Strengthening the System Supporting Perinatal People with Substance Use Disorder in the Midwest Using Group Model Building

• Published in: Maternal and child health journal Vol. 27; no. Suppl 1; pp. 128 - 142
• Main Authors: Simon, Jessica, Guynn, Isabella, Thompson, Meagan, Hambright, Sarah, Jones, Cresta, Lich, Kristen Hassmiller
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2023; Springer; Springer Nature B.V
• Subjects: Care and treatment; Child; Collaboration; Drinking in pregnancy; Drug abuse in pregnancy; Drug use; Education; Evidence-based medicine; Evidence-based practice; Female; Forecasts and trends; From the Field; Group Processes; Gynecology; Humans; Maternal & child health; Maternal and Child Health; Medicine; Medicine & Public Health; Pediatrics; Population Economics; Pregnancy; Public Health; Sociology; Stakeholders; State policies; Substance abuse; Substance use; Substance use disorder; Substance-Related Disorders - therapy; Workforce; United States; Strategic planning; Group model building; Perinatal substance use; Mental models; Causal loop
• ISSN: 1092-7875; 1573-6628; 1573-6628
• DOI: 10.1007/s10995-023-03751-z

Introduction Providing comprehensive, evidence-based care to perinatal people with substance use disorders (SUD) requires multi-stakeholder collaboration and alignment. The National Maternal and Child Health Workforce Development Center facilitated a system-strengthening process with the Midwest substance use in pregnancy (SUPper) club, a regional collaborative of health care providers, state public health agencies, and community-rooted organizations. Methods Facilitators led a 2 day group model building (GMB) workshop with 20 participants and two semi-structured interviews. Workshop participants were invited to complete an evaluation. Results Two primary trends were identified as priorities for change: (1) Birthing people’s perception/experience of stigma and (2) The Midwest SUPper Club’s reach and influence. Three causal loop diagrams (CLDs) were created to capture the interconnected dynamics of the Midwest perinatal SUD system: (1) the influence of stigma on maternal and infant health outcomes, (2) the role of clinic, organizational, and state policies, and (3) the impact of workforce education and evidence-based practices on care. From the CLDs, four priorities for action emerged: (1) align and promote shared mental models across stakeholders, (2) expand education and training opportunities for the perinatal SUD workforce, (3) strengthen systems infrastructure to support care navigation for patients and providers, and (4) collaboratively identify evidence-based practices that meet regional needs. All evaluation respondents reported that the workshop supported the development of a shared mental model. Discussion The GMB process strengthened collaboration and advanced strategic planning for the SUPper Club. GMB can be further utilized among diverse stakeholders across MCH systems to create shared mental models and accelerate collaborative planning efforts. Significance What is already known on this subject? Perinatal SUD is a complex public health challenge, particularly in the Midwestern United States, where rurality and workforce shortages are common. Prevailing approaches often use siloed strategies rather than integrating the complex, interrelated dynamics and perspectives of relevant stakeholders. What does this study add? This is the first known use of GMB with perinatal SUD stakeholders, which we show to be a valuable tool for furthering stakeholder collaboration and action planning. State and local MCH programs should consider using these GMB and systems-thinking approaches, as demonstrated, in their own system-strengthening efforts.