Associations of Mental Health Measures and Retention in a Community-Based Perinatal Care Recovery Support Program for Women of Childbearing Age With Substance Use Disorder

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.

Keywords:

• Substance abuse disorders
• anxiety
• retention
• peer recovery coaches
• maternal health
• mental health
• community-based

Acknowledgements

This research was presented at the 14th Annual Academy Health Conference on the Science of Dissemination and Implementation, virtual meeting, December 12–14, 2021.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was funded by the Indiana University Addiction Grand Challenge Initiative, the Richard M. Fairbanks Foundation, and the Indiana University Clinical Translational Science Institute.