About this trial
Substance use during pregnancy is a leading cause of maternal morbidity and mortality in the United States, with 55-80% of postpartum patients disengaging from substance use disorder (SUD) treatment within one year of delivery. Structural and social determinants of health, including housing instability, transportation barriers, and limited childcare access, further exacerbate disparities in treatment retention.
This pilot study, conducted in two specialized prenatal care clinics, evaluates the feasibility and acceptability of two integrated strategies to promote sustained engagement in recovery-oriented services during the perinatal and postpartum periods. Aim 1 implements a standardized social needs screening and referral protocol to connect patients with community-based supports. Aim 2 pilots a contingency management intervention to incentivize recovery-supportive behaviors.
Findings will inform the design of a larger multi-site randomized controlled trial to evaluate the impact of these interventions on treatment retention, overdose prevention, and maternal-infant health outcomes.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
None
Disqualifiers
None
Trial design
Parallel
Treatments tested in this trial
Social drivers of health screening
Other interventionPatients will undergo a structured and protocoled screening for social drivers of health and be linked to support services
Patients will undergo a program of contingency management
BehavioralPatients will enter into a 12 week program of contingency management
Treatment groups
Trial outcomes
Primary outcomes
Social Drivers: Enrollment
Percentage of eligible patients enrolled in the study
Social Drivers: Screening
Percentage of visits for enrolled patients with social drivers of health screening
Social Drivers: Documentation of Z-codes
Percentage of social driver screenings with z-codes documented
Contingency Management: Intervention Fidelity (Number of Visits)
Number of CM sessions with fidelity to intervention, defined as meeting all six criteria on weekly CM visit checklist
Secondary outcomes
Social Drivers: Frequency of Z-Codes
Frequency of of z-codes documented for each patient
Social Drivers: Percentage of Patients with Referrals
Percentage of patients with referrals to support services
Sponsors and contacts
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Washington University School of Medicine
Lead sponsor
National Institute on Drug Abuse (NIDA)
Collaborator