# Developing a Screening and Brief Intervention Package to Address Substance Use Risk in Pregnant and Postpartum Women in Home Visiting Programs

> **NIH NIH R34** · PARTNERSHIP TO END ADDICTION · 2020 · $258,987

## Abstract

The proposed R34 will develop and test a screening and brief intervention package for addressing substance
use (SU) in pregnant and postpartum women in evidence-based home visiting (SBI-HV). Perinatal SU is an
urgent public health concern, with significant negative impacts on maternal and child health. Pregnant and
postpartum women who use substances are at high risk for losing their children to the child welfare system.
Many perinatal women conceal their SU and do not actively seek treatment, increasing risk to themselves and
their children. As the primary supportive intervention offered to high-risk families during the perinatal period,
HV is a promising venue for addressing SU in this population. However, there is currently no systematic
protocol for addressing SU in routine HV, leaving many HV clients with unmet needs that increase maternal
and child risk. SBIRT is widely endorsed in primary care to improve SU identification and decrease use among
low-to-moderate users, and has potential applicability in HV. Two challenges to implementing traditional SBIRT
in HV are: (1) clients are reluctant to disclose SU due to fear of child removal; and (2) home visitors lack the
training and clinical skill to deliver evidence-based brief interventions with fidelity. The proposed SBI-HV
represents an innovative adaptation of the SBIRT framework, designed to leverage technology and two key
elements of the HV context (the home visitor-client relationship and routine supervision) to overcome these
challenges. The SBI-HV will include (a) a two-session computerized screening and brief intervention (e-SBI),
adapted from a validated e-SBI developed by the Co-I that has proven effective in reducing SU in pregnant and
postpartum women in primary care; and (b) implementation supports for enhancing routine HV service delivery
and supervision to promote effective e-SBI integration in the unique HV context. The SBI-HV will be designed
so that clients are never required to disclose SU to home visitors. The e-SBI is fully automated and self-
administered; home visitors will not see clients’ responses, and will not be asked to implement evidence-based
interventions. Specific aims are to (1) develop the SB-HV (e-SBI intervention plus implementation supports);
(2) evaluate its feasibility, acceptability, and fidelity; and (3) determine its preliminary impacts on symptom
reduction (SU, depression, parenting stress), HV retention, and SU treatment engagement. We will partner
with 2 pilot sites to construct the SBI-HV guided by stakeholder input (Aim 1). We will then conduct a small
RCT in 2 additional sites. Home visitors (N = 10) will be randomized to HV+SBI-HV vs. routine HV. Feasibility,
acceptability, and fidelity will be assessed via HV and client interviews and fidelity checklists (Aim 2). Research
assistants will interview clients (N = 40) at baseline, and 3- and 6-month follow-up to track SBI-HV impacts
(Aim 3). If results are promising, the next step is an R01 to te...

## Key facts

- **NIH application ID:** 9963181
- **Project number:** 5R34DA045831-03
- **Recipient organization:** PARTNERSHIP TO END ADDICTION
- **Principal Investigator:** SARAH E. DAUBER
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $258,987
- **Award type:** 5
- **Project period:** 2018-09-30 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9963181

## Citation

> US National Institutes of Health, RePORTER application 9963181, Developing a Screening and Brief Intervention Package to Address Substance Use Risk in Pregnant and Postpartum Women in Home Visiting Programs (5R34DA045831-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9963181. Licensed CC0.

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