This study examines whether six psychosocial risk factors are predictive of drug use during pregnancy and completion of a drug treatment program. The proposal consists of two separate but closely integrated studies that will through primary data collection sample two populations. Study 1 is a descriptive case-control study of prenatal patients from a large, inner city hospital in Detroit who will be given a 20-minute questionnaire during a prenatal visit to ascertain the presence and severity of six psychosocial factors: family history of alcoholism and/or addiction, depression, lack of social support, childhood history of sexual abuse, lack of social support, partner is a substance abuser, and homelessness. Drug use will be ascertained via urine toxicology and a self-report questionnaire. Once drug use status is ascertained, subjects will be classified into two groups, as users or non-users. Data will be analyzed for significant differences using t-tests for continuous data, and chi- square for categorical data. Study l is important because no empirical studies of this type exist with comparison group data. Study 2 is a concurrent, prospective study that will compare occurrence/severity of the same six psychosocial risk factors between completers and non-completers of a drug treatment program for pregnant, addicted women in Baltimore. The questionnaire will be administered at intake. Other additional factors that will be examined to see their impact on completion rates include: court-ordered status, prior attempts at treatment, as well as potential barriers such as transportation and childcare. The contribution of significant variables will be analyzed via a logistic regression model. Additionally, a one-month follow-up of completers will ascertain drug use status and living situation. This research is designed to increase knowledge that can impact both policy and program development.
