Video Coaching for Opioid-Using Mothers
Recruiting in Palo Alto (17 mi)
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.
12345How 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.
45678Eligibility 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.
+3 more
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
Participant Groups
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.
2Treatment groups
Experimental Treatment
Active Control
Group I: Filming Interactions to Nurture Development (FIND)Experimental Treatment1 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 Control1 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.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of OregonEugene, OR
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Who Is Running the Clinical Trial?
University of OregonLead Sponsor
References
Coordinating Outpatient Care for Pregnant and Postpartum Women with Opioid Use Disorder: Implications from the COACHH Program. [2020]Purpose With the rise of opioid use disorder (OUD) among women of childbearing age, effective care models must address the complex needs of pregnant and postpartum women with OUD. This paper describes promising practices and implementation challenges from the Collaborative Outreach and Adaptable Care at Hallmark Health (COACHH) program, which utilizes a collaborative care team to coordinate outpatient care for pregnant and postpartum women with OUD. Description Semi-structured interviews were conducted with members of the COACHH team to discuss program logistics and takeaways. Interviews were coded to analyze themes. Assessment The COACHH team identified the need for specialized, time-intensive care coordination to address the unique needs of pregnant and postpartum women with OUD. First, the team prioritizes forming trusting relationships with patients to holistically understand patients' needs, improve patient engagement, and connect patients with resources. Second, the wide range of patient needs necessitates a team with diverse professional skills, whose members share an understanding of addiction and pregnancy. Third, finding the right quantitative outcome measurements is difficult; instead, success is measured in qualitative terms, stressing relationships and engagement as signals of change. Finally, the team encounters challenges with low referral rates, lack of provider awareness, and fragmented services. Conclusion We identified care delivery and program design considerations that may inform others who wish to coordinate care for pregnant and postpartum women with OUD. The program continues to face challenges enrolling patients and measuring outcomes, reflecting the need for tailored approaches and metrics for this population.
Group Well Child Care for Mothers with Opioid Use Disorder: Framework for Implementation. [2023]For parents with opioid use disorder (OUD) and their children, group well child care (WCC) is an under-studied intervention that may reduce stigma, increase quality of care, and improve clinical outcomes. We explored barriers and facilitators to this intervention using an implementation science framework.
The Impact of a Multidisciplinary Opioid Use Disorder Prenatal Clinic on Breastfeeding Rates and Postpartum Care. [2022]To evaluate the hypothesis that patients with opioid use disorder (OUD), who receive prenatal care in a multidisciplinary, prenatal OUD clinic, have comparable postpartum breastfeeding rates, prenatal and postpartum visit compliance, and postpartum contraceptive use when compared with matched controls without a diagnosis of OUD.
Project BETTER: Preliminary Feasibility and Acceptability of a Technology-Delivered Educational Program for Pregnant and Postpartum People with Opioid Use Disorder. [2022]Postpartum people with opioid use disorder (OUD) report feeling underprepared for the pregnancy to postpartum transition. We developed a novel, technology-delivered educational intervention for pregnant and parenting people with OUD to address this gap. This study provides a theoretically grounded assessment of the feasibility and acceptability of a new technology-delivered educational intervention (Project BETTER) for pregnant and parenting people receiving medication for OUD (MOUD).
Project BETTER: A Family-Centered, Technology-Delivered Intervention for Pregnant People with Opioid Use Disorder. [2023]Birthing people with opioid use disorder (OUD) face unique stressors during the transition from pregnancy to postpartum that can negatively impact the maternal-infant dyad. This study aimed to describe the development of a family-centered, technology-delivered intervention tailored to help pregnant people receiving medication for OUD (MOUD) prepare for this transition. Formative data from patients and providers identified intervention content: (1) recovery-oriented strategies for the pregnancy-to-postpartum transition; (2) guidance around caring for an infant with opioid withdrawal symptoms; and (3) preparation for child welfare interactions. The content was reviewed in successive rounds by an expert panel and modified. Pregnant and postpartum people receiving MOUD pre-tested the intervention modules and provided feedback in semi-structured interviews. The multidisciplinary expert panel members (n = 15) identified strengths and areas for improvement. Primary areas for improvement included adding content, providing more structure to help participants navigate the intervention more easily, and revising language. Pre-testing participants (n = 9) highlighted four themes: reactions to intervention content, navigability of the intervention, feasibility of the intervention, and recommendation of the intervention. All iterative feedback was incorporated into the final intervention modules for the prospective randomized clinical trial. Family-centered interventions tailored for pregnant people receiving MOUD should be informed by patient-reported needs and multidisciplinary perspectives.
Self-Identified Stage in Recovery and Substance-Use Behaviors among Pregnant and Postpartum Women and People with Opioid Use Disorder. [2023]Opioid use among pregnant and postpartum women and people (PPWP) has significant health repercussions. This study explores how substance-use behaviors may vary by stage in recovery among PPWP with opioid use disorder (OUD). We recruited 29 PPWP with OUD. "High-risk" participants self-identified as "not being engaged in treatment" or "new or early in their recovery" (n = 11); "low-risk" participants self-identified as being "well-established" or "in long-term recovery" (n = 18). Participants were queried regarding sociodemographic, mental health, and drug-misuse factors; urine drug screens were collected at baseline. Univariate group comparisons between high-risk and low-risk PPWP were conducted. High-risk PPWP were more likely to self-identify as non-Hispanic African American and more likely to report current opioid use, other illicit drugs, and tobacco. High-risk PPWP had higher opioid cravings versus low-risk PPWP. High-risk PPWP were more likely to screen positive on urine tests for non-opioid drugs and on concurrent use of both non-opioid drugs and opioids versus low-risk participants. PPWP earlier in recovery are at higher-risk for opioid and other illicit drug misuse but are willing to disclose aspects of their recent use. PPWP early in recovery are an ideal population for interventions that can help facilitate recovery during the perinatal period and beyond.
Unpacking Perinatal Experiences with Opioid Use Disorder: Relapse Risk Implications. [2023]While pregnancy presents a strong motivation to seek and comply with treatment for opioid use disorder (OUD), many women relapse within the first year of childbirth. Addressing relapse risk, we examined the perinatal experiences of mothers with OUD through 6 months postpartum. We recruited mothers (N = 42) with a history of OUD into the Newborn Attachment and Wellness study, all of whom met with a child welfare worker immediately after giving birth. In qualitative interviews, mothers described their social, physical, emotional, and psychological perinatal experiences. Seven themes categorically informed relapse risk (i.e., related to childhood bond, mother-infant attachment, birth support, child protective services, breastfeeding, mental health, and recovery planning). In conclusion, we noted a critical window in which clinical social workers and other health/behavioral health providers have the opportunity to capitalize on mothers' desire not to "ever want to touch it again." We outline specific avenues for directed support in the perinatal and postpartum period associated with reduced risk for relapse, and we make recommendations to enhance risk assessment practices.
Engagement in Early Intervention Services Among Mothers in Recovery From Opioid Use Disorders. [2022]Opioid-exposed infants frequently qualify for early intervention (EI). However, many eligible families choose not to enroll in this voluntary service. This study aims to understand the perceptions and experiences that may impact engagement with, and the potential benefits of, EI services among mothers in recovery from opioid use disorders (OUDs).