K23 Abstract
DESCRIPTION: Nearly one third of individuals with substance use disorders are women of
childbearing age. Life-threatening infant complications from maternal opioid use disorders
(OUD) include neonatal withdrawal syndrome, acute and chronic developmental and behavioral
challenges, increased risks of infection through maternal transmission (i.e. HIV, Syphilis), and
death. Mothers with OUD must negotiate micro and macro level challenges that impact
parenting and recovery management, including reluctance to disclose drug use for fear of legal
issues, child custody and domestic disputes, stigma, financial, and transportation barriers.
There are few proven interventions that support long-term recovery management and parenting
for addicted new mothers embedded within this unique context. Using a community based
participatory research (CBPR) approach, we will determine the feasibility and preliminary effects
of a customized evidence-based digital technology self-management recovery program for
women with OUD during the pregnancy and postpartum period. Based on our preliminary data,
our central hypothesis is that once tailored strategies are identified by primary stakeholders, an
evidence-based program that uses digital technology can be delivered to pregnant and
parenting women with OUD to expand accessibility to evidence-based parenting and recovery
resources. The specific aims of this study include: (1) Customize eRecovery technology
integrating preferred parenting resources and recovery supports in collaboration with a
community advisory board (CAB) and new mothers in early recovery from substance use
disorders; (2) Evaluate the feasibility of using the customized eRecovery technology for
pregnant and postpartum women in early recovery from OUD to determine use and usefulness
based on participant perceptions, engagement and retention in care, drug abstinence, and
parenting outcomes. The results from this proof-of-concept study will provide strong pilot data to
guide development of a full-scale trial in a future RO1 application in Year 4 of this award. The
career development award will provide Dr. Raynor the mentoring and training needed to
develop knowledge and skills in rural health disparities, CBPR methods, digital intervention
development and program evaluation, population health interventions and advanced research
training. At the close of the award, she will be positioned to design, implement, and evaluate
research that will significantly improve the health outcomes of pregnant and parenting women
with OUD and their vulnerable newborn infants living in a rural Southeastern state.