Promoting positive parenting among pregnant women with opioid use disorder

项目摘要 我的研究计划的首要目标是制定和告知预防干预措施，以改善 受物质使用影响的家庭的亲子结果。这个K23奖项的重点是告知和 采用基于证据的预防性育儿干预措施-家庭检查，以改善父母- 阿片类药物使用障碍（OUD）孕妇的儿童结局。通常，它伴随着一种... 出现心理社会挑战（例如，心理健康，人际关系受损）， 高质量。现有的针对OUD女性的育儿干预措施主要是从出生后开始， 现存的产前干预措施狭隘地集中于育儿教育和技能， 出生此外，现有的干预措施往往不足以解决常见和复杂的心理社会问题。 女性与OUD的挑战。因此，现有的育儿干预措施错过了干预的机会， 在孩子出生前预防养育子女的挑战，并在怀孕期间进行干预， 这是参与OUD治疗服务的高峰窗口，并增强了参与OUD治疗服务的动力。 复苏该提案提出了对患有OUD的孕妇进行育儿干预的必要性， 开始在怀孕期间和解决共同发生的心理社会挑战。因此，拟议项目 将使用定性和定量研究方法，以适应和试点FCU在怀孕期间交付 在产前初级保健设置与OUD的妇女。目标1将定性地描述养育 OUD妇女在围产期的需求，参与育儿干预的障碍，以及 干预的预期结果。目标2将使用ADAPT-ITT调整FCU干预妊娠 目标1期间收集的框架和数据。目标3将进行产前FCU评估的试点研究 参与和短期成果，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和过渡到独立，我需要在围产期阿片类药物的使用培训， 应用定性和混合方法研究，以及开发和测试预防性药物的方法 干预措施。一个有经验的团队将指导我的训练。肖博士（共同主要导师）是一个临床和 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 预防科学。克兰斯博士（共同主要导师）是一名妇产科医生和物质使用 具有围产期OUD和妇女健康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具有专长的妇产科医生。培训和 研究计划将构成支持R级提案的基础，其目标是连接产前和产后 父母干预措施，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.