Ruth Rose-Jacobs1, Michelle Trevino-Talbot2, Martha Vibbert3, Christine Lloyd-Travaglini4, Howard J Cabral5. 1. Boston University School of Medicine, Department of Pediatrics, 771 Albany Street, Room G509, Boston, MA 02118, United States. Electronic address: rrosejac@bu.edu. 2. Boston Medical Center, Department of Developmental and Behavioral Pediatrics, 72 E. Concord Street, Vose 426, Boston, MA 02118, United States. Electronic address: michelle.trevino-talbot@bmc.org. 3. Boston University School of Medicine, Departments of Pediatrics and Psychiatry, 255 River Street, Mattapan, MA 02126, United States. Electronic address: mvibbert@bu.edu. 4. Boston University School of Public Health, Biostatistics and Epidemiology Data Analytics Center, 85 East Newton Street, Room 957A, Boston, MA 02118, United States. Electronic address: clloyd@bu.edu. 5. Boston University School of Public Health, Department of Biostatistics, 801 Massachusetts Avenue, Room 310, Boston, MA 02118, United States. Electronic address: hjcab@bu.edu.
Abstract
BACKGROUND: While pregnant women in treatment for opioid use disorder (OUD) face considerable challenges, common material hardships- food insecurity and housing instability, known to negatively impact maternal-child health, have been inadequately researched within this population. This study describes food/housing hardships and evaluates associations with key psychosocial factors. METHODS: A single-site prospective study, 100 3rd trimester women receiving prenatal care and medication-assisted treatment for OUD were interviewed, including screening for food/housing hardships, depressive symptoms, intimate partner vulnerability; and self-reported post-traumatic stress disorder (PTSD) history. We developed a three-level categorization combining food/housing screening outcomes: 1) "both insecure"; 2) "either secure"; and 3) "both secure". Bivariate analyses and linear path analyses evaluated associations among psychosocial variables using "both secure" as the referent group. RESULTS: Of 100 women, 56% reported food insecurity; 61% housing instability; 42% "both insecure"; 33% "either insecure"; 25% "both secure". In unadjusted food/housing groups "either insecure" and "both insecure" reported significantly greater depressive symptoms; "both insecure" additionally reported significantly greater intimate partner vulnerability. Path analyses adjusted for PTSD and compared with "both secure" (adjusted mean = 6.2): "either insecure" had greater depressive symptom scores (adjusted means = 9.8, p = .01) while "both insecure" had greater depressive scores (adjusted means 10.5, p = .002). In addition, "both insecure" had a clinically important 5.7 point greater intimate partner vulnerability score. There were no significant interactions between food/housing and PTSD. CONCLUSIONS: Even in women receiving prenatal care and treatment for OUD, food/housing material hardships and associated psychosocial factors are of major concern, requiring screening and remediation.
BACKGROUND: While pregnant women in treatment for opioid use disorder (OUD) face considerable challenges, common material hardships- food insecurity and housing instability, known to negatively impact maternal-child health, have been inadequately researched within this population. This study describes food/housing hardships and evaluates associations with key psychosocial factors. METHODS: A single-site prospective study, 100 3rd trimester women receiving prenatal care and medication-assisted treatment for OUD were interviewed, including screening for food/housing hardships, depressive symptoms, intimate partner vulnerability; and self-reported post-traumatic stress disorder (PTSD) history. We developed a three-level categorization combining food/housing screening outcomes: 1) "both insecure"; 2) "either secure"; and 3) "both secure". Bivariate analyses and linear path analyses evaluated associations among psychosocial variables using "both secure" as the referent group. RESULTS: Of 100 women, 56% reported food insecurity; 61% housing instability; 42% "both insecure"; 33% "either insecure"; 25% "both secure". In unadjusted food/housing groups "either insecure" and "both insecure" reported significantly greater depressive symptoms; "both insecure" additionally reported significantly greater intimate partner vulnerability. Path analyses adjusted for PTSD and compared with "both secure" (adjusted mean = 6.2): "either insecure" had greater depressive symptom scores (adjusted means = 9.8, p = .01) while "both insecure" had greater depressive scores (adjusted means 10.5, p = .002). In addition, "both insecure" had a clinically important 5.7 point greater intimate partner vulnerability score. There were no significant interactions between food/housing and PTSD. CONCLUSIONS: Even in women receiving prenatal care and treatment for OUD, food/housing material hardships and associated psychosocial factors are of major concern, requiring screening and remediation.
Authors: Stephanie A Hooker; Michelle D Sherman; Mary Lonergan-Cullum; Adam Sattler; Bruce S Liese; Kathryn Justesen; Tanner Nissly; Robert Levy Journal: J Prim Care Community Health Date: 2020 Jan-Dec
Authors: Cindy D Chang; Mohsen Saidinejad; Zaza Atanelov; Ann M Dietrich; Samuel Hiu-Fung Lam; Emily Rose; Tim Ruttan; Sam Shahid; Michael J Stoner; Carmen Sulton; Corrie E Chumpitazi Journal: J Am Coll Emerg Physicians Open Date: 2021-07-21