214950 Identifying Disparities and Evaluating Prevention Programs Related to Perinatal Substance Use at the Local Level

Sunday, November 7, 2010

Stephanie Taylor, MPH , Shasta County Health and Human Services Agency, Public Health Branch, Redding, CA
Robin Schurig, MPH , Shasta County Health and Human Services Agency, Redding, CA
Louis Jarvis, MA , Shasta County Health and Human Services Agency, Redding, CA
Brandy Isola, MPH , Shasta County Health and Human Services Agency, Redding, CA
Andrew Deckert, MD, MPH , Shasta County Health and Human Services Agency, Public Health Branch, Redding, CA
Jennifer Snider, MPH , Shasta Children and Families First Commission, Redding, CA
Background: Substance use during pregnancy is known to have adverse effects on an unborn child. Northern California women show higher rates of alcohol use and smoking during pregnancy compared to the statewide average, but local data were needed to determine local risk factors for perinatal substance use, evaluate prevention programs, and inform future interventions.

Methods: Mothers of six-month old babies (n=367) were surveyed via telephone on substance use behaviors and the screening and intervention practices of their prenatal care providers. Logistic regression models were used to assess the association between educational attainment, race/ethnicity, and payment source for prenatal care, and outcomes such as alcohol and tobacco use during pregnancy, exposure to secondhand smoke, and the practices of respondents' prenatal care providers.

Results: Non-Hispanic white women were significantly more likely than Hispanic women to smoke while pregnant, while women with Medicaid (compared to women with private insurance) and women of lower educational attainment showed increased odds of smoking though non-significant associations. Women with private insurance were significantly more likely than women with Medicaid to use alcohol while pregnant. Prenatal care providers screened almost universally for alcohol use and smoking but in some cases implemented brief interventions with women less likely to use these substances.

Implications: Results will be used to evaluate the impact of local programs addressing perinatal substance use, to inform future interventions, and to advocate for continued universal screening by prenatal care providers. Results may also be included in the upcoming Healthy Shasta County 2020 Strategic Planning process.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Epidemiology
Program planning

Learning Objectives:
1. Demonstrate the application of local data to the identification of health disparities and the evaluation of prevention programs. 2. Describe the associations between race/ethnicity, educational attainment, and income and substance use patterns in Shasta County mothers. 3. Describe the associations between race/ethnicity, educational attainment, and income of Shasta County mothers and the substance use screening and intervention practices of their prenatal care providers.

Keywords: Perinatal Health, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am responsible for the analysis of the survey data, interpretation of the results, and dissemination of findings to local stakeholders.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.