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A socioecological framework for engaging substance-using pregnant persons in longitudinal research: Multi-stakeholder
Ellen Goldstein1, Kendra Nervik2, Shelbey Hagen1
1Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 1100 Delaplaine Ct, Madison, WI 53715, United States of America.
Neurotoxicology and Teratology
|May 23, 2021
Summary
Engaging pregnant individuals with substance use in research requires addressing stigma, legal concerns, and instability. Building trust through support services and participant-centered approaches is key for successful recruitment and retention.
Area of Science:
- Obstetrics and Gynecology
- Addiction Medicine
- Public Health
Background:
- Prenatal substance exposure significantly impacts fetal development and child health.
- Research in this area faces legal, ethical, and practical challenges.
- Effective strategies for reducing prenatal substance exposure and improving child outcomes are essential.
Purpose of the Study:
- To examine approaches for engaging pregnant individuals with substance use, particularly opioid use, in longitudinal research.
- To identify facilitators and barriers to research participation from multi-stakeholder perspectives.
- To inform the design of effective research protocols for high-risk populations.
Main Methods:
- A qualitative analysis was conducted using data from an advisory group of community stakeholders (including individuals with lived experience) and an online survey of content experts.
- A socioecological lens was applied to examine factors at individual, interpersonal, organizational, community, and policy levels.
- Expertise was solicited from 19 community stakeholders and 70 survey respondents (researchers, clinicians, and others).
Main Results:
- Key barriers identified by stakeholders include stigma, confidentiality concerns, legal consequences, and socioeconomic instability.
- Survey respondents emphasized building trusting relationships through participant support (e.g., transportation, childcare) and participant-friendly study design.
- Trust-building strategies and addressing participant needs were highlighted as crucial for retention.
Conclusions:
- Stakeholder input and survey data provide critical insights into overcoming barriers to research participation for pregnant individuals with substance use.
- A socioecological framework is valuable for identifying and addressing factors that influence recruitment and retention.
- Implementing these insights can enhance the long-term retention of high-risk populations in research studies.
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