Improved neonatal outcomes were found among babies whose mothers received substance abuse treatment integrated with prenatal care. The babies of SAT women did as well as control infants on rates of assisted ventilation, low birth weight, and preterm delivery. They had lower rates of these three neonatal outcomes than infants of either SA or S women.

The Philadelphia ACE Task Force is a community based collaborative of health care providers, researchers, community-based organizations, funders, and public sector representatives. The mission of the task force is to provide a venue to address childhood adversity and its consequences in the Philadelphia metropolitan region. In this article we describe the origins and metamorphosis of the Philadelphia ACE Task Force, which initially was narrowly focused on screening for adverse childhood experiences (ACEs) in health care settings but expanded its focus to better represent a true community-based approach to sharing experiences with addressing childhood adversity in multiple sectors of the city and region. The task force has been successful in developing a research agenda and conducting research on ACEs in the urban context, and has identified foci of local activity in the areas of professional training and workforce development, community education, and local practical interventions around adversity, trauma, and resiliency. In this article we also address the lessons learned over the first 5 years of the task force's existence and offers recommendations for future efforts to build a local community-based ACEs collaborative.

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A growing body of evidence on the inequitable distribution of adverse childhood experiences (ACEs; e.g., Merrick et al., 2018) and their impact throughout the life-course (e.g., Metzler et al., 2017) has highlighted the need to focus on their underlying causes (Ellis & Dietz, 2017). This increasing recognition of ACEs as a preventable public health problem (Bellis et al., 2019) with roots in the community environment has spurred collective responses (e.g., Srivastav et al., 2020), including the emergence of multisector, community-based networks organized to address ACEs and trauma and foster resilience, or “ATR networks” (Jones et al., 2017). ATR networks provide a platform for psychologists to contribute their theoretical, clinical, and research skills to community-level ACEs prevention and mitigation efforts collectively designed by a diverse group comprising professionals from a range of disciplines, advocates, grass-roots leaders, and community residents. Using evidence from an evaluation of Mobilizing Action for Resilient Communities, a recent multisite initiative of 14 ATR networks, this article describes the structure, operation, and accomplishments of these networks to make a case for the ways in which psychologists, working with other professionals and grassroots leaders, can contribute to these efforts. Findings highlight how sectors in which psychologists typically work, play pivotal roles in ATR networks, the ways in which network members in these sectors both influence and are influenced by the networks, and the types of outcomes achieved by the networks within these sectors. Suggestions are offered for the roles psychologists can play to enhance network efforts.

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Maternal substance abuse is a serious problem with significant adverse effects to mothers, fetuses, and children. The Early Start Program provides pregnant women in a managed care organization with screening and early identification of substance abuse problems, early intervention, ongoing counseling, and case management by a licensed clinical social worker located in the prenatal clinic, where she is an integral part of the prenatal team. We describe the development of the Early Start Program, its administrative history, and how it has interfaced with clinicians and administrators. We also highlight two important program characteristics: the partnership with a perinatal health services research unit and the degree to which the program could be "exported" to other managed care settings.

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The use of chart reviews to assess substance use one-year postpartum was examined in this pilot study by comparing interviews with chart reviews for 23 women assessed positive for risk during pregnancy. There was no indication that providers asked about alcohol use in 83 percent of the charts, drug use in 57 percent of the charts, and tobacco use in 26 percent of the charts. Few positive or negative matches between interviews and chart reviews were found because substance use was generally not noted. These findings underscore the need to interview women to obtain postpartum substance use information and suggest that providers may not adequately address this issue.