Peacock-Chambers Elizabeth, Moran Michael, Clark Maria Carolina, Borelli Jessica L, Byatt Nancy, Friedmann Peter D, Suchman Nancy E, Feinberg Emily
Department of Pediatrics, University of Massachusetts Chan Medical School - Baystate Campus, Springfield, MA, USA.
Department of Healthcare Delivery and Population Science, University of Massachusetts Chan Medical School - Baystate Campus, Springfield, MA, USA.
Implement Res Pract. 2023 Jan-Dec;4. doi: 10.1177/26334895221151029. Epub 2023 Jan 22.
The objective of this study was to assess potential challenges, prioritize adaptations, and develop an implementation and research approach to integrate and study a parenting intervention for mothers in recovery from substance use disorders in community-based home-visiting programs.
An explanatory mixed-methods design, guided by process mapping with Failure Modes and Effects Analysis tools, and an Advisory Panel of 15 community members, identified potential implementation challenges and recommended solutions for the proposed intervention within five pre-specified domains. Thematic content analysis identified themes from detailed field notes.
The Advisory Panel identified 44 potential challenges across all domains. They determined that the recruitment domain was most likely to create challenges. Regarding the potential challenges, two cross-domain themes emerged: (1) development of mistrust in the community and (2) difficulty initiating and sustaining engagement. Potential solutions and adaptations to protocols are reported.
Mistrust in the community was cited as a potentially important challenge for the delivery and study of an evidence-based parenting intervention for mothers in recovery through home-visiting programs. Adaptations to research protocols and intervention delivery strategies are needed to prioritize the psychological safety of families, particularly for groups that have been historically stigmatized.
本研究的目的是评估潜在挑战，确定适应措施的优先级，并制定一种实施和研究方法，以整合和研究一项针对从物质使用障碍中康复的母亲的育儿干预措施，并将其纳入基于社区的家访项目中进行研究。
采用解释性混合方法设计，以失效模式与效应分析工具进行流程映射为指导，并组建了由15名社区成员组成的咨询小组，确定了潜在的实施挑战，并针对五个预先指定的领域中拟议的干预措施提出了建议解决方案。主题内容分析从详细的实地记录中确定了主题。
咨询小组在所有领域中识别出44个潜在挑战。他们确定招募领域最有可能产生挑战。关于这些潜在挑战，出现了两个跨领域主题：（1）社区中不信任感的产生；（2）启动和维持参与的困难。报告了针对方案的潜在解决方案和适应措施。
社区中的不信任被认为是通过家访项目为康复中的母亲提供循证育儿干预措施及开展相关研究的一个潜在重要挑战。需要对研究方案和干预实施策略进行调整，以优先保障家庭的心理安全，特别是对于那些历史上受到污名化的群体。
