Pregnant women in treatment for opioid use disorder: Material hardships and psychosocial factors.
Adult
Cohort Studies
Depression
/ epidemiology
Female
Food Supply
/ statistics & numerical data
Ill-Housed Persons
/ statistics & numerical data
Housing
/ statistics & numerical data
Humans
Intimate Partner Violence
/ statistics & numerical data
Mental Health Recovery
Opioid-Related Disorders
/ epidemiology
Pregnancy
Pregnancy Complications
/ epidemiology
Stress Disorders, Post-Traumatic
/ epidemiology
Young Adult
Food insecurity
Housing instability
Material hardships
Maternal-child health
Opioid use disorder treatment
Journal
Addictive behaviors
ISSN: 1873-6327
Titre abrégé: Addict Behav
Pays: England
ID NLM: 7603486
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
13
02
2019
revised:
28
05
2019
accepted:
19
06
2019
pubmed:
14
7
2019
medline:
29
10
2020
entrez:
14
7
2019
Statut:
ppublish
Résumé
While pregnant women in treatment for opioid use disorder (OUD) face considerable challenges, common material hardships- food insecurity and housing instability, known to negatively impact maternal-child health, have been inadequately researched within this population. This study describes food/housing hardships and evaluates associations with key psychosocial factors. A single-site prospective study, 100 3rd trimester women receiving prenatal care and medication-assisted treatment for OUD were interviewed, including screening for food/housing hardships, depressive symptoms, intimate partner vulnerability; and self-reported post-traumatic stress disorder (PTSD) history. We developed a three-level categorization combining food/housing screening outcomes: 1) "both insecure"; 2) "either secure"; and 3) "both secure". Bivariate analyses and linear path analyses evaluated associations among psychosocial variables using "both secure" as the referent group. Of 100 women, 56% reported food insecurity; 61% housing instability; 42% "both insecure"; 33% "either insecure"; 25% "both secure". In unadjusted food/housing groups "either insecure" and "both insecure" reported significantly greater depressive symptoms; "both insecure" additionally reported significantly greater intimate partner vulnerability. Path analyses adjusted for PTSD and compared with "both secure" (adjusted mean = 6.2): "either insecure" had greater depressive symptom scores (adjusted means = 9.8, p = .01) while "both insecure" had greater depressive scores (adjusted means 10.5, p = .002). In addition, "both insecure" had a clinically important 5.7 point greater intimate partner vulnerability score. There were no significant interactions between food/housing and PTSD. Even in women receiving prenatal care and treatment for OUD, food/housing material hardships and associated psychosocial factors are of major concern, requiring screening and remediation.
Sections du résumé
BACKGROUND
While pregnant women in treatment for opioid use disorder (OUD) face considerable challenges, common material hardships- food insecurity and housing instability, known to negatively impact maternal-child health, have been inadequately researched within this population. This study describes food/housing hardships and evaluates associations with key psychosocial factors.
METHODS
A single-site prospective study, 100 3rd trimester women receiving prenatal care and medication-assisted treatment for OUD were interviewed, including screening for food/housing hardships, depressive symptoms, intimate partner vulnerability; and self-reported post-traumatic stress disorder (PTSD) history. We developed a three-level categorization combining food/housing screening outcomes: 1) "both insecure"; 2) "either secure"; and 3) "both secure". Bivariate analyses and linear path analyses evaluated associations among psychosocial variables using "both secure" as the referent group.
RESULTS
Of 100 women, 56% reported food insecurity; 61% housing instability; 42% "both insecure"; 33% "either insecure"; 25% "both secure". In unadjusted food/housing groups "either insecure" and "both insecure" reported significantly greater depressive symptoms; "both insecure" additionally reported significantly greater intimate partner vulnerability. Path analyses adjusted for PTSD and compared with "both secure" (adjusted mean = 6.2): "either insecure" had greater depressive symptom scores (adjusted means = 9.8, p = .01) while "both insecure" had greater depressive scores (adjusted means 10.5, p = .002). In addition, "both insecure" had a clinically important 5.7 point greater intimate partner vulnerability score. There were no significant interactions between food/housing and PTSD.
CONCLUSIONS
Even in women receiving prenatal care and treatment for OUD, food/housing material hardships and associated psychosocial factors are of major concern, requiring screening and remediation.
Identifiants
pubmed: 31301645
pii: S0306-4603(19)30184-4
doi: 10.1016/j.addbeh.2019.106030
pii:
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
106030Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.