Online Program

Treatment retention, length of stay and outcomes implications for pregnant/postpartum Latinas in residential treatment

Monday, November 4, 2013

Aileen Ochoa, BA, Institute on Urban Health Research, Northeastern University, Boston, MA
Hortensia Amaro, PhD, University of Southern California, Los Angeles, CA
Rita Nieves, RN, MPH, LCSW, Addictions Prevention, Treatment and Recovery Support Services Bureau, Boston Public Health Commission, Boston, MA
Kerith Conron, ScD, MPH, The Fenway Institute, Boston, MA

Lauren Dealy, BS, Institute on Urban Health Research, Northeastern University, Boston, MA
Marta Pagan-Ortiz, MS, Institute on Urban Health Research, Northeastern University, Boston, MA
Problem: Length of stay (LOS) in residential substance abuse (SA) treatment and implications for outcomes among pregnant and postpartum (PPW) Latinas have rarely been studied. We present findings from a quasi-experimental study of a community-based gender and culturally-tailored residential treatment program for PPW Latinas (Entre Familia). The treatment approach followed an integrated SA, mental health (MH) and trauma model (Amaro, et al. 2007).

Methods: Data were obtained from 71 Latinas (consecutive admissions) via in-person independent structured interviews at program entry and 6 months post-baseline to assess changes in SA, MH and other outcomes. Sample is largely Puerto Rican (65%), young (80% age 18-30), high-school dropouts (66%), and bilingual/English-speaking (93%). Six-month follow-up rate was 87%. Analytic sample is (N=55) comprised of participants who had reached 6-month follow-up date with complete data.

Results: LOS was 48% <4-months, 52% >4-months, 37% >6-months. Only Puerto Rican background predicted LOS > 4 months. Multivariate logistic regression found those with > 4-month vs shorter LOS had greater improvements in drug abstinence (p<.01), last 30-day drug use (p<.02), days with MH problems (p=.06) and anxiety (p=.05), trauma symptomatology (p=.03), criminal involvement (p<.01), and quality of life (p=.01). There was an improvement in days depressed (p=.03) for those with LOS ≥ 6-months.

Conclusions: Findings suggest that residential treatment LOS for Latina PPW should be a minimum of 4 months or longer. Research on treatment retention is discussed in light of the research need in this area and the serious implications of treatment discontinuation for Latinas and their children.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
List three elements of the gender and culturally tailored aspects of the model of integrated residential substance abuse treatment program presented Discuss the importance of treatment length of stay in treatment outcomes for pregnant and postpartum Latinas Evaluate the implications of findings for strategies to increase length of stay in treatment and retention of Latina women in treatment

Keyword(s): Drug Abuse Treatment, Latinas

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the research coordinator for several federally funded grants focusing on treatment of drug addiction, and co-occurring mental health disorders with Latina and African-American women in community-based settings. On the data being presented I was the research coordinator for the last two years of the study. I’m also participating in the writing of several manuscripts regarding these data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.