Prenatal screening for substance use and violence: findings from physician focus groups.
OBJECTIVE
To guide quality improvement activities, the study sought to identify effective strategies for influencing and improving physician screening and referral of pregnant women for violence and substance abuse (alcohol, drugs and tobacco).


METHODS
This qualitative study conducted in Washington State consisted of interviews with eight physicians and focus groups with twenty-eight physicians who practice obstetric care. Physicians, selected using systematic sampling, were asked about perceptions on the importance of screening and barriers to effective screening, awareness of information and resources from the state Department of Health, and the effectiveness of various provider training strategies for improving prenatal screening.


RESULTS
Physicians were most interested in practical, concise information for themselves and office staff. Referral information and patient handouts were identified as important tools to increase the efficacy of screening and intervention. Physicians supported in-person programs in offices or in hospitals but rejected use of audio conferences and direct mailings.


CONCLUSIONS
This study provided insight about the way we deliver best practice information to physicians. Collecting qualitative data from physicians is important prior to developing statewide quality improvement activities aimed at this group.
Taylor
Polly
P
Washington State Department of Health, Maternal and Child Health, PO Box 47880, Olympia, WA 98504-7880, USA. Polly.Taylor@doh.wa.gov
Zaichkin
Jeanette
J
Pilkey
Diane
D
Leconte
Judith
J
Johnson
Bryan K
BK
Peterson
Anne C
AC
D001291:Attitude of Health Personnel; D019985:Benchmarking; D017579:Domestic Violence / Q000517:prevention & control; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008487:Medical History Taking / Q000379:methods / Q000592:standards*; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000517:prevention & control; D011295:Prenatal Care / Q000379:methods / Q000592:standards*; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods; D012309:Risk-Taking; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000517:prevention & control; D014861:Washington