Objective
To describe obstetric provider attitudes, beliefs, approaches, concerns, and needs about addressing perinatal marijuana use with their pregnant patients.
Methods
We conducted individual semi-structured interviews with obstetric providers and asked them to describe their thoughts and experiences about addressing perinatal marijuana use. Interviews were transcribed verbatim, coded and reviewed to identify themes.
Results
Fifty-one providers participated in semi-structured interviews. Providers admitted they were not familiar with identified risks of marijuana use during pregnancy, they perceived marijuana was not as dangerous as other illicit drugs, and they believed patients did not view marijuana as a drug. Most provider counseling strategies focused on marijuana’s status as an illegal drug and the risk of child protective services being contacted if patients tested positive at time of delivery.
Conclusions
When counseling about perinatal marijuana use, obstetric providers focus more on legal issues than on health risks. They describe needing more information regarding medical consequences of marijuana use during pregnancy.
Practice Implications
Provider training should include information about potential consequences of perinatal marijuana use and address ways to improve obstetric providers’ counseling. Future studies should assess changes in providers’ attitudes as more states consider the legalization of marijuana.
Batterer intervention programs (BIPs) constitute the primary treatment for perpetrators of intimate partner violence (IPV). Systematic evaluations of BIPs, however, have yielded modest results in terms of these programs' ability to reduce perpetration. Descriptive studies, which can provide information on the contexts and process associated with BIPs, can provide insights into the underlying mechanisms that might promote change among BIP clients, and as such are important to improving efficacy measures for BIPs. To date, however, limited research exists on what challenges BIPs encounter in working with clients, and how those challenges present barriers to behavioral change among perpetrators at the intervention level. As part of a 2-year ethnographic study, we conducted 36 individual semistructured interviews with professionals working with BIPs. We identified six themes related to challenges to promoting behavioral change among men who perpetrate violence: (a) social acceptance of IPV, (b) hypermasculine attitudes, (c) emotional problems, (d) childhood exposure to violence, (e) co-morbid mental health issues, and (f) denial, minimization, and blame. Our results have implications for thinking about some of the contextual factors that may impede BIPs ability to produce desired outcomes and for identifying areas in which programs can be tailored to improve the overall client experience. Our results also point to the need for a more coordinated community response to IPV, and in particular to helping provide resources that support BIPs sustained, safe, and as effective as possible work.
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