Implementation of the Obstetric Care for Women with Opioid Use Disorder Alliance for Innovation on Maternal Health (AIM) safety bundle in Local Health Departments in Utah

Full Description:

Objectives: The aim of this project was to assist in the implementation of the Obstetric Care for Women with Opioid Use Disorder Alliance for Innovation on Maternal Health (AIM) Safety Bundle. This was set to be completed via two primary objectives:
● Objective 1: Develop, Conduct and Compile Opioid Use Disorder (OUD)/Substance Use Disorder (SUD) Needs Assessment/Gap Analysis with 6 selected Local Health Departments in Utah.
● Objective 2: Compile and create local Opioid Use Disorder Community Resource Summaries for the 6 prioritized Local Health Departments in Utah.

Key Activities: The first aim was to create a Key Informant Interview Guide for six prioritized local health departments (LHDs). A total of five LHDs and one community organization were interviewed and a gap analysis for the selected LHDs with respect to OUD resources for women and families was developed. Resources were cross-referenced with existing resource lists and information from key informant interviews. Medication for Opioid Use Disorder services for pregnant and postpartum persons were verified with each provider via phone. These findings, both as comprehensive summaries and public-facing options, will be shared with the LHDs and various community leaders and organizations statewide.

Results: Throughout the Key Informant interviews, several barriers, opportunities, threats, and existing strengths were identified for the community of pregnant and postpartum persons with Opioid Use Disorder. These surfaced when persons with OUD attempted to access care in their communities. Three of the primary barriers to accessing services were identified as stigma, resource allocation, and accessibility of resource information. Multiple key informants mentioned systems-level and provider-based stigmas and biases as negatively impacting outcomes for those with OUD/SUD that are pregnant and birthing. In an effort to address the barriers of stigma in the healthcare system, an online class and debrief, Breaking Through Implicit Bias in Maternal Healthcare, is being offered to hospitals statewide. Resource lists created and distributed will increase awareness and accessibility of the local recovery resources.

Conclusion: Results of key informant interviews are to be discussed with the AIM Safety bundle steering committee in early August. Resource lists for local health departments, service providers, pregnant persons, families, and community organizations were created and distributed. Templates for social media campaign resource spotlights were also provided. The goal of this process is to better bridge the gap in understanding the available supports and resource connectivity in various local health departments. An increased understanding of the barriers to care and ways to address them will improve the ability to support the population of pregnant and postpartum persons with OUD/SUD statewide.

Abbreviated Description: Substance Use Disorder Resource summaries were created for seven Utah Local Health Departments. Title V interns worked with the Utah Women and Newborns Quality Collaborative in implementing the AIM Safety Bundle Obstetric Care for Women with Opioid Use Disorder. This included informational interviews, compiling resources, and creating a gap analysis. The summaries provided a key to help the maternal population navigate resources such as Medication Assisted Treatment to resources that accept families, prioritize pregnant persons and accept Medicaid. The process of creating the summaries improved the understanding of stigma, barriers and gaps in substance use disorder care. The summaries are a centralized resource for the maternal population to access resources and treatment.