Category Archives: Advocacy

Reflections on Participation in Community Outreach Event

By Sarah Willoughby, LCSW, Freeman Health System

On Sunday, Sept 7, 2025, I attended a community outreach event hosted by the Neighborhood Resilience Project in collaboration with McAuley Ministries and the Society of Teachers of Family Medicine (STFM). This was a partnership through the 2025 STFM Conference on Practice & Quality Improvement in Pittsburgh, PA.

I rode to the main site with Marisol Valentin, the director of McAuley Ministries, who told me about the sad history of the Hill District of Pittsburgh and the area’s increased poverty, violence, and other problems. Then we met Father Paul Abernathy, who had the vision to start the Neighborhood Resilience Project—a trauma-informed community development nonprofit.

He provided a tour of the medical/behavioral health facility and led a round table discussion along with one of the McAuley Ministries board members, two volunteer physicians, chief administrator, the nursing director, and the volunteer coordinator. Together, they described their work in revitalizing the Hill community—a neighborhood negatively affected by gentrification.

Father Abernathy and others realized residents of this neighborhood have experienced individual and community trauma, which is affecting their emotional and physical health. I loved their focus “to promote resilient, healing and healthy communities so that people can be healthy enough to sustain opportunities and realize their potential.” I have spent my entire career—35 years—doing this in various rural and urban areas.

During the last 15 years, the Neighborhood Resilience Project has worked with community members, leaders, volunteers, and donors to strengthen the community by focusing on three pillars:

  • Community Support
  • Health and Well-Being
  • Leadership Development

The Neighborhood Resilience Project’s motto is to engage community members to transform them into a resilient, healing, and healthy community. Programs include a free Health Care Center, a Trauma Response Program, a Backpack Feeding Program, and, during the COVID-19 pandemic, a Vaccination Collaborative.

Father Abernathy was working in a predominantly black and underserved community in Pittsburgh and regularly interacting with men, women, and children who had repeatedly experienced multiple forms of trauma. He was a combat veteran of the Iraq War and realized that trauma in the form of hunger, abuse, homelessness, lack of opportunity, racism, lack of health care, and violence greatly informed the worldview and culture of the community.

Understanding that trauma was the greatest barrier facing the development of his community, Father Abernathy began to ask the question, “how do you heal an entire community that has been inundated with trauma for generations?”

Here are some of the Neighborhood Resilience Project’s recent accomplishments:

  1. Through 2021, the organization has helped facilitate more than 2,500 COVID-19 vaccinations, deployed more than 60 times to homicides related to gun violence, provided more than 14,000 items of food and 5,000 clothing items, provided more than $23,000 in emergency relief and document recovery, and had close to 200 volunteer hours through clinicians alone such as to provide free care to the uninsured in the region.
  2. The organization has hosted groups from across the nation who had been previously trained in the Trauma Informed Community Development Framework for a Summit in June 2021.
  3. The organization utilized “Micro-Community Interventions” in the Hill District and saw an improvement in overall well-being as analyzed by the well-being tool, “ImHealthy.”
  4. The organization has renovated its Free Health Center space to double in size and now offers medical and dental care.
  5. In partnership with the Jefferson Regional Foundation, the Neighborhood Resilience Project is rolling out work in the Mon-Valley – first by training one cohort from the McKeesport, Clairton and Duquesne neighborhoods (for a total of three cohorts) in the Trauma Informed Community Development Framework and then coaching those cohorts through the roll-out phase.

Visiting the Neighborhood Resilience Project and meeting key team members was inspiring to me personally and professionally. We’d like our community residents in the Joplin, MO, area to be healthier, and we struggle to find ways to do this. In April, we had a serious storm in our rural area, causing damage to trees, fences, homes, and sheds. Just this week, a woman whose farm is still significantly damaged and whose life has seriously been impacted told her story.

This “Trauma Informed Community Development” (TICD) model in our community might be helpful to Joplin, as many were devastated by the EF5 tornado in 2011 that killed more than 200 people. I plan to meet with someone from the Neighborhood Resilience Project in the next month and learn more about the imHealthy tool and ”micro interventions” we might be able to implement in our community.

Using While Pregnant

A Life-Changing Knock


By Meheret Mekonnen, MS

The fear of having a newborn taken away—this is a reality for many women who test positive for substances on a urine drug screen during pregnancy. The stigma and complications of substance use disorders are associated with insufficient prenatal care, inadequate nutrition, chronic medical conditions, and domestic violence.¹

Prenatal substance use and neonatal substance exposure have become pressing public health concerns. It is estimated that more than 4.4% of pregnant women in the United States use 1 or more substances during pregnancy.² Opioid use among pregnant women and cases of neonatal abstinence syndrome have risen alarmingly, with a 131% increase in opioid-related diagnoses during delivery hospitalizations from 2010 to 2017.² Each year, approximately 800,000 of the 4.3 million neonates born in the United States are exposed to illicit substances in utero.³ These statistics, along with countless patient testimonials, highlight the critical need for health care professionals to implement screening, brief intervention, and referral to treatment as part of routine care.

One of the many challenges clinicians and institutions face is how to effectively screen pregnant patients. Many facilities still rely on unstandardized substance use screening, often in the form of urine toxicology testing. However, urine drug screens have demonstrated poor positive predictive value and reveal significant disparities in outcomes.⁴ Historically, unstandardized screening and disclosure practices have been shaped by provider bias, particularly against single women with poor psychological, financial, or social functioning; women with delivery complications; Black women; and those receiving care in public health settings.⁵

Leading organizations—including the World Health Organization (WHO), the US Preventive Services Task Force (USPSTF), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the American College of Obstetricians and Gynecologists (ACOG)—strongly recommend standardizing substance use screening as part of comprehensive obstetric care.⁶ Validated screening tools such as the 5Ps (Parents, Peers, Partner, Pregnancy, Past) offer a structured approach to assessing alcohol and substance use during pregnancy.⁷

Critics of universal verbal screening cite concerns about patient honesty, staff burden, and time constraints. Yet, successful models demonstrate that integration into existing clinic workflows, engagement of multidisciplinary stakeholders, and support from institutional leadership can facilitate adoption and acceptance.⁸

More work is needed to address disparities in substance use screening and the broader public health challenge of prenatal substance exposure. However, universal verbal screening is a meaningful step toward building patient trust, mitigating provider bias, and promoting equity in prenatal care.⁹

References

1. Wendell AD. Overview and epidemiology of substance abuse in pregnancy. Clin Obstet Gynecol. 2013;56(1):91–96. Available from: https://journals.lww.com/clinicalobgyn/FullText/2013/03000/Overview_and_Epidemiology_of_Substance_Abuse_in.15.aspx

2. Hirai AH, Ko JY, Owens PL, Stocks C, Patrick SW. Neonatal abstinence syndrome and maternal opioid-related diagnoses in the US, 2010–2017. JAMA. 2021;325(2):146–147.

3. Joseph R, Brady E, Hudson ME, Moran MM. Perinatal substance exposure and long-term outcomes in children: a literature review. 2020.

4. Chin JM, Chen E, Wright T, Bravo RM, Nakashima E, Kiyokawa M, et al. Urine drug screening on labor and delivery. Am J Obstet Gynecol MFM. 2022;4(6):100733. doi:10.1016/j.ajogmf.2022.100733

5. Madora M, Wetzler S, Jose A, Bernstein PS. Pregnant and postpartum people with substance use disorders: understanding the obstetrical care provider’s roles and responsibilities. Matern Child Health J. 2022;26(7):1409–1414.

6. Whittaker A. Guidelines for the identification and management of substance use and substance use disorders in pregnancy. By World Health Organization. Geneva, Switzerland: WHO Press; 2014. Drug Alcohol Rev. 2015;34(3):340–341.

7. Hostage JC, Brock J, Craig W, Sepulveda D. Integrating screening, brief intervention and referral to treatment for substance abuse into prenatal care [3L]. Obstet Gynecol. 2018;131:129S–130S.

8. Chasnoff IJ, Wells AM, McGourty RF, Bailey LK. Validation of the 4P’s Plus© screen for substance use in pregnancy. J Perinatol. 2007;27(12):744–748.

9. Ulrich M, Memmo EP, Cruz A, Heinz A, Iverson RE. Implementation of a universal screening process for substance use in pregnancy. Obstet Gynecol. 2021;137(4):695–701.

Advocacy in Action: A Spotlight on the USC Street Medicine Team

Nina DeJonghe, MPP
Nina is the Director of Government Relations for the Council of Academic Family Medicine (CAFM). Her work supports academic family medicine issues, including graduate medical education, primary care research funding, the healthcare workforce and increasing access to primary care physicians to improve health outcomes.


In October of 2023, I visited STFM member Jehni Robinson, MD, FAAFP, Chair of the Department of Family Medicine at the Keck School of Medicine at the University of Southern California (USC). Upon becoming chair, Dr Robinson secured funding to create a street medicine team at USC. After which, she partnered with a local county hospital to provide services to more than 60,000 unhoused people.

The USC street medicine team focuses on treating unhoused patients whose needs are often overlooked, if not ignored entirely. I was invited to make rounds to witness firsthand the incredible work the family medicine department does within the community.

Over five hours, we visited several areas throughout South LA. I watched as the team conducted evaluations on new and existing patients, provided wound care, reinstated Medi-Cal insurance, administered medications, and handed out necessities. The providers were compassionate, patient, and kind. The patients were treated with humility, dignity, and the utmost respect. During rounds, we learned a long-term patient was moving into a shelter later that week, which was great news. I held an internal moment of celebration for them, as waitlists for shelters can be extensive. It’s important to note that shelters, while not a long-term solution, provide an important step forward for those experiencing homelessness.

Through Dr Robinson’s leadership with California’s Department of Health and Human Services, and work of the USC street medicine team, physicians in the state are now able to seek Medicare reimbursement of medically necessary professional services to unsheltered homeless individuals, if this care is provided in a “non-permanent” location or found environment.

Since visiting USC, I have spent significant time reflecting on this transformative experience. The street medicine team embodies the spirit of Family Medicine through their dedication, compassion, and unwavering patient support. The contributions of Dr. Robinson and USC’s team are admirable; I am grateful to have had the opportunity to spend time observing their commendable work.

Ready to Make a Difference?

STFM will be working with Water Drop LA to assemble care packages on-site at the 2024 STFM Annual Spring Conference. You can purchase items on the Amazon wish list or bring them with you to the conference.

View the Amazon Wishlist

A room will be available at the conference hotel for attendees to assemble care packages during refreshment breaks. Representatives from Water Drop LA will also be on-site to share more about the organization.

Sunday, May 5 from 9:50 to 10:50 am
Monday, May 6 from 10:15 to 11:15 am and 12:45 to 1:45 pm
Tuesday, May 7 from 9:50 to 10:50 am and 2:45 to 3:15 pm

Water Drop LA is a 100% volunteer-run community organization whose mission is to provide clean water and other necessities to communities facing water inaccessibility. By distributing 2,000+ gallons of water to Skid Row each week and by providing water to our partner organizations across Southern California, Water Drop aims to support existing organizers and to meet the immediate needs of the community