OBJECTIVES. Prenatal patients were studied to examine the proportion of women who had been violence victims, women's patterns of substance use (cigarettes, alcohol, and illegal drugs) before and during pregnancy, and relationships between violence and substance use. METHODS. More than 2000 prenatal patients in North Carolina were screened for violence and substance use. Relationships between violence and patterns of substance use before and during pregnancy were examined, as well as women's continuation of substance use during pregnancy as a function of violence and sociodemographic factors. RESULTS. Twenty-six percent of the women had been violence victims during their lives. Before pregnancy, 62% of the women had used one or more substances; during pregnancy, 31% had used one or more substances. Both before and during pregnancy, violence victims were significantly more likely to use multiple substances than nonvictims. Continuation of substance use during pregnancy was significantly more likely among violence victims than nonvictims. CONCLUSIONS. Care providers should screen women for violence as well as for substance use and should ensure that women are provided with appropriate interventions.

The objective of this article is to describe factors which contribute to successful translation of science into evidence-based practices and their implementation in public health practice agencies, based on a review of the literature and evidence from a series of case studies. The case studies involved structured interviews with key informants in four health departments and with four corresponding partners from academic institutions. Interviews were recorded and transcribed, coded by two independent, trained coders, using a standard codebook. A thematic analysis of codes was conducted. Coding was entered into Atlas TI software for further analysis. Results from the literature review indicated that only approximately half of programs implemented in state and local health departments were evidence-based. Lack of time, inadequate funding, and absence of cultural and managerial support – including incentives - are among the most commonly cited barriers to implementing evidence-based practices. Findings from the case studies suggest that these health departments, successful in implementing evidence-based practices, have strong relationships and good communication channels established with their academic partner(s). There is strong leadership engagement from within the health department and in the academic institution. Implementation of evidence-based programs was most often related to high priority community needs and the availability of resources to address these needs. The practice agencies operate with a culture of quality improvement throughout the agency. Information technology, training, how the interventions are bundled, including their complexity and ability to be customized and resource requirements are all fruitful avenues for further research.