R01DA051674

Improving Postpartum Contraceptive Decision-Making Among Women with Substance Use Disorders

The reproductive health needs of women with Substance Use Disorders (SUDs) are unmet. Over 80% of pregnancies among women with SUDs are unintended, compared to 45% of the general population. Additionally, over 20% of women with SUDs have had a short interpregnancy interval, meaning they become pregnant within 18 months of a previous birth.

Pregnancy presents a unique opportunity to address contraceptive needs due to increased healthcare access from expanded Medicaid eligibility and increased access to highly effective contraceptive methods such as Long-Acting Reversible Contraception (LARC). Furthermore, there is enhanced motivation to avoid rapid, repeat pregnancy. However, despite these opportunities, over 75% of women with Opioid Use Disorder fail to use postpartum contraception, and less than 2% receive LARC in the postpartum period.

Currently, there are no effective strategies to improve postpartum contraceptive decision-making for women with SUDs. To address this gap, we will conduct a hybrid Type 1 effectiveness-implementation randomized controlled trial among 350 postpartum women with SUDs. The aim is to test the effect of a novel patient-centered reproductive planning decision support tool, developed by the research team, called MyPath, on postpartum contraceptive method choice and continuation, continuous contraceptive use, unintended pregnancy, and interpregnancy interval until 18 months postpartum.

The primary research aims are as follows:
1) Assess the effect of patient-centered reproductive planning decision support (MyPath) on postpartum contraceptive utilization and reproductive health outcomes among women with SUDs.
2) Determine if the relationship between MyPath and contraceptive utilization is mediated by decision quality.
3) Identify barriers and facilitators to integrating MyPath into routine postpartum clinical care.

This research is significant because using a patient-centered reproductive planning approach to contraceptive decision-making represents a paradigm shift in how we frame and approach reproductive health outcomes among women with SUDs. If successful, our findings will have high impact as decision support tools are a low-cost, scalable solution that can be used in most clinical settings. Additionally, our study design enhances the potential for rapid translation of our findings into routine clinical practice.

Finally, this research is feasible because it builds on prior work by a research team with expertise in decision sciences, implementation, family planning, obstetrics, and SUDs.

Magee-Womens Research Institute And Foundation

TO SUPPORT BASIC AND CLINICAL NEUROSCIENCE, BIOMEDICAL, BEHAVIORAL AND SOCIAL SCIENCE, EPIDEMIOLOGIC, HEALTH SERVICES AND HEALTH DISPARITY RESEARCH. TO DEVELOP NEW KNOWLEDGE AND APPROACHES RELATED TO THE PREVENTION, DIAGNOSIS, TREATMENT, ETIOLOGY, AND CONSEQUENCES OF DRUG ABUSE AND ADDICTION, INCLUDING HIV/AIDS. TO SUPPORT RESEARCH TRAINING AND RESEARCH SCIENTIST DEVELOPMENT. TO SUPPORT DISSEMINATION OF RESEARCH FINDINGS. SMALL BUSINESS INNOVATION RESEARCH (SBIR) LEGISLATION IS INTENDED TO EXPAND AND IMPROVE THE SBIR PROGRAMS TO EMPHASIZE AND INCREASE PRIVATE SECTOR COMMERCIALIZATION OF TECHNOLOGY DEVELOPED THROUGH FEDERAL SBIR RESEARCH AND DEVELOPMENT, INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN THE SBIR PROGRAM. THE LEGISLATION INTENDS THAT THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.279 - Drug Abuse and Addiction Research Programs

National Institute on Drug Abuse (NIDA) [HHS - NIH]

Pittsburgh, Pennsylvania 152134572 United States

Single Zip Code

Women and Sex/Gender Differences in Drug and Alcohol Abuse/Dependence (R01 Clinical Trial Optional) (PA-18-603)

Amendment Since initial award the total obligations have increased 354% from $713,607 to $3,238,862.