Seizing the 9-month moment: addressing behavioral risks in prenatal patients.
OBJECTIVE
Our qualitative study explored prenatal care providers' methods for identifying and counseling pregnant women to reduce or stop smoking, alcohol use, illicit drug use, and the risk of domestic violence.


METHODS
We conducted six focus groups (five with OB/Gyn physicians, one with nurse practitioners and certified nurse midwives), total N=49, using open-ended questions. Investigators analyzed transcripts to identify and describe themes.


RESULTS
Three major themes emerged: (1) specific risk-prevention tactics or strategies exist that are useful during pregnancy; (2) some providers address patients' isolation or depression; and (3) providers can adopt a policy of "just chipping away" at risks. Specific tactics included normalizing risk prevention, using specific assessment techniques and counseling strategies, employing a patient-centered style of smoking reduction, and involving the family.


CONCLUSIONS
Providers generally agreed that addressing behavioral risks in pregnant patients is challenging. Patient-centered techniques and awareness of patients' social contexts help patients disclose and discuss risks.


CONCLUSIONS
Brief but routine assessment and risk reduction messages require little time of the provider, but can make a big difference to the patient, who may make changes later.
Herzig
Karen
K
Division of Behavioral Sciences, University of California San Francisco, 350 Parnassus Avenue, Suite 905, San Francisco, CA 94117, USA.
Danley
Dale
D
Jackson
Rebecca
R
Petersen
Ruth
R
Chamberlain
Linda
L
Gerbert
Barbara
B
D001291:Attitude of Health Personnel; D003376:Counseling / Q000379:methods*; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006801:Humans; D009721:Nurse Midwives / Q000523:psychology; D009722:Nurse Practitioners / Q000523:psychology; D009730:Nursing Assessment / Q000379:methods; D015404:Nursing Methodology Research; D009774:Obstetrics / Q000379:methods; D010353:Patient Education as Topic / Q000379:methods; D018802:Patient-Centered Care / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods*; D036301:Qualitative Research; D018570:Risk Assessment / Q000379:methods*; D040242:Risk Reduction Behavior; D012495:San Francisco; D000074606:Smoking Prevention; D013179:Spouse Abuse / Q000517:prevention & control; D019966:Substance-Related Disorders / Q000517:prevention & control; D011795:Surveys and Questionnaires