This past fall, Dr. Christa Lilly, PhD presented at the annual American Public Health Association (APHA) annual meeting and expo in San Diego, California. Her presentation was titled “Quantitative and qualitative assessment of the Drug Free Moms and Babies Project: A rural, Appalachia pilot project to support healthy baby outcomes.” The Drug-Free Moms and Babies Project (DFMB) pilot program (4 sites; 2012-2017) was designed to develop and evaluate programs that provide treatment and recovery services for pregnant and postpartum women with substance use disorders.
Qualitative assessment was conducted via interviews on programmatic design components. The quantitative assessment utilized a survey on patient demographic, medical and substance use histories, services, and maternal and child health outcome data. Qualitative results followed a SBIRT model (screening, brief intervention, referral, and treatment).
Treatments included case management, counseling, peer recovery coaching, medication assisted treatment, and education. Lessons learned included importance of collaborative team, and program development may be time-intensive. A dedicated staff position along with team flexibility were critical towards programmatic success.
For quantitative results, there were 510 unique participants. Most women had HS/GED or less education (83%) and Medicaid insurance (93%). Prior to pregnancy, most women reported tobacco (91%), cannabis (83%), opioid (77%), and/or stimulant use (41%). Tobacco use remained high during pregnancy (80%), as did cannabis (53%), and opioid use (67%). Urine drug screen data showed a reduction of non-prescribed positive screens among the 354 program completers, from 80% positive in the first trimester to 21% positive during delivery. 83% of the women experienced a live, term birth, and 8% a preterm birth. 47% of the births had cord tissue that tested positive for drugs, but only 55% of those were for non-prescribed drugs.
In summary, DFMB Program pilot program reached high-risk, medically underserved women, with positive maternal and child health outcomes.
To listen to Dr. Lilly’s recorded presentation please visit APHA’s website: https://apha.confex.com/apha/2018/meetingapp.cgi/Paper/399356