No abstract

Home visitation interventions show promise for helping at-risk mothers, yet few programs have been developed and evaluated specifically for alcohol and drug-abusing pregnant women. This study examines outcomes among 216 women enrolled in the Washington State Parent-Child Assistance Program, a three-year intervention program for women who abuse alcohol and drugs during an index pregnancy. Pretest-posttest comparison was made across three sites: the original demonstration (1991-1995), and the Seattle and Tacoma replications (1996-2003). In the original demonstration, the client group performed significantly better than controls. Compared to the original demonstration, outcomes at replication sites were maintained (for regular use of contraception and use of reliable method; and number of subsequent deliveries), or improved (for alcohol/drug treatment completed; alcohol/ drug abstinence; subsequent delivery unexposed to alcohol/drugs). Improved outcomes at replication sites are not attributable to enrolling lower-risk women. Public policies and programs initiated over the study period may have had a positive effect on outcomes. Study findings suggest that this community-based intervention model is effective over time and across venues.

No abstract

We examine the efficacy of a paraprofessional advocacy program for improving health and social outcomes of high-risk substance-abusing mothers and their children. This intervention included 3 years of home visitation, advocacy, and connection with appropriate community services. To assess the overall effectiveness of the model, clients were compared to concurrently enrolled controls on a composite variable comprised of indicators of alcohol/drug treatment, abstinence, family planning, child well-being, and connection to services. Clients obtained higher scores, on average, than controls on the composite variable-as well as on every indicator. Clients who spent more time with advocates had more positive outcomes. Results suggest that this paraprofessional advocacy model can help protect the safety of the children of substance-abusing mothers, while helping mothers take the steps they need to take in order to make fundamental changes in their lives.

OBJECTIVES-We examined trends in rates of self-reported pregnancy alcohol use among women in Western Washington. STUDY DESIGN-Between 1989 and 2004 we conducted three studies in Western WashingtonState on problems associated with maternal prenatal alcohol or drug abuse (N = 12,526). To determine study eligibility, we screened hospitalized postpartum women for alcohol and drug use in the month prior to and during pregnancy. We examined trends in alcohol use rates and identified characteristics associated with any drinking and binge drinking (≥ 5 drinks on any occasion). RESULTS-We found a substantial decrease in pregnancy alcohol use between 1989 and 2004(from 30% to 12%) across almost all demographic categories. Binge drinking in the month prior to pregnancy increased significantly among all race categories except Native American.CONCLUSIONS-Increased pre-pregnancy binge drinking rates may estimate alcohol use during very early gestation, and warrant clinical attention because of the potential for fetal alcohol spectrum disorders.