O27 Knowledge-to-action: promoting best practices for maternal opioid use

Abstract

Background An increase in opioid use during pregnancy fuelled concerns among reproductive health advocates, policymakers, and providers in North Carolina, USA. Stakeholder groups joined together to address these concerns. A knowledge transfer (KT) intervention, which provided specialized education and training for frontline providers, in an effort to increase evidence-based practices became the primary goal of their response. Qualitative methodology can provide critical insight on the process of KT interventions and the contexts in which KT activities occur. Methods Data from a grounded theory study on care provision for perinatal substance use was used to examine a naturalistic KT intervention that emerged from stakeholder concerns. Data was collected over a six-year period and include observations of KT activities (conferences, workshops, and community meetings), focus groups and interviews conducted with stakeholders, and a review of publicly available documents developed as part of KT activities. Identified KT activities were mapped onto a theoretical framework detailing the Knowledge-to-Action (KTA) process and a thick, rich description of the intervention was developed. Additional analyses included Clarke’s situational mapping to identify important contextual factors that influenced the KTA process. Findings This proactive response to maternal opioid use included targeted and tailored toolkits and guidelines of best practices as well as provision of multiple knowledge exchange opportunities between researchers, advocates, and practitioners. Findings demonstrate stakeholders’ biases against maternal drug use and ambivalence towards evidence-based recommendations of harm reduction principles. Tensions around the interpretation of knowledge and the appropriate implementation of best practices occurred between ‘experts’ as well as among practitioners. Conclusion This presentation describes a grassroots response to maternal opioid use within the KTA framework. Findings highlight the complex and iterative nature of a KTA intervention and demonstrate limitations in rational and cognitive approaches to knowledge exchange. The need to systematically address stigma is discussed.