Perinatal OUD Treatment Provider Understandings of Rural Patients’ Experiences

Leiner, Catherine; Antono, Brian; Ostrach, Bayla

doi:10.1097/adm.0000000000000858

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…The child abuse protection and treatment act (CAPTA) is a law that requires physicians to report substance use, and most hospitals are required to test for substance use upon delivery (Leiner et al, 2021; Ostrach & Leiner, 2019). Pregnant populations are well-aware that this reporting occurs, contributing to problems with continuity of care or avoidance of treatment altogether (Leiner et al, 2022).…”

Section: Resultsmentioning

confidence: 99%

“…Another common legal concern expressed by PWUD who are also caretakers was the fear of custody rights being revoked (Leiner et al, 2022). The potential penalties for engaging in illegal substance use keep PWUD from seeking treatment as a way to avoid being identified and having the Department of Social Services (DSS) become involved (Davis et al, 2018; Ibragimov et al, 2021; Ostrach & Leiner, 2019).…”

Section: Resultsmentioning

confidence: 99%

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Barriers to utilizing substance use disorder treatment and harm reduction services in Appalachia.

Wilson,

Brown

2024

Journal of Rural Mental Health

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Substance use progressively raises concerns across the United States. The Appalachian region has been noted for having substantial issues with substance use partly due to various diseases of despair and socioeconomic hardships. Research indicates that harm reduction services have proven beneficial in mitigating the causes and risks associated with substance use. This literature review explores the significant barriers to accessing substance use disorder treatments in rural Appalachia. A distillation of published, peer-reviewed empirical articles in English was performed by both authors. Selected articles included an analysis of barriers or obstacles to substance use disorder (SUD) treatment from Appalachian stakeholders. The most common barriers to accessing SUD treatment included real or perceived legal consequences, varying levels of stigma, access and resource issues, educational and awareness matters, and impacts stemming from social networks. The chief barriers to seeking SUD include legal repercussions, damaging stigmas, resource deficits, access limitations, and maladaptive social networks. Increased research on barriers to seeking SUD treatment in Appalachia would help with the delivery and efficacy of SUD treatments and harm reduction strategies. Public Health Significance StatementThis review of previously conducted research explores barriers to accessing substance use disorder treatments and harm reduction services in rural Appalachia. The most common barriers to accessing substance use disorder treatments and harm reduction services were potential legal consequences, stigma, lack of transportation, and lack of finances. More research and educational efforts are needed to increase access to these services in Appalachia.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Barriers to utilizing substance use disorder treatment and harm reduction services in Appalachia.

Wilson,

Brown

2024

Journal of Rural Mental Health

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Non-prescribing clinicians' treatment orientations and attitudes toward treatments for opioid use disorder: Rural differences

Brown,

Walters,

Harmer

et al. 2023

Journal of Substance Use and Addiction Treatment

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Project BETTER: A technology-delivered intervention for pregnant people with opioid use disorder (Preprint)

Parlier-Ahmad¹,

Eglovitch²,

Martin³

et al. 2022

Preprint

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BACKGROUND Opioid overdose is a leading cause of pregnancy-associated deaths largely occurring after delivery. Birthing people with opioid use disorder (OUD) face unique stressors during the transition from pregnancy to postpartum that are challenging to recovery and increase overdose risk. Prenatal education is insufficient to prepare birthing people with OUD for the pregnancy-to-postpartum transition. Use of evidence-based, technology-delivered interventions as a supplement to standard prenatal care may provide more robust preparation for those facing this transition. To date, no technology-based interventions specific to the pregnancy-to-postpartum transition for people receiving MOUD have been developed and evaluated. OBJECTIVE The primary aim of this manuscript is to describe the iterative development process of a novel technology-delivered intervention tailored for pregnant people receiving medication for OUD (MOUD) as it underwent refinement in preparation for its subsequent evaluation in a prospective randomized clinical trial. METHODS Three evidence-based technology-delivered intervention modules were developed and are described. Formative data from patients and providers identified module content: 1) recovery-oriented strategies for the pregnancy-to-postpartum transition, 2) guidance around caring for an infant with withdrawal symptoms, and 3) preparation for child welfare interactions. Module content matching these content areas was reviewed in successive rounds by an expert panel and modified by the study team. Then, novel modules were programmed into the web-based, easily accessible platform where information is delivered via professionally produced videos and an interactive narrator using behavioral techniques. Pregnant and postpartum people receiving MOUD pre-tested the modules and provided feedback in semi-structured interviews. Feedback from the expert panel and patient pre-testing is summarized. RESULTS Expert panel members (n=15) including patients, multidisciplinary providers, and technology-based intervention researchers identified module strengths and areas for improvement. Panel members liked the intervention format and the informative content. Primary areas for improvement included adding content, providing more structure to help participants navigate the intervention more easily, and revising language. Pre-testing participant (n=9) qualitative data highlighted four themes: reactions to intervention content, navigability of the intervention, feasibility of the intervention, and recommendation of the intervention. Participants also provided some areas for improvement. All iterative feedback was incorporated into final modules for the prospective randomized clinical trial. CONCLUSIONS When developing technology-delivered interventions tailored for pregnant people receiving MOUD, it is feasible (and recommended) for the intervention to be informed by patient-reported needs and multidisciplinary perspectives. Assessment of intervention feasibility, acceptability, and effectiveness with a large sample in a clinical research setting is warranted.

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Perinatal OUD Treatment Provider Understandings of Rural Patients’ Experiences

Cited by 4 publications

References 33 publications

Barriers to utilizing substance use disorder treatment and harm reduction services in Appalachia.

Barriers to utilizing substance use disorder treatment and harm reduction services in Appalachia.

Non-prescribing clinicians' treatment orientations and attitudes toward treatments for opioid use disorder: Rural differences

Project BETTER: A technology-delivered intervention for pregnant people with opioid use disorder (Preprint)

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