RESPECT‐Plus

RESPECT‐Plus (Recovery, Empowerment, Social Services, Prenatal care, Education and Community Treatment – Plus)

bostonmed
One Boston Medical Place
Boston, MA 02118
Phone: (617) 638-8000
Website
Project Director
Ruth Rose‐Jacobs
rrosejac@bu.edu

Project Coordinator
Michelle Trevino-Talbot
Michelle.Trevino-Talbot@bmc.org

Sponsoring Organization
Boston Medical Center

History & Overview

History & Overview

Boston Medical Center (BMC) is a private, not‐for‐profit, 508 licensed bed, academic medical center. The hospital is the primary teaching affiliate for Boston University School of Medicine. With its mission to provide consistently accessible health services to all, BMC emphasizes community‐based care, and is uniquely enhanced by its network of 15 Community Health Centers (CHCs). The largest safety net hospital in New England, BMC provides a full spectrum of pediatric and adult care services, from primary to family medicine to advanced specialty care. In addition, BMC maintains the largest 24‐hour Level I trauma center in New England.

BMC is also home to the largest opioid treatment program in New England, providing medication-assisted treatment to patients within the Boston area and across the state. The BMC Office Based Opioid Treatment (OBOT) program now has 13 prescribing physicians and 500 patients, and trains nurse care managers across the state to provide OBOT.

 

Service Delivery Model

Service Delivery Model

RESPECT‐Plus has three main components:  1) Project DULCE(Developmental Understanding and Legal Collaboration for Everyone), a child maltreatment prevention program that teaches parenting skills and child development to parents of newborns and also helps them meet their basic needs for food, safe housing, income supports, etc.;  2) Parent education in infant soothing techniques, using Harvey Karp’s “5 S’s” (swaddling, shushing, side/stomach position, swinging and sucking) and All Babies Cry approaches; and 3) Parent Cafés, a proven and widespread method for providing parental support, social connections and group problem‐solving.

Service delivery revolves around the pediatric primary care setting. At each routine healthcare visit, families are joined by a DULCE Family Specialist (DFS), a child development specialist who has been intensively trained by Healthy Steps and MLP|Boston. DULCE uses MLP|Boston resources to address concrete needs, and the evidence‐based Healthy Steps program for parenting and developmental support.

The DFS provides “joint” well‐child visits with the parent(s) and pediatrician at each of the 5 or 6 well‐child visits within the first six months, providing developmental and behavioral guidance, as well as legal information when needed. The DFS has several options for additional family support: a home visit, an additional BMC visit with the family specialist, a meeting in conjunction with the mother’s drug treatment visit, or counseling and support delivered by phone. The DFS conducts a formal screening of the child’s cognitive and socio‐emotional development and parental risk factors at regular intervals during pediatric well‐child visits. RESPECT‐Pluswill add a fourth screening at 12 months.

 

Staffing

Staffing

Interventionists will hold bachelor’s or master’s degrees in child development. They will be trained to identify those issues that need medical (or legal) professional consultation, serving to integrate the expertise of their practice environments effectively and seamlessly.

Healthy Steps, an evidence‐based home visiting model, provides training and support for interventionists in effective parenting, early childhood development, and infant assessment. MLP|Boston trains them to identify legal and social needs that may affect a child’s health and development and to take action either by helping family members advocate for themselves, or by referring them to an appropriate public health, legal, or social service agency or resource (including MLP|Boston).

 

Community Collaboration

Community Collaboration

RESPECT‐Plus community partners are the Boston Public Health Commission Opioid Treatment Program and The Department of Children and Families.

 

Evaluation/Outcomes

Evaluation/Outcomes

Anticipated outcomes of the intervention include significantly reduced rates of maternal relapse, fewer reports of suspected child abuse/neglect, fewer infant days in out‐of‐home placement in the first year of life, and fewer terminations of parental rights.