Pediatric Primary Care Diagnoses Among Children with Intrauterine Opioid Exposure

Beldick, Stephanie R.; Rohde, Jessica F; Short, Vanessa L.; Abatemarco, Diane J.; Goyal, Neera K.

doi:10.1353/hpu.2023.0011

Cited by 3 publications

(4 citation statements)

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“…Well child care (WCC) represents a critical opportunity for family support (American Academy of Pediatrics, 2023 ). Unfortunately, available studies suggest that despite multiple clinical concerns in infancy and early childhood among these families, attendance to recommended WCC visits is low (Beldick et al, 2023 ; Goyal et al, 2020 ; Jarlenski et al, 2020 ). Parents with OUD have reported their WCC experiences as lacking key aspects of family centeredness such as open communication and personalized care (Short et al, 2019 , 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Group Well Child Care for Mothers with Opioid Use Disorder: Framework for Implementation

Goyal

Gannon

Sood

et al. 2023

Matern Child Health J

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Objective For parents with opioid use disorder (OUD) and their children, group well child care (WCC) is an under-studied intervention that may reduce stigma, increase quality of care, and improve clinical outcomes. We explored barriers and facilitators to this intervention using an implementation science framework. Methods A qualitative study was conducted from October 2020–March 2021 as part of the planning phase of a cluster-randomized trial of group WCC. Parent participants were recruited from one urban, university-affiliated OUD treatment center to participate in semi-structured telephone interviews. Eligible parents had a child under two years old and were English speaking. Clinician participants were recruited from a nearby pediatric primary care practice. Inductive thematic analysis of interview responses was led by two investigators using open coding procedures. Results Thirty-one parents and thirteen pediatric clinicians participated in the interviews. Most parents (68%) reported that they would be likely or very likely to bring their child to the OUD treatment center for WCC. Six themes emerged describing perceived implementation barriers, including intervention difficulty, complexity, and potential negative outcomes such as loss of privacy. Six themes emerged as implementation facilitators: (1) focus on parental OUD and recovery, (2) peer support, (3) accessibility and coordination of care, (4) clinician skill and expertise in parental OUD, (5) increased time for patient care, and (6) continuity of care. Conclusions for Practice Parents and clinicians expressed multiple perceived benefits of this intervention. Identified barriers and facilitators will inform implementation and evaluation of group WCC within one OUD treatment program.

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Section: Introductionmentioning

confidence: 99%

Group Well Child Care for Mothers with Opioid Use Disorder: Framework for Implementation

Goyal

Gannon

Sood

et al. 2023

Matern Child Health J

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“…This consists of an initial 30-min newborn visit usually within 2-3 days after discharge at the affiliated pediatric primary care office, with any additional 15-min visits in the first few weeks of life as needed, i.e., for jaundice or a weight check. Beginning with the 1-month WCC visit, mother-infant dyads grouped by birth month (anticipated n = 3-5 per group) are scheduled for WCC together, with subsequent visits occurring at the American Academy of Pediatrics recommended intervals (2,4,6,9,12,15, and 18 months of age). Group WCC visits occur on-site at the opioid treatment program.…”

Section: Intervention Description {11a}mentioning

confidence: 99%

“…Newborns are scheduled for an initial 30-min visit within 3-5 days after discharge home, with any additional 15-min visits in the first few weeks of life as needed (i.e., for jaundice or a weight check). Subsequent 15-min WCC visits occur at recommended intervals per American Academy of Pediatrics recommendations (1,2,4,6,9,12,15,18,24,30, and 36 months of age). Routine care in this practice setting includes maternal depression screening, provision of books as part of a national literacy promotion program, developmental screening, and social determinants of health screening.…”

Section: Control Descriptionmentioning

confidence: 99%

“…WCC visits, which occur at age-specific intervals defined by the American Academy of Pediatrics, emphasize anticipatory guidance, psychosocial screening, connection to community resources, and assessments of child growth, health, development, and behavior. There is evidence that WCC could be improved for children impacted by maternal OUD, who often experience multiple clinical and psychosocial concerns in infancy and early childhood such feeding difficulties, hepatitis C exposure, and developmental delays [ 4 ]. Despite these concerns, low attendance to WCC for this patient population has been reported [ 5 ], and mothers with OUD have described traditional WCC visits in the pediatric primary care setting as limited in time and resources to comprehensively address their questions and needs [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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The Child Healthcare at MATER Pediatric Study (CHAMPS): a 2-arm cluster randomized control trial of group well child care for mothers in treatment for opioid use disorder and their children

Short

Abatemarco

Sood

et al. 2023

Trials

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Background Studies suggest that group-based well child care—a shared medical appointment where families come together as a group to receive pediatric primary care—increases patient-reported satisfaction and adherence to recommended care. Evidence supporting the use of group well child care for mothers with opioid use disorder, however, is lacking. The overall objective of the Child Healthcare at MATER Pediatric Study (CHAMPS) trial is to evaluate a group model of well child care for mothers with opioid use disorder and their children. Methods CHAMPS is a single-site 2-arm cluster randomized controlled trial. A total of 108 mother–child dyads will be enrolled into the study. Twenty-six clusters of approximately 4 mother-infant dyads each will be randomized 1:1 to one of two study arms (intervention or control). Clustering will be based on child’s month of birth. In the intervention arm, group well child care will be provided on-site at a maternal substance use disorder treatment program. Mother–child dyads in the control arm will receive individual well child care from one nearby pediatric primary care clinic. Dyads in both study arms will be followed prospectively for 18 months, and data will be compared between the two study arms. Primary outcomes include well child care quality and utilization, child health knowledge, and parenting quality. Discussion The CHAMPS trial will provide evidence to determine if a group well child care offered on-site at an opioid treatment program for pregnant and parenting women is beneficial over individual well child care for families impacted by maternal opioid use disorder. Trial registration ClinicalTrials.gov identifier: NCT05488379. Registered on Aug. 04, 2022.

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Pediatric Primary Care of Children With Intrauterine Opioid Exposure: Survey of Academic Teaching Practices

Rohde,

Chaiyachati,

Demharter

et al. 2024

Academic Pediatrics

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Pediatric Primary Care Diagnoses Among Children with Intrauterine Opioid Exposure

Cited by 3 publications

References 0 publications

Group Well Child Care for Mothers with Opioid Use Disorder: Framework for Implementation

Group Well Child Care for Mothers with Opioid Use Disorder: Framework for Implementation

The Child Healthcare at MATER Pediatric Study (CHAMPS): a 2-arm cluster randomized control trial of group well child care for mothers in treatment for opioid use disorder and their children

Pediatric Primary Care of Children With Intrauterine Opioid Exposure: Survey of Academic Teaching Practices

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