Author ORCID Identifier

https://orcid.org/0000-0003-3886-8609

Semester

Fall

Date of Graduation

2023

Document Type

Dissertation

Degree Type

PhD

College

School of Nursing

Department

Not Listed

Committee Chair

Jennifer Mallow

Committee Member

Ubolrat Piamjaryakul

Committee Member

Kesheng Wang

Committee Member

Steve Davis

Abstract

ABSTRACT

Relationships Among Pregnancy, Substance Use, Social Determinants of Health and Assessment, Referral, and Utilization of Treatment: A Secondary Analysis of NSDUH Data

Heather Coddington

Background: Assessment and referral for substance use disorder during pregnancy is crucial to improving outcomes for mothers and newborns during the antepartum and postpartum period. Healthcare professionals are essential during the entirety of the pregnancy during each trimester to provide effective communication when assessing for substance use early and throughout each trimester of pregnancy. The purpose of this study was to determine if there was a relationship between assessment, referral, and utilization of treatment for women during the antenatal period with SUD and their social determinants of health using the 2021 NSDUH data set.

Research Question: In a nationally representative sample of U.S. pregnant females aged 15-44, is there a relationship between assessment, referral, and utilization of treatment for substance use disorder and the social determinants of health during the antenatal period?

Methods: This study used the NSDUH 2021 dataset with the subgroup of pregnant women (n=705). Descriptive statistics was used to analyze the demographics and social determinants of health. Chi square tests was used to determine the association between assessment and referral from healthcare professionals and utilization of treatment. Logistic regression analysis was utilized to identify significant predicting variables associated with assessment, referral for treatment, and utilization of care.

Results:Those in the over 2 x the federal poverty threshold reported the highest rate (p =

Conclusions: The study findings indicate that assessment and referral for SUD was performed less in young age, high school or less, living in poverty, and unmarried pregnant women with no health insurance. Utilization of treatment showed differences in alcohol and illicit drug use in the last 30 days as the most reported substance related to the need for treatment in the past year. Barriers to care most reported were the need for health insurance or health insurance that covered alcohol/alcoholism or drug abuse. Practice and policy change to include improved assessment with subsequent referral with validated tools is needed. Policy reform to improve health care coverage to include treatment for alcohol/alcoholism and drug abuse is evident.

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