MOM's Project is a Model That Works
by Marguerite Lamb
The MOM's Project, an innovative program founded
by School of Public Health Professor Hortensia
Amaro to reduce drug and alcohol abuse among
pregnant women, has been named one of 10 Models
That Work by the U.S. Department of Health and
Human Services (HHS).
A national campaign sponsored by HHS's Health
Resources and Services Administration, Models That
Work identifies and encourages replication of
community-based health programs that have proven
both successful and cost-effective. "Ours was the
only substance abuse prevention program in the
country to be honored as a Model," says Amaro,
adding that a replication manual for the MOM's
Project will be published this fall by HHS and
distributed to interested public health agencies,
hospitals, and community health centers nationwide.
HHS will also provide funding for Amaro and
others on the project staff to travel to sites
around the country to offer guidance and technical
support should health professionals in other cities
wish to start similar programs. "This is an
exciting and important opportunity," says Amaro.
"Substance abuse among pregnant women is a problem
throughout the United States, in all areas and
among all racial and ethnic populations, and there
simply have not been a lot of prevention programs
that have shown positive outcomes."
Healthy mothers, healthy babies
To date the MOM's Project has served more than
800 pregnant women from some of Boston's poorest
neighborhoods, including Roxbury, Dorchester,
Jamaica Plain, Mattapan, and the South End. Of
these women, 80 percent have delivered healthy
babies and 70 percent have stopped or significantly
reduced their drug use.
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SPH Prof. Hortensia
Amaro's program to curb drug and alcohol
abuse among pregnant women will be
replicated nationwide. Photo: Vernon
Doucette
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What's the formula for success? Project
staff focus on breaking down barriers to care by
linking women with more than 300 community health
and social service providers throughout the city.
"Boston is rich with resources," says Amaro.
"Rather than duplicate services, we collaborate
with existing providers."
The MOM's Project staff helps to "walk women
through the system," she points out. "We have found
that it doesn't work with our clients to write down
a [provider's] address and point them toward the
door." That leaves a woman to find transportation,
perhaps a babysitter for her children. She may have
to contend with an abusive partner who feels
threatened by her decision to kick drugs. And in
most cases, by the time a woman arrives at the
MOM's Project community center in Roxbury, her
"self-esteem is in the gutter," says Amaro, and she
is likely to need support to take those first steps
toward recovery.
And for many of the program's clients, she adds,
the road to recovery is complicated by obstacles
that go well beyond addiction: 97 percent of the
women who come to the project are unemployed and
are living at or below the poverty level. One-third
of the women are homeless or live in shelters or in
welfare hotels. In addition to battling drugs, they
are also trying to feed, clothe, and shelter
themselves, and in many cases, their children.
Where do staffers begin? "We begin where a woman
tells us to begin," says Amaro. "That is how we
build trust, how we build a relationship. There is
no quicker way to lose someone than by not
listening."
MOM's began in 1988 as a federally funded
research project. Today, it employs a full-time
staff of community outreach workers (some of whom
are themselves recovering addicts), nurses,
counselors, and child-care coordinators and is an
integral part of the addiction and prenatal
health-care services offered by the Boston
Department of Health and Hospitals. The goal now,
says Amaro, is to initiate similar programs
statewide. "We have been talking to the Department
of Public Health about providing technical
assistance to agencies throughout the commonwealth
that want to set up programs using what we have
learned."
She and her colleagues have also been working to
win support for the MOM's Project at the State
House. "Our vision is to start a statewide network
of mothers in recovery. We have been meeting with
legislators and so far the response has been
largely positive. A number of them have expressed
interest in the MOM's Project for their own
districts, which is en-couraging since often
politicians don't know much about this subject or
are unwilling to admit that their constituencies
might need these kinds of services."
In persuading legislators, says Amaro, it often
works to draw their attention to the bottom line:
"For every dollar we spend in this country on
substance abuse prevention and treatment, we save
$7 on such things as hospitalization,
incarceration, welfare, and foster care for
children of addicted parents. There are major
systems in this country that are bearing the burden
of substance abuse, yet legislators seldom make
this connection."
Last spring, however, the efforts of Amaro and
others to bring statewide attention to the needs of
pregnant women with addictions got a big boost on
Beacon Hill when then-Governor William Weld
declared May 12 Mothers in Recovery Day. Some 60
mothers were individually recognized for their
triumph over addiction before an audience of about
450 health-care and social service providers,
legislators, and other mothers in recovery. "The
MOM's Project organized Mothers in Recovery Day,"
says Amaro, "as part of an attempt to close the gap
between what we've learned about substance abuse
among women, as well as about the
cost-effectiveness of treatments, and current
public policy surrounding this issue."
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