TY - JOUR
AU - K. Urbanoski
AU - T. Iwajomo
AU - T. Gomes
AU - C. de Oliveira
AU - K. Milligan
A1 - 
AB - BACKGROUND: Integrated treatment programs for pregnant and parenting people seek to provide wrap-around services and supports to overcome the barriers and constraints associated with the gendered contexts of substance use and help-seeking. We investigated retention in outpatient treatment among pregnant people and mothers, comparing integrated treatment programs with standard treatment programs in Ontario, Canada. METHODS: We conducted a population-based retrospective cohort study of females (n = 4440) admitted to 11 integrated treatment programs (cases) and 10 standard treatment programs (controls) between 2008 and 2015. Data sources included linked administrative health data merged with primary data on program characteristics. Exposure was program type and outcomes included days in treatment and number of visits. Multi-level negative binomial regression estimated the effects of program type on retention measures, controlling for individual- and program-level covariates. RESULTS: Relative to standard treatment, integrated treatment programs offered more services in-house or through partnerships, with specific advantages around the availability of prenatal or primary care and child-minding. Controlling for individual- and program-level covariates, individuals in integrated treatment programs spent more days in treatment (adjusted incidence rate ratio [aIRR] = 5.41, 95 % CI 4.10-7.13) and had more visits (aIRR = 5.18, 95 % CI 4.305-6.23) than did controls in standard treatment programs. CONCLUSIONS: This study contributes to a growing body of evidence on the implementation and effectiveness of wrap-around comprehensive service models, or integrated treatment programs, designed for pregnant and parenting people who use substances. Integrated treatment models constitute a promising approach to supporting families affected by substance use.
AD - Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia V8W 2Y2, Canada; School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia V8W 2Y2, Canada. Electronic address: urbanosk@uvic.ca.; Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario M5S 3M1, Canada.; Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M6, Canada; ICES, Toronto, Ontario M4N 3M5, Canada.; Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario M5S 3M1, Canada; Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M6, Canada; ICES, Toronto, Ontario M4N 3M5, Canada.; Psychology, Toronto Metropolitan University, 350 Victoria St., M5B 2K3, Canada.
AN - 40274103
BT - J Subst Use Addict Treat
C5 - Healthcare Disparities; Education & Workforce
DA - Jul
DO - 10.1016/j.josat.2025.209701
DP - NLM
ET - 20250422
JF - J Subst Use Addict Treat
LA - eng
N2 - BACKGROUND: Integrated treatment programs for pregnant and parenting people seek to provide wrap-around services and supports to overcome the barriers and constraints associated with the gendered contexts of substance use and help-seeking. We investigated retention in outpatient treatment among pregnant people and mothers, comparing integrated treatment programs with standard treatment programs in Ontario, Canada. METHODS: We conducted a population-based retrospective cohort study of females (n = 4440) admitted to 11 integrated treatment programs (cases) and 10 standard treatment programs (controls) between 2008 and 2015. Data sources included linked administrative health data merged with primary data on program characteristics. Exposure was program type and outcomes included days in treatment and number of visits. Multi-level negative binomial regression estimated the effects of program type on retention measures, controlling for individual- and program-level covariates. RESULTS: Relative to standard treatment, integrated treatment programs offered more services in-house or through partnerships, with specific advantages around the availability of prenatal or primary care and child-minding. Controlling for individual- and program-level covariates, individuals in integrated treatment programs spent more days in treatment (adjusted incidence rate ratio [aIRR] = 5.41, 95 % CI 4.10-7.13) and had more visits (aIRR = 5.18, 95 % CI 4.305-6.23) than did controls in standard treatment programs. CONCLUSIONS: This study contributes to a growing body of evidence on the implementation and effectiveness of wrap-around comprehensive service models, or integrated treatment programs, designed for pregnant and parenting people who use substances. Integrated treatment models constitute a promising approach to supporting families affected by substance use.
PY - 2025
SN - 2949-8759
SP - 209701
ST - Integrated treatment programs for pregnant and parenting people support longer retention compared to standard treatment programs: A population-based cohort study
T1 - Integrated treatment programs for pregnant and parenting people support longer retention compared to standard treatment programs: A population-based cohort study
T2 - J Subst Use Addict Treat
TI - Integrated treatment programs for pregnant and parenting people support longer retention compared to standard treatment programs: A population-based cohort study
U1 - Healthcare Disparities; Education & Workforce
U3 - 10.1016/j.josat.2025.209701
VL - 174
VO - 2949-8759
Y1 - 2025
ER -