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Access matters: integrating trauma-informed reproductive health care into a family-centered drug court and social service program

Keitra Thompson, MSN, FNP-BC, Johns Hopkins University

Women with opioid and other substance use disorders (SUDs) have an unmet need effective contraceptive methods and high rates of unintended pregnancy. These women often avoid traditional health care settings because of previous poor treatment by providers and fear of criminal justice or child welfare repercussions. This scholarly project seeks to address the clinical problem of unmet contraceptive need among women with SUDs through integration of reproductive health education and family planning services into a family-centered drug court program. Substance use treatment organizations offer an opportunity to promote equity in reproductive health education and family planning services for women with SUDs, but overwhelmingly lack such programming. The Family Recovery Program (FRP) creates healthier futures for children and families by providing holistic SUD and social support services for mothers and families involved with Baltimore City's Family Drug Court. However, FRP currently lacks evidence-based reproductive health programming despite client vulnerability for unintended and unwanted pregnancy. A review of the literature published between 2012 and 2017 reveals women with SUDs experience disparities in reproductive health knowledge, family planning self-efficacy, and access to contraception. This evidence-based quality improvement project will focus on implementing a three-tiered intervention at FRP, consisting of group education, individual counseling about reproductive life planning, and onsite clinical delivery of basic reproductive health care and a variety of contraceptive methods. All intervention activities related to this project will be conducted through a trauma-informed model of care, acknowledging the vulnerabilities of participants and relevance of the health belief model of behavior change.


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