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Psychosocial Res. to Improve Drug Treatment in Pregnancy

社会心理研究。

基本信息

批准号：
7487800
负责人：
Kimberly A Yonkers
金额：
$ 44.88万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-09-20 至 2010-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7487800
关键词：
Address Alcohol or Other Drugs use Alcohols Behavior Behavior Therapy Behavioral Birth Birth Weight Classification Clinic Cocaine Cognitive Cognitive Therapy Connecticut Counseling Defect Dependence Drug usage Enrollment Funding HIV Hazardous Substances Health behavior High birth weight infant Hospitals Infant Intervention Lead Marijuana Mental Health Methamphetamine Mothers Nicotine Numbers Opioid Outcome Outcome Study Patient currently pregnant Patients Perinatal Perinatal Care Pharmaceutical Preparations Population Pregnancy Pregnant Women Prenatal care Prevention strategy Prevention therapy Primary Health Care Principal Investigator Provider Randomized Randomized Controlled Trials Range Relapse Risk Risk Behaviors Schedule Screening procedure Substance Abuse, Other Substance abuse problem Substance of Abuse Testing Toxic effect Visit Woman day disorder later incidence prevention fetal improved motivational enhancement therapy neurodevelopment prenatal programs psychosocial skills training

项目摘要

DESCRIPTION (provided by applicant): Illicit and licit substance abuse by pregnant women is common and can lead to a number of deleterious effects in mother and her offspring. For example, risks of HIV for both mother and baby are elevated and the infant is more vulnerable to both structural defects and impaired neurodevelopment. Not only is hazardous substance use in pregnancy often undetected, but women with substance abuse and dependence frequently receive no treatment for their substance use and less than optimal amounts of prenatal care. Behavioral treatments, including motivational interviewing and relapse prevention for substance abuse, are effective for other substance abuse populations, including primary care patients. However, they have not been systematically tested in pregnant women who use cocaine, marijuana or methamphetamines. Behavioral treatments are ideal candidates to use in pregnant patients since they obviate the need for pharmacological interventions that carry their own risks of toxicity. Moreover, they can capitalize on constructive changes in health behaviors that often accompany pregnancy. Behavioral treatments delivered by the patient's obstetrical providers constitute an integrated approach that strengthens substance abuse treatment and prenatal care. In this application, we propose a randomized, controlled trial to evaluate a combined motivational and cognitive behavioral intervention for pregnant women with hazardous substance use. This trial takes advantage of the repeated prenatal visits a woman has with her clinician and provides a unique opportunity to deliver substance abuse treatment that is fully integrated with perinatal care. This would constitute the first systematic, randomized and controlled relapse prevention study to address cocaine, marijuana and other illicit substance abuse in pregnant women. We propose to: 1) conduct screening at two publicly funded perinatal clinics in Connecticut, the Yale New Haven Hospital Women's Center and the Bridgeport Hospital Prenatal Care Clinic; 2) enroll 260 women; 3) hold counseling sessions conjoint within prenatal visits; and 4) stratify for primary substance of abuse (marijuana, cocaine or alcohol). Outcomes for this study are the percentage of days the mother used any substances (primary), reduction in the HIV risk behaviors, (secondary) and assessment of fetal outcomes (secondary).

描述（由申请人提供）：孕妇非法和合法滥用药物的情况很普遍，可能对母亲及其子女造成一些有害影响。例如，母亲和婴儿感染艾滋病毒的风险增加，婴儿更容易受到结构缺陷和神经发育受损的影响。不仅怀孕期间使用有害物质往往未被发现，而且滥用和依赖药物的妇女经常得不到药物使用治疗，产前护理也达不到最佳水平。行为治疗，包括药物滥用的动机访谈和复发预防，对其他药物滥用人群，包括初级保健患者有效。然而，它们还没有在使用可卡因，大麻或甲基苯丙胺的孕妇中进行系统的测试。行为治疗是妊娠患者的理想选择，因为它们不需要药物干预，而药物干预本身也有毒性风险。此外，他们可以利用通常伴随怀孕的健康行为的建设性变化。由病人的产科提供者提供的行为治疗是一种综合办法，加强了药物滥用治疗和产前护理。在本申请中，我们提出了一个随机对照试验，以评估孕妇使用有害物质的动机和认知行为相结合的干预。这项试验利用了妇女与她的临床医生进行的重复产前检查，并提供了一个独特的机会，提供与围产期护理完全整合的药物滥用治疗。这将是针对孕妇滥用可卡因、大麻和其他非法药物的第一项系统、随机和对照的预防复吸研究。我们建议：1）在康涅狄格州的两个公共资助的围产期诊所，耶鲁纽黑文医院妇女中心和布里奇波特医院产前护理诊所进行筛查; 2）招募260名妇女; 3）在产前访视期间联合举行咨询会议; 4）对主要滥用物质（大麻，可卡因或酒精）进行分层。这项研究的结果是母亲使用任何物质的天数百分比（主要），减少艾滋病毒风险行为（次要）和评估胎儿结局（次要）。