A Digitally Enhanced Model of Peer Doula Support for Substance Use Disorder and Peripartum Care (NIH HEAL Initiative)

Funded by the NIH HEAL Initiative®

Patients with perinatal substance use disorders (PSUD) experience increased rates of morbidity and mortality, with overdose being a leading cause of mortality, especially in the postpartum period. Although engagement in perinatal care and substance use disorder (SUD) treatment is associated with improved outcomes for PSUD, numerous barriers, including lack of access to digital technology and mistrust of healthcare systems, prevent this at-risk population from seeking care. Providing smartphones and data plans may help facilitate access to care for this population. Additionally, a growing body of literature has studied how doula support may improve engagement in care for patients with behavioral health conditions, including postpartum depression and SUD.

This one-year mixed methods pilot study will evaluate the feasibility and acceptability of a novel digitally enhanced peer doula model of care for patients with PSUD. The primary outcomes are the feasibility and acceptability of implementing a digitally enhanced peer doula model of care for PSUD into clinical workflows at two sites, assessed through quantitative surveys and qualitative interviews with site staff, (including providers, recovery support doulas, and administrators) and patient participants. Additionally, this study will assess the impact of this digitally enhanced model of peer doula support on engagement in care by measuring rates of prenatal and postpartum care visits using electronic health record data abstraction. This study will inform a larger multi-site experimental design to evaluate the impact of this model on perinatal and SUD treatment engagement, patient satisfaction, and peripartum outcomes for one-year postpartum.

Lisa A. Marsch, Ph.D.

Professor, Department of Psychiatry; Director, Center for Technology and Behavioral Health; Director, Dartmouth Psychiatric Research Center

Geisel School of Medicine at Dartmouth College

46 Centerra Parkway, Suite 315, Lebanon, NH, 03766, US

Lisa.A.Marsch@Dartmouth.edu

Daisy J. Goodman, DNP, MPH, CARN-AP, APRN, CNM

Associate Professor

Department of Obstetrics and Gynecology

One Medical Center Drive, Lebanon, NH, 03756, US

daisy.j.goodman@dartmouth.edu

Ximena Levander, MD, MCR

Assistant Professor

Division of General Internal Medicine & Geriatrics; Addiction Medicine Section

3181 SW Sam Jackson Park Road, Portand, OR, 97236, US

levander@ohsu.edu

CTN-0157 development