Doula Support Engagement in a Population of Pregnant and Parenting Women in Drug Treatment

项目总结 美国目前的阿片类药物危机是有据可查的，在 阿片类药物使用障碍孕妇的孕产妇结局。使用阿片类药物的女性 精神障碍(OUD)经历较低的产前医疗使用率和较高的 急诊室使用率。此外，在这一人群中，有更高的并存率 条件、普遍的社会人口和健康劣势以及育儿差异。 有社交障碍的女性报告说，在社交活动期间，帮助她们的社会支持和关系较少 过渡到为人父母。目前的医疗保健模式不能满足弱势群体的需求 人口，需要在围产期采取新的方法，如助产士参与。 在这一群体中对育儿妇女进行导乐干预并没有得到很好的研究。这 该项目旨在评估围产期有OUD的妇女对导乐的参与度 研究其对医疗服务利用、孕产妇临床分娩结局和产后的影响 心理社会健康和育儿领域。所有的研究程序都将在母婴中心进行 托马斯·杰斐逊大学成瘾治疗教育与研究(MAMER)项目， 美国最古老、规模最大、最全面的OUD治疗计划之一 怀孕和育儿的妇女。在两年的项目期内，多达100名孕妇在 在母校接受OUD治疗的患者将被纳入导乐组或非导乐组 在他们的围产期进行跟踪。结果的差异将在两者之间进行比较 组。定量和定性数据将从电子健康记录中收集， 经过验证的研究评估、半结构化访谈、人口统计调查和 观察性育儿评估。在目标1中，我们将评估DOLA CARE参与度 影响妇女在围产期治疗妇产科疾病时的卫生保健利用。在AIM 2，我们将评估助产士护理参与度如何影响分娩结局和心理社会健康 在接受OUD治疗的女性中。最后，在目标3中，我们将评估Dola参与度如何 影响母子二元体中的育儿领域，对于那些受OUD影响的二元体。这 该项目回应了AHRQ对卫生服务研究的特别强调通知 阿片类药物危机(NOT-HS-18-015)，并阐述妇女和 居住在城市地区的个人，AHRQ优先人口。鉴于OUD的普及率 在美国各地以及#年医疗保健利用率和孕产妇围产期结局方面的差异 我们预计，这项研究将对OUD孕妇产生重大影响。

PROJECT SUMMARY The current opioid crisis in the United States is well documented, with prevailing disparities in maternal outcomes for pregnant women with opioid use disorder. Women with opioid use disorder (OUD) experience lower rates of prenatal healthcare utilization and increased rates of emergency room utilization. Further, in this population there are higher rates of comorbid conditions, prevailing sociodemographic and health disadvantages, and parenting disparities. Women with OUD report fewer social supports and relationships to help them during the transition to parenthood. Current healthcare models do not meet the needs of this vulnerable population, requiring novel approaches in the perinatal period such as doula engagement. Doula intervention in this population of parenting women with OUD is not well studied. This project seeks to evaluate doula engagement in women with OUD during the perinatal period to study its effect on healthcare utilization, maternal clinical birth outcomes and post-partum psychosocial health, and parenting domains. All study procedures will occur at the Maternal Addiction Treatment Education & Research (MATER) program at Thomas Jefferson University, one of the oldest, largest, and most comprehensive OUD treatment programs in the U.S. for pregnant and parenting women. Over the 2-year project period, up to 100 pregnant women in treatment for OUD at MATER will be enrolled into either a doula or non-doula cohort to be followed over their perinatal period. Differences in outcomes will be compared between the two groups. Quantitative and qualitative data will be collected from electronic health records, validated study assessments, semi-structured interviews, a demographic survey, and an observational parenting assessment. In Aim 1, we will evaluate how doula care engagement affects healthcare utilization of women in treatment for OUD during the perinatal period. In Aim 2, we will evaluate how doula care engagement affects birth outcomes and psychosocial health of women in treatment for OUD. Finally, in Aim 3, we will evaluate how doula engagement affects parenting domains in the mother child dyad, for those dyads affected by OUD. This project responds to AHRQ's special emphasis notice of interest for health services research on the opioid crisis (NOT-HS-18-015) and addresses the experience and outcomes of women and individuals living in an urban area, AHRQ priority populations. Given the prevalence of OUD across the U.S. and the disparities in healthcare utilization and maternal perinatal outcomes for pregnant women with OUD, we anticipate this research will be of significant impact.