P2.088: Parenting Newborns: Building Bonds, Breaking Stigma

Background: Parental incarceration affects 7% of American children, and 16% of Americans have a substance use disorder (SUD), both of which are defined as adverse childhood events. Children of these parents can experience negative secondary mental and physical health outcomes including heart disease, depression, and SUD. Parents from these populations experience stigma in healthcare, which can lead to avoidance of healthcare systems resulting in further negative health outcomes in themselves and their children, potentially widening the gap of health equity. This project was introduced to expose pediatric residents to these patient populations through participation with a community residential treatment program, and to assess if the experience would increase pediatric residents’ interest and comfort level in caring for children with parents experiencing SUD or involvement with the Department of Corrections (DOC), and possibly decreasing any biases residents may have. The project was funded by an American Academy of Pediatrics Community Access to Child Health grant.

Project Description: This project introduced a partnership between the pediatric residency program and a local residential treatment facility where women with DOC involvement live with their infants while undergoing treatment for SUD. On their advocacy rotation, pediatric first-year residents completed readings on SUD and parental incarceration, and led a discussion session on a newborn care topic for the women at the residential treatment facility. Prior to and following the session, residents (n=10) completed a survey in Qualtrics on their comfort levels in providing anticipatory guidance and caring for children whose parents have involvement with the DOC or SUD.

Discussion: Residents overall had a positive experience with the project, and many hoped to return to the community partnership location. The intervention was effective in increasing resident interest in working with community partners (100%). After the session, more residents reported feeling comfortable (60%) caring for children whose parents had SUD compared to before (20%), as well as comfortable (60%) with children whose parents have DOC involvement post-visit compared to pre-visit (10%) (Figure 1). Changes were not significant, likely due to small sample size. Many residents reflected that all parents want to do the best for their children and that SUD or involvement with criminal justice system may present parents with unique challenges.

Conclusion: Working with community partners can broaden resident education by introducing them to specific patient populations. Resident comfort level in caring for these families increased after leading educational sessions for parents with SUD or DOC involvement. Similar experiences may reduce biases for physicians. Future studies could explore the perspectives of parents with SUD or DOC involvement after the educational sessions to assess confidence in newborn care skills and comfort in talking with healthcare providers.