During the late 1980's, clinicians of the Kaiser Permanente Medical Care Program (KPMCP) began to experience the impact of prenatal substance abuse. To address this problem, a care model named "Early Start" was created. Early Start was piloted from 1990 to 1992 in the OB/GYN Department at the Kaiser Permanente Medical Center in Oakland, California. The model integrated substance abuse services with prenatal care by training OB/GYN providers about perinatal substance abuse, educating all pregnant women about risks of prenatal substance use, universally screening all pregnant women for risk by questionnaire and urine toxicology screen, and locating a substance abuse specialist in the OB department to conduct risk assessments, education, and ongoing intervention integrated with prenatal care. The babies of the women who participated in the pilot program had significantly better outcomes than those whose mothers continued to use substances throughout the pregnancy. The Permanente Medical Group has since allocated funds to expand the program, and today these services are available at 16 prenatal clinics in Northern California.
The Early Start Program and the KPMCP Division of Research Perinatal Research Unit have collaborated with the goal of assisting Early Start with database development and report generation in addition to evaluating Early Start in terms of neonatal outcomes and cost effectiveness. As a result, a comprehensive database has been developed, reports are generated regularly providing feedback to the Early Start Specialists and administrators, and a very comprehensive evaluation has been completed showing fewer poor outcomes among patients treated by Early Start.
Learning Objectives: At the conclusion of this presentation, the participant will be able to recognize the benefits of an integrated treatment model, describe the key components of the Early Start model, and recognize the value of collaborations between clinicians and researchers.
Keywords: Substance Abuse Treatment, Prenatal Interventions
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A
Disclosure not received
Relationship: Not Received.