The co-creation and evaluation of a recovery community center bundled model to build recovery capital through the promotion of reproductive health and justice

Abstract

People who can get pregnant who use drugs face disproportionate harms such as violence, exploitation and trauma and have unmet reproductive health needs as they have the greatest burden of unintended pregnancy (>75%). Recovery community centers (RCCs) provide recovery support services and are primarily staffed with people with lived experience using drugs. RCCs employ recovery coaches who are entrusted with helping participants improve their recovery capital, health, and wellbeing through person-centered strengths-based approaches. Although reproductive health and the prevention of unintended pregnancy can greatly impact all domains of recovery capital, recovery coaches generally do not have training to address this complex issue. We aimed to fill this gap by co-creating and evaluating a bundled model as an intervention tailored for RCCs (training & low-barrier resources including pregnancy tests, prenatal vitamins, and emergency contraception) to promote more equitable outcomes in reproductive health. We described the training and used mixed methods to assess pre-post knowledge, belief, and comfort with the bundled model (n = 20) and further explored perceptions of the model qualitatively to inform future iterations (n = 58). Results included significant gains in all three domains following the training, as well as favorable perceptions that the model will enhance recovery capital. Most were empowered to champion the model, asking for more information about the three resources, perinatal health, and referral information. We seek to begin to expand the theoretical construct of recovery capital by pilot testing an intervention to promote recovery through enhancing reproductive health and justice for people who use drugs (PWUD) who can get pregnant.

Keywords:

• Unintended pregnancy
• people who use drugs
• recovery capital
• reproductive health
• justice
• training

Acknowledgements

Dr. Hartley Feld would like to acknowledge professional and mentorship support as a scholar in Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) and the Translation of Research Interventions into Practice, Populations, and Policy Leadership (TRIPPPLe) alliance for the internal pilot funds from the University of Kentucky. All authors would like to acknowledge the support and vital partnership with Voices of Hope in Lexington, KY. All authors would also like to posthumously acknowledge the contributions of Amanda Foley-Byard, PhD to the development of the initial training for this project.

Author contributions

All authors have contributed to the manuscript. Dr. Fallin-Bennett (senior author) and I have worked most closely to develop this model and took the lead writing this paper. Jeremy Byard helped to create and deliver the training, analyze the qualitative components, and write the training portion. Dr. Alex Elswick wrote most of the introduction and background related to recovery community centers and helped facilitate the study.

Ethical statement

The research in this paper was approved by the University of Kentucky Office of Research Integrity, IRB# 64430.

Disclosure statement

Alex Elswick is a co-founder and member of the Board of Directors of Voices of Hope. Amanda Fallin-Bennett is a co-founder of and former Program Director and member of the Board of Directors of Voices of Hope. Jeremy Byard is an independent trainer and consultant and trains peer recovery coaches at Voices of Hope.

Data availability statement

Data reported in this paper is available upon reasonable request by emailing the corresponding author.

Notes

1 References to ‘women’ or ‘female’ are from the literature, however we will be using the more inclusive ‘people who can get pregnant’ when we discuss our current study.

Additional information

Funding

This publication was made possible by Grant Number K12DA035150 from the Office of Women's Health Research and the National Institute of Drug Abuse at the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.