Promoting positive parenting among pregnant women with opioid use disorder

项目总结 我的研究计划的首要目标是开发和提供预防干预措施，以改善 受药物使用影响的家庭的亲子结局。这个K23奖项的重点是告知和 采用一种基于证据的预防性育儿干预措施--家庭体检(FCU)，以改善父母的 患有阿片类药物使用障碍(OUD)的孕妇的儿童结局。OUD经常伴随着共同的 正在发生的心理社会挑战(例如，心理健康、人际关系受损) 照顾他人的品质。现有的育儿干预措施主要是从出生后开始的，很少有 现有的产前干预措施仅局限于育儿教育和技能，并在或之后不久结束 出生。此外，现有的干预措施往往不足以解决普遍和复杂的心理社会问题。 OUD女性面临的挑战。因此，现有的育儿干预措施错失了干预的机会 在孩子出生前预防养育挑战的发展，并在怀孕期间进行干预， 这是参与OUD治疗服务和增强参与动机的高峰期窗口 恢复。这项建议解决了对患有胎儿发育迟缓的孕妇进行育儿干预的必要性 从怀孕期间开始，解决共同出现的心理社会挑战。因此，拟议的项目 将使用定性和定量的研究方法来调整和试行FCU在怀孕期间分娩 在产前初级保健环境中为患有胎儿发育迟缓的妇女提供服务。目标1将定性地描述育儿方式 围产期先天性发育迟缓妇女的需求，参与育儿干预的障碍，以及 预期的干预结果。目标2将使用Adapt-ITT使FCU干预适用于妊娠 目标1.目标3将对产前FCU评估进行试点研究 参与度和短期结果，包括产妇的心理社会功能(心理健康和 人际功能)、亲子关系质量和自我效能感。 为了实现拟议的目标并过渡到独立，我需要对围产期阿片类药物的使用进行培训， 应用定性和混合方法研究，以及开发和测试预防措施的方法 干预措施。一支经验丰富的队伍将指导我的训练。肖医生(联合首席导师)是一名临床和 发展心理学家和产后FCU的共同开发者，具有育儿干预方面的专业知识 和预防科学。Krans医生(联合初级导师)是一名妇产科医生和药物使用专家 在围产期和妇女健康方面具有专业知识的治疗提供者。张博士(共同导师)是一位 在定性研究方法和妇女健康方面有专长的产科-妇科医生。培训和 研究计划将构成支持R级建议的基础，目标是连接出生前和出生后 育儿干预措施，以优化对受药物使用影响的家庭和幼儿的支持。

PROJECT SUMMARY The overarching goal of my program of research is to develop and inform preventive interventions to improve parent–child outcomes for families affected by substance use. The focus of this K23 award is to inform and adapt an evidenced-based preventive parenting intervention, the Family Check-Up (FCU), to improve parent– child outcomes among pregnant women with opioid use disorder (OUD). OUD is often accompanied by co- occurring psychosocial challenges (e.g., mental health, compromised interpersonal relationships) that impact caregiving quality. Existing parenting interventions for women with OUD largely begin postnatally, with the few extant prenatal interventions narrowly focused on parenting education and skills and ending at or shortly after birth. Further, existing interventions are often ill-equipped to address the common and complex psychosocial challenges of women with OUD. As such, existing parenting interventions miss opportunities to intervene to prevent the development of parenting challenges before the child’s birth and to intervene during pregnancy, which is a peak window of engagement in OUD treatment services and enhanced motivation to engage in recovery. This proposal addresses the need for parenting interventions for pregnant women with OUD that begin during pregnancy and address co-occurring psychosocial challenges. Accordingly, the proposed project will use qualitative and quantitative research methods to adapt and pilot the FCU for delivery during pregnancy within a prenatal primary care setting for women with OUD. Aim 1 will qualitatively characterize the parenting needs of women with OUD across the perinatal period, barriers to engagement in parenting interventions, and desired outcomes of intervention. Aim 2 will adapt the FCU intervention for pregnancy using the ADAPT-ITT framework and data collected during Aim 1. Aim 3 will conduct a pilot study of the prenatal FCU assessing engagement and short-term outcomes including maternal psychosocial functioning (mental health and interpersonal functioning) and parent–child relationship quality and self-efficacy. To achieve the proposed goals and transition to independence, I require training in perinatal opioid use, applied qualitative and mixed-methods research, and methods for developing and testing preventive interventions. An experienced team will guide my training. Dr. Shaw (co-primary mentor) is a clinical and developmental psychologist and co-developer of the postpartum FCU with expertise in parenting interventions and prevention science. Dr. Krans (co-primary mentor) is an obstetrician-gynecologist and substance use treatment provider with expertise in perinatal OUD and women’s health. Dr. Chang (co-mentor) is an obstetrician-gynecologist with expertise in qualitative research methods and women’s health. The training and research plan will form the basis to support an R-level proposal with the goal of bridging pre- and postnatal parenting interventions to optimize support for families and young children affected by substance use.