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Schiff DM, Partridge S, Gummadi NH, et al. Caring for Families Impacted by Opioid Use: A Qualitative Analysis of Integrated Program Designs. Acad Pediatr. 2021;22(1):125-136doi: 10.1016/j.acap.2021.04.016.
Schiff, D. M., Partridge, S., Gummadi, N. H., Gray, J. R., Stulac, S., Costello, E., Wachman, E. M., Jones, H. E., Greenfield, S. F., Taveras, E. M., & Bernstein, J. A. (2022). Caring for Families Impacted by Opioid Use: A Qualitative Analysis of Integrated Program Designs. Academic pediatrics, 22(1), 125-136. https://doi.org/10.1016/j.acap.2021.04.016
Schiff, Davida M, et al. "Caring for Families Impacted by Opioid Use: A Qualitative Analysis of Integrated Program Designs." Academic pediatrics vol. 22,1 (2022): 125-136. doi: https://doi.org/10.1016/j.acap.2021.04.016
Schiff DM, Partridge S, Gummadi NH, Gray JR, Stulac S, Costello E, Wachman EM, Jones HE, Greenfield SF, Taveras EM, Bernstein JA. Caring for Families Impacted by Opioid Use: A Qualitative Analysis of Integrated Program Designs. Acad Pediatr. 2022 Jan-Feb;22(1):125-136. doi: 10.1016/j.acap.2021.04.016. Epub 2021 Apr 24. PMID: 33901729; PMCID: PMC8542059.
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Acad Pediatr. 2022 Jan-Feb;22(1):125-136. doi: 10.1016/j.acap.2021.04.016. Epub 2021 Apr 24.

Caring for Families Impacted by Opioid Use: A Qualitative Analysis of Integrated Program Designs.

Academic pediatrics

Davida M Schiff, Shayla Partridge, Nina H Gummadi, Jessica R Gray, Sara Stulac, Eileen Costello, Elisha M Wachman, Hendrée E Jones, Shelly F Greenfield, Elsie M Taveras, Judith A Bernstein

Affiliations

  1. Division of General Academic Pediatrics, Massachusetts General Hospital for Children (DM Schiff, S Patridge, and EM Taveras), Boston, Mass. Electronic address: [email protected].
  2. Division of General Academic Pediatrics, Massachusetts General Hospital for Children (DM Schiff, S Patridge, and EM Taveras), Boston, Mass.
  3. Boston University School of Medicine (NH Gummadi, S Stulac, and E Costello), Boston, Mass.
  4. Department of Medicine and Pediatrics, Massachusetts General Hospital (JR Gray), Boston, Mass.
  5. Boston University School of Medicine (NH Gummadi, S Stulac, and E Costello), Boston, Mass; Department of Pediatrics, Boston Medical Center (S Stulac, E Costello, and EM Wachman), Boston, Mass.
  6. Department of Pediatrics, Boston Medical Center (S Stulac, E Costello, and EM Wachman), Boston, Mass.
  7. UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina Chapel Hill (HE Jones), Carrboro, NC.
  8. Division of Women's Mental Health and Division of Alcohol, Drugs, and Addiction, McLean Hospital (SF Greenfield), Belmont, Mass; Harvard Medical School (SF Greenfield), Boston, Mass.
  9. Division of Community Health Sciences, Boston University School of Public Health (JA Bernstein), Boston, Mass.

PMID: 33901729 PMCID: PMC8542059 DOI: 10.1016/j.acap.2021.04.016

Abstract

OBJECTIVE: We sought to 1) identify models of integrated care that offer medical care and social services for children and families impacted by opioid use disorder (OUD) in the postpartum year; and 2) describe how each program was developed, designed, and sustained, and explore facilitators and barriers to implementation of a dyadic, two-generation approach to care.

METHODS: In-depth semi-structured interviews (n = 23) were conducted with programs for women and children affected by OUD across North America. Using a phenomenologic approach, key program components and themes were identified. Following thematic saturation, these results were triangulated with experts in program implementation and with a subset of key informants to ensure data integrity.

RESULTS: Five distinct types of programs were identified that varied in the degree of medical and behavioral care for families. Three themes emerged unique to the provision of dyadic care: 1) families require supportive, frequent visits with a range of providers, but constraints around billable services limit care integration across the perinatal continuum; 2) individual program champions are critical, but degree and reach of interdisciplinary care is limited by siloed systems for medical and behavioral care; and 3) addressing dual, sometimes competing, responsibilities for both parental and infant health following recurrence of parental substance use presents unique challenges.

CONCLUSIONS: The key components of dyadic care models for families impacted by OUD included prioritizing care coordination, removing barriers to integrating medical and behavioral services, and ensuring the safety of children in homes with ongoing parental substance use while maintaining parental trust.

Copyright © 2021 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Keywords: family-based care; neonatal abstinence syndrome; opioid use disorder; opioid-exposed dyad; postpartum

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