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      Electronic Brief Intervention and Text Messaging for Marijuana Use During Pregnancy: Initial Acceptability of Patients and Providers

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          Abstract

          Background

          Marijuana is the most widely used illicit substance during pregnancy. Technology-delivered brief interventions and text messaging have shown promise in general and pregnant samples but have not yet been applied to marijuana use in pregnancy.

          Objective

          The objective of the study was to evaluate, among pregnant women and prenatal care providers, the acceptability of an electronic brief intervention and text messaging plan for marijuana use in pregnancy.

          Methods

          Participants included patients (n=10) and medical staff (n=12) from an urban prenatal clinic. Patient-participants were recruited directly during a prenatal care visit. Those who were eligible reviewed the interventions individually and provided quantitative and qualitative feedback regarding software acceptability and helpfulness during a one-on-one interview with research staff. Provider-participants took part in focus groups in which the intervention materials were reviewed and discussed. Qualitative and focus group feedback was transcribed, coded manually, and classified by category and theme.

          Results

          Patient-participants provided high ratings for satisfaction, with mean ratings for respectfulness, interest, ease of use, and helpfulness ranging between 4.4 and 4.7 on a 5-point Likert scale. Of the 10 participants, 5 reported that they preferred working with the program versus their doctor, and 9 of 10 said the intervention made them more likely to reduce their marijuana use. Provider-participants received the program favorably, stating the information presented was both relevant and important for their patient population.

          Conclusions

          The findings support the acceptability of electronic brief intervention and text messaging for marijuana use during pregnancy. This, combined with their ease of use and low barrier to initiation, suggests that further evaluation in a randomized trial is appropriate.

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          Most cited references29

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          Screening, Brief Intervention, and Referral to Treatment (SBIRT): toward a public health approach to the management of substance abuse.

          Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive and integrated approach to the delivery of early intervention and treatment services through universal screening for persons with substance use disorders and those at risk. This paper describes research on the components of SBIRT conducted during the past 25 years, including the development of screening tests, clinical trials of brief interventions and implementation research. Beginning in the 1980s, concerted efforts were made in the US and at the World Health Organization to provide an evidence base for alcohol screening and brief intervention in primary health care settings. With the development of reliable and accurate screening tests for alcohol, more than a hundred clinical trials were conducted to evaluate the efficacy and cost effectiveness of alcohol screening and brief intervention in primary care, emergency departments and trauma centers. With the accumulation of positive evidence, implementation research on alcohol SBI was begun in the 1990s, followed by trials of similar methods for other substances (e.g., illicit drugs, tobacco, prescription drugs) and by national demonstration programs in the US and other countries. The results of these efforts demonstrate the cumulative benefit of translational research on health care delivery systems and substance abuse policy. That SBIRT yields short-term improvements in individuals' health is irrefutable; long-term effects on population health have not yet been demonstrated, but simulation models suggest that the benefits could be substantial.
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            Primary care: is there enough time for prevention?

            We sought to determine the amount of time required for a primary care physician to provide recommended preventive services to an average patient panel. We used published and estimated times per service to determine the physician time required to provide all services recommended by the US Preventive Services Task Force (USPSTF), at the recommended frequency, to a patient panel of 2500 with an age and sex distribution similar to that of the US population. To fully satisfy the USPSTF recommendations, 1773 hours of a physician's annual time, or 7.4 hours per working day, is needed for the provision of preventive services. Time constraints limit the ability of physicians to comply with preventive services recommendations.
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              Special delivery: an analysis of mHealth in maternal and newborn health programs and their outcomes around the world.

              Mobile health (mHealth) encompasses the use of mobile telecommunication and multimedia into increasingly mobile and wireless health care delivery systems and has the potential to improve tens of thousands of lives each year. The ubiquity and penetration of mobile phones presents the opportunity to leverage mHealth for maternal and newborn care, particularly in under-resourced health ecosystems. Moreover, the slow progress and funding constraints in attaining the Millennium Development Goals for child and maternal health encourage harnessing innovative measures, such as mHealth, to address these public health priorities. This literature review provides a schematic overview of the outcomes, barriers, and strategies of integrating mHealth to improve prenatal and neonatal health outcomes. Six electronic databases were methodically searched using predetermined search terms. Retrieved articles were then categorized according to themes identified in previous studies. A total of 34 articles and reports contributed to the findings with information about the use and limitations of mHealth for prenatal and neonatal healthcare access and delivery. Health systems have implemented mHealth programs to facilitate emergency medical responses, point-of-care support, health promotion and data collection. However, the policy infrastructure for funding, coordinating and guiding the sustainable adoption of prenatal and neonatal mHealth services remains under-developed. The integration of mobile health for prenatal and newborn health services has demonstrated positive outcomes, but the sustainability and scalability of operations requires further feedback from and evaluation of ongoing programs.
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                Author and article information

                Contributors
                Journal
                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMU
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                2291-5222
                November 2017
                08 November 2017
                : 5
                : 11
                : e172
                Affiliations
                [1] 1 Merrill Palmer Skillman Institute Department of Psychiatry and Behavioral Neurosciences Wayne State University Detroit, MI United States
                [2] 2 Department of Psychology Virginia Commonwealth University Richmond, VA United States
                [3] 3 Department of Psychiatry Virginia Commonwealth University Richmond, VA United States
                [4] 4 Department of Obstetrics and Gynecology Virginia Commonwealth University Richmond, VA United States
                [5] 5 School of Medicine Department of Obstetrics and Gynecology Wayne State Unviersity Detroit, MI United States
                [6] 6 School of Public Health University of Michigan Ann Arbor, MI United States
                Author notes
                Corresponding Author: Jessica R Beatty jbeatty@ 123456wayne.edu
                Author information
                http://orcid.org/0000-0001-9093-8083
                http://orcid.org/0000-0003-0649-3777
                http://orcid.org/0000-0002-7258-2367
                http://orcid.org/0000-0003-1143-1757
                http://orcid.org/0000-0003-1416-9627
                http://orcid.org/0000-0001-5702-2655
                http://orcid.org/0000-0002-6372-2145
                http://orcid.org/0000-0001-6724-2248
                http://orcid.org/0000-0003-1134-7723
                Article
                v5i11e172
                10.2196/mhealth.7927
                5700401
                29117931
                2e243989-5670-4ea7-8e59-70be5466f027
                ©Justin Gray, Jessica R Beatty, Dace S Svikis, Karoline S Puder, Ken Resnicow, Janine Konkel, Shetoya Rice, Lucy McGoron, Steven J Ondersma. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 08.11.2017.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

                History
                : 26 April 2017
                : 29 June 2017
                : 23 August 2017
                : 10 September 2017
                Categories
                Original Paper
                Original Paper

                pregnancy,marijuana,intervention study,text messaging
                pregnancy, marijuana, intervention study, text messaging

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