Evidence map›Paper›PMID 42104470›Full record

ArticleAddiction science & clinical practice2026

Referral linkages to support pregnant and postpartum individuals with opioid use disorders in Florida: a social network analysis.

Amandeep Kaur Ratta, Rafaella Stein Elger, Wouter Vermeer, Tanner Wright, Asa Oxner, Kimberly Fryer, Jennifer Marshall

Registry-linked trialAbstract read
In one paragraph

Article in Addiction science & clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05609669 (Continuous And Data-drivEN CarE), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05609669 naactive not recruitingnot on this map

Continuous And Data-drivEN CarE (CADENCE)

TypeinterventionalSponsorUniversity of South FloridaRan2023 to 2027Enrolled10ConditionsPregnancy Related, Opioid Use DisorderArmsCADENCE program
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Amandeep Kaur RattaChiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA. amandeepratta@usf.edu.
Rafaella Stein ElgerChiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA.
Wouter VermeerFeinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Tanner WrightCollege of Medicine, University of South Florida, Tampa, FL, USA.
Asa OxnerCollege of Medicine, University of South Florida, Tampa, FL, USA.
Kimberly FryerCollege of Medicine, University of South Florida, Tampa, FL, USA.
Jennifer MarshallChiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA.

Funding

CADENCE - Continuous And Data-drivEN CarER33DA057667 · NIDA · UNIVERSITY OF SOUTH FLORIDA · PI MARSHALL, JENNIFER, WRIGHT, TANNER · 2024 to 2024
$2.0M
NIDA NIH HHS R33 DA057667NIH National Institute on Drug Abuse through the NIH HEAL Initiative® 4R33DA057667-02
6 · The paper itself

Abstract

backgroundOpioid Use Disorder (OUD) has emerged as a critical public health issue among pregnant and postpartum individuals. To address this concern, it is of utmost importance that healthcare institutions, community-based programs, and other agencies collaborate to improve the support offered to the concerned population in their OUD recovery journey. A social network analysis was conducted to understand collaborations among multisectoral agencies serving or having potential to serve pregnant and postpartum individuals with OUD.

methodsCollaborations among agencies (n = 79), including three Continuous And Data-drivEN CarE (CADENCE) program clinics, in a large Florida county were mapped. A cross-sectional web-based survey was distributed to these agencies to capture inter-agency collaborations, including services provided (e.g., housing, transportation, etc.), interaction frequency, and perceptions of partner agency confidence, dependence, and value. Open-ended questions identified champion agencies and needs of agencies to better serve the population. Network maps of the agencies were generated to characterize the nature of existing collaborations and identify opportunities for strengthening interagency coordination.

resultsTwenty-six out of 79 enlisted agencies (33%) responded, describing connections with 72 enlisted agencies. The social network analysis of total 376 ties among these agencies demonstrated low density (0.108) but high clustering (0.637), indicating a connected core with tightly knit subgroups and cross-sector bridges especially through social services. CADENCE clinics were inter-linked; CADENCE Co-located pediatric/ psychiatric/Maternal-Fetal Medicine clinic was most connected (38 ties), followed by CADENCE Outpatient Prenatal Care clinic (16 ties), and CADENCE Addiction Medicine (9 ties). Collaboration frequency varied, with 34% of referral ties used only once a year or less, 13% used daily, and 17% never used. Agencies reported having confidence in 82% of collaborations, yet more than half (56%) were considered non-essential (no or little dependency) to achieving patient care goals. Qualitative insights emphasized integrated, trauma-informed care, standardized referral pathways and shared data; destigmatization, and harm reduction; simpler resource navigation and supports for housing and transportation.

conclusionOverall, the county possesses a multisector perinatal OUD network that is yet underutilized. Strengthening structured referrals, interoperability, and wraparound, stigma-free services leveraging CADENCE could reduce fragmentation and improve maternal-infant outcomes.

trial registrationClinicalTrails.gov (NCT05609669). November 02, 2022.

Indexed as

Opioid-Related DisordersPregnancy ComplicationsReferral and ConsultationSocial Network AnalysisCross-Sectional StudiesFemaleFloridaHumansPostpartum PeriodPregnancyCollaborationsIntersectoral coordinationPerinatalSocial networkSubstance use disorder

Identifiers

PMID42104470
PMCPMC13156855

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.