VisitBoost: A Home Visiting Enhancement to Reduce Harm for Families Affected by Substance Misuse

项目摘要 对围产期物质使用障碍（SUD）患者的污名化源于有毒的信念， 吸毒的人不能做好父母，也不关心自己的孩子。这 这种信念会对SUD患者及其子女造成周期性和系统性的伤害。家访 项目不太可能与SUD父母保持接触，因为这些父母经历过， 感觉到耻辱。然而，家庭游客希望做得更好。尽管家庭访客报告说， 由于难以支持患有SUD的父母，大多数家庭访客希望在这方面进行额外的培训。此外，伤害 减少的做法越来越普遍，家庭访客希望得到更多的培训， 父母在这个领域。目前的家访方案不具备支持父母在这一范围内， 改变景观有潜力改善目前的做法，减少伤害，并改善整体 通过减少家庭访视中的污名化，对围产期SUD患者的父母和子女结局 程序.这种变化不能仅仅是对家庭访客的一次性培训。它必须是一个全面的 改变家访组织的解决办法，包括取消造成伤害的政策， 执行政策，提供支持，领导教育和指导，确定社区 为家庭访客提供温暖的交接资源、培训和支持，以及持续的实践机会 和反思。我们提出的解决方案，VisitBoost，包括解决多层次的耻辱感的战略， 改善对围产期SUD患者的家访服务。拟议第一阶段的总体目标 一个项目是创建VisitBoost，并展示减少家庭访客中的污名化的可行性 客户与SUD。我们将通过两个具体目标来实现我们的目标：1。使用一种迭接 开发VisitBoost移动的应用程序原型的形成过程，以开发模块， 支持在组织领导人和家访者中消除污名化的做法。2.评估VisitBoost 使用混合方法程序评估的可接受性、可用性和有效性的原型 与我们的咨询委员会联系。我们将评估家访者的态度、知识、自我效能、做法， 实践意图（仅培训后），以及52名家庭访客的可用性，以优化 移动的应用。

Project Summary Stigmatization of people with substance use disorders (SUD) during perinatal results from the toxic belief that people who use substances are incapable of being good parents and do not care about their children. This belief perpetuates cyclical and systemic harm towards people with SUD and their children. Home visiting programs are less likely to sustain engagement with parents with SUD because those parents experience and perceive stigmatization. However, home visitors want to do better. Despite home visitors reporting that it is difficult to support parents with SUD, most home visitors want additional training in this area. Additionally, harm reduction practices are becoming more common and home visitors want more training to be able to support parents in this area. The current home visiting programs are not equipped to support parents within this changing landscape. There is the potential to improve current practices, reduce harm, and improve overall parent and child outcomes for people with SUD during perinatal by reducing stigmatization within home visiting programs. This change cannot just be a one-time training for home visitors. It must be a comprehensive solution to change home visiting organizations including de-implementation of polices that cause harm, implementation of policies to provide support, leadership education and guidance, identification of community resources for warm hand-offs, training and support for home visitors, and ongoing opportunities for practice and reflection. Our proposed solution, VisitBoost, includes strategies to address multiple levels of stigma and improve home visiting services for people with SUD during perinatal. The overall goal of the proposed Phase I project is to create VisitBoost and demonstrate feasibility for reducing stigmatization among home visitors towards clients with SUD. We will accomplish our goal through two specific aims: 1. Use an iterative formative process to develop a prototype of the VisitBoost mobile application to develop modules to support de-stigmatization practices among organizational leaders and home visitors. 2. Evaluate VisitBoost prototype for acceptability, usability, and effectiveness using a mixed-methods program evaluation approach with our advisory boards. We will assess home visitor attitudes, knowledge, self-efficacy, practices, practices intentions (post-training only), and usability with 52 home visitors to optimize successful use of the mobile application.