A pilot multisite study of patient navigation for pregnant women with opioid use disorder

Cochran, Gerald; Smid, Marcela C.; Bryan, M. Aryana; Gordon, Adam J.; Lundahl, Brad; Silipigni, John; Haaland, Benjamin; Tarter, Ralph E.

doi:10.1016/j.cct.2019.105888

Cited by 14 publications

(18 citation statements)

References 59 publications

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Section: Methodsmentioning

confidence: 99%

“…The parent study of the current project was Optimizing Pregnancy and Treatment Interventions for Moms 2.0 (OPTI-Mom 2.0) (NCT03833245), a prospective clinical trial testing the efficacy of a patient navigator intervention to facilitate linkage to MOUD treatment engagement and psychosocial services among PPP-OUD ( 24 ). Details of the protocol can be viewed elsewhere ( 24 ) and are summarized here in brief to relate those most relevant to the current study. OPTI-Mom 2.0 participants included pregnant individuals ≤32 weeks of gestation presenting with OUD at University of Utah Hospital and Magee-Womens Hospital of UPMC, which are tertiary, academic medical centers providing general and specialty services to urban, suburban, and rural populations in Utah and Western Pennsylvania, respectively.…”

Section: Methodsmentioning

confidence: 99%

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Prospective acceptability of digital phenotyping among pregnant and parenting people with opioid use disorder: A multisite qualitative study

et al. 2023

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BackgroundWhile medications for opioid use disorder (MOUD) effectively treat OUD during pregnancy and the postpartum period, poor treatment retention is common. Digital phenotyping, or passive sensing data captured from personal mobile devices, namely smartphones, provides an opportunity to understand behaviors, psychological states, and social influences contributing to perinatal MOUD non-retention. Given this novel area of investigation, we conducted a qualitative study to determine the acceptability of digital phenotyping among pregnant and parenting people with opioid use disorder (PPP-OUD).MethodsThis study was guided by the Theoretical Framework of Acceptability (TFA). Within a clinical trial testing a behavioral health intervention for PPP-OUD, we used purposeful criterion sampling to recruit 11 participants who delivered a child in the past 12 months and received OUD treatment during pregnancy or the postpartum period. Data were collected through phone interviews using a structured interview guide based on four TFA constructs (affective attitude, burden, ethicality, self-efficacy). We used framework analysis to code, chart, and identify key patterns within the data.ResultsParticipants generally expressed positive attitudes about digital phenotyping and high self-efficacy and low anticipated burden to participate in studies that collect smartphone-based passive sensing data. Nonetheless, concerns were noted related to data privacy/security and sharing location information. Differences in participant assessments of burden were related to length of time required and level of remuneration to participate in a study. Interviewees voiced broad support for participating in a digital phenotyping study with known/trusted individuals but expressed concerns about third-party data sharing and government monitoring.ConclusionDigital phenotyping methods were acceptable to PPP-OUD. Enhancements in acceptability include allowing participants to maintain control over which data are shared, limiting frequency of research contacts, aligning compensation with participant burden, and outlining data privacy/security protections on study materials.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Prospective acceptability of digital phenotyping among pregnant and parenting people with opioid use disorder: A multisite qualitative study

et al. 2023

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“…Those who attended substance use treatment program support groups cited their peers as "significant source(s) of support and information, " and many people found comfort in hearing the stories of other births following treatment for OUD (Goodman et al, 2020). One-toone clinical support to assist patients in navigating the healthcare system and other sources of assistance has also been cited as a way to help people engage with medical providers, overcome barriers, and set goals for themselves and their newborns (Cochran et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Stakeholder Perspectives on Advancing Understanding of Prenatal Opioid Exposure and Brain Development From the iOPEN Consortium of the Healthy Brain and Child Development Study

et al. 2021

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Introduction: There is a dire need for research regarding the implications of opioid use during pregnancy on fetal and childhood development to better inform both medical practice and policy. The Healthy Brain and Child Development Study will examine brain and behavioral development from birth through the first decade of life. Due to large scope and anticipated complexity of this initiative, an 18-month planning phase was implemented across 28 sites across the nation. A core element of the Phase I initiative involved the development of Stakeholder Advisory Committees to inform the next phase of the initiative.Methods: Phase I stakeholder meetings were conducted at Oregon Health and Science University, New York University Langone Medical Center, the University of Pittsburgh, and the University of Vermont to better understand perspectives and inform upcoming research. Despite differences in the structure of the stakeholder meetings by site, the overarching goals for the meetings included establishing relationships, gathering input, and learning about research engagement. Documents from each meeting were reviewed for location, duration, attendees, common research themes, and pertinent suggestions for improving research approaches.Results: All stakeholders had high levels of interest in research for pregnant people with substance use disorders and agreed on research priorities including collaboration, connection, communication, and support. Different stakeholders offered unique perspectives on various aspects of study design and themes that emerged through meetings.Discussion: Overall, there was excitement about the research, especially the opportunity to include the voices of people with lived experience; collaboration between providers, peer support specialists, patients, and others; and excitement around contributing to research that could elucidate new and pertinent findings in the realm of addiction medicine and child development. Sites also found that there is mistrust between people with substance use disorder and the medical system, and this could be addressed by including people with lived experience on the research team, forming connections, communicating clearly, training the research team in implicit bias, and practicing trauma-informed care. In conclusion, these stakeholder meetings provided valuable information for structuring upcoming studies; however, researchers would have benefitted from more time and more opportunities for in-person connection.

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“…Details of the study protocol and methods have been reported previously. 5 Participants were recruited from two academic tertiary care medical centers (University of Utah and the University of Pittsburgh). Both centers have perinatal addiction clinics tailored to this population.…”

Section: Methodsmentioning

confidence: 99%

“…Demographics of respondents, including race and ethnicity, were reported, because they are important social determinants of OUD treatment and overdose disparities. [5][6][7] Overdose history was ascertained using the OESWD (Overdose Experiences, Self and Witnessed-Drug Assessment) tool, a validated tool for assessing these events among individuals who use drugs. [8][9][10] Participants completed six questions about prior overdose events at study enrollment, which ranged between 7 and 32 weeks of gestation.…”

Section: Methodsmentioning

confidence: 99%

Nonfatal Overdoses Among Pregnant Individuals With Opioid Use Disorder

Charles

Baylis

Smid

et al. 2023

Obstetrics &Amp; Gynecology

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A pilot multisite study of patient navigation for pregnant women with opioid use disorder

Cited by 14 publications

References 59 publications

Prospective acceptability of digital phenotyping among pregnant and parenting people with opioid use disorder: A multisite qualitative study

Prospective acceptability of digital phenotyping among pregnant and parenting people with opioid use disorder: A multisite qualitative study

Stakeholder Perspectives on Advancing Understanding of Prenatal Opioid Exposure and Brain Development From the iOPEN Consortium of the Healthy Brain and Child Development Study

Nonfatal Overdoses Among Pregnant Individuals With Opioid Use Disorder

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