Objective

Understanding the impact of substance use during pregnancy on fetal development and child health is essential for designing effective approaches for reducing prenatal substance exposures and improving child outcomes. Research on the developmental impacts of prenatal substance exposure has been limited by legal, ethical, and practical challenges. This study examined approaches to engage substance-using (with an emphasis on opioids) pregnant persons in longitudinal research, from multi-stakeholder perspectives.

Methods

The present study solicited the expertise of 1) an advisory group of community stakeholders, including people with lived experienced of opioid/substance use; and 2) an online survey with content experts. Qualitative analysis examined facilitators and barriers to recruiting and retaining substance-using pregnant persons through a socioecological lens at the individual, interpersonal, organizational, community, and policy levels.

Results

Stakeholders (N = 19) prioritized stigma, loss of confidentiality, legal consequences, and instability (e.g., homelessness and poverty) as important barriers that prevent substance-using persons from enrolling in research studies. Of 70 survey respondents, most self-identified as researchers (n = 37), followed by clinicians (n = 19), and ‘others’ (n = 14). Survey respondents focused on retention strategies that build trusting relationships with participants, including incentives (e.g., transportation and childcare support), participant-friendly study design, and team-related factors, (e.g., attitudes and practices).

Conclusion

The stakeholder input and survey data offer key insights strengthening our understanding of facilitators and barriers to research participation, and ways to overcome barriers among substance-using pregnant persons. A socioecological framework can be used to identify and address these factors to increase recruitment and long-term retention of high-risk populations.

中文翻译：

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让使用物质的孕妇参与纵向研究的社会生态框架：多利益相关者的观点

客观的

了解怀孕期间物质使用对胎儿发育和儿童健康的影响对于设计减少产前物质暴露和改善儿童结局的有效方法至关重要。对产前物质暴露对发育影响的研究受到法律、伦理和实际挑战的限制。本研究从多方利益相关者的角度研究了让使用药物（重点是阿片类药物）的孕妇参与纵向研究的方法。

方法

本研究征求 1) 社区利益相关者咨询小组的专业知识，包括有阿片类药物/药物使用经验的人；2) 与内容专家进行的在线调查。定性分析通过个人、人际关系、组织、社区和政策层面的社会生态学视角，检查了招募和留住吸毒孕妇的促进因素和障碍。

结果

利益相关者 ( N  = 19) 将污名、失去机密性、法律后果和不稳定（例如，无家可归和贫困）列为阻止吸毒者参加研究的重要障碍。在 70 名受访者中，大多数人自称是研究人员（n  = 37），其次是临床医生（n  = 19）和“其他人”（n  = 14）。调查受访者关注与参与者建立信任关系的保留策略，包括激励措施（例如交通和儿童保育支持）、对参与者友好的研究设计以及与团队相关的因素（例如态度和实践）。

结论

利益相关者的意见和调查数据提供了重要的见解，加强了我们对促进者和研究参与障碍的理解，以及克服药物使用孕妇之间障碍的方法。社会生态学框架可用于识别和解决这些因素，以增加高危人群的招募和长期保留。