Performance Measurement: A Proposal to Increase Use of SBIRT and Decrease Alcohol Consumption During Pregnancy

Abstract

Objectives Alcohol consumption during pregnancy has negative implications for maternal and child health. Appropriate early universal Screening, Brief Intervention and Referral to Treatment (SBIRT) for pregnant women is necessary to identify women at risk and reduce the likelihood of continued drinking. Because SBIRT is not consistently used, the development and use of performance measures to assure implementation of SBIRT are key steps towards intervention and reduction of alcohol consumption during pregnancy. Methods Practice guidelines provide ample support for specific instruments designed for SBIRT in prenatal care. An examination of existing performance measures related to alcohol consumption during pregnancy, however, reveals no comprehensive published performance measure designed to quantify the use of SBIRT for alcohol use in prenatal care. Results Process performance measures were developed that can determine the proportion of pregnant women who are screened during the course of prenatal care and the proportion of women requiring either brief intervention or referral to substance use disorder treatment who received those interventions. The measures require use of screening instruments validated for use with pregnant women. Conclusions The two proposed measures would represent a significant step in efforts to assure appropriate intervention for women who drink during pregnancy, hold accountable providers who do not employ SBIRT, and provide a basis from which necessary systemic changes might occur. Pregnancy is a time when many women are motivated to stop drinking. That opportunity should be seized, with timely intervention offering assistance for pregnant women who have not stopped drinking of their own accord.

The Role of Health Information Sources in Decision-Making Among Hispanic Mothers During Their Children’s First 1000 Days of Life

“…Healthcare providers and public health professionals should consider the health information environment of their patients and provide culturally-relevant communication strategies and interventions. Practically, healthcare providers can ask patients about information they have found 8 and/or provide an easy-to-read, bulleted printed handout or email that also lists trustworthy Internet sites 32,33 that have been HONcode certified. The sites can also provide a platform to discuss health information with patients, especially among immigrants who may not have a strong support system established yet.…”

Pregnancy Intentions and Maternal and Child Health: An Analysis of Longitudinal Data in Oklahoma

“…The data are retrospective, creating the potential for recall bias [42, 43]; however, the retrospective recall period is shorter than in many other surveys. Furthermore, as in any self-reports, responses are open to social desirability, whether underreporting of negative health behaviors or overreporting of positive behaviors; all of the outcome measures other than low birth weight are self-reported.…”

Racial and ethnic differences in contraceptive use among women who desire no future children, 2006–2010 National Survey of Family Growth

“…both mistimed and unwanted pregnancies), [1, 8–11], black and Hispanic women are also more likely than white women to experience an unwanted pregnancy [2, 12–16]. As unwanted pregnancies are more closely linked to pre-term delivery and PROM, understanding disparities in unwanted pregnancy may present an opportunity to address well-documented racial/ethnic disparities in adverse perinatal outcomes [17–19].…”