Opioid Use Disorder, Postpartum Period, Pregnancy
Conditions
Keywords
HEAL Inititative, HEAL, MOUD, OUD, Pregnancy, Postpartum, Substance
Brief summary
The investigators seek to adapt a collaborative care model (CCM) for community-based, low-resource obstetric settings and to test the effects of this adapted CCM on health outcomes among Pregnant, postpartum, and parenting person (PPPP) with Opioid use disorder (OUD) and their families. To achieve this goal, investigators will conduct a nonrandomized, Type 1 hybrid implementation-effectiveness study across 3 community-based, low-resource obstetric sites in Northwest PA, a region with rates of maternal opioid-related diagnoses 4 times higher than national averages.
Detailed description
Our central hypothesis is that person-centered, recovery supports, provided in the CCM will increase medication for OUD (MOUD) initiation and continuation, decrease overdose and reduce child removal rates among PPPP with OUD. Specifically, investigators will: 1. Conduct an intervention adaptation project to adapt the Pregnancy and Women's Recovery Center (PWRC) CCM for rural and low-resource obstetric settings; and 2. Create a common data model to harmonize variables across data sources and data collection processes across study sites. Investigators will also: 1. Evaluate the effects of the adapted PWRC CCM on outcomes among PPPP with OUD; 2. Determine if improvements in person-centered, recovery supports mediate the relationship between PWRC Community and outcomes using causal mediation methods; and 3. Identify PWRC Community adaptations that are associated with increased MOUD access, improved outcomes and that facilitate sustainability and scalability. Research findings will: 1. provide high-quality evidence on how CCMs affect service delivery and health outcomes for PPPP with OUD, 2. inform stakeholders about ways to adapt CCMs for low-resource and rural healthcare settings, and 3. inform policymakers about the adaptations necessary to replicate these models widely.
Interventions
BEHAVIORALUsual Care
Usual, referral-based, care.
BEHAVIORALAdapted Collaborative Care Model (CCM)
Person-centered, recovery supports.
Sponsors
Magee-Women's Research Institute
National Institute on Drug Abuse (NIDA)
University of Pittsburgh
Study design
Observational model
CASE_ONLY
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(Stakeholder Participant) 1. 18 years or older 2. Providing care at participating obstetric site 3. English speaking (Patient Participant) 1. 18 years or older 2. Receiving care at participating obstetric site 3. English speaking
Exclusion criteria
1\. Unwillingness to have participation audio recorded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient Initiation of Medication for Opioid Use Disorder (MOUD) | During pregnancy (up to 40 weeks), up to 1 year post delivery | Patient Initiation of Medication for Opioid Use Disorder (MOUD) as measured by total buprenorphine or methadone initiation in Electronic Health Record (EHR) and Medicaid claims data |
| Patient Duration of MOUD | During pregnancy (up to 40 weeks), up to 1 year post delivery | Patient Duration of MOUD as measured by proportion of days' covered incorporating buprenorphine or methadone treatment in EHR and claims data |
| Patient Overdose | During pregnancy (up to 40 weeks), up to 1 year post delivery | Patient Overdose as measured by total count of nonfatal or fatal overdose events in EHR and claims data |
| Patient child foster care placement | Delivery through 1 year postpartum | Patient child foster care placement as measured by total child placements in foster care system according to child protective service data linked with Medicaid data |
| Patient utilization of well-child services | Delivery through 1 year postpartum | Patient utilization of well-child services as measured by total well-child visits in EHR and claims data |
Countries
United States
Outcome results
None listed