Perspectives among women receiving medications for opioid use disorder: Implications for development of a peer navigation intervention to improve access to family planning services.
Perspectives among women receiving medications for opioid use disorder: Implications for development of a peer navigation intervention to improve access to family planning services.
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DOI：
10.1080/08897077.2021.2007514
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发表时间：
2022
期刊：
影响因子：
3.5
通讯作者：
Rinehart, Deborah J.
中科院分区：
文献类型：
--
作者：
Stowell, Melanie A.;Thomas-Gale, Tara;Jones, Hendree E.;Binswanger, Ingrid;Rinehart, Deborah J.
关键词：
研究一致发现，阿片类药物使用障碍 (OUD) 女性的意外怀孕率很高。很少有干预措施能够专门吸引和满足妇女在药物滥用障碍治疗方面的计划生育 (FP) 需求。我们的目标是收集形成性定性数据，以确定接受 OUD 药物治疗的女性的 FP 经历、需求和服务偏好，并利用这些数据开发 FP 教育和导航干预措施，可以在多样化、资源有限的治疗环境中进行测试。 2016 年 8 月至 2017 年 4 月，我们对来自科罗拉多州丹佛市两家门诊治疗诊所的女性进行了 21 次有指导的定性访谈。我们对所有采访进行了记录、转录和编码。然后，我们从 2017 年 5 月至 7 月促成了三个焦点小组（n=16），以验证或挑战访谈主题，并进一步为 FP 干预的发展提供信息。大多数参与者对意外怀孕表示矛盾或认为风险较低，并希望获得有关避孕方法的更多信息。许多参与者表示对医疗系统的不信任或缺乏参与，而创伤史是寻求服务的常见障碍。焦点小组参与者认可了同行主导的 FP 导航干预措施，并提供反馈以定制现有的 FP 教育材料，以满足康复中女性的特定需求。这项定性研究的结果表明，从 OUD 中恢复的女性有独特的、未满足的 FP 教育和服务需求。这些发现为在多样化、资源有限的治疗环境中制定可行且可接受的 FP 服务提供提供了重要信息，并为开发创伤知情、同伴主导的 FP 教育和导航干预措施提供了信息，这些干预措施将在研究的后续阶段实施。
Studies have consistently found high rates of unintended pregnancy among women with opioid use disorder (OUD). Few interventions have been developed to specifically engage and address the family planning (FP) needs of women in substance use disorder treatment. Our goal was to collect formative qualitative data to identify the FP experiences, needs and service preferences of women receiving medications for OUD and to use these data to develop a FP education and navigation intervention that could be tested in diverse, resource-limited treatment settings. From August 2016-April 2017, we conducted 21 guided qualitative interviews with women from two outpatient treatment clinics in Denver, Colorado. We recorded, transcribed, and coded all interviews. We then facilitated three focus groups (n=16) from May-July 2017 to verify or challenge interview themes and to further inform the development of the FP intervention. Most participants expressed ambivalence or low perceived risk regarding unintended pregnancy and desired more information about contraceptive methods. Many participants described mistrust or lack of engagement in the medical system and histories of trauma were a common barrier to seeking services. Focus group participants endorsed a peer-led FP navigation intervention and provided feedback to tailor existing FP educational materials to fit the specific needs of women in recovery. Results from this qualitative study suggest that women in recovery from OUD have unique, unmet FP education and service needs. These findings provide important information for the development of feasible and acceptable FP service delivery within diverse, resource-limited treatment settings and informed the development of a trauma-informed, peer-led FP education and navigation intervention that would be implemented in a subsequent phase of the study.
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