effective interventions for newborns with drug exposure and their families
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Effective Interventions for Newborns with Drug Exposure and Their Families. Harolyn M.E. Belcher, M.D., M.H.S. Associate Professor of Pediatrics Johns Hopkins School of Medicine Director of Research The Family Center at Kennedy Krieger Institute. Objectives. - PowerPoint PPT PresentationTRANSCRIPT
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EFFECTIVE INTERVENTIONS FOR NEWBORNS WITH DRUG EXPOSURE AND THEIR FAMILIES
Harolyn M.E. Belcher, M.D., M.H.S.Associate Professor of PediatricsJohns Hopkins School of MedicineDirector of ResearchThe Family Center at Kennedy Krieger Institute
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Objectives Identify key components of effective
programs
Project STRIVE
HUGS (Home-U-Go Safely)
Dayspring Community Programs, Inc.
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Components of Effective Programs for Newborns with IUDE and Their Families
Integrated comprehensive program services
Evidence-based interventions
Culturally responsive
Accessible
Family centered
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HUGS Study: Caregiver Child Interaction
Butz et al., 2002
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HUGS Study: Parent Child Interaction
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STRIVE Goals
Promote coordinated multi-organization services for pregnant drug dependent women & their infants
Increase the availability of prevention, early intervention, & treatment services
Decrease AOD use among pregnant participants
Improve birth & child developmental outcome
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Maternal Demographics (N=80) Age (mean): 28.1 years (20-39) Never married: 59.5% Mean years of education: 10.7 (7-15) 66.2% did not complete HS 79.7% unemployed 79 % previous arrest history Race/Ethnicity
African American: 63.3% White: 30.4% Hispanic: 3.8%
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Age at First Use
Alcohol: 15.8 years (5-26 yrs)
Marijuana: 16.2 years (6-25 yrs)
Cocaine/Heroin: 20.5 years (12-33 yrs)
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Maternal Psycho-social History 52% had co-morbid psychiatric illnesses
83% had experienced physical violence
64.3% had experienced sexual abuse/rape
23% had experienced sexual abuse as a child
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*p<.05;**p<.01
Birth Outcomes
Birth Outcome STRIVE Infants(n=57)
Foster CareInfants (n=15)
APGAR 1min 7.88 7.77
APGAR 5 min 8.71 8.80
Gestational Age 38.14 35.77
Birth Weight(gm)**
3000.42 2274.47
Birth Length(cm)*
47.54 44.52
Head Circumference(cm)*
33.61 31.66
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Butz, et al.
HUGS Study
Longitudinal randomized study (birth to 6 years) Home-based developmental intervention
(16 visits in 18 months)
Prenatal cocaine and/or opiate exposed children (N=204)
Non-exposed community controls (N=50)
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Infant and Maternal Demographics (Drug Exposed Cohort)
Infant Mean Birth Weight : 2817 g
+ 427 Mean Head Circumference:
33 cm + 1.4 Mean Length: 48.2 cm + 2.7 Mean Gestational Age: 38.4
wks + 1.5 Mean Length of Stay: 9 days
+ 6.5 Gender (female): 51% Apgar 1 minute <7: 18% Apgar 5 minute <7: 3%
Maternal Mean Age (years): 28 + 5 Education (>HS grad):
47.8% Unemployed: 94.5% Never married/single:
85% Tobacco use: 84.2% Race (African American):
97%
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Butz et al., 2001
Effectiveness of Home-Based Nursing Intervention
100 2 and 3 year old children with intrauterine cocaine and/or opiate exposure and their caregivers
Home based nursing intervention (N=49) 16 home visits from birth to age18 months parent education & health monitoring
Standard care (N=51) Outcome: Child Behavior Checklist &
Parenting Stress Index
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Results and ConclusionsButz et al., 2001
Children in the HUGS intervention group had significantly lower scores suggestive of less emotional or behavioral problems when compared to children in the Standard Care group Total behavior (p=0.04) Internalizing behavior (p=0.05) Externalizing behavior (p=0.02) Anxiety-Depression subscale (p=0.009)
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Dayspring Programs, Inc.
“To improve the quality of life for children and families, focusing on those affected by substance abuse, homelessness and poverty.”
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Housing Continuum
Client Referrals Treatment &Recovery Community Integration
SUPPORTIVE SERVICESWe value community, creating linkages &
partnerships for resources that assist families to become stable, children to live in nurturing
environments and individuals to become more productive citizens.
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What Does Dayspring Do? Rental assisted
housing & support services
Long term residential drug treatment
Head Start child developmental services
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How Does Dayspring Partner With Johns Hopkins?
Johns Hopkins Early Learning Center
Bright Spaces Project painted, purchased materials and
supplies for a child care area Holiday food and gift giving
JHH School of Nursing Vision and Hearing Screening for Head Start childrenHealth activities with housing families
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Family Accomplishments FY 2009
• 13 families moved out of housing program successfully• 55% of parents were working• 30% of parents were in school• 99% of children were enrolled and attending school• 0% child abuse incidents• 86% of families remained drug free
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“Dayspring Gave Us Back Our Family”