Rural service coordination programming for women using substances and their families.

Area of Science:

• Public Health
• Maternal and Child Health
• Substance Use Disorder Treatment

Background:

• Women with substance use disorders during pregnancy or postpartum face stigma and barriers to care, fearing child loss.
• Service barriers include repetitive information sharing and detailed recounting of substance use history, leading to non-compliance.
• Existing care models often fail to address the complex needs of these families holistically.

Purpose of the Study:

• To evaluate a service coordination program for pregnant/postpartum women with substance use disorders, their children, and caregivers.
• To examine stakeholder interest, program feasibility, and initial effectiveness.
• To assess the impact of coordinated care on maternal and infant outcomes.

Main Methods:

• A 4-year mixed-methods study across three sites: a birthing hospital, reunification program, and home visiting program.
• Data collection included needs assessments, health surveys, training evaluations, and budget records.
• Univariate analyses of variance examined maternal and infant characteristics' effects on outcomes.

Main Results:

• 182 women and families enrolled; patient navigators provided direct aid, training, and service coordination.
• Families stayed in the program an average of 655 days and reported satisfaction; the model was feasible in rural settings.
• The program significantly improved outcomes in basic needs, violence reduction (p < 0.001), infant development (p < 0.02), and maternal depression (p < 0.05).

Conclusions:

• A service coordination model with patient navigators is feasible, desirable, and effective for families in rural settings.
• This approach successfully addresses the multifaceted needs of mothers with substance use disorders and their infants.
• Coordinated care significantly impacted select maternal and infant outcomes, highlighting its value.