Maternal Substance Use Treatment During a Time Of Crisis: The Effect Of COVID-19 Restrictions on Programming, Family Functioning, and Community Service Engagement
Notice bibliographique
Résumé
Substance use among pregnant and parenting women is a problem in Canada which was exacerbated by the COVID-19 pandemic. Stressors that drive and sustain maternal substance use can be understood through a domain-specific conceptualization of risk and protection. Although integrated treatment promotes positive outcomes in substance-involved families, there is limited understanding of how the pandemic affected clients referred to treatment. Methods: This study used qualitative and quantitative data to evaluate the influence of the pandemic and its related health restrictions on families referred to Breaking the Cycle (BTC), an integrated treatment program for maternal substance use. In Study 1, interviews from three BTC staff members were analysed using thematic analysis to investigate changes to BTC programming, client engagement and psychosocial functioning, and access to partnering agencies, from pre-pandemic to during the pandemic. Subsequently, quantitative analyses were completed to compare clients referred to BTC pre-pandemic vs. during the pandemic using the profiles of 68 families (Study 2) and to evaluate cumulative risk and protection profiles of 30 families (Study 3). Results: Thematic analyses in Study 1 yielded 2 primary themes, 5 secondary themes, and 12 tertiary themes. Marginalized, substance-involved families referred during the pandemic, compared to pre-pandemic, were found to have increased rates of displacement, interpersonal violence, substance use, and reduced access to family supports, among others. In turn, protective intervention factors, including the relational and predictable nature of programming, emerged as critical to service engagement. Study 2 indicated that women referred during the pandemic, compared to pre-pandemic, reported less engagement with services, more depressive symptoms, lower self-efficacy around their substance use and a trend suggesting increased use during pregnancy. Study 3 revealed that 7% of pre-pandemic families vs. 50% of pandemic families were characterized by more domains of risk relative to protection. A mixed-methods investigation revealed specific factors of risk and protection that characterized moderate-to-high-risk vs. low-risk families. Conclusions: The findings revealed exacerbated levels of adversity experienced by these families during the pandemic. This research contributes to an evolving understanding of the interplay of cumulative risk and protective factors, with clinical and policy implications for early intervention work.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,014 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,002 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,004 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».