TY - JOUR
KW - Adult
KW - California
KW - Counseling/methods
KW - Delivery of Health Care, Integrated/methods/trends
KW - Female
KW - Humans
KW - Mass Screening/methods
KW - Patient Participation/methods/psychology/statistics & numerical data
KW - Pregnancy
KW - Pregnant Women/psychology
KW - Prenatal Care/methods
KW - Socioeconomic Factors
KW - Substance-Related Disorders/psychology/therapy
KW - Surveys and Questionnaires
KW - Integrated healthcare
KW - Prenatal Care
KW - Prenatal substance use
KW - Screening
KW - Self Report
KW - Socioeconomic Status
KW - Urine toxicology test
AU - K. C. Young-Wolff
AU - L . Y. Tucker
AU - M. A. Armstrong
AU - A. Conway
AU - C. Weisner
AU - N. Goler
A1 - 
AB - INTRODUCTION: Screening and referral for substance use are essential components of prenatal care. However, little is known about barriers to participation in substance use interventions that are integrated within prenatal care. METHODS: Our study examines demographic and clinical correlates of participation in an initial assessment and counseling intervention integrated into prenatal care in a large healthcare system. The sample comprised Kaiser Permanente Northern California pregnant women with a live birth in 2014 or 2015 who screened positive for prenatal substance use via a self-reported questionnaire and/or urine toxicology test given as part of standard prenatal care (at ~ 8 weeks gestation). RESULTS: Of the 11,843 women who screened positive for prenatal substance use (median age = 30 years; 42% white; 38% screened positive for alcohol only, 20% for cannabis only, 5% nicotine only, 17% other drugs only, and 19% ≥ 2 substance categories), 9836 (83%) completed the initial substance use assessment and counseling intervention. Results from multivariable logistic regression analyses indicated that younger age, lower income, single marital status, and a positive urine toxicology test predicted higher odds of participation, while other/unknown race/ethnicity, greater parity, receiving the screening later in pregnancy, and screening positive for alcohol only or other drugs only predicted lower odds of participation (all Ps < .05). DISCUSSION: Findings suggest that integrated substance use interventions can successfully reach vulnerable populations of pregnant women (e.g., younger, lower income, racial/ethnic minorities). Future research should address whether differences in participation are due to patient (e.g., type of substance used, perceived stigma) or provider factors (e.g., working harder to engage traditionally underserved patients).
AD - Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA. Kelly.c.young-wolff@kp.org.; Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA. Kelly.c.young-wolff@kp.org.; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.; Early Start Program, Kaiser Permanente Northern California, Oakland, CA, USA.; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.; Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.; Regional Offices, Kaiser Permanente Northern California, Oakland, CA, USA.
BT - Maternal and child health journal
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 4
DO - 10.1007/s10995-020-02897-4
IS - 4
JF - Maternal and child health journal
LA - eng
M1 - Journal Article
N2 - INTRODUCTION: Screening and referral for substance use are essential components of prenatal care. However, little is known about barriers to participation in substance use interventions that are integrated within prenatal care. METHODS: Our study examines demographic and clinical correlates of participation in an initial assessment and counseling intervention integrated into prenatal care in a large healthcare system. The sample comprised Kaiser Permanente Northern California pregnant women with a live birth in 2014 or 2015 who screened positive for prenatal substance use via a self-reported questionnaire and/or urine toxicology test given as part of standard prenatal care (at ~ 8 weeks gestation). RESULTS: Of the 11,843 women who screened positive for prenatal substance use (median age = 30 years; 42% white; 38% screened positive for alcohol only, 20% for cannabis only, 5% nicotine only, 17% other drugs only, and 19% ≥ 2 substance categories), 9836 (83%) completed the initial substance use assessment and counseling intervention. Results from multivariable logistic regression analyses indicated that younger age, lower income, single marital status, and a positive urine toxicology test predicted higher odds of participation, while other/unknown race/ethnicity, greater parity, receiving the screening later in pregnancy, and screening positive for alcohol only or other drugs only predicted lower odds of participation (all Ps < .05). DISCUSSION: Findings suggest that integrated substance use interventions can successfully reach vulnerable populations of pregnant women (e.g., younger, lower income, racial/ethnic minorities). Future research should address whether differences in participation are due to patient (e.g., type of substance used, perceived stigma) or provider factors (e.g., working harder to engage traditionally underserved patients).
PY - 2020
SN - 1573-6628; 1092-7875; 1092-7875
SP - 423
EP - 431
EP - 
T1 - Correlates of Pregnant Women's Participation in a Substance Use Assessment and Counseling Intervention Integrated into Prenatal Care
T2 - Maternal and child health journal
TI - Correlates of Pregnant Women's Participation in a Substance Use Assessment and Counseling Intervention Integrated into Prenatal Care
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 32056081
U3 - 10.1007/s10995-020-02897-4
VL - 24
VO - 1573-6628; 1092-7875; 1092-7875
Y1 - 2020
Y2 - Apr
ER -