title: Recovery coaches and substance exposed births: an experiment in child welfare.
abstract: OBJECTIVE
  Substance exposed infants present a major challenge to child welfare and public health systems. Prenatal substance exposure and continued substance abuse in the home are associated with a wide range of adverse social, emotional, and developmental outcomes. The objective of the current study is to evaluate the use of recovery coaches in child welfare.
  
  
  METHODS
  The current study is longitudinal and utilizes an experimental design. The sample includes 931 substance abusing women enrolled in a Title IV-E Waiver Demonstration, 261 in the control group, and 670 in the experimental group. Women in the experimental group received traditional services plus the services of a recovery coach. Administrative records are used to indicate substance exposure at birth.
  
  
  RESULTS
  Of the 931 women enrolled in the waiver demonstration, 21% of the control group and 15% of the experimental group were associated with a subsequent substantiated allegation indicating substance exposure at birth. Cox proportional hazards modeling indicates that women in the experimental group were significantly less likely to be associated with a new substance exposed birth.
  
  
  CONCLUSIONS
  The use of recovery coaches in child welfare significantly decreases the risk of substance exposure at birth. Integrated and comprehensive approaches are necessary for addressing the complex and co-occurring needs of families involved with child protection.
authors.affiliation: School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Ryan
authors.forename: Sam
authors.initials: S
authors.lastname: Choi
authors.forename: Jun Sung
authors.initials: JS
authors.lastname: Hong
authors.forename: Pedro
authors.initials: P
authors.lastname: Hernandez
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Larrison
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods*; D005260:Female; D005581:Foster Home Care; D006801:Humans; D007087:Illinois; D007229:Infant Welfare; D007231:Infant, Newborn; D015993:Life Tables; D008137:Longitudinal Studies; D008605:Mental Health Services; D008875:Middle Aged; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D009357:Neonatal Abstinence Syndrome / Q000517:prevention & control; D012947:Social Work / Q000379:methods; D019966:Substance-Related Disorders / Q000517:prevention & control* / Q000534:rehabilitation*; D016019:Survival Analysis; D016896:Treatment Outcome