Perspective: How We're Strengthening Provider Capacity to Serve Postpartum Women at Risk of Opioid Misuse

Altarum is helping new moms in Texas access behavioral health services. Image credit: Getty Images

Last year Altarum began working with communities in Central Texas to address opioid misuse among postpartum women, particularly those who are struggling to make ends meet. We set out to help WIC and community health centers increase screening of new mothers for substance misuse and refer them to recovery support services so they can get the help they need. We’re already seeing promising results—a large majority of providers participating in our program indicate they are better equipped to identify warning signs and effects of opioid misuse in their postpartum patients and clients, and to discuss drug use with them. 

How did we achieve these results? We and our partner, Cardea, combined our expertise in recovery services, maternal health, and community health service delivery to overcome the stigma that so often prevents patients from seeking care for substance use disorder, and providers from delivering it. 

Our objective was to integrate substance use screening and referrals into community health centers and WIC clinics. We began by conducting extensive research and discussions with key stakeholders to identify clinical capacity to integrate interventions and referrals and local recovery services. 

We then customized training and technical assistance to WIC clinics and community health centers that built upon their existing systems, infrastructure, and capacity. 

Our trainings helped health center and WIC clinic staff understand the basics about opioids and substance use disorders, including the unique impacts of opioid use on women’s reproductive health; identifying strategies for initiating conversations about substance use; enhancing motivational interviewing techniques; determining how and when to make a referral; and, developing implementation and monitoring plans, tailored for each participating clinic. 

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We successfully introduced a new universal screening tool for opioid use disorder that was merged into providers’ electronic medical record, standardizing the process across all community health centers and increasing referral placements. 

WIC and community health center staff who also participated in our trainings indicated a substantial increase in knowledge, self-efficacy, and an intent to improve their current practices as a result of our trainings: 

• 89% indicated that they intend to change practices as a result of our training. 
• 88% rated their ability to discuss postpartum drug use as good, very good, or excellent, as compared to only 39% before the training. 
• 100% indicated an increase in awareness of strategies to connect and engage more effectively with patients. 
• 78% reported an increase in awareness of warning signs and effects of opioid misuse on women. 

We can’t address opioid misuse among the most vulnerable, especially new mothers, unless we understand both the systematic and cultural barriers to providing needed person-centered care. It requires deep interdisciplinary, and a hands-on approach to training that leads to real change. 

Contact us to learn how we can implement a similar program to help new mothers in your community. 

** This project was made possible by St. David’s Foundation’s Focus on the Fourth initiative to improve postpartum access and outcomes for low-income and underserved women in Central Texas.