ORAU response to Enhancing partnerships to address birth defects, infant disorders and related conditions, and the health of pregnant and postpartum people (Component A). - Background - The number of babies born with neonatal abstinence syndrome increased by 82% nationally from 2010 to 2017. Women are at highest risk for developing substance use disorders (SUD) during their reproductive years and women with opioid use disorder (OUD) become pregnant more often than women in the general population. Use of drugs increases risk of maternal death and other adverse outcomes. For pregnant women with OUD, the use of medication treatment is linked to better adherence to prenatal care and improved pregnancy outcomes, yet only 50-60% of pregnant women with OUD access it. While women are more motivated to seek harm reduction for substance use during pregnancy, they face many challenges. Research demonstrates that Peer Recovery Workers (PRW) improve outcomes for people who use drugs, reduce use of emergency services and hospitalization, and enhance recovery capital, which sustains recovery and reduces risk of relapse and overdose death. As more states adopt statewide certification and training for PRW and approve reimbursement for peers within Medicaid programs, PRW are in more diverse settings, including criminal justice settings, social services, and harm reduction programs. SAMHSA evaluations have found that when pregnant/postpartum people (P/PP) with SUD engage with PRW, it significantly decreases substance exposure at birth. Objective - ORAU will complete 13 activities during the 5-year award in support of CDC-RFA-DD-23-0004 Strategies 2, 3, and 6. These activities will enable us to create a nationally accredited P/PP Certificate Program for PRW. This effort will improve the health of P/PP with SUD, who disproportionately experience adverse pregnancy outcomes, and their infants. Methods - ORAU and Faces and Voices of Recovery will partner to: - Conduct a landscape analysis - Define current practices and needs of PRW as it relates to their pregnant/postpartum clients - Assemble an Advisory Group of PRW and P/PP with SUD - Draft the first course in a series of new continuing education (CE) modules - Engage local Recovery Community Organizations (RCOs) to review, pilot, and champion the CE - Facilitate discussion groups with PRW and P/PP with SUD - Revise and accredit the CE - Train PRW champions at RCO partner sites - Pilot CE content in live trainings - Build and post online CE module - Develop and disseminate a supporting digital communication campaign of evidenced-based messages for P/PP with SUD - Repeat steps until series of CEs are finalized as a complete P/PP certificate program - Conduct process and outcome evaluation in partnership with RCO sites Outcomes - Conducting the outlined activities will: - Increase dissemination of data informed public health messaging and resources to PRW and P/PP with SUD - Increase use of data informed public health messages and resources to support P/PP with SUD and their infants - Increase awareness of effective data informed public health materials, messaging, resources, and interventions - Increase incorporation of diverse PRW and P/PP with SUD perspectives into public health messages, materials, and interventions - Increase capacity to implement standardized clinical and public health approaches among PRW - Increase implementation of data informed prevention strategies among SUD and peer recovery communities - Improve information sharing and coordination among Association of Recovery Community Organizations ARCO network Discussion-PRW are trusted and effective spokespersons to deliver evidenced-based messages to P/PP with SUD. Moreover, they can connect their P/PP clients to the local resources needed to act on those messages. The Association of Recovery Community Organizations is eager to offer credible and consistent training to their PRW with information tailored to the P/PP experience. This proposal seeks to fill the gap that exists and methodically develop and evaluate a needed series of CE courses for PRW serving P/PP clients.
