Prevention, Intervention and Evaluation of Maternal Child Health Programs and Practices

PowerPoint presentation given by Diane Abatemarco, PhD, MSW

Understanding Social Needs of Families with Young Overweight Children in an Urban Primary Care Setting: A Mixed-Methods Study

Unmet social needs, such as stable housing, reliable access to food and treatment of parental depression are associated with childhood overweight. Little information exists on parental perception of addressing these needs. We sought to understand the perspective of parents of young overweight children on how to best address social needs in the primary care setting. We conducted a mixed-methods study. The 11-item WE CARE survey, PHQ-2, and 2-item food insecurity screener were used to screen for social needs. Semi-structured interviews were conducted with English-speaking parents of overweight (BMI ≥ 85%) children 2-5 years of age with Medicaid. Interviews assessed parental perception about addressing social needs in the primary care setting. Twenty-two parents participated. Parents responded positively to having a social need 46 times on the WE CARE survey, with the majority being in the areas of smoking cessation and employment. However, parents reported that they did not want to address the majority of these needs at the visit. Only 2 of 11 parents who screened positive for depression on the PHQ-2 endorsed wanting help to address mood, and only 1 in 10 who screened positive for food insecurity endorsed wanting help accessing food. Two salient themes arose during the interviews that influence asking for support: 1) level of comfort disclosing needs and 2) family resourcefulness and resiliency. Discomfort was associated with parental fear of being considered neglectful and involvement of child protective services. Though a majority of parents found the screener to be useful, they suggested reframing to highlight support available, emphasizing how resources may benefit the child. Screening tools may benefit from adaptation for families are uncomfortable asking for support or who are resourceful at meeting their needs. Emphasizing the non-punitive nature and providing information on resources upfront may promote resource utilization among this patient population

Delay discounting of pregnancy- and condom-protected sex among methadone-maintained women

Introduction Over 80% of pregnancies are unintended among women with opioid use disorder (OUD; Heil et al., 2011). Use of effective contraception is uncommon in this population (Terplan et al., 2015). Initiating and using effective contraception involves delays: to obtain the method from a provider, to become protected after initiating use. Interventions that include delay reductions among other elements have increased contraceptive use (Heil et al., 2016; Secura et al., 2014). Women with OUD have reported greater likelihood of engaging in unprotected sex at shorter delays to acquiring protection from sexually-transmitted infection (STI) than women without OUD (Herrmann et al., 2014). There is no current method for assessing how delays to pregnancy protection affect sexual decision-making. The present study was designed to evaluate a novel tool for measuring how delays to pregnancy protection affect self-reported likelihood to engage in protected vs. unprotected sexual intercourse

Mindfulness and Relapse Prevention among New Mothers during Recovery for Opioid Misuse

The opioid epidemic is a growing problem in the US and continues to affect various populations, including new mothers. We examined the effect of attendance to Mindfulness-Based Parenting (MBP) on risk of relapse and determined the influence of psychosocial factors – such as Adverse Childhood Events (ACE), Perceived Stress Scale (PSS), Parental Stress Index (PSI), and Five Facet Mindfulness scores – on risk of relapse. We abstracted urine drug screens to capture relapse among participants (N = 78) who enrolled in MBP and self-selected controls from their first cohort enrollment to six months after their last MBP session/cohort participation, and then analyzed the data using bivariate Chi-squared tests and bivariate logistic regressions. Lastly, we created multivariate binary logistic regression models to predict risk of relapse with number of sessions attended and repeating the course while controlling for demographic and psychosocial measures. We found that 48.5% of MBP participants and 33.3% of controls had at least one incident of relapse of any substance within six months post-MBP/last cohort. In our multivariate models evaluating risk of relapse, lower post-MBP total PSI scores were significantly associated with a decreased risk of any substance use by 6.7% and opioid use by 8.4%. Repeating the MBP curriculum was significantly associated with a decreased risk of relapse of any substance by 97.3%. Our models also showed that higher ACE scores were associated with an increased risk of relapse of other substance use and any substance use by 52.7% and 80.4%, respectively. This study provides evidence that MBP is associated with reducing the risk of relapse and highlighted the interaction of factors that can influence relapse among new mothers undergoing treatment for opioid use disorder

Prevalence and Characterization of Adverse Childhood Experiences of Women in Substance Use Treatment

Rates of illicit drug use among women reproductive age significant national public health problem Adverse childhood experiences (ACE’s) associated with higher rates of prenatal depression and maternal childhood maltreatment Ace’s prevalent in those with Opioid Use Disorder (OUD) Aims of Study: Determine prevalence of ACE’s in a population of pregnant and parenting women in treatment for substance use disorder Characterize ACE’s Compare our sample to Behavioral Risk Factor Surveillance System (BRFSS) Pennsylvania datahttps://jdc.jefferson.edu/obgynposters/1007/thumbnail.jp

Fitwits MD: An intervention to prevent childhood obesity

Objectives: The purpose of this presentation is to describe a comprehensive evaluation undertaken to study the feasibility of Fitwits MD, an intervention designed to assist primary care physicians to increase health fluency and affect wellness choices of children and their families. Childhood obesity is a growing epidemic but there are few if any successful interventions to alter the course of childhood obesity. The intervention was created through the use of participatory design