title: Does adopting a prenatal substance use protocol reduce racial disparities in CPS reporting related to maternal drug use? A California case study.
abstract: OBJECTIVE
  This study examined whether adopting a standardized prenatal substance use protocol (protocol) in a hospital labor and delivery unit reduced racial disparities in reporting to child protective services (CPS) related to maternal drug use during pregnancy.
  
  
  METHODS
  This study used an interrupted time series design with a non-equivalent control. One hospital adopted a protocol and another hospital group serving a similar geographic population did not change protocols. Data on CPS reporting disparities from these hospitals over 3.5 years were analyzed using segmented regression.
  
  
  RESULTS
  In the hospital that adopted the protocol, almost five times more black than white newborns were reported during the study period. Adopting the protocol was not associated with reduced disparities.
  
  
  CONCLUSIONS
  Adopting a protocol cannot be assumed to reduce CPS reporting disparities. Efforts to encourage hospitals to adopt protocols as a strategy to reduce disparities may be misguided. Other strategies to reduce disparities are needed.
authors.affiliation: Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, CA, USA.
authors.forename: S C M
authors.initials: SC
authors.lastname: Roberts
authors.affiliation: Public Health Institute, Oakland, CA, USA.
authors.forename: E
authors.initials: E
authors.lastname: Zahnd
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Sufrin
authors.affiliation: Division of Research, Kaiser Permanente, Oakland, CA, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Armstrong
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D003696:Delivery Rooms / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007229:Infant Welfare / Q000706:statistics & numerical data; D007231:Infant, Newborn; D065186:Interrupted Time Series Analysis; D010346:Patient Care Management / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology / Q000517:prevention & control; D011295:Prenatal Care / Q000379:methods*; D011314:Preventive Health Services / Q000379:methods / Q000458:organization & administration; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000208:ethnology / Q000517:prevention & control