growing together: women in opioid treatment and their infants

Conditions: Substance-Related Disorders

Summary: this study evaluates the effectiveness of the home-based therapeutic parenting intervention bright with pregnant women and postpartum mothers with opioid use disorders (ouds) and their infants. it examines whether participation in the bright intervention improves parent-child relationships, parenting capacities, the mother's overall mental health, participation in oud treatment, infant social-emotional development and decreases the likelihood of child maltreatment. approximately half of the participants will receive the bright intervention, monthly handouts, and the standard of care at the maternal-fetal medical clinic and the other half will receive star, or enhanced treatment as usual (tau+), which includes monthly handouts and the standard of care from the medical clinic.

growing together is a two-armed pragmatic randomized controlled trial of a trauma and evidence-informed therapeutic parenting intervention, bright. this trial lasts approximately 9 months. bright has been offered to young children ages birth through 6 years and their parents affected by substance use disorders (suds) to mitigate the effects of trauma, promote resilience, and enhance the quality of parent-child relationships and parenting skills. bright has been successfully piloted and evaluated within residential treatment and outpatient opioid treatment programs for pregnant women/mothers with suds and ouds with young children . for this study, bright has been adapted for home-based delivery for pregnant women receiving treatment for ouds and is offered from the 3rd trimester of pregnancy until the infant is about 6 months old. participants in both arms will be recruited from a high-risk maternal-fetal medicine clinic and followed for approximately 15 months. the two arms of the trial are 1) the bright (building resilience through intervention, growing healthier together) intervention, and 2) star. both arms of the study will receive the typical standard of care of at a high-risk maternal-fetal medical clinic and 7 monthly psycho-educational handouts on child development specifically for mothers in recovery. the investigators are testing the effectiveness of the adapted version of bright by utilizing measures to examine if participation in bright decreases the likelihood of child maltreatment, improves parent-child relationships, parenting capacities, the mother's overall mental health, participation in oud treatment, and infant social-emotional development.

Eligibility criteria:
inclusion criteria: * a patient at bumc respect clinic with history of opioid use or history of polysubstance use * 18 years orolder * being treated with methadone, naltrexone, or suboxone * in 3rd trimester of pregnancy * deemed by mds able to give informed consent * planning to parent infant after birth * willing to participate in rct exclusion criteria: * planning to relinquish custody of neonate * residing, or expected to reside post-birth 20+ miles from boston * deemed by mds unable to give informed consent

Keywords: maternal opioid use substance use parent-child relationship parenting social and emotional development mental health and well-being perinatal postpartum health disparities