Association of prenatal stress with distance to delivery for pregnant women in Western North Carolina.

PURPOSE: Rural areas throughout the US continue to see closures of maternity wards and decreasing access to prenatal and intrapartum care. Studies examining closure's impacts have demonstrated both positive and negative effects on maternal and neonatal outcomes of mortality and morbidity. Our study aims to build on growing evidence from Canada and Scandinavia that suggests increased travel time to give birth is associated with increased emotional and financial stress for rural pregnant women. METHODS: Pregnant patients at 7 clinic sites in western North Carolina were invited to complete the Rural Pregnancy Experience Scale (RPES) while waiting for their prenatal appointments. Results were analyzed using adjusted linear regressions to examine the correlation between RPES scores and self-reported distance to anticipated birth location as well as RPES scores with recent local labor and delivery closure. FINDINGS: A total of 174 participants completed the survey and met inclusion criteria. For every 10 min increase in travel distance to the patient's anticipated place of delivery, RPES scores increased by an average of 0.72 points. Participants who reported a recent labor and delivery unit closure near them saw average increases of 2.52 on the RPES. CONCLUSIONS: Our findings are consistent with the growing body of literature internationally that demonstrates the distance required to travel to delivery location is associated with increased stress among rural pregnant women.

Librarian Contributions to a Regional Response in the COVID-19 Pandemic in Western North Carolina.

At the start of the COVID-19 pandemic, the Mountain Area Health Education Center formed a response team with the goal of building capacity across Western North Carolina health systems to collectively identify needs, coordinate resources to fill gaps, and strategically manage the regional threats of the pandemic. The library team collaborated on interprofessional projects by gathering information and using LibGuides to quickly and easily organize and share resources. The team met challenges, including moving to telecommuting, balancing a growing workload, and navigating a changing information landscape, and in doing so, strengthened relationships across the organization and the region.

The association of cannabis use late in pregnancy with engagement and retention in perinatal substance use disorder care for opioid use disorder: A cohort comparison.

BACKGROUND: Prenatal use of cannabis and opioids are increasing and very concerning. Engagement and retention in comprehensive, perinatal substance use disorder (PSUD) care are associated with better outcomes for mothers and babies. We compared the characteristics and engagement in care among women with opioid use disorder who used cannabis late in pregnancy versus those who didn't. METHODS: The primary outcome, "overall engagement and retention in PSUD care" included: utilization of substance use treatment prenatally, negative screening/toxicology at delivery (excluding cannabis), and attendance at expected prenatal and postpartum visits. Cannabis use late in pregnancy was objectively assessed at delivery via maternal urine drug screen and/or neonatal meconium/cord toxicology. Between-group comparisons utilized chi square, t-test or Mann-Whitney. Associations were assessed using Spearman Rho and two multivariate, binary logistic regressions for cannabis use and the primary outcome. RESULTS: 18.0% (85/472) consumed cannabis late in pregnancy. Women of color, younger women, and those diagnosed with concurrent cannabis use disorder were more likely to consume cannabis. Engagement and retention in PSUD care was not associated with cannabis use, but rather, with prescribed pharmacotherapy for psychiatric disorders. The use of prescribed buprenorphine+naloxone was associated with cannabis avoidance late in pregnancy. CONCLUSIONS: Cannabis use late in pregnancy, compared to none, did not impact engagement and retention in our PSUD program. Adjunctive psychotropic medication and/or buprenorphine+naloxone prescription were associated with cannabis avoidance suggesting the use and interactions of pharmacotherapies in an opioid dependent population is complex. A shared decision-making process during PSUD care is warranted.

Librarian readiness for research partnerships.

This study investigated health sciences librarians' knowledge and skill-based readiness to partner on sponsored research involving human participants. The authors developed and deployed, at two time points, a web-based survey on nine indicators of research activities with response choices reflecting the transtheoretical model of stages of behavior change. Librarians with research experience or membership in the Medical Library Association Research Section reported higher levels of having completed indicators. Our results suggest that creating awareness in precontemplation responders could encourage skill development. Mentoring and continuing education could support librarians who are contemplating or preparing to perform indicator activities.