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Project Link

Ages 15-21

Rating: Level 2


Project Link is a multicomponent program designed to integrate specialized substance abuse treatment services into the existing maternal-child health system at Women and Infants Hospital of Rhode Island. The program targets pregnant and postpartum women with substance abuse problems. Project Link addresses risk and protective factors in multiple domains using two principal components: 1) clinical services and 2) case management services. Clinical services include substance abuse assessment, crisis intervention, comprehensive psychosocial assessment, individual therapy, group therapy, child and family therapy, toxicology screening, and referral to ancillary services. Case management services include home visiting, parenting assessment, parenting education, monitoring of pediatric visits, HIV education, and GED/literacy tutoring.


The evaluation used a quasi-experimental longitudinal design with repeated measures (baseline, postintervention, and follow-up measurements). The subjects included 87 women who voluntarily enrolled in the program and received substance abuse treatment in conjunction with the prenatal care. The comparison group of 87 women received equivalent prenatal care but did not enroll in the substance abuse treatment program until after they delivered their children. The two groups were similar demographically and socioeconomically and had similar substance abuse histories. Univariate and multivariate analyses were performed. Targeted outcomes include gestational age at delivery, birth-weight, preterm delivery, Apgar scores, and neonatal intensive care admission rate. Factors controlled for include demographics, socioeconomic status, parity, and prenatal care.


The evaluation revealed that the program succeeded in improving the birth outcomes of infants born to women who enrolled prenatally. These infants were 418 grams heavier on average, and their gestational age was 2 weeks longer than infants whose mothers enrolled postpartum. In addition, they were roughly one third as likely to be born with a low birth-weight and about half as likely to be admitted to the neonatal intensive care unit. Finally, the postpartum enrollees were more likely to have infants whose toxicology screens were positive.

Risk Factors


  • Early sexual involvement
  • Favorable attitudes toward drug use/Early onset of AOD use/Alcohol and/or drug use
  • Teen parenthood


  • Family history of the problem behavior/Parent criminality


  • Peer alcohol, tobacco, and/or other drug use

Protective Factors


  • Healthy / Conventional beliefs and clear standards
  • Perception of social support from adults and peers
  • Self-efficacy
  • Social competencies and problem-solving skills


  • Effective parenting
  • Having a stable family


  • Presence and involvement of caring, supportive adults


  • SAMHSA: Model Programs


Sweeney, Patrick J., Rachel M. Schwartz, Noreen G. Mattis, and Betty Vohr. 2000. “The Effect of Integrating Substance Abuse Treatment With Prenatal Care on Birth Outcome.” Journal of Perinatology 4, 219–24.


Noreen Mattis, F.N., M.Ed., Program Director
Women and Infants Hospital
101 Dudley Street
Providence, RI 02905
Phone: (401) 453-7618
Fax: (401) 453-7692
Web site: