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Caring for Families Affected by Prenatal Substance Use

Hispanic mother stands by a window holding her baby.

Project Summary

Substance use during pregnancy is a growing issue and families affected are at higher risk for infant and maternal mortality, lifelong health issues, and family separation. Colorado struggles to know what works to prevent prenatal substance use because the information exists in different systems. In 2019, Senate Bill (SB) 228 and subsequent legislation responded to this challenge by authorizing an innovative project to link data across systems. The Colorado Lab provides leadership for this statewide linkage project and companion studies. Findings inform what prevention measures improve outcomes for parents and their newborns. Early results inspired a policy brief on how Plans of Safe Care can improve care coordination for these families. This resulted in a funded pilot targeting rural health in the San Luis Valley. The pilot is also being used to explore the role of Social Health Information Exchanges in maternal health innovation. A qualitative companion study is underway to center the lived experiences of families. This project is bolstered by strategies to improve evidence-based decision making in perinatal health policymaking, using findings from a study authorized by SB21-194. The perinatal substance use data linkage project and Plan of Safe Care Pilot are multi-year and responsive to decision-maker needs.

Steps to Building Evidence

Together with state agencies, clinicians, community organizations, families, and researchers, the Colorado Lab is leveraging the Linked Information Network of Colorado to conduct multiple, rigorous designs (Steps 3 and Step 4 on the Steps to Building Evidence) that build evidence in prevention, treatment, and recovery of prenatal substance use. Companion studies employ descriptive and mixed methods approaches (Step 1 to Step 3) to unpack the “why” behind quantitative results and apply a rapid design model in activating findings. 

Summary of Findings

This project is ongoing. Findings to date have illustrated leading risk and protective factors associated with child welfare involvement, such as adequate prenatal care, use of social services, and social determinants of health. Initial results make clear the need for improved care coordination through Plans of Safe Care. Companion studies show the importance of de-stigmatizing, harm reduction approaches–such as use of peer support–in the care of these families, and the role upstream collaboration during pregnancy to reduce disparities.


Evidence generated from this suite of projects will:

  • Measure progress and impact of prevention practices in prenatal substance use 
  • Promote fiscal responsibility in prevention dollars from state allocations
  • Innovate technology solutions in maternal health
  • Strengthen care coordination across systems and with communities and families
  • Advance evidence-based decision making in perinatal health policy

Get Involved

For more information about working with the Colorado Lab, see Government and Community Partnerships or Research Partnerships.