Poster #107 - State Policy Environment Shaping Surveillance Practices on SUD in MIECHV Programs

• In Event: Saturday Poster Luncheon

Abstract

The opioid epidemic has disproportionately impacted pregnant mothers and families. From 2010 to 2017, there was a 131% increase in opioid-related diagnoses among mothers, from 3.5 per 1,000 to 8.2 per 1,000 (National Institute of Child Health and Human Development, 2024). Home visiting can be an effective tool in screening substance use disorder (SUD) or opioid use disorder (OUD) as well as monitoring and making referrals for treatment. Historically, states have implemented Maternal, Infant, and Early Childhood Home Visiting (MIECHV) programs to meet state-specific needs for maternal and child health populations. In order for states to continue receiving federal funding to supplement state funding for their MIECHV programs, states are required to report on specific performance measures. In 2022, Health Resources and Services Administration (HRSA) established two optional performance measures for MIECHV programs – substance use screening and substance use referrals. However, there is an immense discrepancy in the strategies used to address SUDs and a lack of consensus among home visitors on the best methods to support families impacted by SUD (Hossain et al., 2020). At the same time, the state policy environment – state laws on substance use during pregnancy, state regulations, federal laws, state-level and local levels of funding of MIECHV programs – can greatly shape usage of certain surveillance practices of SUD in home visiting. That is why I am interested in answering the following research question: how do state policy environments shape surveillance practices on substance use disorder (SUD) in MIECHV programs? Following the multi-site case study approach established by Yin (2018), I construct the two case studies, Kansas and Indiana, based on the following materials as data for the qualitative study: state law, state regulations, state department website documents provided to patients and providers, service records published by the state on performance related to surveillance of substance use among pregnant populations, Needs Assessment Report, and Maternal Opioid Misuse (MOM) Model report. My preliminary findings set up the two cases. I identify similar yet distinct trends in surveillance practices on SUD in home visiting within and across the cases. The multi-site case study approach of the state policy environment demonstrates an innovative attempt in understanding the important and influential role of state policies on a pressing social need of states, supporting postpartum mothers and families impacted by substance use disorder.

Author

• Smitha Prabhu, University of Maryland, Baltimore County
  Presenting Author