State-level opioid policies and policies that regulate substance use duringpregnancy: a mixed methods exploration of their effects on maternal and infantoutcomes

国家级阿片类药物政策和规范怀孕期间药物使用的政策:混合方法探讨其对孕产妇和婴儿结局的影响

基本信息

项目摘要

The opioid and overdose crisis in the United States (US) disproportionately affects women of childbearing age (15–44 years), particularly pregnant women and their newborns: 20% of pregnant women are prescribed opioids during pregnancy.1,2 States have enacted both general opioid policies (e.g., access to medication for opioid use disorder (MOUD)) and policies specific to substance use during pregnancy, but the effects of these policies on pregnant women’s opioid use and newborn outcomes remain poorly defined. States’ policy responses to prenatal opioid use vary widely, resulting in inconsistent approaches to pregnant women’s opioid use. In this mixed- methods project, we will apply a convergent parallel design to examine the separate and combined impacts and consequences of state opioid policies on pregnant women and their newborns using Medicaid and commercial insurance databases (MarketScan). We aim to: 1. Examine the separate effects of general and prenatal state opioid policies on pregnant/postpartum women and newborns. We will: 1a) systematically map all 50 states’ prenatal opioid policies (2011–2020) to categorize policy variations and build a publicly available time-varying dataset; 1b) use this prenatal policy dataset and existing data on general opioid policies to explore the individual- level impact of general and prenatal opioid policies on opioid use disorder (OUD), MOUD access, and neonatal opioid withdrawal syndrome (NOWS) for pregnant women and their newborns; and 1c) test for effect modification by maternal race/ethnicity and age. 2. Investigate the combined effects of general and prenatal state opioid policies on pregnant/postpartum women and their newborns (2011-2020). To move beyond the impact of single policies in isolation, we will: 2a) use a modified Delphi approach to create a time-varying taxonomy of each state’s overall opioid policy climate relevant to pregnant women, ranging from penalizing to health- promoting, based on states’ combination of prenatal and general opioid policies; and 2b) explore the individual- level impact of states’ overall policy climates on pregnant/postpartum women and newborns using the same outcomes and effect modification as Aim 1. 3. Explore how prenatal policy implementation affects daily life for pregnant women and their newborns. We will: 3a) apply the Consolidated Framework for Implementation Research (CFIR) to interviews with 60 key stakeholders across states that vary by their overall policy climate to explore multilevel drivers of prenatal opioid policy implementation and how variations in implementation affect maternal and newborn health; and 3b) create an ethnographic cohort of 40 pregnant women who use opioids across states with four different prenatal policy climates (punitive, prosocial, mixed, inaction) and conduct three interviews with each over one year. We will explore how variations in prenatal opioid policy implementation affect how women navigate pre- and postnatal care, MOUD use, and state services. Findings will have concrete real- world impacts by describing the effects of state opioid policies on pregnant/postpartum women and their newborns and by identifying intervention points and policy changes that promote maternal and infant wellbeing.
美国的阿片类药物和过量危机对育龄妇女的影响尤为严重

项目成果

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Silvia Saboia Martins其他文献

Silvia Saboia Martins的其他文献

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{{ truncateString('Silvia Saboia Martins', 18)}}的其他基金

Social safety net programs as interventions to reduce opioid-related harms in reproductive-age women
社会安全网计划作为减少育龄妇女阿片类药物相关危害的干预措施
  • 批准号:
    10772665
  • 财政年份:
    2023
  • 资助金额:
    $ 78.13万
  • 项目类别:
State-level opioid policies and policies that regulate substance use duringpregnancy: a mixed methods exploration of their effects on maternal and infantoutcomes
国家级阿片类药物政策和规范怀孕期间药物使用的政策:混合方法探讨其对孕产妇和婴儿结局的影响
  • 批准号:
    10669127
  • 财政年份:
    2022
  • 资助金额:
    $ 78.13万
  • 项目类别:
State medical marijuana laws and NSDUH marijuana use and consequences since 2004
自 2004 年以来各州医用大麻法和 NSDUH 大麻使用及其后果
  • 批准号:
    8744452
  • 财政年份:
    2014
  • 资助金额:
    $ 78.13万
  • 项目类别:
State medical marijuana laws and NSDUH marijuana use and consequences since 2004
自 2004 年以来各州医用大麻法和 NSDUH 大麻使用及其后果
  • 批准号:
    8926931
  • 财政年份:
    2014
  • 资助金额:
    $ 78.13万
  • 项目类别:
State medical marijuana laws and NSDUH marijuana use and consequences since 2004
自 2004 年以来各州医用大麻法和 NSDUH 大麻使用及其后果
  • 批准号:
    9112984
  • 财政年份:
    2014
  • 资助金额:
    $ 78.13万
  • 项目类别:
Predictors of Pathological Gambling among African-American Young Adults
非裔美国年轻人病态赌博的预测因素
  • 批准号:
    7460395
  • 财政年份:
    2009
  • 资助金额:
    $ 78.13万
  • 项目类别:
Predictors of Pathological Gambling among African-American Young Adults
非裔美国年轻人病态赌博的预测因素
  • 批准号:
    8055463
  • 财政年份:
    2009
  • 资助金额:
    $ 78.13万
  • 项目类别:
Predictors of Pathological Gambling among African-American Young Adults
非裔美国年轻人病态赌博的预测因素
  • 批准号:
    7776830
  • 财政年份:
    2009
  • 资助金额:
    $ 78.13万
  • 项目类别:
Predictors of Pathological Gambling among African-American Young Adults
非裔美国年轻人病态赌博的预测因素
  • 批准号:
    8230457
  • 财政年份:
    2009
  • 资助金额:
    $ 78.13万
  • 项目类别:
Predictors of Pathological Gambling among African-American Young Adults
非裔美国年轻人病态赌博的预测因素
  • 批准号:
    8472255
  • 财政年份:
    2009
  • 资助金额:
    $ 78.13万
  • 项目类别:

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