Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis

<p>Abstract</p> <p>Background</p> <p>The rate of women with substance abuse issues is increasing. Women present with a unique constellation of risk factors and presenting needs, which may include specific needs in their role as mothers. Numerous integrated programs (tho...

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Main Authors: Milligan Karen, Niccols Alison, Sword Wendy, Thabane Lehana, Henderson Joanna, Smith Ainsley, Liu Jennifer
Format: Article
Language:English
Published: BMC 2010-09-01
Series:Substance Abuse Treatment, Prevention, and Policy
Online Access:http://www.substanceabusepolicy.com/content/5/1/21
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author Milligan Karen
Niccols Alison
Sword Wendy
Thabane Lehana
Henderson Joanna
Smith Ainsley
Liu Jennifer
author_facet Milligan Karen
Niccols Alison
Sword Wendy
Thabane Lehana
Henderson Joanna
Smith Ainsley
Liu Jennifer
author_sort Milligan Karen
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>The rate of women with substance abuse issues is increasing. Women present with a unique constellation of risk factors and presenting needs, which may include specific needs in their role as mothers. Numerous integrated programs (those with substance use treatment and pregnancy, parenting, or child services) have been developed to specifically meet the needs of pregnant and parenting women with substance abuse issues. This synthesis and meta-analysis reviews research in this important and growing area of treatment.</p> <p>Methods</p> <p>We searched PsycINFO, MedLine, PubMed, Web of Science, EMBASE, Proquest Dissertations, Sociological Abstracts, and CINAHL and compiled a database of 21 studies (2 randomized trials, 9 quasi-experimental studies, 10 cohort studies) of integrated programs published between 1990 and 2007 with outcome data on maternal substance use. Data were summarized and where possible, meta-analyses were performed, using standardized mean differences (<it>d</it>) effect size estimates.</p> <p>Results</p> <p>In the two studies comparing integrated programs to no treatment, effect sizes for urine toxicology and percent using substances significantly favored integrated programs and ranged from 0.18 to 1.41. Studies examining changes in maternal substance use from beginning to end of treatment were statistically significant and medium sized. More specifically, in the five studies measuring severity of drug and alcohol use, the average effect sizes were 0.64 and 0.40, respectively. In the four cohort studies of days of use, the average effect size was 0.52. Of studies comparing integrated to non-integrated programs, four studies assessed urine toxicology and two assessed self-reported abstinence. Overall effect sizes for each measure were not statistically significant (<it>d </it>= -0.09 and 0.22, respectively).</p> <p>Conclusions</p> <p>Findings suggest that integrated programs are effective in reducing maternal substance use. However, integrated programs were not significantly more effective than non-integrated programs. Policy implications are discussed with specific attention to the need for funding of high quality randomized control trials and improved reporting practices.</p>
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spelling doaj.art-0d5e063bfc9347b097a46a06879333062022-12-21T21:43:34ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2010-09-01512110.1186/1747-597X-5-21Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysisMilligan KarenNiccols AlisonSword WendyThabane LehanaHenderson JoannaSmith AinsleyLiu Jennifer<p>Abstract</p> <p>Background</p> <p>The rate of women with substance abuse issues is increasing. Women present with a unique constellation of risk factors and presenting needs, which may include specific needs in their role as mothers. Numerous integrated programs (those with substance use treatment and pregnancy, parenting, or child services) have been developed to specifically meet the needs of pregnant and parenting women with substance abuse issues. This synthesis and meta-analysis reviews research in this important and growing area of treatment.</p> <p>Methods</p> <p>We searched PsycINFO, MedLine, PubMed, Web of Science, EMBASE, Proquest Dissertations, Sociological Abstracts, and CINAHL and compiled a database of 21 studies (2 randomized trials, 9 quasi-experimental studies, 10 cohort studies) of integrated programs published between 1990 and 2007 with outcome data on maternal substance use. Data were summarized and where possible, meta-analyses were performed, using standardized mean differences (<it>d</it>) effect size estimates.</p> <p>Results</p> <p>In the two studies comparing integrated programs to no treatment, effect sizes for urine toxicology and percent using substances significantly favored integrated programs and ranged from 0.18 to 1.41. Studies examining changes in maternal substance use from beginning to end of treatment were statistically significant and medium sized. More specifically, in the five studies measuring severity of drug and alcohol use, the average effect sizes were 0.64 and 0.40, respectively. In the four cohort studies of days of use, the average effect size was 0.52. Of studies comparing integrated to non-integrated programs, four studies assessed urine toxicology and two assessed self-reported abstinence. Overall effect sizes for each measure were not statistically significant (<it>d </it>= -0.09 and 0.22, respectively).</p> <p>Conclusions</p> <p>Findings suggest that integrated programs are effective in reducing maternal substance use. However, integrated programs were not significantly more effective than non-integrated programs. Policy implications are discussed with specific attention to the need for funding of high quality randomized control trials and improved reporting practices.</p>http://www.substanceabusepolicy.com/content/5/1/21
spellingShingle Milligan Karen
Niccols Alison
Sword Wendy
Thabane Lehana
Henderson Joanna
Smith Ainsley
Liu Jennifer
Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis
Substance Abuse Treatment, Prevention, and Policy
title Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis
title_full Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis
title_fullStr Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis
title_full_unstemmed Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis
title_short Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis
title_sort maternal substance use and integrated treatment programs for women with substance abuse issues and their children a meta analysis
url http://www.substanceabusepolicy.com/content/5/1/21
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