Abstract

Objective: This research was undertaken to evaluate factors related to program retention among participants in a community-based peer recovery program for women of childbearing age with a history of substance use disorder. Methods: In all, 184 women of childbearing age with a history of substance use disorder were enrolled in a community-based peer recovery program. Half of the participants were pregnant or postpartum. The outcome of interest was retention in the program as measured at 2 and 6 months. Participants were paired with a peer recovery coach (PRC). PRCs were women with a personal history of substance use disorder who assisted with healthcare system navigation, facilitated access to local resources, and provided advice and emotional support. All PRCs were also licensed perinatal community health workers. Independent variables included gestational status, depression, anxiety, type and frequency of substance use, childhood trauma, abuse, readiness for treatment, and attachment patterns. Results: Anxiety was found to be a key factor associated with retention. Moderate anxiety was associated with higher rates of retention compared to normal to mild anxiety. Severe anxiety was associated with lower rates of retention compared to normal to mild anxiety. Attrition was highest in the first 2 months. Conclusions: Early integration with mental health services to address severe anxiety symptoms could potentially improve retention in substance use disorder recovery programs, thereby improving outcomes. More research is needed regarding severe anxiety and care-avoidant behaviors, particularly among women of childbearing age.

摘要

目的：本研究旨在评估以社区为基础的同伴康复计划参与者的计划保留相关因素，该计划针对有物质使用障碍史的育龄妇女。方法：总共有 184 名有物质使用障碍史的育龄妇女参加了一项以社区为基础的同伴康复计划。一半的参与者怀孕或产后。感兴趣的结果是在 2 个月和 6 个月时测量的项目保留率。参与者与同伴康复教练 (PRC) 配对。PRCs 是有物质使用障碍个人史的女性，她们协助医疗保健系统导航，促进获取当地资源，并提供建议和情感支持。所有 PRC 也都是获得许可的围产期社区卫生工作者。自变量包括妊娠状态、抑郁、焦虑、物质使用的类型和频率、童年创伤、虐待、治疗准备情况和依恋模式。结果：焦虑被发现是与保留相关的关键因素。与正常至轻度焦虑相比，中度焦虑与更高的保留率相关。与正常或轻度焦虑相比，严重焦虑与较低的保留率相关。前 2 个月的流失率最高。结论：早期与心理健康服务相结合以解决严重的焦虑症状可能会提高物质使用障碍康复计划的保留率，从而改善结果。需要对严重的焦虑和回避护理行为进行更多研究，尤其是在育龄妇女中。