Conceptualizing integrated service delivery for pregnant and parenting women with addictions: Defining key factors and processes

Meixner, Tamara; Milligan, Karen; Urbanoski, Karen; McShane, Kelly

doi:10.1097/02024458-201609000-00008

Cited by 22 publications

(30 citation statements)

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“…Our findings suggest that integrated treatment programs are more likely to approach care in a holistic manner that includes partnering with services that provide support for parenting, child development, and social determinants of health. This is consistent with models of integrated care that highlight the importance of holistic care and attending to the needs of three clients, including mother, child and the mother-child relationship [ 18 ]. We also found, across all participating communities, that the integrated treatment programs occupied central positions within these community care networks, commonly brokering the connections between other service partners.…”

Section: Discussionsupporting

confidence: 82%

“…Prior research has demonstrated the importance of matching services to holistic needs for this population leads to longer retention in treatment and better substance use outcomes [ 37 , 38 ]. The relative frequency of services for parenting, child support and protection, and social services (versus pre-natal, primary and medical care) is particularly interesting in this case as it indicates the successful development of cross-sectoral linkages (described as a core feature of effective integrated treatment by stakeholders in Ontario) [ 18 ]. These findings are notable, given the challenges associated with cross-sector partnerships.…”

Section: Discussionmentioning

confidence: 99%

“…At a conceptual level, integrated treatment programs are guided by a set of core principles and practices, including: care that is holistic, empowering, and tailored to women’s needs; strong investment in staff and organizational health; innovative and coordinated partnerships; and supportive policies from multiple service sectors [ 18 ]. Specific service complements vary but commonly include specialized substance use services, maternal and child mental health care, pre-natal and primary care, child protection services, parenting programs, child-minding, and supports for social determinants of health (e.g., housing, income supports, transportation assistance) [ 3 , 11 , 16 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Community networks of services for pregnant and parenting women with problematic substance use

et al. 2018

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Integrated treatment programs for pregnant and parenting women who use substances operate at the intersection of multiple service systems, including specialized substance use services, the broader health system, child protection, and social services. Our objectives were to describe the composition and structure of community care networks surrounding integrated treatment programs in selected communities in Ontario, Canada. We used a two-stage snowball method to collect network data from 5 purposively selected integrated treatment programs in communities in Ontario. Front-line staff with integrated treatment programs identified their top 5 service partners, who were then contacted and asked to provide the same information (n = 30). We used social network analysis to measure the cohesiveness, reciprocity, and betweenness centrality in the integrated treatment program’s ego network. We described network composition in terms of representation of different service types. Across communities, common service partners were child protection, substance use or mental health services, parenting and child support, and other social services. Primary and pre-natal care, opioid agonist therapy, and legal services were rarely named as partners. Networks varied in network cohesiveness, as indicated by connectivity between the service partners and reciprocal ties to the integrated treatment programs. Integrated treatment programs commonly brokered the connections between other service partners. Findings suggest that these integrated treatment programs have achieved a level of success in developing cross-sectoral partnerships, with child protection services, parenting and child support, and social services featuring prominently in the networks. In contrast, there was a lack of close connections with physician-based services, highlighting a potential target for future quality improvement initiatives in this sector.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Community networks of services for pregnant and parenting women with problematic substance use

et al. 2018

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“…These have been well documented and include: feeling judged by others; fear of child welfare intervention; poor mental health supports; inadequate housing and transportation; lack of child care; and their partner's substance use [1,6,[9][10][11]. Systemic barriers also exist: substance use services and child protection services typically have operated discretely with their own set of goals, policies, philosophies, expectations, and legislative regulations and timelines, resulting in high rates of child apprehensions and reluctance to positively sanction parenting by women who use substances [12][13][14]. Nevertheless, pregnancy has been shown to be a pivotal time when women are interested in contemplating or making a significant life change, partly as a result of their desire to keep their newborn in their care and to regain custody of older children, and thus they are receptive to engaging with services [5,[15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Multi-service prevention programs for pregnant and parenting women with substance use and multiple vulnerabilities: Program structure and clients’ perspectives on wraparound programming

Rutman¹,

Hubberstey²,

Poole

et al. 2020

BMC Pregnancy Childbirth

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Background: In Canada, several community-based, multi-service programs aimed at reaching vulnerable pregnant or parenting women with substance use and complex issues have emerged. These programs offer basic needs and social supports along with perinatal, primary, and mental health care, as well as substance use services. Evaluations of these 'one-stop' programs have demonstrated positive outcomes; nevertheless, few published studies have focused on how these programs are structured, on their cross-sectoral partnerships, and on clients' perceptions of their services. Methods: The Co-Creating Evidence (CCE) project was a three-year evaluation of eight multi-service programs located in six Canadian jurisdictions. The study used a mixed-methods design involving semi-structured interviews, questionnaires, output data, and de-identified client data. This article focuses on qualitative interviews undertaken with 125 clients during the first round of site visits, supplemented by interview data with program staff and service partners. Results: Each of the programs in the CCE study employs a multi-service model that both reflects a wrap-around approach to care and is intentionally geared to removing barriers to accessing services. The programs are either operated by a health authority (n = 4) or by a community-based agency (n = 4). The programs' focus on the social determinants of health, and their provision of primary, prenatal, perinatal and mental health care services is essential; similarly, on-site substance use and trauma/violence related services is pivotal. Further, programs' support in relation to women's child welfare issues promotes collaboration, common understanding of expectations, and helps to prevent child/infant removals. Conclusions: The programs involved in the Co-Creating Evidence study have impressively blended social and primary care and prenatal care. Their success in respectfully and flexibly responding to women's diverse needs, interests and readiness, within a community-based, wraparound service delivery model paves the way for others offering pre-and postnatal programming.

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“…These women enter motherhood with uncertainty, fear, shame, and stress (Cleveland, Bonugli, & McGlothen, 2016). Consequently, although motherhood seems to be a time of increased motivation for entering addiction treatment and changing maladaptive patterns of substance use, treatment engagement could also be limited by barriers related to pregnancy and motherhood (Meixner, Milligan, Urbanoski, & McShane, 2016).…”

Section: Introductionmentioning

confidence: 99%

Profiles of mothers who seek treatment for substance use disorders in a clinical centre

Fernández‐Montalvo

López-Goñi

2019

ADD

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Purpose The purpose of this paper is to explore the prevalence and profile of mothers among women who sought treatment for drug addiction, as well as the therapeutic progression of these patients. Design/methodology/approach A sample of 180 Spanish women with addiction problems was assessed. Information was collected on the patients’ socio-demographic characteristics, consumption variables and psychological symptoms. Findings Of the total sample, 22.2 per cent (n = 40) of the women seeking treatment for substance use disorder were mothers. Compared with women without children, mothers scored significantly higher on several EuropASI and psychological variables. Specifically, mothers presented with more medical problems, worse employment/financial situations, and more severity in alcohol use. Moreover, having a history of lifetime physical and/or sexual abuse was related to belonging to the group of mothers. Regarding therapeutic progression, no statistically significant differences in the retention rate were found between mothers and non-mothers. Originality/value The results of this study show that mothers generally have more severe problems than non-mothers. Therefore, comprehensive, continuum-based, and client-centred care for mothers is paramount for effective treatment in mothers. The implications of these results for further research and clinical practice are discussed.

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Conceptualizing integrated service delivery for pregnant and parenting women with addictions: Defining key factors and processes

Cited by 22 publications

References 0 publications

Community networks of services for pregnant and parenting women with problematic substance use

Community networks of services for pregnant and parenting women with problematic substance use

Multi-service prevention programs for pregnant and parenting women with substance use and multiple vulnerabilities: Program structure and clients’ perspectives on wraparound programming

Profiles of mothers who seek treatment for substance use disorders in a clinical centre

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