Abstract
Objectives
The purpose of this study was to understand pregnant women’s perceptions of three validated substance use screening tools and identify a preferred tool for use during pregnancy. The three screening tools studied included the 4P’s Plus, the NIDA Quick Screen/ NIDA-Modified Alcohol, Smoking and Substance Involvement Screening Test, and the Substance Use Risk Profile-Pregnancy Scale.
Methods
A total of 493 cognitive interviews were completed with a diverse sample of pregnant women presenting to two obstetrics practices in Baltimore, MD from January 2017 to January 2018. This study served as a qualitative companion to a larger study comparing the accuracy and acceptability of substance use screening tools in prenatal care. After completing each screening tool, participants were asked their perceptions of the tool and to choose their preferred tool. Interviews were recorded, transcribed verbatim, coded, and analyzed using NVivo software.
Results
The plurality of participants (43.4%) reported they preferred the 4P’s Plus. Fewer participants preferred the NIDA Quick Screen (32.5%) and the SURP-P (24.1%). Participants felt that the 4P’s Plus was both comprehensive and concise. While many participants felt that disclosure of substance use would vary by individual, participants also suggested that when screening is confidential, includes questions about a patient’s background, and administered by a non-judgmental provider, pregnant people may be more likely to answer honestly.
Conclusions for Practice
The 4P’s Plus is a promising and acceptable substance use screening tool for use in prenatal care. Clinicians can use several methods to increase acceptability of substance use screening and encourage disclosure of prenatal substance use.
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Acknowledgements
We would like to acknowledge our study participants for their time and sharing deeply personal information and perspectives with us. We would also like to thank the practice staff and on-site interviewers for their help implementing the study.
Funding
Research reported in this publication was supported by the National Institute On Drug Abuse of the National Institutes of Health under Award Number R01DA041328. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Trocin, K.E., Oga, E.A., Mulatya, C. et al. Patient Perceptions of Three Substance Use Screening Tools for Use During Pregnancy. Matern Child Health J 26, 1488–1495 (2022). https://doi.org/10.1007/s10995-022-03442-1
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DOI: https://doi.org/10.1007/s10995-022-03442-1