A Case Report on a Women’s Residential Substance use Program in a Rural and Urban Setting

Authors

Deborah Winders Davis, University of LouisvilleFollow
Yana Feygin, University of LouisvilleFollow
Madeline Shipley, Norton Infectious Diseases InstituteFollow
Tiffany Cole Hall, Volunteers of America Mid-statesFollow
Chaly Downs, Volunteers of America Mid-statesFollow
Stephanie Hoskins, Volunteers of America Mid-statesFollow
Natalie Pasquenza, Volunteers of America Mid-states
Scott D. Duncan, University of LouisvilleFollow
Liza M. Creel, University of Colorado Anschutz Medical CampusFollow

Abstract

Purpose To describe program characteristics and outcomes of a residential substance use recovery program serving pregnant and parenting women in a rural and urban location.

Description This assessment of administrative records from April 1, 2020 through March 31, 2022, included women in a rural (n = 140) and urban (n = 321) county in Kentucky.

Assessment This retrospective case study used descriptive and non-parametric analyses to assess the population and examine differences between locations, race, and ethnicity for women served. Logistic regression tested predictors of goal achievement by community. Of 461 women served, 65 (14.1%) delivered a baby while in treatment; 62 of which were considered healthy. 13% of the women were Black, 83.1% non-Hispanic (NH) white, and 3.7% were other races/biracial; 1.3% were Hispanic. The mean age was 30.92 years (SD 6.23) and treatment duration was 90.11 days (SD 67.70). Program goals were achieved by 312 (67.7%). There were no differences in rates of goal achievement or treatment duration by race, ethnicity, or age and no difference in the rate of achievement by location in univariate analyses. However, treatment duration was positively associated with program success in both communities. In the urban community, Black women were 8% more likely to successfully complete the program compared to NH white women (OR = 9.77 [95% CI 1.21,79.18; p = 0.033]) after controlling for confounders. Insufficient sample size for non-white women in the rural community prohibited evaluation.

Conclusions Duration of time in the program best predicted successful completion for women in recovery. These findings have policy implications.

Significance Women having difficulties with substance use are typically of childbearing age. Integrated programs are needed to address the multi-factorial needs of these women. Models suggest that optimal care involves services that are co-located or closely aligned. The current evaluation contributes to the literature by examining outcomes for women in recovery. This case study examines client outcomes at a community-based residential treatment program and found evidence that the length of stay was associated with achievement of program goals. Lastly, contrary to previous reports, Black women in an urban community had an 8% greater probability of successful completion compared to white women.

Document Type

Article

Publication Date

2024

Notes/Citation Information

© The Author(s) 2024

Funding Information

This project was supported by the Robert Wood Johnson Foundation Aligning Systems for Health Program (#77407)

Repository Citation

Davis, Deborah Winders; Feygin, Yana; Shipley, Madeline; Hall, Tiffany Cole; Downs, Chaly; Hoskins, Stephanie; Pasquenza, Natalie; Duncan, Scott D.; and Creel, Liza M., "A Case Report on a Women’s Residential Substance use Program in a Rural and Urban Setting" (2024). Biostatistics Faculty Publications. 60.
https://uknowledge.uky.edu/biostatistics_facpub/60