EFFECTS OF CASE-MANAGEMENT ON RETENTION IN PRENATAL SUBSTANCE-ABUSE TREATMENT

Participation in substance abuse treatment during pregnancy is associa ted with improved pregnancy outcomes. Case management has been propose d as one way to reduce barriers to receiving and continuing treatment. An evaluation was conducted on a case management program to retain pr egnant women in drug treatment. Two hundred twenty-five pregnant women received case management services consisting of home visits, telephon e counseling, transportation, and referral. All women contacted a subs tance abuse treatment center and most (56%) obtained treatment during pregnancy. Sociodemographic factors, personal and family history of su bstance use and drug treatment, protective services involvement, histo ry of physical and sexual abuse, and need for tangible resources were assessed. Charts were reviewed at the substance abuse treatment center for number of visits and urine toxicology reports, and at the hospita l for pregnancy outcome. Data were analyzed by LISREL path analysis. F ive factors had significant path correlations to prenatal attendance a t the substance abuse treatment center: history of protective services involvement, number of drugs ever used, currently receiving methadone , intensity of case management, and receiving transportation to drug t reatment appointments. We conclude that case management, including pro viding transportation, contributes significantly to retention in subst ance abuse treatment during pregnancy.