Application of a RE-AIM Evaluation Framework to Test Integration of a Mindfulness Based Parenting Intervention into a Drug Treatment Program
Background The RE-AIM framework was applied to the Mindfulness Based Parenting (MBP) intervention to evaluate the feasibility and effectiveness of this innovative trauma informed model in a drug treatment program. The MBP intervention is aimed at mitigating the stress experienced by women in treatment for substance use disorders, and thereby improving parenting and dyadic attachment between mother and child. Methods This was a single arm pre-test post-test design using repeated measure data collected between 2013 and 2016. The design also includes comprehensive process and impact evaluation data. Participants were 120 parenting women enrolled in an opioid treatment program between 2013 and 2016 in Philadelphia, PA. The MBP intervention included weekly 2-h MBP group sessions over 12 weeks, including three dyadic sessions with their child. The main outcomes of this study include the five facets of RE-AIM: Reach, Effectiveness, Adoption, Implementation, and Maintenance. Results The MBP intervention was associated with improvements in parenting across participants. Data showed implementation and sustainability are contingent upon a strong multidisciplinary team and clinical staff support and “buy-in”. Iterative adaptations of interventions used in the general population may be necessary when working with a traumatized population burdened by low literacy levels, trauma history and co-occurring disorders. Conclusions MBP is a feasible and effective intervention for improving parenting and dyadic attachment between women with opioid use disorder and their children, and may be useful for other programs that serve parenting women with substance use disorders.
KeywordsOpioid Parenting Substance use Mindfulness
This work was supported by the Children’s Bureau which is located within the Administration for Children and Families, a division of the US Department of Health and Human Services (Grant Award no. 90CB0190). The authors especially thank the MBP participants, Esther Chung, Michelle Calvano, Kimberly McLaughlin, Megan Foss, Ruth Gubernick, Mariana LaNoue, Carolyn Palmer, Lindsay Reid, Wendy Weingarten, and the staff at the following institutions for their help in various aspects of the project: MATER, Family Center and My Sisters Place.
Compliance with Ethical Standards
Conflict of interest
The authors report that they have no conflict of interest.
- Atlas ti. (2013). Released 2013. Atlas for Windows, Version 7.0. ATLAS.ti Scientific Software Development GmbH. Berlin: Atlas.Google Scholar
- Bagner, D. M., Sheinkopf, S. J., Miller-Loncar, C., LaGasse, L. L., Lester, B. M., Liu, J., Bauer, C. R., Shankaran, S., Bada, H., & Das, A. (2009). The effect of parenting stress on child behavior problems in high risk children with prenatal drug exposure. Child Psychiatry and Human Development. 40(1), 73–84. https://doi.org/10.1007/s10578-008-0109-6.CrossRefGoogle Scholar
- Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., Hsu, S., Grow, J., Clifasefi, S., Garner, M., Douglass, A., Larimer, M. E., & Marlatt, A. (2009). Mindfulness-based relapse prevention for substance use disorders: A pilot efficacy trial. Substance Abuse, 30(4), 295–305. https://doi.org/10.1080/08897070903250084.CrossRefGoogle Scholar
- Coatsworth, J. D., Duncan, L. G., Greenberg, M. T., & Nix, R. L. (2010). Changing parents mindfulness, child management skills and relationship quality with their youth: Results from a randomized pilot intervention trial. Journal of Child And Family Studies, 19(2), 203–217. https://doi.org/10.1007/s10826-009-9304-8.CrossRefGoogle Scholar
- Comfort, M., & Gordon, P. (2010). Keys to interactive parenting scale: KIPS shows how parents grow. Zero to Three Journal, 30(4), 33–39.Google Scholar
- Corbin, J., & Strauss, M. (2007). Basics of qualitative research: Techniques and procedures for developing grounded theory (3rd edn.). Thousand Oaks: Sage.Google Scholar
- IBM Corp. (2015). Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk: IBM Corp.Google Scholar
- Johnson, H., et al. (2014). Decline in drug overdose deaths after state policy changes—Florida, 2010–2012. MMWR Morbidity Mortality Weekly Report, 63, 569–574.Google Scholar
- Kabat-Zinn, J. (1994). Wherever you go there you are. New York: Hyperion.Google Scholar
- Liles, B. D., Newman, E., LaGasse, L. L., Derauf, C., Shah, R., Smith, L. M., Arria, A. M., Huestis, M. A., Haning, W., Strauss, A., Dellagrotta, S., Dansereau, L. M., Neal, C., & Lester, B. M. (2012). Perceived child behavioral problems, parenting stress, and maternal depressive symptoms among prenatal methamphetamine users. Child Psychiatry and Human Development. 43(6), 943–957. https://doi.org/10.1007/s10578-012-0305-2.CrossRefGoogle Scholar
- Marcus, M. T., & Fine, M. (2001). Mindfulness-based meditation in a therapeutic community. Journal of Substance Abuse, 5(4), 305–311.Google Scholar
- RE-AIM. Retrieved May 26, 2017, from http://re-aim.org/category/publications.
- Reeves, R., Sawhill, I., & Howard, K. (2013). The parenting gap. Washington, DC: Brookings Center on Children and Families.Google Scholar
- Richards, L. (2005). Handling qualitative data: A practical guide. London: Sage.Google Scholar
- Sheinkopf, S. J., Lester, B. M., LaGasse, L. L., Seifer, R., Bauer, C. R., Shankaran, S., Bada, H. S., Poole, W. K., & Wright, L. L. (2006). Interactions between maternal characteristics and neonatal behavior in the prediction of parenting stress and perception of infant temperament. Journal of Pediatric Psychology, 31(1), 27–40.CrossRefGoogle Scholar
- Short, V. L., Gannon, M., Weingarten, W., Kaltenbach, K., LaNoue, M., & Abatemarco, D. J. (2017). Reducing stress among mothers in drug treatment: a description of a mindfulness based parenting intervention. Matern Child Health Journal, 21(6), 1377–1386.Google Scholar
- Singh, N. N., Lancioni, G. E., Winton, A. S., Fisher, B. C., Wahler, R., McAleavey, K., Singh, J., & Sabaawi, M. (2006). Mindful parenting decreases aggression, noncompliance, and self-injury in children with autism. Journal of Emotional and Behavioral Disorders, 14(3), 169–177.CrossRefGoogle Scholar
- United States Department of Health and Human Services. Retrieved May 25, 2017, from. https://www.hhs.gov/opioids/about-the-epidemic/.