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Randomized Controlled Trial
. 2011 May-Jun;20(3):196-204.
doi: 10.1111/j.1521-0391.2011.00119.x. Epub 2011 Mar 8.

Reinforcement-based treatment improves the maternal treatment and neonatal outcomes of pregnant patients enrolled in comprehensive care treatment

Hendrée E Jones  1 , Kevin E O'Grady, Michelle Tuten
Affiliations
Randomized Controlled Trial

Reinforcement-based treatment improves the maternal treatment and neonatal outcomes of pregnant patients enrolled in comprehensive care treatment

Hendrée E Jones et al. Am J Addict. 2011 May-Jun.

Abstract

This randomized clinical trial examined the efficacy of comprehensive usual care (UC) alone (n = 42) or enhanced by reinforcement-based treatment (RBT) (n = 47) to produce improved treatment outcomes, maternal delivery, and neonatal outcomes in pregnant women with opioid and/or cocaine substance use disorders. RBT participants spent, on average, 32.6 days longer in treatment (p < .001) and almost six times longer in recovery housing than did UC participants (p = .01). There were no significant differences between the RBT and UC conditions in proportion of participants testing positive for any illegal substance. Neonates in the RBT condition spent 1.3 fewer days hospitalized after birth than UC condition neonates (p = .03), although the two conditions did not differ significantly in neonatal gestational age at delivery, birth weight, or number of days hospitalized. Integrating RBT into a rich array of comprehensive care treatment components may be a promising approach to increase maternal treatment retention and reduce neonatal length of hospital stay.

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Conflict of interest statement

Declaration of Interest:

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.

Figures

Figure 1
Figure 1. CONSORT Diagram
Of the 225 eligible CAP patients, 97 declined participation for the following reasons: lack of interest in the study (n=50), did not want to live in recovery housing (n=29), living out of the area/not returning to CAP (n=4), childcare issues (n=6), other aftercare plans (n=6), declined randomization process (n=1), and employment conflicted with study participation (n=1). Thus, 128 CAP patients signed written informed consent. Of these 128 patients, 39 participants left CAP shortly after consenting to participation in the study but before they could be informed of their study group assignment. The remaining 89 participants were informed of their group assignment and thus were considered randomized. All analyses reported in this paper are based on the data from these 89 participants and their respective 89 neonates.
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