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更好项目:一项针对患有阿片类药物使用障碍的孕妇的以家庭为中心、通过技术提供的干预措施。

Project BETTER: A Family-Centered, Technology-Delivered Intervention for Pregnant People with Opioid Use Disorder.

作者信息

Parlier-Ahmad Anna Beth, Eglovitch Michelle, Martin Sarah, Svikis Dace S, Martin Caitlin E

机构信息

Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA.

School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA.

出版信息

Children (Basel). 2023 Feb 11;10(2):359. doi: 10.3390/children10020359.

Abstract

Birthing people with opioid use disorder (OUD) face unique stressors during the transition from pregnancy to postpartum that can negatively impact the maternal-infant dyad. This study aimed to describe the development of a family-centered, technology-delivered intervention tailored to help pregnant people receiving medication for OUD (MOUD) prepare for this transition. Formative data from patients and providers identified intervention content: (1) recovery-oriented strategies for the pregnancy-to-postpartum transition; (2) guidance around caring for an infant with opioid withdrawal symptoms; and (3) preparation for child welfare interactions. The content was reviewed in successive rounds by an expert panel and modified. Pregnant and postpartum people receiving MOUD pre-tested the intervention modules and provided feedback in semi-structured interviews. The multidisciplinary expert panel members ( = 15) identified strengths and areas for improvement. Primary areas for improvement included adding content, providing more structure to help participants navigate the intervention more easily, and revising language. Pre-testing participants ( = 9) highlighted four themes: reactions to intervention content, navigability of the intervention, feasibility of the intervention, and recommendation of the intervention. All iterative feedback was incorporated into the final intervention modules for the prospective randomized clinical trial. Family-centered interventions tailored for pregnant people receiving MOUD should be informed by patient-reported needs and multidisciplinary perspectives.

摘要

患有阿片类物质使用障碍(OUD)的产妇在从孕期过渡到产后期间面临着独特的压力源,这可能会对母婴二元关系产生负面影响。本研究旨在描述一种以家庭为中心、通过技术提供的干预措施的开发过程,该干预措施旨在帮助接受阿片类物质使用障碍药物治疗(MOUD)的孕妇为这一过渡做好准备。来自患者和提供者的形成性数据确定了干预内容:(1)从孕期到产后过渡的以康复为导向的策略;(2)照顾有阿片类物质戒断症状婴儿的指导;以及(3)为儿童福利互动做准备。专家小组对内容进行了连续几轮审查并进行了修改。接受MOUD的孕妇和产后妇女对干预模块进行了预测试,并在半结构化访谈中提供了反馈。多学科专家小组成员(n = 15)确定了优势和改进领域。主要改进领域包括增加内容、提供更多结构以帮助参与者更轻松地完成干预,以及修改语言。预测试参与者(n = 9)突出了四个主题:对干预内容的反应、干预的可操作性、干预的可行性以及对干预的推荐。所有迭代反馈都被纳入了前瞻性随机临床试验的最终干预模块。为接受MOUD的孕妇量身定制的以家庭为中心的干预措施应以患者报告的需求和多学科观点为依据。

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