During the late 1980's, Kaiser Permanente clinicians began to experience the impact of prenatal substance abuse. To address this problem, a care model named "Early Start" was created. Early Start was piloted from 1990 to 1992 in the OB/GYN Department at the Kaiser Permanente Medical Center in Oakland, California. The model integrated substance abuse services with prenatal care. This was accomplished by: (1) Training OB/GYN providers about perinatal substance abuse, (2) Educating all pregnant women about risks of prenatal substance use, (3) Universally screening all pregnant women for risk by questionnaire and urine toxicology screen, and (4) Locating a substance abuse specialist in the OB department to conduct risk assessments, education, and ongoing intervention integrated with prenatal care. Eighty-one pregnant women were identified as substance abusers during the 15-month pilot project. They were referred to the Early Start substance abuse specialist for counseling. Ninety-two percent of these women agreed to participate in the Early Start program. Of the participants, 69% remained alcohol and drug free through delivery. Their babies had significantly better outcomes than those whose mothers continued to use substances throughout the pregnancy. Encouraged by the pilot's results, The Permanente Medical Group allocated funds to expand the program to additional sites. Subsequent evaluation continues to show positive outcomes. Today, Early Start services are available at 16 prenatal clinics in the Northern California Region, serving over 20,000 pregnant women annually.
Learning Objectives:
Keywords: Substance Abuse Treatment, Pregnancy
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.