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Q&A with Ekaterina Burduli

Published February 8, 2022, by Judith Van Dongen

Portrait photo of Eka BurduliThe road to being a scientist isn’t always a straight path. For Eka Burduli, an assistant professor in the College of Nursing who studies the impact of substance use on maternal health outcomes, there were a few twists and turns on her path to academia. It started with a tennis scholarship that brought her to WSU from Israel in 2004. After completing an undergraduate degree in psychology at WSU Pullman and finishing her college tennis career, Burduli spent six years working as an assistant coach for WSU women’s tennis while pursuing a PhD in psychology in her spare time. Her love of academia and interest in research eventually won out, and she quit her coaching job to focus on her PhD before moving to Spokane for a postdoc position.

Where did your interest in substance use and maternal health outcomes come from?
I was born in the country of Georgia to a single mother with whom I had a very close bond. When I was nine years old, we emigrated to Israel, where we spent the next 10 years. This obviously entailed a lot of struggles for her and for us, and so I was always interested in psychology and in women’s issues. While I was in the PhD program, I also got interested in advanced statistics. For my dissertation, I had an opportunity to analyze a data set on birth satisfaction in the US and the UK, and I loved it. It was the perfect merge: a women’s health project that incorporated some advanced analytic techniques that I wanted to do. My interest in substance use came from my postdoc at IREACH—the WSU Institute for Research and Education to Advance Community Health—where I got great experience analyzing clinical trial data on substance use collected in Native communities. Then I connected all of those topics and that’s how my research focus on perinatal substance use—substance use around the time of birth—emerged. There seemed to be a real need for more research in that area, even on our campus where so much great substance use research is being done.

What do you think prompts that need?
One of the topics I focus on is opioid use, which has unfortunately exploded in the general population and has also increased in perinatal women. Treatment entry and retention haven’t caught up with the rise in opioid use disorder. We need more perinatal women who are reporting substance use—and particularly opioid use—to be in evidence-based treatment. However, these women are experiencing barriers that prevent them from accessing treatment or put them at higher risk of dropping out. My goal is to help better prepare them for that critical period from pregnancy to parenthood, which is a challenging time for any woman but especially for women with substance use disorders. The idea is that this would hopefully improve outcomes for both women and children.

What are some of those treatment barriers?
Logistics is one of them—from the logistics around making it to daily or weekly treatment appointments to dealing with the extra hospital care required for infants that may experience withdrawal symptoms. If the mother is the primary caregiver and doesn’t have social support, economic support, and family support, how does she navigate that? Fear of Child Protective Services (CPS) involvement is another driver for women not to seek treatment or drop out. And then there is stigma and judgment in the health care setting. There is a false perception even among some providers that pregnant women with opioid use disorder need to be in detox, but it can be dangerous to withdraw from substances during pregnancy. So the official recommendation for pregnant women with a diagnosed opioid use disorder is opioid agonist therapy, such as methadone or buprenorphine.

How is your research contributing toward better outcomes for these women and their babies?
With funding from the National Institute on Drug Abuse, I’m working on a project to develop a mobile-based caregiving tool to prepare pregnant women who are in treatment for opioid use disorder on how to successfully navigate the perinatal period. Based on a similar tool for NICU nurses and with input gained from interviews with women and providers, I am developing educational modules that address such topics as dealing with stigma and judgment in healthcare settings, navigating CPS involvement, preparing for your delivery, caring for an infant experiencing opioid withdrawal, and so on. Once the final modules are ready, we are going to pilot test the tool in a small clinical trial with 30 women, half of whom will get this tool during pregnancy versus the general information given to the other half. We will follow them until three months after the delivery, tracking outcomes such as treatment retention and drug relapse, but also things like anxiety, depression, postpartum depression, and how well they bond with their babies. The five-year grant that funds this project is a mentored research scientist (K01) award, so it also includes training activities and mentorship aimed at supporting me to become a strong independent investigator.

What has it been like to launch your career as a scientist at WSU?
There is this narrative out there that it is important that you move institutions during your training as a scientist. I’ve spent almost 18 years at WSU—both in Pullman and Spokane—and feel that I have had a wonderful and very diverse experience scientifically. I appreciate all the advice and guidance I’ve gotten on my journey, both from my mentors—especially Celestina Barbosa-Leiker and Sterling McPherson—and from peers like Oladunni Oluwoye. I wouldn’t be where I am today without their support.

This interview has been edited and condensed for clarity.