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

项目摘要 在围产期对有物质使用障碍(SUD)的人的污名化是因为有毒的信念 吸食毒品的人没有能力成为好父母，也不关心自己的孩子。这 信仰使对SUD患者及其子女的周期性和系统性伤害持续存在。家访 项目不太可能维持与患有SUD的父母的接触，因为这些父母经历和 感受到污名化。然而，家庭访客想要做得更好。尽管家庭访客报告说 很难支持患有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，危害 减少开支的做法正变得越来越普遍，家庭访客希望获得更多培训，以便能够支持 这一地区的父母。目前的家访计划还没有准备好在这个范围内支持父母 不断变化的景观。有可能改进当前的做法，减少危害，并全面提高 减少家访中的污名化对围产期SUD患者的亲子结局的影响 程序。这一变化不能仅仅是对国内游客的一次性培训。它必须是一个全面的 改变家访组织的解决方案，包括取消造成伤害的政策， 落实政策，提供支持、领导教育和指导、社区认同 为家庭访客提供热情交接、培训和支持的资源，以及持续的实践机会 和反思。我们建议的解决方案VisitBoost包括解决多个层次的污名和 改善围产期SUD患者的家访服务。拟议的第一阶段的总体目标 项目是创建VisitBoost并展示减少家庭访客污名的可行性 对患有SUD的客户。我们将通过两个具体目标来实现我们的目标：1.使用迭代 开发VisitBoost移动应用程序原型的形成过程，以开发以下模块 支持在组织领导人和家庭访客中消除污名化做法。2.评估VisitBoost 使用混合方法项目评估的可接受性、可用性和有效性的原型 与我们的顾问委员会进行沟通。我们将评估家庭访客的态度、知识、自我效能、做法、 与52名家庭访客一起练习意图(仅限培训后)和可用性，以优化成功使用 移动应用程序。

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.