A Case Report on a Women's Residential Substance use Program in a Rural and Urban Setting

Purpose: To describe program characteristics and outcomes of a residential substance use recovery program serving pregnant and parenting women in a rural and urban location.

Description: This assessment of administrative records from April 1, 2020 through March 31, 2022, included women in a rural (n = 140) and urban (n = 321) county in Kentucky.

Assessment: This retrospective case study used descriptive and non-parametric analyses to assess the population and examine differences between locations, race, and ethnicity for women served. Logistic regression tested predictors of goal achievement by community. Of 461 women served, 65 (14.1%) delivered a baby while in treatment; 62 of which were considered healthy. 13% of the women were Black, 83.1% non-Hispanic (NH) white, and 3.7% were other races/biracial; 1.3% were Hispanic. The mean age was 30.92 years (SD 6.23) and treatment duration was 90.11 days (SD 67.70). Program goals were achieved by 312 (67.7%). There were no differences in rates of goal achievement or treatment duration by race, ethnicity, or age and no difference in the rate of achievement by location in univariate analyses. However, treatment duration was positively associated with program success in both communities. In the urban community, Black women were 8% more likely to successfully complete the program compared to NH white women (OR = 9.77 [95% CI 1.21,79.18; p = 0.033]) after controlling for confounders. Insufficient sample size for non-white women in the rural community prohibited evaluation.

Conclusions: Duration of time in the program best predicted successful completion for women in recovery. These findings have policy implications.