Research examining health conditions unique to women, more prevalent in women, or affecting women differently than men have been at the heart of Women’s Health Research at Yale since its founding in 1998. The center’s innovative Pilot Project Program is one essential mechanism for promoting such research by providing competitive funding to faculty investigators with new and important projects for improving the health of women.
Recently, two year-long projects were selected by the center’s interdisciplinary Scientific Review Committee composed of Yale scientists, which reviews all proposals submitted to Women’s Health Research at Yale. The 2024 research awards are “Long-Acting Degradable Implants for Endometriosis Treatment” and “Mobile Care for Women with a History of Justice Involvement.”
“Both of these pilot projects have the potential to determine how best to respond to critical concerns for women,” said Carolyn M. Mazure, PhD, Norma Weinberg Spungen and Joan Lebson Bildner Professor of Women’s Health Research, professor of psychiatry and psychology, and Director of Women’s Health Research at Yale.
Long-Acting Degradable Implants for Endometriosis Treatment
This year’s Wendy U. and Thomas C. Naratil Pioneer Award will provide renowned Bioengineer W. Mark Saltzman, PhD, the opportunity to develop and test long-acting degradable implants designed to treat endometriosis – a painful condition that can also affect the capacity to become pregnant. Endometriosis is a medical condition that only affects women, where tissue similar to the lining of the uterus grows outside of the uterus. As endometriosis most commonly starts in young women, it often interferes with educational opportunities and career performance.
Saltzman’s research team includes Hugh Taylor, MD, Anita O’Keeffe Young Professor and Chair, Department of Obstetrics, Gynecology, and Reproductive Sciences, who has long studied endometriosis. Together, they will determine if endometriosis can be treated noninvasively with a specific estrogen-blocking drug by delivery through a manufactured, degradable, implantable device. Historically, endometriosis was managed by prescribing an estrogen-blocking birth control pill or by invasive surgeries.
“Dr. Saltzman is certainly one of the leading bioengineering figures in this country who has designed amazing drug delivery pathways. We have drugs that we can use for endometriosis, but getting them close to the source of the disease and released in a sustained fashioned has been a major challenge,” said Taylor. “I’m thrilled about our collaboration to engineer a degradable device to slowly deliver a drug right where we want it. It has the potential to be a major advance in the field.”
The team will manufacture the device using polymers – large molecules composed of repeating structural units that are either natural, like DNA or proteins, or synthetic, like plastic and nylon. The three phases of this pilot study include, first, engineering the polymer device and determining the proper dose of the estrogen blocker; discovering the optimal placement for the degradable device; and third, examining the intervention’s efficacy and safety. The device will release the estrogen-blocking drug slowly over time. This would be a novel application of an already FDA-approved drug in the treatment of endometriosis.
“Funding from Women’s Health Research at Yale is a proven method to bring next technology, new solutions, and new innovation forward,” said Saltzman, the Goizueta Foundation Professor for Chemical and Biomedical Engineering. “The goal of the Pilot Project Program is to get you enough of a research runway so that you can prove to other funders the potential impact of your work, enabling you to continue to develop an intervention, with the ultimate goal of getting it to the women who need it most. This Pilot Project Program award gives us a tremendous advantage.”
Mobile Care for Women With a History of Justice Involvement
A second Pilot Project award was provided to Sandra Springer, MD, Professor of Medicine, and Sheela Shenoi, MD, MPH, Associate Professor of Medicine, to determine if a mobile model of healthcare, which can provide medical services in the community, leads to improved health outcomes for women rejoining the community from correctional institutions.
An earlier award to Springer by the National Institute of Drug Abuse (NIDA) underwrote the development of the first legalized combination mobile retail pharmacy and mobile clinic in the United States, called InMOTION. The goal of InMOTION is to increase healthcare access and remove barriers to care by bringing healthcare and medication directly to individuals, wherever they are.
The time of release from incarceration to transitional housing is a particularly difficult adjustment period, and obtaining medical care and medications is often overwhelming. In addition, many women living in transitional housing face restrictions that prevent them from leaving their residences. Consequently, women returning to the community from prison often do not receive the health care and medicine needed, despite having a significantly higher prevalence of chronic disorders such as cardiovascular disease, diabetes, hypertension, obesity, addictive behaviors, and mental health conditions.
“We believe this mobile retail pharmacy and clinic will improve access to whole person healthcare by overcoming barriers that women often face as they reenter the community after incarceration. This includes the major barriers of lack of transportation and substantial stigma,” said Springer.
Working closely with the Connecticut Department of Correction, InMOTION will offer primary and holistic care along with prescription medications where women are living to test the feasibility of mobile medical care to prevent disruptions in care for this population and thus a better outcome.
“Community-based approaches are important strategies to reach women at-risk for poor health outcomes. With the support of Women’s Health Research at Yale, we hope to demonstrate the feasibility of this model of care to improve health outcomes during a tumultuous period for women as they transition to the community,” said Shenoi.
InMOTION is staffed by a pharmacist, clinician, and a medical assistant/community health outreach worker, who provide support and connections to telehealth for specialty services and to non-health care related services. The community health outreach workers provide services off the mobile unit as well, connecting people in need to medical care and social services. During this project, InMOTION will provide essential transitional care to women upon release, as they adjust to transitional housing.
The Power of Research
These new studies are just the latest examples of Women’s Health Research at Yale-funded projects that target improved health for women. Currently, our investigators also are addressing unmet needs in ovarian cancer, perinatal infection, and cardiovascular disease.
“Since our establishment more than 25 years ago, Women’s Health Research at Yale has provided the essential start-up funding researchers need to get their work underway. This funding often represents critical support for the foundation upon which significant scientific breakthroughs are built,” said Mazure.