Literature Collection

BACKGROUND: The postpartum period represents a critical period for both birthing and nonbirthing parents due to mental health concerns and new caregiving demands. Collaborative care models aim to address these needs, but postpartum care remains fragmented, lacking continuity and holistic support. Baby2Home (B2H) is a digital intervention rooted in the collaborative care model, specifically designed to support parents through their transition into parenthood by addressing their physical, emotional, and psychosocial needs. This intervention seeks to close the gaps left by traditional care models by providing continuous, organized, and accessible support throughout the postpartum period. In our qualitative study of the B2H intervention, we reference the parallel journeys framework and use it as a part of our analysis to evaluate whether mobile health (mHealth) technology addresses the holistic needs (postpartum and psychosocial) of new parents. OBJECTIVE: We aimed to assess how the B2H app supports the holistic needs of new parents and addresses care gaps identified in traditional postpartum services. METHODS: We conducted semistructured interviews with 20 birthing and nonbirthing parents selected through purposive sampling based on their app use. Data were analyzed using the postpartum parallel journeys framework and inductive coding. RESULTS: Our findings demonstrate the comprehensive impact of the B2H intervention in addressing both the physical and psychosocial needs of new parents. B2H supported postpartum care by helping parents navigate uncertainties, enhancing health care provider-parent communication, promoting self-care, and increasing parental self-efficacy. Psychosocial support included symptom identification, timely care manager assessments, coordinated treatment, and transition resources. The app also addressed care gaps by promoting inclusivity for nonbirthing parents, bridging screening and treatment, supporting real-time treatment navigation, and ensuring continuity of care. CONCLUSIONS: We demonstrate that the use of mHealth technology such as the B2H app can effectively support the multifaceted needs of new parents during their postpartum care period. By applying the parallel journeys framework, the research also identifies gaps in care that are addressed by the B2H app, presenting unique opportunities for future development and research.

Craniofacial conditions often require extensive medical care and surgeries throughout childhood and adolescence. However, there is limited research investigating the psychological effects of craniofacial care, including risks for medical traumatic stress. This cross-sectional study investigated the medical care experiences of adults with craniofacial conditions, including the frequency of potentially traumatic medical events, post-traumatic stress disorder (PTSD) symptoms, and resilience. Participants (N=34; mean age 35.2 ± 12.2 y; 71% female) were recruited at 3 US pediatric hospitals and craniofacial support organizations. Participants completed the PTSD Checklist (PCL-5), Connor-Davidson Resilience Scale, the Craniofacial Experiences Questionnaire, and open-ended questions about their medical care experiences. Most participants reported experiencing potentially traumatic medical experiences, such as prolonged and/or painful dental (79%) and medical treatments (73%) and hospitalization in the intensive care unit (70%). On the PCL-5, 21% met the criteria for PTSD, which is similar to other medical populations and higher than the 6% rate of PTSD in the general US population. Participants reported both stressors and positive aspects related to living with a craniofacial condition; however, resilience scores were lower relative to a US community sample. Qualitative analysis of open-ended responses identified themes including interactions with providers, medical treatment experiences, and psychosocial impacts. Adults with craniofacial conditions appear to be vulnerable to post-traumatic stress symptoms related to their medical care experiences, and report reduced resilience relative to community samples. Implications for clinical care and research include the integration of trauma-informed care approaches and strategies to support coping and resilience across the lifespan.

INTRODUCTION: The COVID-19 pandemic has instigated the development of telemedicine-mediated provision of medications for opioid use disorder such as buprenorphine and methadone, referred to as TMOUD in this study. As services start to return to pre-pandemic norms, there is a debate around the role of TMOUD as addition to or replacement of the conventional cascade of care for people with opioid use disorder (PWOUD). This scoping review is designed to characterize existing TMOUD services and provide insights to enable a more nuanced discussion on the role of telemedicine in the care of PWOUD. METHODS: The literature search was conducted in OVID Medline, CINAHL, and PsycINFO, from inception up to and including April 2023, using the Joanna Briggs Institute methodology for scoping reviews. The review considered any study design that detailed sufficient descriptive information on a given TMOUD service. A data extraction form was developed to collect and categorize a range of descriptive characteristics of each discrete TMOUD model identified from the obtained articles. RESULTS: A total of 45 articles met the inclusion criteria, and from this, 40 discrete TMOUD services were identified. In total, 33 services were US-based, three from Canada, and one each from India, Ireland, the UK, and Norway. Through a detailed analysis of TMOUD service characteristics, four models of care were identified. These were TMOUD to facilitate inclusion health, to facilitate transitions in care, to meet complex healthcare needs, and to maintain opioid use disorder (OUD) service resilience. CONCLUSIONS: Characterizing TMOUD according to its functional benefits to PWOUD and OUD services will help support evidence-based policy and practice. Additionally, particular attention is given to how digital exclusion of PWOUD can be mitigated against.

OBJECTIVE: To examine the associations between unhealthy alcohol use and risk of coronary heart disease (CHD) among women and men aged 18-65 years. METHODS: An observational study in an integrated healthcare system with systematic alcohol screening. We identified 432,265 primary care patients aged 18-65 years who, in 2014-2015, reported weekly alcohol intake levels. Weekly alcohol intake, categorized into below (≤14/week men; ≤7/week women) and above limits (≥15/week men; ≥ 8/week women) per U.S. guidelines, and heavy episodic drinking (HED, ≥5/≥4 drinks any day in past 3 months for men/women, respectively). Main outcome was CHD during 4-year follow-up, based on inpatient ICD diagnoses of myocardial infarction and CHD. Cox proportional hazards models adjusted for age, sex, race/ethnicity, body mass index, physical activity, smoking, hypertension, diabetes, and hyperlipidemia. RESULTS: The cohort comprised 44 % women, mean age (standard deviation) of 43.5 years (±13.1). Weekly alcohol intake above limits was associated with higher prevalence of cardiovascular risk factors, and a 26 %, 19 % and 43 % higher risk on the overall, men- and women-specific risk of CHD after adjusting for these risk factors (hazard ratio [95 % confidence interval] = 1.26[1.13 -1.40], 1.19[1.04-1.35] and 1.43[1.20-1.71], respectively). CONCLUSIONS: In a large, real-world, diverse population with a systematic alcohol screening program, having weekly alcohol intake above limits was associated with increased risk of CHD among young and middle-aged men and women. Increased CHD risk due to alcohol intake above limits warrants particular awareness and interventions.