Deborah J Rinehart1, Melanie Stowell2, Adriana Collings3, M Joshua Durfee4, Tara Thomas-Gale5, Hendrée E Jones6, Ingrid Binswanger7. 1. Center for Health Systems Research, Office of Research, Denver Health and Hospital Authority, 777 Bannock St., M.C. 6551, Denver, CO 80204, USA; Division of General Internal Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12631 E. 17(th) Ave., Aurora, CO 80045, USA. Electronic address: deborah.rinehart@dhha.org. 2. Center for Health Systems Research, Office of Research, Denver Health and Hospital Authority, 777 Bannock St., M.C. 6551, Denver, CO 80204, USA. Electronic address: melanie.stowell@dhha.org. 3. Center for Health Systems Research, Office of Research, Denver Health and Hospital Authority, 777 Bannock St., M.C. 6551, Denver, CO 80204, USA. Electronic address: adriana.collings@dhha.org. 4. Center for Health Systems Research, Office of Research, Denver Health and Hospital Authority, 777 Bannock St., M.C. 6551, Denver, CO 80204, USA. Electronic address: josh.durfee@dhha.org. 5. Ambulatory Care Services, Denver Health and Hospital Authority, 777 Bannock St., M.C. 1916, Denver, CO 80204, USA. Electronic address: tara.thomas-gale@dhha.org. 6. UNC Horizons and Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, 410 North Greensboro St., NC 27510, USA. Electronic address: hendree_jones@med.unc.edu. 7. Division of General Internal Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12631 E. 17(th) Ave., Aurora, CO 80045, USA; Institute for Health Research, Kaiser Permanente Colorado, PO Box 378066, Aurora, CO 80014, USA; Colorado Permanente Medical Group, 10350 E. Dakota Ave., Denver, CO 80247, USA. Electronic address: ingrid.a.binswanger@kp.org.
Abstract
OBJECTIVE: High rates of unintended pregnancy occur among women with opioid use disorder (OUD). OUD treatment settings may provide an ideal opportunity to address the family planning needs of patients. However, few studies have rigorously evaluated interventions designed to address family planning needs in the OUD treatment setting. This study assessed the feasibility, acceptability, and preliminary efficacy of a peer-led navigation intervention designed to educate and link women receiving medications for OUD to family planning services. METHODS: The study recruited women from four OUD treatment programs in Denver, Colorado, to participate in a pilot randomized controlled trial from March 2018 to February 2019. Eligible participants were English-speaking adult females who were neither pregnant nor desiring a pregnancy and who were not using a long-acting reversible contraceptive (LARC) method. Participants completed a baseline survey, and the study randomized them to receive a two-session, peer-led family planning navigation intervention or usual care. The study assessed feasibility by participant engagement in the intervention. The study used follow-up self-report surveys and electronic health record data to assess intervention acceptability and intervention efficacy for the primary outcomes of a family planning visit and use of a LARC method. RESULTS: The study enrolled 119 women who were randomized to the Sexual Health Initiative for Navigation and Empowerment (SHINE) peer-led navigation intervention (n = 56) or usual care (n = 63). The average age was 32 (SD = 6.4); 76% were receiving methadone, 24% were receiving buprenorphine and 19% reported a treatment provider had ever discussed family planning with them. Most had a previous pregnancy (82%) and of these, 93% reported an unplanned pregnancy. Among intervention participants, 93% completed the first navigation session, 90% felt that intervention topics were important, 76% indicated that the information was new, and 82% found working with a peer helpful. At six months postbaseline, significantly more (p = 0.01) intervention participants (36%) received a family planning visit compared to control participants (14%). There was no between-group difference on use of LARC methods. CONCLUSIONS: A peer-led family planning navigation intervention was feasible to implement, acceptable to participants, and showed evidence of preliminary efficacy. This model may be an effective and potentially sustainable approach to support the family planning needs of women in treatment for OUD.
OBJECTIVE: High rates of unintended pregnancy occur among women with opioid use disorder (OUD). OUD treatment settings may provide an ideal opportunity to address the family planning needs of patients. However, few studies have rigorously evaluated interventions designed to address family planning needs in the OUD treatment setting. This study assessed the feasibility, acceptability, and preliminary efficacy of a peer-led navigation intervention designed to educate and link women receiving medications for OUD to family planning services. METHODS: The study recruited women from four OUD treatment programs in Denver, Colorado, to participate in a pilot randomized controlled trial from March 2018 to February 2019. Eligible participants were English-speaking adult females who were neither pregnant nor desiring a pregnancy and who were not using a long-acting reversible contraceptive (LARC) method. Participants completed a baseline survey, and the study randomized them to receive a two-session, peer-led family planning navigation intervention or usual care. The study assessed feasibility by participant engagement in the intervention. The study used follow-up self-report surveys and electronic health record data to assess intervention acceptability and intervention efficacy for the primary outcomes of a family planning visit and use of a LARC method. RESULTS: The study enrolled 119 women who were randomized to the Sexual Health Initiative for Navigation and Empowerment (SHINE) peer-led navigation intervention (n = 56) or usual care (n = 63). The average age was 32 (SD = 6.4); 76% were receiving methadone, 24% were receiving buprenorphine and 19% reported a treatment provider had ever discussed family planning with them. Most had a previous pregnancy (82%) and of these, 93% reported an unplanned pregnancy. Among intervention participants, 93% completed the first navigation session, 90% felt that intervention topics were important, 76% indicated that the information was new, and 82% found working with a peer helpful. At six months postbaseline, significantly more (p = 0.01) intervention participants (36%) received a family planning visit compared to control participants (14%). There was no between-group difference on use of LARC methods. CONCLUSIONS: A peer-led family planning navigation intervention was feasible to implement, acceptable to participants, and showed evidence of preliminary efficacy. This model may be an effective and potentially sustainable approach to support the family planning needs of women in treatment for OUD.
Keywords:
Buprenorphine; Family planning; Medications for opioid use disorder; Methadone; Opioid use disorder; Peer navigation; Reproductive health; Sexual health
Authors: Sarah H Heil; Hendree E Jones; Amelia Arria; Karol Kaltenbach; Mara Coyle; Gabriele Fischer; Susan Stine; Peter Selby; Peter R Martin Journal: J Subst Abuse Treat Date: 2010-10-30
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: Patrick W Corrigan; Dana J Kraus; Susan A Pickett; Annie Schmidt; Ed Stellon; Erin Hantke; Juana Lorena Lara Journal: Psychiatr Serv Date: 2017-01-17 Impact factor: 3.084
Authors: Catalina N Rey; Gary J Badger; Heidi S Melbostad; Deborah Wachtel; Stacey C Sigmon; Lauren K MacAfee; Anne K Dougherty; Sarah H Heil Journal: Contraception Date: 2020-02-01 Impact factor: 3.375
Authors: Nancy Carter; Ruta K Valaitis; Annie Lam; Janice Feather; Jennifer Nicholl; Laura Cleghorn Journal: BMC Health Serv Res Date: 2018-02-08 Impact factor: 2.655
Authors: Lauren K Whiteside; Ly Huynh; Sophie Morse; Jane Hall; William Meurer; Caleb J Banta-Green; Hannah Scheuer; Rebecca Cunningham; Mark McGovern; Douglas F Zatzick Journal: J Subst Abuse Treat Date: 2021-11-24