Indirect Assessment and Intervention for Perinatal Drug Use
| Status: | Completed |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 45 |
| Updated: | 4/21/2016 |
| Start Date: | June 2012 |
| End Date: | May 2015 |
The purpose of this study is to assess the validity of an indirect computer-delivered
screener for drug use and assess the efficacy of a computer-delivered brief intervention
with urban post-partum women at-risk for substance abuse and HIV during the post-partum
period.
screener for drug use and assess the efficacy of a computer-delivered brief intervention
with urban post-partum women at-risk for substance abuse and HIV during the post-partum
period.
Two factors limit the potential of brief interventions for the reduction of substance abuse
and HIV risk. First, the ability to conduct such interventions is dependent upon willingness
to disclose drug use and risky sexual behaviors. This is a significant obstacle given
evidence that as few as half of drug-positive individuals-particularly women in the
perinatal period-report that use. Second, there are logistic and financial obstacles to
implementing even brief intervention programs, particularly with regard to time, training
and provider willingness. In response to these limitations, and with NIDA support
(DA018975), the Parent Health Lab at the Wayne State University School of Medicine developed
and validated a sensitive indirect screener that evaluates correlates of illicit drug use
rather than drug use itself. The Lab also developed a brief computer-delivered intervention
designed to build change motivation without presuming the presence of risks to accompany the
screener. This intervention demonstrated excellent feasibility and acceptability in Phase I
testing. Following NIDA's Stage Model of Behavioral Therapy Development, the proposed study
will take the next step of validating the computer-delivered indirect screening and
intervention process in a Phase II/Stage IIb trial with women determined to be at risk by
the indirect drug use screener. In addition, given that 47.8% of the prior sample's
participants had an STI at some point in their lives, the proposed study will also further
expand the existing focus on HIV risk. Specifically, we plan to: (a) continue development
and validation of the WIDUS screener via concomitant collection of WIDUS protocols and
hair/urine samples, as well as by building its ability to indirectly predict HIV risk; (b)
revise and upgrade the draft indirect intervention based on expert and participant informant
feedback; (c) recruit 500 at-risk women from an urban obstetric hospital; and (d) randomly
assign participants into intervention and control conditions, with blinded follow-up
assessments at 3- and 6-months. If proven efficacious, this logistically feasible,
replicable, and low-cost approach could allow a dramatic increase in the reach--and
therefore the population impact--of brief interventions for drug use among at-risk
post-partum women. Further, any impact on maternal drug use would be further multiplied by
indirect effects on the at-risk child.
and HIV risk. First, the ability to conduct such interventions is dependent upon willingness
to disclose drug use and risky sexual behaviors. This is a significant obstacle given
evidence that as few as half of drug-positive individuals-particularly women in the
perinatal period-report that use. Second, there are logistic and financial obstacles to
implementing even brief intervention programs, particularly with regard to time, training
and provider willingness. In response to these limitations, and with NIDA support
(DA018975), the Parent Health Lab at the Wayne State University School of Medicine developed
and validated a sensitive indirect screener that evaluates correlates of illicit drug use
rather than drug use itself. The Lab also developed a brief computer-delivered intervention
designed to build change motivation without presuming the presence of risks to accompany the
screener. This intervention demonstrated excellent feasibility and acceptability in Phase I
testing. Following NIDA's Stage Model of Behavioral Therapy Development, the proposed study
will take the next step of validating the computer-delivered indirect screening and
intervention process in a Phase II/Stage IIb trial with women determined to be at risk by
the indirect drug use screener. In addition, given that 47.8% of the prior sample's
participants had an STI at some point in their lives, the proposed study will also further
expand the existing focus on HIV risk. Specifically, we plan to: (a) continue development
and validation of the WIDUS screener via concomitant collection of WIDUS protocols and
hair/urine samples, as well as by building its ability to indirectly predict HIV risk; (b)
revise and upgrade the draft indirect intervention based on expert and participant informant
feedback; (c) recruit 500 at-risk women from an urban obstetric hospital; and (d) randomly
assign participants into intervention and control conditions, with blinded follow-up
assessments at 3- and 6-months. If proven efficacious, this logistically feasible,
replicable, and low-cost approach could allow a dramatic increase in the reach--and
therefore the population impact--of brief interventions for drug use among at-risk
post-partum women. Further, any impact on maternal drug use would be further multiplied by
indirect effects on the at-risk child.
Inclusion Criteria:
- 18 years of age or older
- able to communicate in English
- recently gave birth to healthy infant
Exclusion Criteria:
- received narcotic pain medication in past 3 hours
- no sleep since giving birth
- infant deceased or in intensive care
- psychosis or other clear cognitive impairment
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