Healthy Mothers, Healthy Families
Wellness through Integrated Systems and Evaluation – Mothers.
The “Healthy Mothers Healthy Families” evaluation is part of our larger program of research examining the needs of and associated treatments for women with problematic substance use who are pregnant or parenting. Our lab undertakes this research in partnership with Dr. Karen Urbanoski, Canada Research Chair in Substance Use, Addictions, and Health Services at the Canadian Institute for Substance Use Research and Assistant Professor in the School of Public Health and Social Policy at the University of Victoria. We are also grateful to the central contributions of our partner knowledge users from Ontario ECD programs and our advisory committee of experts in the field.
Rates of substance use are on the rise for Canadian women. Addressing problematic substance use in this population necessitates an understanding of the unique profiles of risk and barriers to care experienced by women and the treatment processes and outcomes they prioritize and see as important. Most women in substance use treatment are mothers. This role can increase motivation to engage in treatment while at the same time present barriers to care (e.g., fear of stigma and child welfare involvement, lack of childcare). Many women with problematic substance use treatment have co-occurring mental health challenges, including depression, anxiety and trauma and violence (present and past). Housing, food security, and other social determinants of health also frequently magnify challenges experienced. Parenting in the context of these risks understandably increases parenting stress and for some can be associated with a greater parenting challenge.
Recognition of these unique needs has led to the development of integrated treatment approaches that bring together substance use treatment with maternal and child health and social services. Within Ontario’s addiction treatment system, there are currently 34 integrated programs, funded by the Ontario Ministry of Health and a Long-term Care’s (MOHLTC) Early Childhood Development Addiction Initiative. Many of these programs have been in operation for 10-20 years, while others are in the earlier stages of development. There isn’t a single treatment model employed by these programs – rather they tend to be locally developed based on the needs, strengths, and resources of the local community.
Building on our prior work with the CIHR-funded Connections team (Niccols, 2008-2013), we received funding from the MOHLTC and a CIHR Partnerships for Health Systems Improvement Grant to evaluate the ECD programs. Using a mixed-methods approach, including qualitative interviews and administrative data analysis, our current research aims to:
- Describe the characteristics of women attending integrated programs.
- Define the integrated services model and describe how it is being implemented in Ontario.
- Evaluate the effectiveness of integrated programs (women’s perceptions of care, attendance and engagement, maternal and child health outcomes, cost-effectiveness).
A selection of our publications, presentations, and videos is below. Feel free to reach out to us to learn more about our work or to engage with us in research and knowledge translation!
- Milligan, K., Meixner, T., Tremblay, M., Tarasoff, L. A., Usher, A., Smith, A., Niccols, A., & Urbanoski, K. A. (2020). Parenting Interventions for Mothers With Problematic Substance Use: A Systematic Review of Research and Community Practice. Child Maltreatment, 25(3), 247–262, https://doi.org/10.1177/1077559519873047
- Le, T. L., Kenaszchuk, C., Milligan, K., & Urbanoski, K. (2019). Levels and predictors of participation in integrated treatment programs for pregnant and parenting women with problematic substance use. BMC public health, 19(1), 154. https://doi.org/10.1186/s12889-019-6455-4
- Urbanoski, K., Joordens, C., Kolla, G., & Milligan, K. (2018). Community networks of services for pregnant and parenting women with problematic substance use. PloS one, 13(11), e0206671. https://doi.org/10.1371/journal.pone.0206671
- Tarasoff, L.A., Milligan, K., Le, T.L., Usher, A.M., & Urbanoski, K. (2018). Integrated treatment programs for pregnant and parenting women with problematic substance use: Service descriptions and client perceptions of care. Journal of Substance Abuse Treatment, 90, 9-18.
- Milligan, K., Usher, A.M., & Urbanoski, K. (2017). Supporting pregnant and parenting women with substance-related problems by addressing emotion regulation and executive function needs. Addiction Research & Theory, 25(3), 251-261.
- Meixner, T., Milligan, K., Urbanoski, K., & McShane, K. (2016). Conceptualizing integrated service delivery for pregnant and parenting women with addictions: Defining key factors and processes. Canadian Journal of Addiction, 7(3), 57-65.
Research snapshots – These summaries of the above-published articles have been created in collaboration with EENet to highlight key findings in a way that is accessible to the broader community:
- Professionals’ thoughts on best practice for integrated treatment for pregnant and parenting women with addictions
- Addressing emotional regulation and problem-solving needs in pregnant and parenting women with substance-related problems
- How pregnant and parenting women in integrated substance use programs feel about their care
Video: Women’s views of treatment received in Ontario’s ECD programs Click here
Healthy Mothers Healthy Families Knowledge Sharing Event (May, 2018)
We hosted a knowledge-sharing event highlighting our study findings and discussing future directions for research and action. Here are the slides from the presentation by Drs. Karen Milligan and Karen Urbanoski, as well as a press release highlighting some of our findings. Findings have also been shared at national conferences including Issues of Substance (November 2017), Addictions and Mental Health Ontario (May 2018), Canadian Association for Health Services and Policy Research (CAHSPR, May 2018), and the Canadian Association of Perinatal and Women’s Health Nurses (CAPWHN, October 2018). We look forward to presenting in Oslo, Norway in May 2018 at the It Take a Village Conference on families experiencing substance use, mental health, or physical health challenges.
Click the links below to learn more about our current research in this area examining the needs of and associated treatments for women with problematic substance use who are pregnant or parenting and executive functioning of parents in samples of mothers with problematic substance use.