Prevention of Substance Exposed Newborns: Preconception Outreach Education for Criminal Justice Populations

Purpose for the program: This presentation addresses the evolution of an outreach program aimed at reducing the number of substance exposed newborns (SEN), conducted by the Perinatal Addictions Prevention Project of the Central New Jersey Maternal and Child Health Consortium, in collaboration with the NJ Department of Health and Senior Services.   In concert with the perspective that addictions is a family disease and that the behaviors of those closest to the childbearing-aged woman influence her risk behaviors, both men and women within the criminal justice system following substance misuse and abuse comprise the targeted population.

Proposed change:    The goal of the program is to prevent or reduce the number of SEN, however the proposed changes are increasing knowledge of the potential effects of risk behaviors on a fetus/newborn and skills to reduce or eliminate maladaptive behaviors of men and women.  The program is based on the Stages of Change Model, and uses Cognitive Behavioral Therapy and Motivational Interviewing techniques.

Implementation, outcomes and evaluation:    Strategies and skills used to gain access to criminal justice settings are integral to the implementation of the program.  The process of networking with agencies that provide interventions for populations that have legal sanctions are highlighted.  Access to state prisons, Intoxicated Driving Resource Centers (IDRCs), and Drug Court approved Intensive Outpatient Programs (IOPs) has been achieved. 

Prevention strategies and teaching methods, tailored to the setting and population, are implemented to facilitate progression through the Stages of Change Model.  The overall strategies include helping individuals develop knowledge, skills and resiliency to reduce or eliminate maladaptive behaviors. Prisons provide a setting to offer ongoing education on a variety of topics related to addiction.  IDRCs provide the opportunity to reach large numbers of people who engaged in risky substance using behavior.  Each session at the IDRCs is comprised of new “Driving Under the Influence” offenders.  IOPs allow for multiple sessions with small group interaction.  Topics include addiction as a brain disease, maternal and fetal effects from substance use, risk factors that increase likelihood of addiction, and effective strategies, e.g. stress management, accessing supportive services, and anger management.  Outcome measures include pre and post-test, community responses, and anecdotal comments.  

Implications for nursing practice:    This outreach program, including the process and skills used to implement it, can serve as a model for nurses to bring preconceptual and perinatal education to imprisoned populations.   

Keywords:

Preconception, substance exposed newborns prevention; criminal justice population , networking.