Background State policies pertaining to health care provider reporting of perinatal substance use have implications for provider screening and referral behavior, patients’ care-seeking and access to prenatal substance use disorder treatment, and pregnancy and birth outcomes. Objectives To characterize specific provisions enacted in state statutes pertaining to mandates that health care providers report perinatal substance use, and to determine the proportion of births occurring in states with such laws. Methods We conducted a systematic content analysis of statutes in all U.S. states that mentioned reporting by health care providers of substance use by pregnant women or infants exposed to substances in utero; inter-rater reliability was high. We calculated the number of states, and proportion of U.S. births occurring in states, with processes for mandatory reporting of perinatal substance use to authorities, and substance use disorder treatment provision for individuals who are reported. Results Twenty states (corresponding to 31% of births) had laws requiring health care providers to report perinatal substance use to child protective authorities, and four states (18% of births) had laws requiring reporting only when a health care provider believed the substance use was associated with child maltreatment. About half of states (13) with any reporting law had a provision promoting substance use disorder treatment in the perinatal period. Conclusions Findings inform the ongoing debate about how health policies may be used to reduce the population burden of perinatal substance use.

Context: Leaders in public health have made great advances in workforce development over the past 30 years, while shifting from an emphasis based in training on individual, technical skills to a more holistic development approach, which boosts crosscutting skills. Efforts to increase public health workforce capabilities remain focused on workers as individuals, rather than the workforce as a collective unit. Program: Research has shown that a strategic adult learning approach can improve both individual capabilities and the collective performance of the workforce, which can be explained using social cognitive theory and the concept of collective efficacy, or the collective belief of workers in the ability of the group to succeed. We explain how a prior training program pushed us to explore this approach. Implementation: The proposed approach covers proposed implementation strategies to build collective efficacy as part of existing workforce development initiatives, with a focus on 5 key steps. Evaluation: Experience in fields as diverse as sports psychology and organizational development has shown that it is possible to evaluate changes in collective efficacy using measures that can be adopted in public health. Discussion: Adjusting existing public health workforce development initiatives to build collective efficacy can help link workforce self-confidence to performance. More actionable data are needed to determine the best methods for achieving those goals in the field of public health.