Prenatal substance use contributes birth defects, prematurity, and infant mortality in the United States. 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 obstetrics and gynecology (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.
Data were collected from 131 Ob/Gyn physicians in Kentucky using a web-based survey. χ2 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.
Female Ob/Gyn physicians 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.
In summary, less than half of Ob/Gyn physicians were using a standardized screening tool and most physicians were using the CAGE. This suggests additional training is needed to increase their use of substance use screening tools, especially those geared toward pregnant women.
From the Departments of Sociology (CO), Center on Drug and Alcohol Research and Sociology (EB), University of Kentucky, Lexington, KY; Pacific Institute for Research and Evaluation (MH), Calverton, MD; Bluegrass Care Clinic (EK), University of Kentucky; and Department of Behavioral Science (CL), Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY.
Received August 6, 2009; accepted November 26, 2009.
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Supported by a March of Dimes Foundation Chapter Community Grant and a grant K01-DA21309 (to C.O.) from the National Institute on Drug Abuse.