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Rates of substance use during pregnancy have continued to rise through 2017. It is likely that obstetrical providers are encountering many pregnant persons who use substances either during prenatal care or postpartum. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based model that has been successfully implemented in some obstetrical settings, but its implementation has been sporadic. The objective of this study was to determine the baseline level of familiarity and use of SBIRT elements among obstetrical providers to identify needs for future SBIRT implementation efforts.


Participants were physicians, medical students, nurses, and other staff attending Grand Rounds presentations on SBIRT at six delivering academic medical centers with maternity services in Philadelphia. Throughout the Grand Rounds presentation, before each topic was discussed, the audience was asked to rate on a 5-point Likert scale their disagreement/agreement with statements like “I am comfortable managing pregnant patients with substance use disorder.” Participants responded anonymously through an online polling platform via their personal mobile device. Participants also provided demographic information anonymously. Responses and demographics were analyzed with descriptive statistics overall and at each medical center.


Less than 29% of participants reported being comfortable managing a pregnant patient with a substance use disorder. One third was familiar with substance use screening methods, 30% were comfortable providing brief interventions, and 48% were comfortable referring patients to substance use disorder treatment. 33% reported being familiar with substance use disorder treatment programs in the area. Generally, medical centers that also had substance use treatment programs were more comfortable and knowledgeable about SBIRT elements.


Very few obstetrical providers were comfortable or knowledgeable about SBIRT elements, even at medical centers with specific programs for treating substance use disorder among pregnant individuals. Efforts to implement SBIRT are sorely needed, and will require significant training given these results.

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SBIRT, pregnant, opioid, substance, drug screening


Medicine and Health Sciences | Obstetrics and Gynecology | Psychiatry

Obstetrical Providers’ Comfort and Knowledge of Screening, Brief Intervention, and Referral to Treatment