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Exploring the Social Determinants of Health Among Pregnant Women with Substance Use Disorder: An In-depth Analysis of the Drug Free Moms and Babies Project

Glover, Carly F (2023) Exploring the Social Determinants of Health Among Pregnant Women with Substance Use Disorder: An In-depth Analysis of the Drug Free Moms and Babies Project. Master Essay, University of Pittsburgh.

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Substance use disorder (SUD) in pregnancy is a pressing public health concern that affects not only the health and well-being of the mother but also that of the infant. Using a social determinants of health framework is useful to address substance use disorder in pregnancy as it acknowledges the various interconnected social factors that influence health outcomes, including race, income, education, employment, and housing and helps to promote health equity by addressing the underlying the factors that contribute to health disparities.
This study aims to identify social determinants of health associated with urine drug screening results at delivery for program completers of the Drug Free Moms and Babies (DFMB) Project, which integrates maternal and behavioral healthcare services for pregnant and postpartum women with substance use disorder. A secondary analysis of DFMB data was conducted using bivariate statistical analysis to identify significant associations with the main outcome of interest: drug screening results at delivery. Of the 958 program completers who met inclusion criteria for the study, 434 participants (45.3%) tested positive for illicit substance use at time of delivery. Women who enrolled in prenatal care (p<0.001) and the DFMB Project during the first trimester (p<0.001) and those who entered with a planned pregnancy (p<0.001) were less likely to test positive. Social determinants of health, including older maternal age (p=0.002), lack of stable housing (p=0.010), Medicaid insurance coverage (p<0.001), no or partial employment (p=0.001), low income (p<0.001), and cohabitation (p=0.010), were significantly associated with urine drug screen results. As expected, birth outcomes were significantly better for women who tested negative at time of delivery (p<0.001).
The findings necessitate further assessment and revision of the DFMB Project, and other similar programs. Tailoring interventions to grow statewide partnerships for referrals through the use of a helpline to engage participants in earlier trimesters, build on current program supports including the use of Peer Recovery Coaches for mentorship of younger program participants, and advocate for the expansion of services for pregnant women with Medicaid insurance enrolled in programs could aid in mitigating drug use during pregnancy.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Glover, Carly Fcfg15@pitt.educfg15
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairBryce, Cindybryce99@pitt.edubryce99UNSPECIFIED
Committee MemberSalter, Cynthiacys6@pitt.educys6UNSPECIFIED
Date: 16 May 2023
Date Type: Completion
Number of Pages: 96
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Health Policy & Management
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 16 May 2023 18:33
Last Modified: 16 May 2023 18:33


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