Project BETTER: Preliminary Feasibility and Acceptability of a Technology-Delivered Educational Program for Pregnant and Postpartum People with Opioid Use Disorder.

Abstract

Postpartum people with opioid use disorder (OUD) report feeling underprepared for the pregnancy to postpartum transition. We developed a novel, technology-delivered educational intervention for pregnant and parenting people with OUD to address this gap. This study provides a theoretically grounded assessment of the feasibility and acceptability of a new technology-delivered educational intervention (Project BETTER) for pregnant and parenting people receiving medication for OUD (MOUD). Pregnant and postpartum people receiving MOUD were recruited from a perinatal addiction clinic research registry to pilot test the technology-delivered intervention. Participants completed one of three modules (Postpartum Transition, Neonatal Opioid Withdrawal Syndrome, or Child Welfare Interactions) and a survey assessing acceptability based on the theoretical framework of acceptability (TFA). We measured feasibility using process, resource, management, and scientific assessments. Demographics were self-reported. Clinical characteristics were abstracted from the medical record. Feasibility was promising, with 17 of 28 participants approached (61%) agreeing to participate; 70% of these participants (N = 12; 58% White and 23% Black, all with public insurance) completed an intervention module and the study assessments, and all reported understanding how the modules worked. Acceptability was strong, with median ratings of 4 or 5 on a 5-point scale for all positively scored TFA domains. Compared to learning from a provider, participants also reported feeling more comfortable and less stigmatized learning from the intervention. Our theoretically grounded assessment suggests high feasibility and acceptability for Project BETTER, and provides justification for further evaluation in a clinical trial setting. Technology-delivered educational interventions may help reduce stigma and enhance prenatal education.