Expanding Knowledge About and Evaluating Services for Incarcerated Pregnant and Postpartum Women in Arkansas

Growing Together: Expanding Knowledge About and Evaluating Services for Incarcerated Pregnant and Postpartum Women in Arkansas

The number of women who are incarcerated in the U.S. has increased dramatically over the past 20 years-over 750%, or from 13,258 in 1980 to 111,616 in 2016. Arkansas incarcerates 92 women per 100,000 population compared to 57 per 100,000 average across all states, ranking the state as the 8th highest in the nation. Over 75% of incarcerated women are of childbearing age and about 4% are pregnant upon intake. However, little is known about the population of women who have become incarcerated while pregnant in Arkansas - including the outcomes of these women and their children and how these outcomes may vary in relation to services that are received during incarceration. This research study aims to first expand knowledge on incarcerated women in Arkansas by using administrative data to retrospectively examine the health status and outcomes of pregnant women who were incarcerated in state prison by Arkansas from June 1, 2014 to May 31, 2019 (a five-year cohort; Aim 1). Then, we will lay the groundwork for and subsequently analyze data on outcomes and perspectives of women who have been incarcerated in Arkansas while pregnant (Aims 2 and 3). We will also seek to understand the feasibility and acceptability of elements of an enhanced support program for incarcerated pregnant women recently launched via a collaboration between Arkansas Department of Corrections and UAMS.

Study Overview

• Status: Active, not recruiting
• Conditions: Quality of Life; Parent-Child Relations; Emotional Stress; Health Risk Behaviors; Childbirth Problems; Maternal Care Patterns; Health Care Acceptability; Health Problems in Pregnancy
• Intervention / Treatment: Behavioral: Childbirth support

• Study Type: Interventional
• Enrollment (Actual): 10
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Arkansas
    • Little Rock, Arkansas, United States, 72205
      • University of Arkansas for Medical Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Women incarcerated in Arkansas state prison system
• 18 years or older
• Able to give informed consent
• Pregnant or has given birth in past year

Exclusion Criteria:

• Under 18 years of age

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Other: Childbirth Support; Women who enroll in the intervention portion of this study will receive the childbirth support elements for which they are eligible in and elect to participate. Possible program elements include prenatal education classes, support group, lactation program, doula support, and parenting classes.

Behavioral: Childbirth support; There are 5 program components that women may receive as a part of childbirth support: Prenatal education - consists of up to 8 sessions of education on pregnancy, childbirth, and postpartum health and wellness. Support group - semi-structured group which provides time for women to process their pregnancy and postpartum-related experiences with other women facing similar challenges. Integrates mindfulness exercises, cognitive-behavioral skills, and special topics as requested by group members. Lactation program - program for women who wish to provide breastmilk for infants from which they are separated. Doula support program - 2 prenatal and 2 postnatal individual visits with a doula who will also provide continuous childbirth support and support during separation from infants. Parenting classes - group classes focused on helping women learn parenting skills and (if applicable) meet state requirements for reunification with children

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Program Utilization	% of eligible women who choose to enroll in each program component	Up to 12 months after delivery
Program Acceptability	Self-report ratings of the acceptability of each program component	Up to 12 months after delivery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depressive Symptoms	Self-report scores on Patient Health Questionnaire (PHQ-9)	Up to 12 months after delivery
Depressive Symptoms	Self-report scores on the Edinburgh Postnatal Depression Scale	Up to 12 months after delivery
PTSD Symptoms	Self-report scores on PTSD Checklist (PCL-5)	Up to 12 months after delivery
Drug Use	Binary self-report for common classes of drugs	Up to 12 months after delivery
Health-Related Quality of Life	Self-report scores on Quality of Life Scale (QOLS)	Up to 12 months after delivery
Health-Related Quality of Life	Self-report scores on the EQ-5D-5L	Up to 12 months after delivery
Social Support	Self-report scores on Multidimensional Scale of Perceived Social Support	Up to 12 months after delivery
Parental Stress	Self-report scores on the Parenting Stress Index	Up to 12 months after delivery
Parental Sense of Competence	Self-report scores on the Parenting Sense of Competence Scale	Up to 12 months after delivery
Pregnancy Complications	Chart review to determine presence/absence of common pregnancy complications	From the date of enrollment until the date of childbirth or the date of pregnancy loss or termination, whichever came first, assessed up to 50 weeks
Childbirth Complications	Chart review to determine presence/absence of common pregnancy complications	Up to 12 months after delivery

Collaborators and Investigators

• Sponsor: University of Arkansas
• Investigators: Principal Investigator: Melissa Zielinski, Phd, University of Arkansas

Study record dates

Study Major Dates

• Study Start (Actual): November 19, 2021
• Primary Completion (Estimated): June 30, 2024
• Study Completion (Estimated): June 30, 2024

Study Registration Dates

• First Submitted: May 27, 2020
• First Submitted That Met QC Criteria: June 5, 2020
• First Posted (Actual): June 9, 2020

Study Record Updates

• Last Update Posted (Actual): October 12, 2023
• Last Update Submitted That Met QC Criteria: October 11, 2023
• Last Verified: October 1, 2023

More Information

Terms related to this study

• Keywords: Prison; Incarcerated Women
• Other Study ID Numbers: 260265; PTC2020-02 (Other Grant/Funding Number: UAMS Translational Research Institute)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No