Policy perceptions of US state public health and child and family services regarding maternal opioid use and neonatal exposure

Scott, Lisa Fath; Stone, Cynthia; Duwve, Joan

doi:10.1016/j.apnu.2019.04.002

Cited by 6 publications

(6 citation statements)

References 21 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Case management, in the form of care coordination or patient navigation models, has also shown to improve success in recovery, [28][29][30][31] but often are limited due to structural impacts from federal, state, or local policies around issues such as housing and provider shortages. 3,4 Differences in access to treatment and ancillary services were also evident in our study by county of residence, with rural counties significantly affected by lack of access to treatment options, housing, and the necessary infrastructure to support parenting individuals in recovery. The literature has supported these observations, with a stark difference in access for care, treatment, and support for rural communities.…”

Section: Discussionmentioning

confidence: 58%

“…Although colocated or combined services for prenatal care and substance use treatment have been shown to be promising, 26,27 gaps still exist in transitions of care. Case management, in the form of care coordination or patient navigation models, has also shown to improve success in recovery, 28–31 but often are limited due to structural impacts from federal, state, or local policies around issues such as housing and provider shortages 3,4 . Differences in access to treatment and ancillary services were also evident in our study by county of residence, with rural counties significantly affected by lack of access to treatment options, housing, and the necessary infrastructure to support parenting individuals in recovery.…”

Section: Discussionmentioning

confidence: 63%

“…However, current efforts to support pregnant and parenting people with OUD have largely not been successful at promoting a lasting recovery. Several factors have been highlighted as contributing to the lack of success at the policy level, including barriers to care, access to services, provider shortages, stigma, and legal repercussions 3,4 . Additionally, there has been limited emphasis on social determinants of health and their impacts on those with OUD who are working towards recovery 5,6 .…”

mentioning

confidence: 99%

See 2 more Smart Citations

Community-led Priority Setting for Opioid Use Disorder in Pregnancy and Parenting

Altman

Busse

Kim

et al. 2020

Journal of Addiction Medicine

View full text Add to dashboard Cite

Objectives: To engage community members with opioid use disorder (OUD) and case managers working with pregnant and parenting individuals with OUD in a priority setting process to identify the key priorities for research, policy, and care improvement during pregnancy, birth, and postpartum. Methods: We conducted focus groups across Washington State with pregnant and parenting people with OUD and with case managers working with this community as part of research priority setting using the validated Research Prioritization by Affected Communities protocol. Priorities for research, policy, and service improvement were developed during each focus group by the participants. Results: Three focus groups with pregnant and parenting people with OUD and 2 focus groups with case managers were conducted (total N ¼ 24 and 16, respectively). Both prioritized topics such as stigma and bias, housing, access to treatment, and steps toward successful recovery. The community and case manager groups shared similar, complementary strategies for each priority, with differences reflecting their perspectives in relation to OUD. Conclusions: Community-engaged priority setting among those with OUD was an effective and meaningful way to guide future research, policy, and care improvement efforts.

show abstract

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 63%

mentioning

confidence: 99%

See 1 more Smart Citation

Community-led Priority Setting for Opioid Use Disorder in Pregnancy and Parenting

Altman

Busse

Kim

et al. 2020

Journal of Addiction Medicine

View full text Add to dashboard Cite

show abstract

“…23 Studies of provider attitudes have shown that stigmatizing beliefs contribute to suboptimal care for patients with SUDs. 12,24,25 Service-learning has been shown to be an effective educational tool to address this issue. One study demonstrated positive changes in attitudes toward individuals experiencing homelessness, a similarly vulnerable population that is often stigmatized, after service-learning experiences.…”

Section: Discussionmentioning

confidence: 99%

Impact of Cuddler Service-Learning Program in Medical Student Education of Opioid use Disorder in Pregnancy and Neonatal Opioid Withdrawal Syndrome

et al. 2021

View full text Add to dashboard Cite

Background Given the increasing incidence of neonatal opioid withdrawal syndrome (NOWS), medical student training on substance use disorders (SUDs) and opioid use disorder (OUD) in pregnancy must be augmented. Through the Cuddling Assists in Lowering Maternal and Infant Stress (CALM) service-learning program, medical students attend SUD-related didactics and provide monthly cuddling services to infants with NOWS. Objective: This study examines the impact of CALM on medical students’ attitudes toward individuals with SUDs and self-reported comfort with clinical skills related to caring for this population. Methods Self-reported pre- and post-survey data was collected at the beginning and end of an academic year from the intervention group, CALM cuddlers, and the control group, non-cuddlers for 2 years. Mean total survey scores and individual survey questions using a 3-point Likert scale were compared before and after 1 year of participation for cuddlers and for non-cuddlers using paired t-tests and two sample t-tests. Results The mean total score increased for cuddlers after participation in the intervention (MD 0.13, SD 0.26, p = 0.03). Mean scores for the comfort-related subset of questions also increased significantly for cuddlers after participation in the intervention (MD 0.22, SD 0.41, p = 0.01). Cuddlers felt more comfortable discussing substance use with appropriate language (72.0% vs 51.5%, p = 0.03), talking with patients about substance use (72.0% vs 36.0%, p = 0.01), and asking about substance use or recovery (80.0% vs 48.0%, p = 0.01). Conclusion OUD- and NOWS-related service-learning positively impacts student attitudes and self-reported comfort with skills related to caring for individuals with SUDs, such as communicating about substance use.

show abstract

“…Motivation to seek treatment for OUD can increase during pregnancy because of the desire to protect the fetus and parent the future child 4 . Unfortunately, the opportunity to engage individuals in treatment for OUD during pregnancy has not been fully realized because of several identified barriers, such as poor access to services, lack of trained providers, stigma, and legal ramifications of OUD 5,6 . Parents with OUD have been shown to avoid care as a result of guilt, shame, embarrassment, fear of judgment from health care providers, criminalization, and loss of custody of their children 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Nurses’ Priorities for Improving Pregnancy and Birth Care for Individuals with Opioid use Disorder

Busse

Kim

Unite

et al. 2021

J Midwife Womens Health

View full text Add to dashboard Cite

Introduction The motivation to seek treatment for opioid use disorder (OUD) can increase during the perinatal period. However, several identified barriers, such as poor access to services, lack of trained providers, stigma, and legal ramifications of OUD, limit the ability for individuals with OUD to receive safe and supportive care during pregnancy and birth. During the birth hospital stay in particular, nurses provide the majority of care for pregnant and birthing families. We aimed to engage nurses, with experience caring for pregnant and postpartum individuals with OUD, in priority setting as a way to identify areas of need in the current health care systems. Methods Using community‐engaged priority setting methods, we recruited a sample of 47 nurses (phase 1) and 20 nurses (phase 2), including nurse‐midwives and other advanced practice nurses, at a statewide nursing conference, who reported regularly providing care for pregnant and postpartum individuals with OUD. We invited participants to submit questions and concerns regarding the provision of care for individuals with OUD (phase 1). A selection of those who submitted questions attended a focus group to rank and prioritize submitted questions into a set of priorities for research, policy, and care improvement (phase 2). Results In phase 1, participants submitted a total of 165 questions and concerns. In phase 2, participants prioritized the following: funding to support improvements in OUD care in the perinatal period, increased access to services, supportive housing for individuals in recovery, standardization of care for individuals with OUD, and efforts to destigmatize care. Discussion Nurses who work with pregnant and postpartum individuals with OUD have a unique insight as to how health care providers, including midwives, can better support this community and should be engaged setting priorities for research, changes to policy, and improvement in care.

show abstract

Policy perceptions of US state public health and child and family services regarding maternal opioid use and neonatal exposure

Cited by 6 publications

References 21 publications

Community-led Priority Setting for Opioid Use Disorder in Pregnancy and Parenting

Community-led Priority Setting for Opioid Use Disorder in Pregnancy and Parenting

Impact of Cuddler Service-Learning Program in Medical Student Education of Opioid use Disorder in Pregnancy and Neonatal Opioid Withdrawal Syndrome

Nurses’ Priorities for Improving Pregnancy and Birth Care for Individuals with Opioid use Disorder

Contact Info

Product

Resources

About