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Developing a Screening and Brief Intervention Package to Address Substance Use Risk in Pregnant and Postpartum Women in Home Visiting Programs

Award Number: R34DA045831
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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The proposed R34 will develop and test a screening and brief intervention package for addressing substance use (SU) in pregnant and postpartum women in evidence-based home visiting (SBI-HV). Perinatal SU is an urgent public health concern, with significant negative impacts on maternal and child health. Pregnant and postpartum women who use substances are at high risk for losing their children to the child welfare system. Many perinatal women conceal their SU and do not actively seek treatment, increasing risk to themselves and their children. As the primary supportive intervention offered to high-risk families during the perinatal period, HV is a promising venue for addressing SU in this population. However, there is currently no systematic protocol for addressing SU in routine HV, leaving many HV clients with unmet needs that increase maternal and child risk. SBIRT is widely endorsed in primary care to improve SU identification and decrease use among low-to-moderate users, and has potential applicability in HV. Two challenges to implementing traditional SBIRT in HV are: (1) clients are reluctant to disclose SU due to fear of child removal; and (2) home visitors lack the training and clinical skill to deliver evidence-based brief interventions with fidelity. The proposed SBI-HV represents an innovative adaptation of the SBIRT framework, designed to leverage technology and two key elements of the HV context (the home visitor-client relationship and routine supervision) to overcome these challenges. The SBI-HV will include (a) a two-session computerized screening and brief intervention (e-SBI), adapted from a validated e-SBI developed by the Co-I that has proven effective in reducing SU in pregnant and postpartum women in primary care; and (b) implementation supports for enhancing routine HV service delivery and supervision to promote effective e-SBI integration in the unique HV context. The SBI-HV will be designed so that clients are never required to disclose SU to home visitors. The e-SBI is fully automated and self- administered; home visitors will not see clients’ responses, and will not be asked to implement evidence-based interventions. Specific aims are to (1) develop the SB-HV (e-SBI intervention plus implementation supports); (2) evaluate its feasibility, acceptability, and fidelity; and (3) determine its preliminary impacts on symptom reduction (SU, depression, parenting stress), HV retention, and SU treatment engagement. We will partner with 2 pilot sites to construct the SBI-HV guided by stakeholder input (Aim 1). We will then conduct a small RCT in 2 additional sites. Home visitors (N = 10) will be randomized to HV+SBI-HV vs. routine HV. Feasibility, acceptability, and fidelity will be assessed via HV and client interviews and fidelity checklists (Aim 2). Research assistants will interview clients (N = 40) at baseline, and 3- and 6-month follow-up to track SBI-HV impacts (Aim 3). If results are promising, the next step is an R01 to test the SBI-HV in a larger trial, spanning multiple states and HV models. If effective, the SBI-HV would fill a significant gap in HV services and has potential for widespread deployment in state HV systems.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2020	PARTNERSHIP TO END ADDICTION	711 3RD AVE RM 500	NEW YORK	NY	10017	NEW YORK	USA	Drug Use and Addiction Research Programs	000	3	2/12/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2020	PARTNERSHIP TO END ADDICTION	711 3RD AVE FL 5	NEW YORK	NY	10017	NEW YORK	USA	Drug Use and Addiction Research Programs	000	3	6/9/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $0 )
2021	2020	PARTNERSHIP TO END ADDICTION	485 LEXINGTON AVE STE 300	NEW YORK	NY	10017	NEW YORK	USA	Drug Abuse and Addiction Research Programs	000	3	8/12/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2020 ( Subtotal = $258,987 )
2020	2020	NATIONAL CENTER ON ADDICTION AND SUBSTANCE ABUSE, THE	485 LEXINGTON AVE RM 300	NEW YORK	NY	10017	NEW YORK	USA	Drug Abuse and Addiction Research Programs	000	3	7/27/2020	NON-COMPETING CONTINUATION	$258,987
														Subtotal = $258,987

Issue Date FY: 2019 ( Subtotal = $258,430 )
2019	2019	NATIONAL CENTER ON ADDICTION AND SUBSTANCE ABUSE, THE	633 3RD AVE FL 19	NEW YORK	NY	10017	NEW YORK	USA	Drug Abuse and Addiction Research Programs	001	2	6/24/2019	NON-COMPETING CONTINUATION	$258,430
2019	2018	NATIONAL CENTER ON ADDICTION AND SUBSTANCE ABUSE, THE	633 3RD AVE FL 19	NEW YORK	NY	10017	NEW YORK	USA	Drug Abuse and Addiction Research Programs	000	1	6/19/2019	NEW	$0
														Subtotal = $258,430

Issue Date FY: 2018 ( Subtotal = $258,797 )
2018	2018	NATIONAL CENTER ON ADDICTION AND SUBSTANCE ABUSE, THE	633 3RD AVE FL 19	NEW YORK	NY	10017	NEW YORK	USA	Drug Abuse and Addiction Research Programs	000	1	9/18/2018	NEW	$258,797
														Subtotal = $258,797

Grand Total All Awards = $776,214

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Developing a Screening and Brief Intervention Package to Address Substance Use Risk in Pregnant and Postpartum Women in Home Visiting Programs

Award Number: R34DA045831

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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