Video Coaching for Opioid-Using Mothers

Overseen by Philip A Fisher, Ph.D.

Age: < 65

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of Oregon

Disqualifiers: Metal implants, Pregnancy, Neurological disorders, others

No Placebo Group

Trial Summary

What is the purpose of this trial?

This trial tests a video coaching program called FIND to help women using opioids improve their parenting skills. The program targets mothers with young children and uses video feedback to enhance caregiving, which may also support the mothers' recovery and well-being.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Filming Interactions to Nurture Development (FIND) for opioid-using mothers?

While there is no direct data on the effectiveness of FIND for opioid-using mothers, similar interventions like Project BETTER and COACHH show that tailored, family-centered, and collaborative care approaches can help address the unique needs of pregnant and postpartum women with opioid use disorder, suggesting potential benefits for FIND in this context. ^{1 2 3 4 5}

How is the FIND treatment different from other treatments for opioid-using mothers?

The FIND treatment is unique because it uses video coaching to support opioid-using mothers, focusing on nurturing child development through filmed interactions, which is different from traditional treatments that may not emphasize this interactive and developmental approach. ^{4 5 6 7 8}

Research Team

Philip A Fisher, Ph.D.

Principal Investigator

University of Oregon

Eligibility Criteria

This trial is for adult mothers (18+) who are in or have been referred to treatment for opioid misuse and have custody of their child, aged 0-36 months, at least half the time each week. It's not suitable for those with claustrophobia, neurological disorders, a weight over 550 lbs, left-handedness, pregnancy or potential pregnancy, or any metal implants/electronic medical devices.

Inclusion Criteria

I am an adult mother with a child who is 3 years old or younger.

I have custody of my child for at least half of each week.

Must be in or have been referred for treatment due to maternal opioid use

Exclusion Criteria

I am or might be pregnant.

You are left-handed.

You weigh more than 550 pounds.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the FIND or HTP intervention over 10 weekly sessions

10 weeks

10 visits (in-person)

Follow-up

Participants are monitored for changes in parenting skills and child development outcomes

6 months

Treatment Details

Interventions

• Filming Interactions to Nurture Development (Behavioral Intervention)
• The Healthy Toddler Program (Behavioral Intervention)

Trial Overview The study is testing a video coaching program called Filming Interactions to Nurture Development (FIND), designed to improve parenting among mothers dealing with opioid addiction. The Healthy Toddler Program is also part of the intervention being evaluated.

Participant Groups

Group I: Filming Interactions to Nurture Development (FIND) Experimental Treatment 1 Intervention

FIND is a brief video coaching intervention which involves feedback provided by the coach to the caregiver using brief film clips derived from video of caregiver-child interaction. The coaching focuses on showing caregivers instances in which they are engaging in developmentally-supportive interactions during coaching sessions. FIND is delivered over 10 weekly sessions lasting 30-45 minutes. The process begins with an initial session in which the coach provides an overview, records 10-15 minutes of caregiver-child interaction, then introduces the concept of serve and return. The video is edited to show brief clips in which the caregiver is engaged in the first of five specific caregiver-based components of serve and return. The next week, the FIND coach reviews the edited clips in detail with the caregiver. Sessions continue, alternating between filming and coaching sessions until all five components have been covered sequentially.

Group II: The Healthy Toddler Program (HTP) Active Control 1 Intervention

HTP, the active control intervention, consists of weekly sessions alternating between (a) coaching sessions covering one of five domains of child development (Motor, Cognitive, Language, Play, and Social-Emotional and (b) observation sessions that will include a review of the prior coaching session and an observation and discussion of the caregiver-child interaction. This intervention will consist of 10 sessions each lasting 25-30 minutes. The coach will not engage in any filming or video coaching, but will be able to discuss caregiving concerns. HTP materials are adapted from the Partners for a Healthy Baby curriculum developed by Florida State University's Center for Prevention and Early Intervention Policy.

Who Is Running the Clinical Trial?

University of Oregon

Lead Sponsor

Trials

91

Recruited

46,700+

Marc Lesnick

University of Oregon

Chief Executive Officer since 2023

PhD in Biology, University of Oregon

Frank Czerwiec

University of Oregon

Chief Medical Officer since 2024

PhD in Biochemistry & Molecular Biology and MD, University of Miami

Findings from Research

The COACHH program emphasizes the importance of building trusting relationships with pregnant and postpartum women with opioid use disorder (OUD) to enhance patient engagement and effectively address their complex needs.

A diverse care team is essential for providing specialized, time-intensive support, but challenges such as low referral rates and difficulties in measuring outcomes highlight the need for tailored care approaches for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Coordinating Outpatient Care for Pregnant and Postpartum Women with Opioid Use Disorder: Implications from the COACHH Program. Hodgins, FE., Lang, JM., Malseptic, GG., et al.[2020]

A qualitative study involving 31 parents with opioid use disorder and 13 pediatric clinicians revealed that most parents (68%) are open to participating in group well child care (WCC) at their OUD treatment center, indicating a potential for increased engagement in care.

The study identified key barriers to implementing group WCC, such as concerns about privacy and complexity, as well as facilitators like peer support and clinician expertise, which can help shape future implementation strategies for this intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Group Well Child Care for Mothers with Opioid Use Disorder: Framework for Implementation. Goyal, N., Gannon, M., Sood, E., et al.[2023]

A pilot study involving 28 pregnant and postpartum individuals receiving medication for opioid use disorder (OUD) showed that a technology-delivered educational intervention (Project BETTER) was feasible, with 61% agreeing to participate and 70% completing the modules.

Participants reported high acceptability of the intervention, feeling more comfortable and less stigmatized learning through the technology compared to traditional provider-led education, indicating potential benefits for enhancing prenatal education in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Project BETTER: Preliminary Feasibility and Acceptability of a Technology-Delivered Educational Program for Pregnant and Postpartum People with Opioid Use Disorder. Martin, S., Parlier-Ahmad, AB., Eglovitch, M., et al.[2022]

A family-centered, technology-delivered intervention was developed to support pregnant individuals with opioid use disorder (OUD) during their transition to postpartum, focusing on recovery strategies, infant care, and child welfare preparation.

Feedback from both patients and a multidisciplinary expert panel was crucial in refining the intervention, ensuring it met the needs of the target population and enhancing its usability for future clinical trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Project BETTER: A Family-Centered, Technology-Delivered Intervention for Pregnant People with Opioid Use Disorder. Parlier-Ahmad, AB., Eglovitch, M., Martin, S., et al.[2023]

Pregnant and postpartum women with opioid use disorder (OUD) who are early in their recovery are at a higher risk for continued opioid and other drug misuse, as shown by a study of 29 participants that highlighted significant differences in substance use behaviors between high-risk and low-risk groups.

High-risk participants, who were less engaged in treatment, reported higher opioid cravings and were more likely to test positive for non-opioid drugs, indicating a critical need for targeted interventions to support this vulnerable population during the perinatal period.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-Identified Stage in Recovery and Substance-Use Behaviors among Pregnant and Postpartum Women and People with Opioid Use Disorder. Szlyk, HS., Constantino-Pettit, A., Li, X., et al.[2023]

A study involving 42 mothers with a history of opioid use disorder (OUD) revealed that their perinatal experiences significantly influence the risk of relapse within the first year postpartum.

Identified themes such as mother-infant attachment, mental health, and support systems highlight critical areas where healthcare providers can offer targeted support to reduce relapse risk during the postpartum period.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Unpacking Perinatal Experiences with Opioid Use Disorder: Relapse Risk Implications. Rankin, L., Mendoza, NS., Grisham, L.[2023]

Mothers in recovery from opioid use disorders often face emotional barriers such as fear, guilt, and shame, which hinder their enrollment in early intervention services for their opioid-exposed infants.

Perceived stigma and the need for personal connections with service providers are significant factors influencing mothers' decisions to engage with early intervention, suggesting that a supportive, strengths-based approach could improve participation rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Engagement in Early Intervention Services Among Mothers in Recovery From Opioid Use Disorders. Peacock-Chambers, E., Feinberg, E., Senn-McNally, M., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Coordinating Outpatient Care for Pregnant and Postpartum Women with Opioid Use Disorder: Implications from the COACHH Program. [2020]

2. United States pubmed.ncbi.nlm.nih.gov

Group Well Child Care for Mothers with Opioid Use Disorder: Framework for Implementation. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

The Impact of a Multidisciplinary Opioid Use Disorder Prenatal Clinic on Breastfeeding Rates and Postpartum Care. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Project BETTER: Preliminary Feasibility and Acceptability of a Technology-Delivered Educational Program for Pregnant and Postpartum People with Opioid Use Disorder. [2022]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Project BETTER: A Family-Centered, Technology-Delivered Intervention for Pregnant People with Opioid Use Disorder. [2023]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Self-Identified Stage in Recovery and Substance-Use Behaviors among Pregnant and Postpartum Women and People with Opioid Use Disorder. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Unpacking Perinatal Experiences with Opioid Use Disorder: Relapse Risk Implications. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Engagement in Early Intervention Services Among Mothers in Recovery From Opioid Use Disorders. [2022]