Saret Program Provides NYU Silver Grad Students Stipend-Supported Substance Use Research Training
September 12, 2019
NYU Silver Class of 2020 MSW students Moorea Colby, Sally Martir, and ViniNatalie Zaninovic conducted stipend-supported, mentored substance use research projects this past summer through the Substance Abuse Research Education and Training (SARET) program, an interprofessional collaboration between NYU Silver, NYU School of Medicine, and NYU’s colleges of nursing, dentistry, and global public health.
Based at NYU School of Medicine and funded by the National Institute of Drug Abuse (NIDA), SARET aims to increase students’ knowledge of and sensitivity to substance use disorders, promote interdisciplinary collaboration, and stimulate participants’ interest in addiction research.
NYU Silver Associate Professor Jennifer Manuel, who is a co-investigator on the project, explained that SARET has two components. The first is a free, web-based curriculum, available to all students, that provides an introduction to core concepts of clinical research and addresses addiction-related topics including epidemiology, neurobiology, screening, treatment, and personal impact. The second, open only to students at participating NYU schools, is a competitive, stipend-supported training, lasting either a summer or a full year.
Colby, Martir, and Zaninovic were among 11 students selected for SARET’s 2019 summer cohort, joining two students from NYU School of Medicine and three students each from NYU Rory Meyers College of Nursing and NYU College of Global Public Health. During the eight-week, full-time program, each student conducted an intensive substance use-related research project with a seasoned faculty mentor, and attended lectures, seminars, and site visits with their multidisciplinary peers.
Moorea Colby was paired with Dr. Erin Rogers, an Assistant Professor in NYU School of Medicine’s Department of Population Health, whose research focuses on tobacco use, smoking cessation, mental health, and health disparities. Colby’s mentored research project – a title and abstract screening of the literature about people who use tobacco and have co-occurring psychiatric diagnoses – was the first phase of a larger scoping review Dr. Rogers and her team are doing of the existing literature on tobacco use among people with psychiatric conditions. “Dr. Rogers noticed that most studies on smoking cessation excluded populations with mental health diagnoses or were limited in their focus on that population,” Colby said. “So she wanted to do a comprehensive review of the literature to see what has actually been done and where the gaps are to identify priorities for future research on reducing smoking by people with psychiatric conditions.”
Colby said that Dr. Rogers and her research team began with over 12,000 articles imported for screening using search terms related to tobacco use and psychiatric diagnoses. After Colby and other members of Dr. Rogers’ team did their initial screen based on inclusion and exclusion criteria, about 2,000 of those articles were advanced to the next stage of the review. “It was definitely unexpected to me how much time it took,” Colby said. “For each article, we had to achieve consensus between two reviewers as to whether it should be included or excluded. We would have rich discussions during team meetings about why certain articles should or should not be included. Of course, I have read journal articles in school before, but this research project made me a faster, more astute reader, and gave me a much greater understanding of how research studies are conducted.” Colby added, “I also gained an appreciation and respect for public health,” which is the field Dr. Rogers and the rest of her team members specialize in. “I found that social work and public health are complementary fields.”
Although the SARET summer program ended on July 30, Colby is continuing to work remotely with Dr. Rogers’ team on a volunteer basis. Her field placement this year is in an outpatient clinic working primarily with people with alcohol use disorder. “I have had an interest in substance use for some time, but prior to SARET I didn’t have an experience in the field,” Colby said. “Now I have a stronger understanding of addiction and substance using populations as well as of clinical research.”
Like Colby, Sally Martir did not have prior substance use experience, but her interest was piqued last January after she took NYU Silver’s study away course in Tel Aviv on Assessment and Treatment of Children of Substance Misusing Parents. “I was compelled to address substance use after having studied the impact it has on children of substance users,” she said.
While Martir is particularly interested in policy and is in NYU Silver’s Macro Focused Learning Opportunity, which encompasses policy-oriented coursework, seminars, and a related field placement, she observed that, “You need to know your research to influence policy.” She was intrigued by the opportunity SARET provided to gain a holistic understanding of substance use, strengthen her research skills, work with an experienced mentor, and be part of a cohort with peers from other disciplines.
Martir’s SARET mentor was Dr. Joshua Lee, an Associate Professor in the Departments of Population Health and Medicine at NYU School of Medicine and the Director of the NYU Fellowship in Addiction Medicine. Her research project was part of a larger study Dr. Lee is conducting of 150 recently incarcerated adults with a history of opioid misuse in order to gain a greater understanding of buprenorphine diversion within the criminal justice system – and to potentially support the inclusion of buprenorphine injection as form of medication-assisted treatment in correctional facilities. Martir conducted qualitative interviews with eight of the study participants who had used illicit buprenorphine while incarcerated and identified salient themes regarding that use, including the fact that it eased their withdrawal symptoms and was the most accessible opioid option while incarcerated.
Even though she is now back in school at our Westchester County campus, Martir is staying involved with Dr. Lee and his team by helping to transcribe interviews. She hopes to stay connected as the study continues and to assist with writing the manuscript once it concludes.
ViniNatalie Zaninovic, who is also a student at our Westchester County campus, did her SARET mentored research project with Dr. Magdalena Cerdá, Director of the NYU Langone Center for Opioid Epidemiology and Policy and Associate Professor in the Department of Population Health at NYU School of Medicine. Dr. Cerdá is currently conducting research on the health consequences of marijuana legalization in Uruguay for people in that country as well as Argentina and Chile. ViniNatalie conducted a logistic regression analysis, under Dr. Cerdá’s guidance, of data from Chile’s national school-based health survey of approximately 50,000 students to determine if students’ perceptions of their parents’ reactions if they found out they used marijuana or alcohol had a statistically significant impact on their use of those substances. ViniNatalie presented the results of the logistic regression and compared them to findings from of similar studies she identified in a review of U.S. literature on the relationship between perceived parental norms on adolescent substance use. Among the findings of ViniNatalie’s logistic regression were that adolescent perceptions of whether their parents approve of their substance use is strongly associated with adolescent use of alcohol and marijuana – which is consistent with findings in the U.S. literature. ViniNatalie also found that mothers may have a greater impact on their daughters and fathers on their sons.
ViniNatalie said her background in child and adolescent psychology prior to pursuing her MSW made her particularly excited to pursue her research question. “It ties into adolescent development and the fact that the adolescent brain is emotionally focused,” she said. “Thus it is really important to understand how adolescents themselves are viewing their reality.”
ViniNatalie added, “I came to Silver interested in both clinical practice with children and social work research. The SARET experience was unique because it had a little bit of both. We made site visits to clinics and shelters where we could talk to the people in charge as well as the people being served. At the buprenorphine clinic at Bellevue, for example, we were able shadow the doctors for the whole day and also speak to clients about how they were doing. Since I am social worker in training, clients sometimes turned to me for guidance, for instance, if they were in a shelter and wanted to find permanent housing. It was very enlightening. On the research side, working with Dr. Cerdá and her team, I learned about conducting a literature review, how to construct my own hypothesis, and how to follow it through with data analysis. I now have a clear picture of the research flow. The whole SARET experience will help me as I continue in my social work career.”
Colby, Martir, and Zaninovic all said they particularly appreciated the interdisciplinary nature of SARET. They noted that many of their peers in their cohort did not have much experience with social workers. “It was great for us MSW students to talk to them and express what we do, what we are learning, and how we contribute to substance use research and treatment,” said Zaninovic. “Many of them focus heavily on biology, so they were interested in the way we take into account psychological and socio-environmental factors as well.” At the same time, Martir, said, “It was helpful for us to be exposed to our peers’ medical and public health perspectives.” Colby added, “It was valuable to attend seminars and lectures on epidemiology and the biology of addiction, since those are topics we don't get in our program in as much depth.”
All three also came away from their SARET experience with greater empathy for people who use substances. “There was a lot of conversation about the language we use, and the importance of being supportive rather than blaming,” Colby said. “That is something I was aware of before, but after the program I have made a more conscious effort to shift my language and constantly challenge myself about where the terminology I use comes from.” Martir noted that interviewing formerly incarcerated people who had used illicit buprenorphine made her more understanding. “I could hear the despair in their voices,” she said. “While some reported they used it just to get high, most just didn't want to feel sick anymore. It is easier to categorize people who use drugs as poor choice-makers but substance use and addictions are all diseases. I think the more educated we are on this topic the more we can work towards changing the stigma as a whole.”