Advancing Equity in Treatment Outcomes for Black Pregnant and Postpartum People Who Use Drugs and have Child Welfare and Criminal Legal Systems Involvement

项目概要/摘要 在怀孕期间提供物质使用障碍治疗是改善孕产妇和 新生儿福利，但歧视性政策，做法和获得必要的资源有助于 成瘾护理和养育结果的不平等。许多怀孕的人谁使用药物的经验 此外，还有儿童福利系统的参与。刑事法律的政策和 儿童福利系统倾向于将怀孕期间使用毒品定为犯罪，而不是投资于健全的 治疗值得注意的是，由于监禁背后的结构性种族主义和历史力量， 这些政策系统地贬低了黑人妇女的生殖能力， 对黑人孕妇和养育子女的人，造成不成比例的儿童搬迁以及不同的 药物治疗结果。虽然政策，历史和社会学分析已经记录了 种族主义和刑事犯罪的黑人怀孕的个人谁使用毒品，一个未充分研究的方面是如何这些 结构性和人际歧视的力量影响着生活经历、治疗和康复 怀孕和产后的黑人与这些系统的双重参与的结果。 了解这些相互交叉的系统对于消除种族歧视的根源和消除种族歧视至关重要。 在药物使用治疗和产妇保健方面的差距和歧视。本报告的总体目标 NIDA关于健康公平的行政补充是审查种族主义的经验和对健康的影响。 治疗，怀孕和养育结果之间的样本怀孕和产后的人谁使用 毒品和有刑事法律的和儿童福利系统双重参与的人。本研究还将 评估儿童福利系统工作人员对案件作出决定的做法和观点 涉及在怀孕期间使用毒品以及目前或最近被监禁的人。该提案 我将通过一系列定性访谈来评估有效的种族主义措施， 在产妇保健方面，并与社区成员进行方法上的合作， 体验.这个项目将加强家长职业发展奖的培训目标，以提高 通过提供以下方面的培训机会，为患有阿片类药物使用障碍的孕妇和被监禁者提供护理 如何研究和影响产妇保健中的种族主义。访谈数据将产生可操作的见解， 为在监禁和儿童福利系统工作的人制定未来的政策和培训干预措施。这 研究是创新的，因为它将增加对监禁的种族化方面的现有理解 和儿童福利制度，通过研究这些制度对个人生活的交叉影响， 治疗途径和养育结果。本补编的拟议工作， 与NIDA的种族平等倡议的目标，将有助于促进种族平等的长期目标 孕产妇健康和药物使用治疗和结果。

PROEJCT SUMMARY/ABSTRACT Providing substance use disorder treatment in pregnancy is an essential strategy to improve maternal and newborn wellbeing, but discriminatory policies, practice, and access to necessary resources contribute to inequities in addiction care and parenting outcomes. Many pregnant people who use drugs experience incarceration and also have involvement from the child welfare system. Policies in both the criminal legal and child welfare systems have trended toward criminalizing drug use in pregnancy rather than investing in robust treatment. Significantly, due to the structural racism that underlies incarceration and historical forces that have systematically devalued Black women’s reproduction, these policies have had a differentially negative impact on Black pregnant and parenting people, contributing to disproportionate child removals as well as disparate drug treatment outcomes. While policy, historical, and sociologic analyses have documented the links between racism and criminalizing Black pregnant individuals who use drugs, one understudied aspect is how these forces of structural and interpersonal discrimination affect the lived experiences, treatment, and recovery outcomes among pregnant and postpartum Black people with dual involvement in these systems. Understanding these intersecting systems is essential for targeting root causes of and eliminating racial disparities and discrimination in substance use treatment and maternal health. The overall objective of this NIDA Administrative Supplement on Health Equity is to examine experiences of racism and the impact on treatment, pregnancy, and parenting outcomes among a sample of pregnant and postpartum people who use drugs and who have dual involvement from criminal legal and child welfare systems. This study will also evaluate the practices and perspectives of child welfare system workers who make decisions on cases involving people who used drugs in pregnancy and who were currently or recently incarcerated. The proposal will accomplish these aims through a series of qualitative interviews that assess validated measures of racism in maternal health, and with methodological collaboration from community members with direct, lived experience. This project will enhance the training goals of the parent career development award to improve access to care for pregnant, incarcerated people with opioid use disorder by providing training opportunities in how to study and impact racism in maternal health. Data from interviews will produce actionable insights for future policy and training interventions for people who work in incarceration and child welfare systems. This research is innovative because it will add to existing understandings of racialized dimensions of incarceration and child welfare systems by examining the impact at the intersection of these systems on individuals’ treatment pathways and parenting outcomes. The work proposed for this supplement, which directly aligns with the goals of NIDA’s Racial Equity Initiative, will contribute to the long-term goal of advancing racial equity in maternal health and substance use treatment and outcomes.