Optimizing Pregnancy Treatment Interventions for Moms (OPTI-Mom): A Pilot Study

Cochran, Gerald; Hruschak, Valerie; Abdullah, Walitta; Krans, Elizabeth E.; Douaihy, Antoine; Bobby, Stephanie; Fusco, Rachel A.; Tarter, Ralph E.

doi:10.1097/adm.0000000000000370

Cited by 28 publications

(23 citation statements)

References 56 publications

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“…9,31,32,40 -43 We examined an increase in different treatment modalities, but most programs strived to be convenient, 5,44 practical, 12,31 and emotionally supportive. 13,31,32 The attention to enhanced convenience was evident in multiple treatment interventions: these program components included child care options, 45 parenting education sessions, 29 case management, 43 and treatment coordination. 19,32,40 The treatment programs attended to the social and psychosocial needs of mothers by focusing on self-sufficiency, 41 integrating family involvement and support, 6 teaching parenting techniques, 29,31,41 providing a linkage to social service agencies, 12 and offering vocational education.…”

Section: Effectiveness Of Interventionsmentioning

confidence: 99%

Differential Gateways, Facilitators, and Barriers to Substance Use Disorder Treatment for Pregnant Women and Mothers: A Scoping Systematic Review

et al. 2022

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ObjectivesAccess to substance use disorder (SUD) treatment is complex, and more so for pregnant women and mothers who experience unique barriers. This scoping systematic review aimed to summarize contemporary findings on gateways, facilitators, and barriers to treatment for pregnant women and mothers with SUD.MethodsWe used the scoping review methodology and a systematic search strategy via MEDLINE/PubMed and Google Scholar. The search was augmented by the similar article lists for sources identified in PubMed. Scholarly and peer-reviewed articles that were published in English from 1996 to 2019 were included. A thematic analysis of the selected studies was used to summarize pathways to SUD treatment and to identify research gaps.ResultsThe analysis included 41 articles. Multiple gateway institutions were identified: health care settings, social service agencies, criminal justice settings, community organizations, and employers. Some of the identified facilitators and barriers to SUD treatment were unique to pregnant women and mothers (eg, fear of incarceration for child abuse). Both personal (emotional support and social support) and child-related factors (loss of children, suspension or termination of parental rights, the anticipation of reuniting with children) motivated women to seek treatment. Major access barriers included fear, stigma, charges of child abuse, inconvenience, and financial hardship.ConclusionsThere has been progress in implementing different types of interventions and treatments for that were attentive to pregnant women and mothers’ needs. We developed a conceptual model that characterized women’s pathways to treatment by deciphering women’s potential engagement in gateway settings.

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Section: Effectiveness Of Interventionsmentioning

confidence: 99%

Differential Gateways, Facilitators, and Barriers to Substance Use Disorder Treatment for Pregnant Women and Mothers: A Scoping Systematic Review

et al. 2022

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“…However, PN has only recently begun to be researched in relation to behavioral health problems [29,[54][55][56], such as smoking cessation improvements [57], HIV management [58] and our team's proof-of-concept study that demonstrated intervention feasibility among pregnant women with OUD. Specifically, our proof-of-concept study findings demonstrated promising initial results for women in a number of behavioral and physical health domains, including improvements in opioid/substance use, mental health, and prenatal care outcomes [20]. This multisite pilot trial study expands upon this previous PN intervention to further establish the internal and external validity of these findings and the potential value of the PN intervention for pregnant women with OUD.…”

Section: Discussionmentioning

confidence: 64%

“…This study is testing a PN intervention for pregnant women with OUD and assessing linkage/retention in care. Importantly, this study builds upon a proof-of-concept project among 21 pregnant women with who were provided the PN intervention that utilized a one-group repeated measures design [20].…”

Section: Introductionmentioning

confidence: 99%

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

Cochran

Smid

Bryan

et al. 2019

Contemporary Clinical Trials

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The opioid crisis continues to affect pregnant and postpartum women the United States, with the number of pregnant women diagnosed with opioid use disorder (OUD) quadrupling over the last decade. The associated increase in morbidity and mortality among mother and baby warrants prompt, targeted intervention efforts that improve engagement, linkage of care, and treatment retention. Patient navigation (PN) is a chronic care intervention that can directly address this need by helping women identify medical, behavioral, and psychosocial care goals. Moreover, PN can assist women in preparing for, engaging in, and maintaining patient participation in necessary services. Specifically, PN includes strengths-based case management, 1-1 clinical support, motivational interviewing, and addiction-relapse prevention programming. The objective of this article is to present the study protocol of a pilot multisite randomized clinical trial, entitled: Optimizing Pregnancy and Treatment Interventions for Moms 2.0 (OPTI-Mom 2.0; NCT03833245). In this study, we build upon a proof-of-concept study, employing evidenceinformed frameworks for protocol and intervention expansion in order to construct a PN *

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“…Parents with OUD have been shown to avoid care as a result of guilt, shame, embarrassment, fear of judgment from health care providers, criminalization, and loss of custody of their children 7,8 . Health care workers, including midwives, should approach individuals and families experiencing OUD with compassion, understanding, and the use of a comprehensive care model consisting of medication‐assisted therapy (MAT), 9 concomitant psychiatric care, 10,11 and a focus on progression rather than complete substance abstinence. The use of such a model has been shown to improve maternal and infant outcomes 8,9,12 .…”

Section: Introductionmentioning

confidence: 99%

Nurses’ Priorities for Improving Pregnancy and Birth Care for Individuals with Opioid use Disorder

Busse

Kim

Unite

et al. 2021

J Midwife Womens Health

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Introduction The motivation to seek treatment for opioid use disorder (OUD) can increase during the perinatal period. However, several identified barriers, such as poor access to services, lack of trained providers, stigma, and legal ramifications of OUD, limit the ability for individuals with OUD to receive safe and supportive care during pregnancy and birth. During the birth hospital stay in particular, nurses provide the majority of care for pregnant and birthing families. We aimed to engage nurses, with experience caring for pregnant and postpartum individuals with OUD, in priority setting as a way to identify areas of need in the current health care systems. Methods Using community‐engaged priority setting methods, we recruited a sample of 47 nurses (phase 1) and 20 nurses (phase 2), including nurse‐midwives and other advanced practice nurses, at a statewide nursing conference, who reported regularly providing care for pregnant and postpartum individuals with OUD. We invited participants to submit questions and concerns regarding the provision of care for individuals with OUD (phase 1). A selection of those who submitted questions attended a focus group to rank and prioritize submitted questions into a set of priorities for research, policy, and care improvement (phase 2). Results In phase 1, participants submitted a total of 165 questions and concerns. In phase 2, participants prioritized the following: funding to support improvements in OUD care in the perinatal period, increased access to services, supportive housing for individuals in recovery, standardization of care for individuals with OUD, and efforts to destigmatize care. Discussion Nurses who work with pregnant and postpartum individuals with OUD have a unique insight as to how health care providers, including midwives, can better support this community and should be engaged setting priorities for research, changes to policy, and improvement in care.

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Optimizing Pregnancy Treatment Interventions for Moms (OPTI-Mom): A Pilot Study

Abstract: These findings provide support that PN is a feasible adjunctive intervention that shows promise for health improvements and service engagement among treatment-seeking pregnant women with opioid dependence initiating buprenorphine.

Cited by 28 publications

References 56 publications

Differential Gateways, Facilitators, and Barriers to Substance Use Disorder Treatment for Pregnant Women and Mothers: A Scoping Systematic Review

Differential Gateways, Facilitators, and Barriers to Substance Use Disorder Treatment for Pregnant Women and Mothers: A Scoping Systematic Review

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

Nurses’ Priorities for Improving Pregnancy and Birth Care for Individuals with Opioid use Disorder

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