1

Conduct 2-3 focus groups with 3-5 foster parents who have previously cared for NOWS infants to identify  gaps, preferred educational content, and formats in discharge education by July 2026.

Project Objective 2

Based on the information gathered in the focus groups, develop handouts and 10 QR code-based videos and initiate distribution among all foster caregivers receiving infants with NOWS from the NICU at Studer Family Children's Hospital (SFCH), Pensacola by September 2026.

Project Objective 3

Evaluate the impact of the NICU discharge handouts and videos among foster caregivers receiving infants with NOWS by assessing caregiver confidence, knowledge of NOWS, perceived usefulness of the material and post-discharge healthcare utilization by March 2027.

AAP District

District X

Institutional Name

Studer Family Children's Hospital, Ascension Sacred Heart

Contact 1

Manognya Chekragari, MBBS