Funded Projects

Parenting Newborns: Building Bonds, Breaking Stigma

Project Year

2024

City & State

Madison, Wisconsin

Program Name

CATCH Resident

Topic

Parenting/Parent Education

Program Description

Problem:  People who use substances during pregnancy often face large amounts of stigma during and after their pregnancies, and may have had negative experiences in healthcare. These women may be less likely to bring their children for future medical visits, thus promoting ongoing barriers to care including possibly falling behind on vaccinations, as well as decreased health literacy (1). Children exposed to intrauterine substances are at higher risk for negative neurodevelopmental, behavioral, and psychosocial outcomes and if missing doctors’ appointments due to stigma or other barriers to care may miss opportunities for screening and referrals (2). Well-child checks are often time-limited, and if there is not an established relationship between parent and provider, parents may hesitate to ask questions on care of their children.    For women who are attempting to stop substance use, there are often residential programs they can access, which could be challenging with a new baby. Studies have shown that integrated programs where mothers can stay with their child while receiving treatment for substance use disorders are effective in improving mental health, birth outcomes, and likelihood of retaining custody of their children (2, 3, 4). Additionally, when these programs included teaching parenting skills and more supportive parenting behaviors, the children had fewer behavioral disorders and improved mental health in the long term (2). These programs are often difficult to access but improve health outcomes of both children and parents.  Primary Setting: ARC House is a 15-bed residential program located in Madison, Wisconsin in Dane County where women who are pregnant or have children under one year can live with their infants while undergoing treatment for substance use disorder. The average age of the women served by ARC programs was 22 years in a recent annual report (5). The majority of these women are also involved in the criminal justice system, either on probation or parole. They stay for up to six months while they receive mental health services, parenting initiatives, and medications for substance use disorder. It is funded primarily by the Department of Corrections, and the program is free to the participants. They have parenting classes there and are able to be connected with medical care. Currently, there are few opportunities for the women to meet with a physician or healthcare provider to discuss pediatric anticipatory guidance topics in more depth outside of routine medical visits.  Number of Children Affected: 30-50  Project Goal: The goal of the project will be to promote increased health literacy and confidence in newborn care skills of the women living at ARC House, and additionally foster positive relationships between these women and pediatric resident physicians so as to decrease biases on the part of the residents and hesitancy for the women to access care.   Proposed Intervention: We will hold monthly interactive educational sessions at ARC House on a variety of parenting and newborn care topics, led by pediatric residents on their advocacy rotations. Prior to these sessions, residents will receive education on care of children who have parents with substance use disorder and parents who are incarcerated via readings or an educational lecture/video.   Anticipated Outcomes:  We will improve parental comfort level in newborn care and increase parental knowledge of topics such as feeding and pediatric development in terms of what to watch out for and when to seek care. Additionally, we will foster positive relationships between the women and residents providing the sessions, which will serve to decrease both maternal hesitancy to access future care, as well as biases that residents may have towards parents with substance use disorders or involvement in the criminal justice system.

Project Goal

To improve the parenting and newborn care skills of the women participating in programs at ARC House and to foster positive relationships between these women and pediatric residents. Additionally, this will provide ARC House participants with positive associations in the healthcare field to decrease hesitancy to access care, and provide pediatric residents with positive exposure to parents with substance use disorder to decrease biases.

Project Objective 1

To improve the confidence of 30-40 women participating in programs at ARC House in the care of their own newborns, by 1-2 points on a Likert scale by June 2025. The project will offer education to all of the women at ARC House who belong to the historically marginalized populations of people with substance use disorder and involvement with the criminal justice system. 

Project Objective 2

To improve the comfort of all 16 pediatric interns on care of children whose parents have substance use disorders and/or involvement in criminal justice system by the end of their month-long advocacy rotation, and to decrease biases they may have towards these populations. This objective will be measured by pre- and post-rotation surveys.

Project Objective 3

To elicit positive healthcare associations for all women at ARC House (30-40 women) by the end of June 2025 in order to decrease any hesitancy to access care, as measured by intermittent surveys.

AAP District

District VI

Institutional Name

University of Wisconsin

Contact 1

Julia Clemens, MD