Stotts, A. L., Villarreal, Y. R., Green, C., Berens, P., Blackwell, S., Khan, A., Suchting, R., Velasquez, M., Markham, C., Klawans, M. R., & Northrup, T. F. (2022). Facilitating treatment initiation and reproductive care postpartum to prevent substance-exposed pregnancies: A randomized bayesian pilot trial. Drug and alcohol dependence, 239, 109602. https://doi.org/10.1016/j.drugalcdep.2022.109602 Evidence Rating: Emerging Intervention Components (click on component to see a list of all articles that use that intervention): Motivational Interviewing, Intervention Description: A brief, hospital-initiated, adaptive motivational interviewing plus acceptance and commitment therapy (MIACT) intervention to facilitate substance-use treatment initiation and reproductive planning postpartum among mothers who used substances during pregnancy. The brief MIACT was developed as an adaptive intervention with treatment intensity (1, 2 or 3 sessions; about 45 min each) dependent upon verification of participant response. The MIACT intervention was delivered by masters-level counselors or a doctoral-level social worker. Participants assigned to the CC condition met with a trained research assistant and/or NICU social worker who offered support along with a list of referrals for substance use disorder treatment. Intervention Results: Results indicated that during treatment the MIACT group demonstrated an 84% probability of benefit relative to CC with regard to initiating treatment (RR=1.5), however the effect was not seen at follow-up. MIACT was also associated with an increased probability of attending a postpartum obstetrics visit (RR=1.4), and receiving contraception during treatment and at both follow-ups, with posterior probabilities of 96% or higher and relative risks ranging from 1.5 to 5.1 at varying timepoints. Substance use rates for the MIACT versus CC were higher at follow-up. Conclusion: Brief, hospital-initiated interventions can assist postpartum mothers who use substances to enter treatment and obtain contraception in order to reduce future substance-exposed pregnancies. Study Design: Parallel group, randomized controlled design Setting: Hospital Population of Focus: Mothers with an infant admitted to a neonatal intensive care unit if they or their infant tested positive for an illicit substance at delivery or had a documented positive drug screen during pregnancy Sample Size: 64 Age Range: Women of chilbearing age Access Abstract
|