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Development of an Electronic Screening and Brief Intervention to Address Perinatal Substance Use in Home Visiting: Qualitative User-Centered Approach

BACKGROUND: Perinatal substance use (SU) is prevalent during pregnancy and the postpartum period and may increase the risks to maternal and child health. Many pregnant and postpartum women do not seek treatment for SU because of fear of child removal. Home visiting (HV), a voluntary supportive progr...

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Autores principales: Dauber, Sarah, Hammond, Cori, Hogue, Aaron, Henderson, Craig, Nugent, Jessica, Ford, Veronica, Brown, Jill, Scott, Lenore, Ondersma, Steven
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682454/
https://www.ncbi.nlm.nih.gov/pubmed/36346648
http://dx.doi.org/10.2196/37865
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author Dauber, Sarah
Hammond, Cori
Hogue, Aaron
Henderson, Craig
Nugent, Jessica
Ford, Veronica
Brown, Jill
Scott, Lenore
Ondersma, Steven
author_facet Dauber, Sarah
Hammond, Cori
Hogue, Aaron
Henderson, Craig
Nugent, Jessica
Ford, Veronica
Brown, Jill
Scott, Lenore
Ondersma, Steven
author_sort Dauber, Sarah
collection PubMed
description BACKGROUND: Perinatal substance use (SU) is prevalent during pregnancy and the postpartum period and may increase the risks to maternal and child health. Many pregnant and postpartum women do not seek treatment for SU because of fear of child removal. Home visiting (HV), a voluntary supportive program for high-risk families during the perinatal period, is a promising avenue for addressing unmet SU needs. Confidential delivery of screening and brief intervention (BI) for SU via computers has demonstrated high user satisfaction among pregnant and postpartum women as well as efficacy in reducing perinatal SU. This study describes the development of the electronic screening and BI for HV (e–SBI-HV), a digital screening and BI program that is adapted from an existing electronic screening and BI (e-SBI) for perinatal SU and tailored to the HV context. OBJECTIVE: This study aimed to describe the user-centered intervention development process that informed the adaptation of the original e-SBI into the e–SBI-HV, present specific themes extracted from the user-centered design process that directly informed the e–SBI-HV prototype and describe the e–SBI-HV prototype. METHODS: Adaptation of the original e-SBI into the e–SBI-HV followed a user-centered design process that included 2 phases of interviews with home visitors and clients. The first phase focused on adaptation and the second phase focused on refinement. Themes were extracted from the interviews using inductive coding methods and systematically used to inform e–SBI-HV adaptations. Participants included 17 home visitors and 7 clients across 3 Healthy Families America programs in New Jersey. RESULTS: The e–SBI-HV is based on an existing e-SBI for perinatal SU that includes screening participants for SU followed by a brief motivational intervention. On the basis of the themes extracted from the user-centered design process, the original e-SBI was adapted to address population-specific motivating factors, address co-occurring problems, address concerns about confidentiality, acknowledge fear of child protective services, capitalize on the home visitor–client relationship, and provide information about SU treatment while acknowledging that many clients prefer not to access the formal treatment system. The full e–SBI-HV prototype included 2 digital intervention sessions and home visitor facilitation protocols. CONCLUSIONS: This study describes a user-centered approach for adapting an existing e-SBI for SU for use in the HV context. Despite the described challenges, home visitors and clients generally reacted favorably to the e–SBI-HV, noting that it has the potential to fill a significant gap in HV services. If proven effective, the e–SBI-HV could provide a way for clients to receive help with SU within HV, while maintaining their privacy and avoiding the overburdening of home visitors. The next step in this study would be to test the feasibility and preliminary efficacy of the e–SBI-HV.
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spelling pubmed-96824542022-11-24 Development of an Electronic Screening and Brief Intervention to Address Perinatal Substance Use in Home Visiting: Qualitative User-Centered Approach Dauber, Sarah Hammond, Cori Hogue, Aaron Henderson, Craig Nugent, Jessica Ford, Veronica Brown, Jill Scott, Lenore Ondersma, Steven JMIR Form Res Original Paper BACKGROUND: Perinatal substance use (SU) is prevalent during pregnancy and the postpartum period and may increase the risks to maternal and child health. Many pregnant and postpartum women do not seek treatment for SU because of fear of child removal. Home visiting (HV), a voluntary supportive program for high-risk families during the perinatal period, is a promising avenue for addressing unmet SU needs. Confidential delivery of screening and brief intervention (BI) for SU via computers has demonstrated high user satisfaction among pregnant and postpartum women as well as efficacy in reducing perinatal SU. This study describes the development of the electronic screening and BI for HV (e–SBI-HV), a digital screening and BI program that is adapted from an existing electronic screening and BI (e-SBI) for perinatal SU and tailored to the HV context. OBJECTIVE: This study aimed to describe the user-centered intervention development process that informed the adaptation of the original e-SBI into the e–SBI-HV, present specific themes extracted from the user-centered design process that directly informed the e–SBI-HV prototype and describe the e–SBI-HV prototype. METHODS: Adaptation of the original e-SBI into the e–SBI-HV followed a user-centered design process that included 2 phases of interviews with home visitors and clients. The first phase focused on adaptation and the second phase focused on refinement. Themes were extracted from the interviews using inductive coding methods and systematically used to inform e–SBI-HV adaptations. Participants included 17 home visitors and 7 clients across 3 Healthy Families America programs in New Jersey. RESULTS: The e–SBI-HV is based on an existing e-SBI for perinatal SU that includes screening participants for SU followed by a brief motivational intervention. On the basis of the themes extracted from the user-centered design process, the original e-SBI was adapted to address population-specific motivating factors, address co-occurring problems, address concerns about confidentiality, acknowledge fear of child protective services, capitalize on the home visitor–client relationship, and provide information about SU treatment while acknowledging that many clients prefer not to access the formal treatment system. The full e–SBI-HV prototype included 2 digital intervention sessions and home visitor facilitation protocols. CONCLUSIONS: This study describes a user-centered approach for adapting an existing e-SBI for SU for use in the HV context. Despite the described challenges, home visitors and clients generally reacted favorably to the e–SBI-HV, noting that it has the potential to fill a significant gap in HV services. If proven effective, the e–SBI-HV could provide a way for clients to receive help with SU within HV, while maintaining their privacy and avoiding the overburdening of home visitors. The next step in this study would be to test the feasibility and preliminary efficacy of the e–SBI-HV. JMIR Publications 2022-11-08 /pmc/articles/PMC9682454/ /pubmed/36346648 http://dx.doi.org/10.2196/37865 Text en ©Sarah Dauber, Cori Hammond, Aaron Hogue, Craig Henderson, Jessica Nugent, Veronica Ford, Jill Brown, Lenore Scott, Steven Ondersma. Originally published in JMIR Formative Research (https://formative.jmir.org), 08.11.2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
Dauber, Sarah
Hammond, Cori
Hogue, Aaron
Henderson, Craig
Nugent, Jessica
Ford, Veronica
Brown, Jill
Scott, Lenore
Ondersma, Steven
Development of an Electronic Screening and Brief Intervention to Address Perinatal Substance Use in Home Visiting: Qualitative User-Centered Approach
title Development of an Electronic Screening and Brief Intervention to Address Perinatal Substance Use in Home Visiting: Qualitative User-Centered Approach
title_full Development of an Electronic Screening and Brief Intervention to Address Perinatal Substance Use in Home Visiting: Qualitative User-Centered Approach
title_fullStr Development of an Electronic Screening and Brief Intervention to Address Perinatal Substance Use in Home Visiting: Qualitative User-Centered Approach
title_full_unstemmed Development of an Electronic Screening and Brief Intervention to Address Perinatal Substance Use in Home Visiting: Qualitative User-Centered Approach
title_short Development of an Electronic Screening and Brief Intervention to Address Perinatal Substance Use in Home Visiting: Qualitative User-Centered Approach
title_sort development of an electronic screening and brief intervention to address perinatal substance use in home visiting: qualitative user-centered approach
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682454/
https://www.ncbi.nlm.nih.gov/pubmed/36346648
http://dx.doi.org/10.2196/37865
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