Previously submitted to: JMIR Formative Research (no longer under consideration since Jan 09, 2023)
Date Submitted: Jun 8, 2022
Open Peer Review Period: Jun 8, 2022 - Aug 3, 2022
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Project BETTER: A technology-delivered intervention for pregnant people with opioid use disorder
ABSTRACT
Background:
Opioid overdose is a leading cause of pregnancy-associated deaths largely occurring after delivery. Birthing people with opioid use disorder (OUD) face unique stressors during the transition from pregnancy to postpartum that are challenging to recovery and increase overdose risk. Prenatal education is insufficient to prepare birthing people with OUD for the pregnancy-to-postpartum transition. Use of evidence-based, technology-delivered interventions as a supplement to standard prenatal care may provide more robust preparation for those facing this transition. To date, no technology-based interventions specific to the pregnancy-to-postpartum transition for people receiving MOUD have been developed and evaluated.
Objective:
The primary aim of this manuscript is to describe the iterative development process of a novel technology-delivered intervention tailored for pregnant people receiving medication for OUD (MOUD) as it underwent refinement in preparation for its subsequent evaluation in a prospective randomized clinical trial.
Methods:
Three evidence-based technology-delivered intervention modules were developed and are described. Formative data from patients and providers identified module content: 1) recovery-oriented strategies for the pregnancy-to-postpartum transition, 2) guidance around caring for an infant with withdrawal symptoms, and 3) preparation for child welfare interactions. Module content matching these content areas was reviewed in successive rounds by an expert panel and modified by the study team. Then, novel modules were programmed into the web-based, easily accessible platform where information is delivered via professionally produced videos and an interactive narrator using behavioral techniques. Pregnant and postpartum people receiving MOUD pre-tested the modules and provided feedback in semi-structured interviews. Feedback from the expert panel and patient pre-testing is summarized.
Results:
Expert panel members (n=15) including patients, multidisciplinary providers, and technology-based intervention researchers identified module strengths and areas for improvement. Panel members liked the intervention format and the informative content. Primary areas for improvement included adding content, providing more structure to help participants navigate the intervention more easily, and revising language. Pre-testing participant (n=9) qualitative data highlighted four themes: reactions to intervention content, navigability of the intervention, feasibility of the intervention, and recommendation of the intervention. Participants also provided some areas for improvement. All iterative feedback was incorporated into final modules for the prospective randomized clinical trial.
Conclusions:
When developing technology-delivered interventions tailored for pregnant people receiving MOUD, it is feasible (and recommended) for the intervention to be informed by patient-reported needs and multidisciplinary perspectives. Assessment of intervention feasibility, acceptability, and effectiveness with a large sample in a clinical research setting is warranted.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.