Stigmatization of people with substance use disorders (SUD) during perinatal results from the toxic belief that people who use substances are incapable of being good parents and do not care about their children. This belief perpetuates cyclical and systemic harm towards people with SUD and their children. Home visiting programs are less likely to sustain engagement with parents with SUD because those parents experience and perceive stigmatization. However, home visitors want to do better. Despite home visitors reporting that it is difficult to support parents with SUD, most home visitors want additional training in this area. Additionally, harm reduction practices are becoming more common and home visitors want more training to be able to support parents in this area. The current home visiting programs are not equipped to support parents within this changing landscape. There is the potential to improve current practices, reduce harm, and improve overall parent and child outcomes for people with SUD during perinatal by reducing stigmatization within home visiting programs. This change cannot just be a one-time training for home visitors. It must be a comprehensive solution to change home visiting organizations including de-implementation of polices that cause harm, implementation of policies to provide support, leadership education and guidance, identification of community resources for warm hand-offs, training and support for home visitors, and ongoing opportunities for practice and reflection. Our proposed solution, VisitBoost, includes strategies to address multiple levels of stigma and improve home visiting services for people with SUD during perinatal. The overall goal of the proposed Phase I project is to create VisitBoost and demonstrate feasibility for reducing stigmatization among home visitors towards clients with SUD. We will accomplish our goal through two specific aims: 1. Use an iterative formative process to develop a prototype of the VisitBoost mobile application to develop modules to support de-stigmatization practices among organizational leaders and home visitors. 2. Evaluate VisitBoost prototype for acceptability, usability, and effectiveness using a mixed-methods program evaluation approach with our advisory boards. We will assess home visitor attitudes, knowledge, self-efficacy, practices, practices intentions (post-training only), and usability with 52 home visitors to optimize successful use of the mobile application.
Public Health Relevance Statement: Project Narrative This Phase I SBIR proposes a program to enhance home visiting programs to systematically address stigmatization of people with substance use disorders (SUD) during perinatal (during and shortly after pregnancy). We propose to develop VisitBoost, an integrated technological solution that provides organizational leadership and home visitors with opportunities for assessing current practices, education to transform existing approaches, and ongoing support for reflection and practice. Stigma reduction within home visiting programs will lead to improvements in client satisfaction, increased client engagement, and improved parent and infant health and well-being, including reductions in child welfare involvement and decreased intergenerational transmission of SUD.
Project Terms: Achievement Attainment; Achievement; Affect; Attitude; Belief; Birth; Parturition; Child; 0-11 years old; Child Youth; Children (0-21); kids; youngster; Child Rearing; Parenting; Parenting behavior; childrearing; Child Welfare; adolescent welfare; child well being; child wellbeing; Client; Clinical Trials; Communities; Discrimination; Cognitive Discrimination; Education; Educational aspects; Family; Fright; Fear; Feedback; Goals; Health; Health Personnel; Health Care Providers; Healthcare Providers; Healthcare worker; health care personnel; health care worker; health provider; health workforce; healthcare personnel; medical personnel; treatment provider; Health Services; Health Services Accessibility; Access to Care; access to health services; access to services; access to treatment; accessibility to health services; availability of services; care access; health service access; health services availability; service availability; treatment access; Hospitals; Language; Leadership; literacy; Marketing; Methods; Persons; Overdose; Parents; parent; Client satisfaction; Patient Satisfaction; Personal Satisfaction; well-being; wellbeing; Pregnancy; Gestation; Prenatal care; pregnancy care; prenatal appointment; prenatal checkup; prenatal visit; Program Evaluation; Relapse; Resources; Research Resources; Risk; Self Disclosure; Stigmatization; Substance Use Disorder; substance use and disorder; Technology; Use Effectiveness; effectiveness using; Police; Organizational Change; doubt; Uncertainty; Caring; Peripartum; Perinatal; improved; Area; Phase; Infant Health; Ensure; Training; Recovery; Withdrawal; Data Bases; data base; Databases; Policies; Perinatal Care; uptake; Supportive care; Supportive Therapy; Knowledge; Life; programs; Clinic; System; Country; Benchmarking; Best Practice Analysis; benchmark; meetings; meeting; Services; preference; experience; intergenerational; Self Efficacy; Harm Reduction; Harm Minimization; Reporting; Positioning Attribute; Position; social stigma; stigma; Effectiveness; Address; Small Business Innovation Research Grant; SBIR; Small Business Innovation Research; transmission process; Transmission; Process; Development; developmental; Health Professional; Health Care Professional; Healthcare professional; Home visitation; House Call; home visit; treatment center; computerized; Outcome; Abstinence; perinatal health; usability; prototype; mobile app; mobile device application; mobile application; online app; web application; web based app; web based application; web app; substance misuse; financial burden; financial distress; financial strain; financial stress; Financial Hardship; De-implementation; Deimplementation; substance using; substance use; homes; Home; implementation facilitation; post pregnancy; after pregnancy; Equity
