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Bouvé College of Health Sciences at Northeastern University

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Institute on Urban Health Research - Post-Partum Study

Post-Partum Women and Infants Study

Purpose:
The purpose of this project is to address an identified need to expand residential substance abuse treatment services for pregnant and postpartum Latina women within the greater Boston area by providing comprehensive services to them, their infants and other children in treatment.

The PPWI expanded treatment model addresses specific treatment enhancements in three domains:

  1. outreach, treatment engagement and retention
  2. prenatal/postpartum education and parenting education
  3. trauma treatment for women

The interventions will incorporate three evidence-based strategies to improve early treatment engagement and treatment retention. The interventions will focus on using Motivational Interviewing (MI) and Cognitive Management (CM) techniques to enhance the successful enrollment of women in treatment, specific participant-centered strategies and the implementation of culturally appropriate prenatal and postpartum educational interventions and trauma treatment (TREM).

Methods:
The evaluation adopts a two-group, pre-post test design with repeated measurements at baseline, and 6- and 12-month follow-up. The primary and secondary outcomes include substance abuse, pregnancy outcomes, infant outcomes, children outcomes HIV risk, economic protective factors resulting from intervention, psychological protective factors resulting from the intervention, service utilization and parenting skills, after graduating from program.

Data Analysis will include:

  1. descriptive statistics of major variables
  2. Chi-square, t-tests and ANOVA to ascertain differences in the characteristics of women who complete all instruments and those who are lost to follow-up
  3. change score analysis to assess differences between baseline and follow-up measures and in the post test outcomes between intervention and comparison groups, while accounting for the original differences between groups at the baseline
  4. multiple regression analyses to ascertain the effects of the degree of exposure to the intervention, and possible confounding variables on program outcomes
  5. survival analysis to examine predictors of treatment retention. Once recruited to the program, all women (including those who drop out of the program or treatment) will be included in the data analyses, following an intent-to-treat approach.

Preliminary Results:
Descriptive statistics with baseline data collected from 59 Hispanic/Latina participants shows that the average age at baseline of the entire sample is 29 years (SD=10.7). The overwhelming majority of the sample had a criminal justice history (91.5% had a lifetime history of arrest, 52.5% had a history of drug related arrest, and 79.7% had a lifetime history of incarceration). Similarly, 97% had a lifetime history of physical abuse and 90% a lifetime history of sexual abuse. 48% were in treatment because either a criminal court (29%) or DSS (19%) required their participation.

Conclusions:
Implementation of this program, lessons learned and outcomes will provide a model to decreased incidence of substance use among PPW Latinas; improved pregnancy and birth outcomes; improved health of mothers and children; and improved parenting skills. Further results of evaluating these services are expected to contribute important information for the development of other programs for Latinas in recovery.

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