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Marilyn Lewis, PhD

Award Name CCTS Pilot 2009
Award Date 04/01/2009

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Maternal-Fetal Bonding with Substance Abusing Mothers

Marilyn Lewis, PhD and her team, who have been awarded a one-year pilot grant from the Pilot and Collaborative Translational and Clinical Science Program, have proposed a clinical research project to focus on maternal-fetal bonding among substance abusing women.

Awarded by the Center for Clinical and Translational Science (CCTS), the grant provides one year of funding for a behavioral science approach using positive reinforcement. This will determine the level of bonding among substance-abusing women during their pregnancies.

“This [collaboration] builds on my previous experiences,” said Lewis, “and I’m excited about [the project.]”

Lewis, an Assistant Professor in the College of Social Work, says poor results are seen in reduction of drug use among pregnant women with negative reinforcement, or punishment. She and her colleagues will apply a creative method of Nancy Petry’s contingency-management prize reinforcement therapy in order to reinforce abstinence and increase maternal-fetal bonding.

This method of contingency management reinforcement works much like a lottery. Pregnant women will be randomized to two groups where one of the groups will receive reinforcement of abstinence and pregnancy related activities, while the other group will receive reinforcement of abstinence and other non-drug-related activities.

The system is like a lottery where women can earn positive reinforcement as incentives. At each visit, a participant who is abstinent and can document completion of activities will earn the opportunity to draw a token from a prize bowl that can be exchanged for prize. The value of tokens varies, can accumulate over time, and can be exchanged for prizes such as jewelry, gas cards, and baby items.

“Research shows that reinforcement every time reduces its effect,” said Lewis, “whereas intermittent reinforcement remains effective longer.”

Lewis is working in collaboration with: Dr. Mona R. Prasad, Assistant Professor of Medicine in the Division of Maternal Fetal Medicine in the Department of Obstetrics and Gynecology, and Director of the Substance Treatment Education Prevention in Pregnancy (STEPP); Dr. Edward G. Shepherd is the Associate Medical Director of the Neonatal Intensive Care Unit at the Nationwide Children’s Hospital and Assistant Professor of Clinical Pediatrics at the Ohio State University; and Dr. Jay D. Iams is Professor and Vice Chair of the Department of Obstetrics & Gynecology.

By Amy Hoover, Wednesday, May 22, 2009

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