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Introduction: The effectiveness of group prenatal care (G‐PNC) compared with individual prenatal care (I‐PNC) for women with opioid use disorder (OUD) is unknown. The objectives of this study were to (1) assess the acceptability of co‐locating G‐PNC at an opioid treatment program and (2) describe the maternal and infant characteristics and outcomes of pregnant women in treatment for OUD who participated in G‐PNC and those who did not. Methods: This was a retrospective cohort study of 71 women (G‐PNC n = 15; I‐PNC n = 56) who were receiving treatment for OUD from one center and who delivered in 2019. Acceptability was determined by assessing the representativeness of the G‐PNC cohorts, examining attendance at sessions, and using responses to a survey completed by G‐PNC participants. The receipt of health services and healthcare use, behaviors, and infant health between those who participated in G‐PNC and those who received I‐PNC were described. Results: G‐PNC was successfully implemented among women with varying backgrounds (e.g., racial, ethnic, marital status) who self‐selected into the group. All G‐PNC participants reported that they were satisfied to very satisfied with the program. Increased rates of breastfeeding initiation, breastfeeding at hospital discharge, receipt of the Tdap vaccine, and postpartum visit attendance at 1–2 weeks and 4–8 weeks were observed in the G‐PNC group compared with the I‐PNC group. Fewer G‐PNC reported postpartum depression symptomatology. Conclusion: Findings suggest that co‐located G‐PNC at an opioid treatment program is an acceptable model for pregnant women in treatment for OUD and may result in improved outcomes. [ABSTRACT FROM AUTHOR]

Background The RE-AIM framework was applied to the Mindfulness Based Parenting (MBP) intervention to evaluate the feasibility and effectiveness of this innovative trauma informed model in a drug treatment program. The MBP intervention is aimed at mitigating the stress experienced by women in treatment for substance use disorders, and thereby improving parenting and dyadic attachment between mother and child. Methods This was a single arm pre-test post-test design using repeated measure data collected between 2013 and 2016. The design also includes comprehensive process and impact evaluation data. Participants were 120 parenting women enrolled in an opioid treatment program between 2013 and 2016 in Philadelphia, PA. The MBP intervention included weekly 2-h MBP group sessions over 12 weeks, including three dyadic sessions with their child. The main outcomes of this study include the five facets of RE-AIM: Reach, Effectiveness, Adoption, Implementation, and Maintenance. Results The MBP intervention was associated with improvements in parenting across participants. Data showed implementation and sustainability are contingent upon a strong multidisciplinary team and clinical staff support and 'buy-in'. Iterative adaptations of interventions used in the general population may be necessary when working with a traumatized population burdened by low literacy levels, trauma history and co-occurring disorders. Conclusions MBP is a feasible and effective intervention for improving parenting and dyadic attachment between women with opioid use disorder and their children, and may be useful for other programs that serve parenting women with substance use disorders., Author(s): Meghan A. Gannon [sup.1] , Michael Mackenzie [sup.2] , Dennis J. Hand [sup.3] , Vanessa Short [sup.1] , Diane Abatemarco [sup.1] Author Affiliations: (Aff1) 0000 0001 2166 5843, grid.265008.9, [...]

Background and Objectives: Parenting women in treatment for opioid use disorder (OUD) report a lack of family centeredness and anticipatory guidancewithin well child care (WCC), andWCC utilization is low among affected children. We explore priorities for WCC visit content to inform primary care recommendations for this population. Methods: This study is a qualitative study of parenting women from one urban, academic OUD treatment program and pediatric primary care clinicians from a nearby affiliated pediatric practice. Eligible parent participants had a child =2 years old and were English speaking. Semistructured interviews elicited perspectives on WCC, with questions and prompts related to visit content. Inductive thematic analysis was led by 2 investigators using open coding procedures. Results:Among 30 parent participants, the majority were White (83%) and unmarried (90%). Approximately 60% reported their child received pharmacotherapy for neonatal opioid withdrawal syndrome. Of 13 participating clinicians, 9 were attending pediatricians. Five themes emerged from parental and clinician interviews: (1) improving knowledge and confidence related to child development, behavior, and nutrition; (2) mitigating safety concerns; (3) addressing complex health and subspecialty needs through care coordination; (4) acknowledging parental health and wellbeing in the pediatric encounter; and (5) supporting health education and care related to neonatal opioid withdrawal syndrome. Parents and clinicians expressed difficulty comprehensively addressing such issues due to time constraints, social determinants of health, and significant informational needs. Conclusions: Parenting women in treatment for OUD and pediatric clinicians share multiple priorities for anticipatory guidance withinWCC visits and barriers to addressing them comprehensively. [ABSTRACT FROM AUTHOR]

Objectives: Among mothers receiving medication-assisted treatment (MAT) for opioid use disorder (OUD) and their children, (1) assess characteristics associated with adequate prenatal care and well-child care, and (2) determine if prenatal care predicts well-child care and up-to-date immunizations (UTDI). Methods: This is a retrospective study of mothers with OUD and their children, maternal sociodemographic and health characteristics, and child health characteristics. Adequate prenatal care was defined by the Kotelchuck Index, well-child care by AAP recommendations, and UTDI by the 4:3:1:3:3:1:4 series. Results: For the 138 mother-child dyads, mothers were largely young (mean: 29 years), multiparous (73%), and receiving Medicaid (93%); only 31% had adequate prenatal care. The majority of children (67%) had adequate well-child care, and UTDI (93%). Children born to non-Hispanic mothers or with LOS > 5 days were more likely to have adequate well-child care, in contrast to those with wheezing who were less likely. In the adjusted analysis, younger children and those born to primiparous mothers were more likely to have adequate well-child care. Adequate prenatal care did not predict adequate well-child care or UTDI. Conclusions: Despite the fact that mothers receiving MAT for OUD often lacked adequate prenatal care, their children had adequate well-child care and UTDI. Abbreviations: AAP: American Academy of Pediatrics; aOR: Adjusted odds ratio; DTaP: Diphtheria, tetanus toxoids and acellular pertussis vaccine; GA: Gestational age; HepA: Hepatitis A vaccine; HepB: Hepatitis B vaccine; Hib: Haemophilus influenzae type b vaccine; IPV: Inactivated polio vaccine; ICN: Intensive care nursery; LOS: Length of stay; MATER: Maternal Addiction Treatment Education and Research; MAT: Medication-Assisted Treatment; MMR: Measles, mumps, and rubella vaccine; OUD: Opioid use disorder; PCV: Pneumococcal conjugate vaccine; TJU: Thomas Jefferson University; TJUH: Thomas Jefferson University Hospital; US: United States; UTDI: Up-to-date immunizations; 4:3:1:3:3:1:4: 4 DTaP:3 IPV:1 MMR:3 Hib:3 HepB:1 Varicella:4 PCV [ABSTRACT FROM AUTHOR]