Gender Differences in Provider's Use of a Standardized Screening Tool for Prenatal Substance Use

Abstract

Objectives-Prenatal substance use contributes birth defects, prematurity, and infant mortality in the U.S. As such, it is critical that medical professionals receive appropriate education and actively engage in screening patients; however, a physician's gender may influence differences in screening practices. The purpose of this study is to examine male and female Ob/Gyn physician's beliefs and practices related to perinatal substance use screening and to identify the significant correlates of using a standardized screening tool.Methods-Data were collected from 131 Ob/Gyn physician's in Kentucky using a web-based survey. Chi-square and t-tests were used to distinguish differences between male (n=84) and female (n=47) providers. Binary logistic regression was also used to assess the independent correlates of the use of a standardized screening tool. Results-FemaleOb/Gyn physician's were more likely to "believe in" the effectiveness of screening, to discuss sensitive topics with patients, and were motivated to screen as a part of comprehensive care or because screening could produce a behavioral change. Female providers were also more likely to use a screening tool in a multivariate model; however, being female was no longer significant after additional variables were included in the model. Specifically, younger Ob/Gyn physicians who frequently discussed mental health issues with female patients of childbearing age, and were motivated to screen because it is part of comprehensive care were significantly more likely to use a standardized substance use screening tool.Conclusions-In summary, less than half of Ob/Gyn physicians were using a standardized screening tool and the majority of physicians were using the CAGE. This suggests additional training is needed to increase their use of substance use screening tools, especially those geared towards pregnant women. Lexington, KY 40506; cboser0@uky.edu This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (NSDUH, 2005), in the past month 4.3% of pregnant women reported using illicit drugs, 9.8% reported using alcohol, 4.1% reported binge drinking, and 18.0% reported smoking cigarettes. While there has been a documented decline in substance use during pregnancy, the number of prenatal substance using women is still significant and the problems experienced by their unborn child are preventable (Goler et al., 2008). Therefore, it is critical that medical professionals adhere to guidelines which suggest that universal screening should occur for substance use disorders in both primary care practices as well as in specialized medicine (Chasnoff et al.,...

Obstetrician–gynecologists’ practices and attitudes on substance use screening during pregnancy

“…Physician self-reported use of validated screening instruments in this study is similar to previous research that finds a low utilization of validated screening tools even when the majority of obstetrician-gynecologists ask their patients about alcohol use and illicit drugs (22)(23)(24)(25)(26). Utilization of verbal validated screening tools, such as 4P's, NIDA Quick Screen, and CRAFFT to identify drug and alcohol use among pregnant women is recommended by ACOG (12).…”

“…Additionally, the use of validated tools to screen for alcohol use fell from 23% in 2000 to 11% in 2010 (22,23). While a majority of obstetrician-gynecologists report screening their patients for other illicit substance use during pregnancy (24,25), a 2011 survey found that 42% used a validated screening tool to screen for substance use (26). It is unknown whether these estimates have changed in the context of the opioid crisis and cannabis legalization.…”

Obstetrician-Gynecologists' Knowledge, Attitudes, and Practice Regarding Elder Abuse Screening

“…However, the fact that they are more likely to consult with a colleague on issues of elder abuse indicates that they may recognize and compensate for these differences. Although the reasons for younger males' lower screening rates are not clear, these differences may be a result of both younger age (and thus less attuned to the issue), as well as an extension of other findings that females tend to perform more screening and preventive care in general (Cook et al, 2001;Lurie, Margolis, & Mink, 1997;Millstein, Igra, & Gans, 1996;Oser, Biebel, Harris, Klein, & Leukefeld, 2011). This study highlights a potential group that could be specifically targeted for further education and training on elder abuse.…”

Primary Care Screening, Brief Intervention, and Referral to Treatment for Adolescent Substance Use in Lebanon: A National Cross-sectional Study

“…Similar results were reported in the international literature and were related to poor training, logistic concerns, and the availability of resources needed to handle a positive screen. 16,40,41 In this sample, the significant positive correlation between SBIRT use and perceived self-efficacy points to the potential role of training in augmenting provider confidence in addressing substance use issues and thus encouraging SBIRT practice. 36 On another note, this study revealed high levels of perceived comfort and effectiveness in addressing substance use issues among adolescents despite the very low screening rates.…”