Group Well Child Care for Mothers with Opioid Use Disorder: Framework for Implementation

SignificanceWhat is Already Known on the Subject? Birthing parents with opioid use disorder and their children often face social and economic hardships, including barriers to well child care engagement. Group well child care has improved family outcomes in other patient populations.What this Study Adds? Birthing parents in treatment for opioid use disorder and pediatric clinicians identify potential facilitators of implementing group well child care within a parental treatment program; these facilitators include a focus on parental recovery and wellness, peer support, and accessibility and coordination of care. ObjectiveFor parents with opioid use disorder (OUD) and their children, group well child care (WCC) is an under-studied intervention that may reduce stigma, increase quality of care, and improve clinical outcomes. We explored barriers and facilitators to this intervention using an implementation science framework.MethodsA qualitative study was conducted from October 2020-March 2021 as part of the planning phase of a cluster-randomized trial of group WCC. Parent participants were recruited from one urban, university-affiliated OUD treatment center to participate in semi-structured telephone interviews. Eligible parents had a child under two years old and were English speaking. Clinician participants were recruited from a nearby pediatric primary care practice. Inductive thematic analysis of interview responses was led by two investigators using open coding procedures.ResultsThirty-one parents and thirteen pediatric clinicians participated in the interviews. Most parents (68%) reported that they would be likely or very likely to bring their child to the OUD treatment center for WCC. Six themes emerged describing perceived implementation barriers, including intervention difficulty, complexity, and potential negative outcomes such as loss of privacy. Six themes emerged as implementation facilitators: (1) focus on parental OUD and recovery, (2) peer support, (3) accessibility and coordination of care, (4) clinician skill and expertise in parental OUD, (5) increased time for patient care, and (6) continuity of care.Conclusions for PracticeParents and clinicians expressed multiple perceived benefits of this intervention. Identified barriers and facilitators will inform implementation and evaluation of group WCC within one OUD treatment program.