Women who smoke during pregnancy face psychosocial barriers to cessation, and women with opioid use disorder (OUD) face amplified barriers. We pilot tested a Perinatal Wellness Navigator (PWN) program for a group of high-risk perinatal women ( N = 50; n = 42 with OUD) that consisted of (a) one-on-one tobacco treatment, (b) comprehensive assessment of cessation barriers, and (c) linkage to clinical/social services. Outcome measures were assessed at baseline and postintervention. Participants smoked 10 fewer cigarettes per day ( p = .05) at postintervention and were less dependent on nicotine ( p < .01). Mean postnatal depression scores ( p = .03) and perceived stress ( p = .03) decreased postintervention. Participants received at least one referral at baseline ( n = 106 total), and 10 participants received an additional 18 referrals at postintervention to address cessation barriers. The PWN program was minimally effective in promoting total tobacco abstinence in a high-risk group of perinatal women, but participants experienced reductions in cigarettes smoked per day, nicotine dependence, stress, and depression.

This study investigates trauma exposure as a risk factor for increased parenting stress, controlling for social support utilization and specific caregiver characteristics. Interviews were conducted with 190 caregivers of children ages 3 to 12 in rural Appalachia to determine the prevalence and type of trauma exposure using a trauma detail form, and parenting stress as measured by the Parenting Stress Inventory. Half of the participants reported lifetime exposure to trauma, and 44% reported 3 or more exposures. A similar trend was noted for children with 73% of caregivers reporting more than one child exposure. Logistic regression revealed trauma exposure alone, as compared to trauma related disorder, predicted greater parenting distress; parent's perception of their child as difficult; and increased risk for dysfunctional parent-child relationships. Identifying individual trauma exposure as a family risk factor provides an opportunity for early intervention, and can help indicate relational models of care that are most appropriate for trauma-exposed parents and children.