Predicting length of treatment involvement of substance using perinatal women in an integrated inpatient healthcare program

Abstract

Services for perinatal (pregnant and one year postpartum) women are limited, and inpatient settings where women receive substance abuse services specific to the perinatal population, although ideal, are rare in eastern North Carolina. A collaborative effort between East Carolina University's Navigate-Pregnancy and Recovery Clinic (PARC), Vidant Medical Center, and Walter B. Jones Alcohol and Drug Center made services available to 96 pregnant and postpartum women with previous or present substance use issues. The women received group counseling, which was based in Motivational Interviewing. To improve outcomes for themselves and their babies, pregnant and postpartum substance using women must engage and remain in treatment. This exploratory, non-experimental, relational study examined: (a) the relationship between number of living children, number of previous treatment attempts, level of mental distress as measured by the Global Appraisal of Individual Needs-Short Screener (GAIN-SS), and level of behavioral complexity as measured by the GAIN-SS with the number of sessions completed by pregnant and postpartum women participating in a manual based motivational interviewing counseling and perinatal education group and (b) the relationship between positive attitudes towards breastfeeding as measured by the IOWA Infant Feeding Attitude Scale and the number of completed sessions. Simultaneous multiple regression analysis was used to evaluate potential predictors of number of treatment sessions completed. Pearson product--moment correlation coefficient was used to examine the relationship of positive attitudes towards breastfeeding and number of sessions attended by perinatal women participating in an inpatient manual based motivational interviewing counseling intervention and perinatal education group. Significance was not found for either research question. However, prospective results did reveal significance for predicting the number of treatment sessions that pregnant and postpartum women would attend based on current number of living children, number of previous treatment attempts, level of mental distress, and level of behavioral complexity when the sample size was doubled and tripled. Further research is needed to replicate the current findings. Suggestions for future research include: (a) replication of the study with a larger sample which includes additional predictors of treatment attendance such as involvement with Department of Social Services and criminal justice system (b) research which compares the Transtheoretical Model of Change/Processes of Change treatment to the traditional 12-step facilitation treatment and client attendance rates, (c) research which compares outpatient versus inpatient substance abuse treatment of perinatal women and client attendance rate, and (d) research that compares inpatient substance abuse treatment which allows for children to remain with their mothers during treatment versus having the children in foster care and/or kinship placement and client attendance rates.