Opportunities to Increase Well-Child Care Engagement for Families Affected by Maternal Opioid Use Disorder: Perceptions of Mothers and Clinicians

Short, Vanessa L.; Gannon, Meghan; Sood, Erica; Harris, Grace; Kale, Aditi; Abatemarco, Diane J.; Hand, Dennis J.; Goyal, Neera K.

doi:10.1016/j.acap.2022.07.013

Cited by 8 publications

(11 citation statements)

References 35 publications

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“…Even after adjusting for poverty, children with prenatal opioid exposure are less likely to receive recommended WCC 12,13 . Previous exploration of barriers to WCC for mothers in treatment for OUD has revealed stigmatizing experiences in the pediatric office, insufficient time during the encounter, and a perceived lack of relevant anticipatory guidance 9,10 . In our interviews, clinicians emphasized maternal knowledge gaps and low confidence as important aspects of WCC for this population, which may itself reflect clinician bias.…”

Section: Discussionmentioning

confidence: 76%

“…For parents with OUD and their children, risks to child health and development may include ongoing substance use, poverty, parental trauma, social isolation, and stigmatization. Regularly scheduled preventative visits to the pediatrician—or well child care (WCC)—present an understudied opportunity to improve their healthcare 6–9 . The American Academy of Pediatrics promotes anticipatory guidance, screenings, and referral to community-based resources during WCC visits, with more recent recommendations for a dyadic approach for families affected by OUD 7,8 .…”

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confidence: 99%

“…The American Academy of Pediatrics promotes anticipatory guidance, screenings, and referral to community-based resources during WCC visits, with more recent recommendations for a dyadic approach for families affected by OUD 7,8 . However, parents with OUD have reported pediatric experiences that lack enhanced anticipatory guidance and key aspects of family centeredness including open communication, personalized care, and respect 9,10 . Children with prenatal opioid exposure attend fewer WCC visits, despite frequent clinical concerns and higher acute care utilization 11–13 .…”

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confidence: 99%

“…Regularly scheduled preventative visits to the pediatrician-or well child care (WCC)-present an understudied opportunity to improve their healthcare. [6][7][8][9] The American Academy of Pediatrics promotes anticipatory guidance, screenings, and referral to community-based resources during WCC visits, with more recent recommendations for a dyadic approach for families affected by OUD. 7,8 However, parents with OUD have reported pediatric experiences that lack enhanced anticipatory guidance and key aspects of family centeredness including open communication, personalized care, and respect.…”

mentioning

confidence: 99%

“…7,8 However, parents with OUD have reported pediatric experiences that lack enhanced anticipatory guidance and key aspects of family centeredness including open communication, personalized care, and respect. 9,10 Children with prenatal opioid exposure attend fewer WCC visits, despite frequent clinical concerns and higher acute care utilization. [11][12][13] Given a lack of specific WCC guidelines for these families, research is needed to inform visit content and implementation of WCC for these families that is accessible and effective.…”

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confidence: 99%

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Priorities for Well Child Care of Families Affected by Parental Opioid Use Disorder

Goyal,

Sood,

Gannon

et al. 2023

J Addict Med

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Background and Objectives Parenting women in treatment for opioid use disorder (OUD) report a lack of family centeredness and anticipatory guidance within well child care (WCC), and WCC utilization is low among affected children. We explore priorities for WCC visit content to inform primary care recommendations for this population. Methods This study is a qualitative study of parenting women from one urban, academic OUD treatment program and pediatric primary care clinicians from a nearby affiliated pediatric practice. Eligible parent participants had a child ≤2 years old and were English speaking. Semistructured interviews elicited perspectives on WCC, with questions and prompts related to visit content. Inductive thematic analysis was led by 2 investigators using open coding procedures. Results Among 30 parent participants, the majority were White (83%) and unmarried (90%). Approximately 60% reported their child received pharmacotherapy for neonatal opioid withdrawal syndrome. Of 13 participating clinicians, 9 were attending pediatricians. Five themes emerged from parental and clinician interviews: (1) improving knowledge and confidence related to child development, behavior, and nutrition; (2) mitigating safety concerns; (3) addressing complex health and subspecialty needs through care coordination; (4) acknowledging parental health and wellbeing in the pediatric encounter; and (5) supporting health education and care related to neonatal opioid withdrawal syndrome. Parents and clinicians expressed difficulty comprehensively addressing such issues due to time constraints, social determinants of health, and significant informational needs. Conclusions Parenting women in treatment for OUD and pediatric clinicians share multiple priorities for anticipatory guidance within WCC visits and barriers to addressing them comprehensively.

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Section: Discussionmentioning

confidence: 76%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Priorities for Well Child Care of Families Affected by Parental Opioid Use Disorder

Goyal,

Sood,

Gannon

et al. 2023

J Addict Med

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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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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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Opportunities to Increase Well-Child Care Engagement for Families Affected by Maternal Opioid Use Disorder: Perceptions of Mothers and Clinicians

Cited by 8 publications

References 35 publications

Priorities for Well Child Care of Families Affected by Parental Opioid Use Disorder

Priorities for Well Child Care of Families Affected by Parental Opioid Use Disorder

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

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

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