title: "New Choices" for women with addictions: perceptions of program participants.
abstract: BACKGROUND
  Substance use in pregnancy is a major public health problem. It can have profound effects on pregnancy outcomes, and childhood health and development. Additionally, women who use substances have their own health-related issues. Although intervention is important, these women often have difficulty using traditional systems of care. The New Choices program is a centralized, multi-sector approach to service delivery that has attempted to overcome barriers to care by offering one-stop shopping in a supportive environment. As part of an evaluation of this program designed for women who are pregnant and/or parenting young children, interviews were conducted with participants to gain insight into their experiences in New Choices and perceptions of any changes attributed to program involvement.
  
  
  METHODS
  A qualitative, exploratory design was used to guide data collection and analysis. Four women participated in a focus group interview and seven women agreed to individual interviews over the course of the program evaluation (N = 11). A semi-structured interview guide was used to explore women's experiences in New Choices and their perceptions of the program and its impact. The interview data were analyzed using NVivo software and an inductive approach to data analysis.
  
  
  RESULTS
  The emergent themes captured women's motivations for attending New Choices, benefits of participation, and overall quality of the program. Children were the primary motivating factor for program enrollment. Perceived benefits included decreased substance use, improved maternal health, enhanced opportunity for employment, increased access to other resources, enhanced parenting skills, and improved child behaviour and development. Women highly valued the comprehensive and centralized approach to service delivery that provided a range of informal and formal supports.
  
  
  CONCLUSIONS
  Interview findings endorse the appropriateness and potential efficacy of a collaborative, centralized approach to service provision for women with substance use issues. Although the findings provide insight into an alternative model of service delivery for women with addictions, future research is needed to evaluate the effectiveness of the intervention. Research also is needed to determine which program components or constellation of components contribute to desired outcomes, and to learn more about processes that underlie changes in behaviour.
authors.affiliation: School of Nursing, HSc 3N25G McMaster University, 1200 Main Street, West Hamilton, Ontario L9N 3Z5 Canada. sword@mcmaster.ca
authors.forename: Wendy
authors.initials: W
authors.lastname: Sword
authors.forename: Alison
authors.initials: A
authors.lastname: Niccols
authors.forename: Aimei
authors.initials: A
authors.lastname: Fan
mesh_terms: D000328:Adult; D002654:Child Care / Q000523:psychology; D002675:Child, Preschool; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008427:Maternal Health Services / Q000592:standards / Q000706:statistics & numerical data*; D009035:Mothers / Q000523:psychology*; D009042:Motivation; D009864:Ontario; D016487:Parenting / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D015397:Program Evaluation; D011787:Quality of Health Care; D019966:Substance-Related Disorders / Q000628:therapy*