Department of Pediatrics, West Virginia University, Morgantown, WV, USA.
Center for Excellence in Disabilities, West Virginia University, Morgantown, WV, USA.
Womens Health (Lond). 2024 Jan-Dec;20:17455057241278858. doi: 10.1177/17455057241278858.
Women experiencing substance use during their pregnancies or after the birth of a child report being fearful of losing their children based on care, stigmatized when seeking assistance, and barriers to care such as having to provide the same information to different providers, and having to repeat their lived experiences with substance use in detail. Particularly these service barriers can be confusing, complicated, and difficult to follow, which could lead to non-compliance or not seeking services.
We evaluated components of a service coordination program for women experiencing substance use, their children, and larger families who help with caregiving. We examined stakeholder interest in the program, feasibility providing services over time, and initial program effectiveness.
Participant enrollment and outcomes as well as service coordination activities provided over a 4-year period was gathered across three demonstration site locations (a birthing hospital, reunification program, and home visiting program).
Program information was gathered from needs assessment data, health survey data from enrolled caregivers and infants, training evaluations, and budget recordings of direct aid. In this mixed method design, we examined potential differences between baseline and the last assessment for women and children enrolled in the program. We also utilized univariate analyses of variance to examine the main effects of maternal and infant characteristics on final maternal and infant outcomes.
Three sites enrolled 182 women and families for program services. Patient navigators provided direct aid, training, goal setting, and service coordination and planning. Families remained in the program, on average, 655 days and were satisfied with the services received. Respondents thought the program elements were easy to implement within the rural setting. The program effectively addressed basic needs, violence ( < 0.001; η = 0.34 (0.05-0.53)), infant development ( < 0.02; η = 0.51 (0.13-0.61)), and maternal depression ( < 0.05; η = 0.9 (0.00-0.22)). Select outcomes did differ by site.
A service coordination model utilizing a patient navigator role to coordinate client services coupled with an approach that serves the infant and caregiver needs was feasible and desirable by all stakeholders within a rural setting. Service coordination effectively impacted select caregiver and infant outcomes.
在怀孕期间或孩子出生后使用药物的女性报告说，由于担心失去孩子的抚养权，她们害怕寻求帮助，同时也面临着一些服务障碍，例如需要向不同的提供者提供相同的信息，并且需要详细重复她们的药物使用经历。特别是这些服务障碍可能令人困惑、复杂且难以遵循，这可能导致不遵守或不寻求服务。
我们评估了一个为正在使用药物的女性、她们的孩子以及帮助照顾孩子的大家庭提供服务的协调计划的组成部分。我们研究了利益相关者对该计划的兴趣、随着时间的推移提供服务的可行性以及该计划的初步效果。
在四年期间，在三个示范地点（一家分娩医院、团聚计划和家访计划）收集参与者的入组情况和结果以及提供的服务协调活动。
通过需求评估数据、入组照顾者和婴儿的健康调查数据、培训评估以及直接援助的预算记录来收集计划信息。在这种混合方法设计中，我们检查了参加该计划的女性和儿童的基线和最后评估之间的潜在差异。我们还使用单变量方差分析来检查母婴特征对最终母婴结局的主要影响。
三个地点共为 182 名女性和家庭提供了计划服务。患者导航员提供了直接援助、培训、目标设定以及服务协调和规划。家庭平均在该计划中停留 655 天，对所接受的服务感到满意。受访者认为该计划元素在农村环境中易于实施。该计划有效地满足了基本需求、解决了暴力问题（ < 0.001；η = 0.34（0.05-0.53））、促进了婴儿的发展（ < 0.02；η = 0.51（0.13-0.61））以及缓解了母亲的抑郁（ < 0.05；η = 0.9（0.00-0.22））。一些结果因地点而异。
在农村环境中，利用患者导航员角色协调客户服务的服务协调模型，以及一种满足婴儿和照顾者需求的方法，对所有利益相关者来说都是可行和可取的。服务协调有效地影响了特定的照顾者和婴儿的结果。
