Influencing and Improving Prenatal Screening and Intervention for Substance Abuse, Tobacco, and Domestic Violence

Project Overview

Insight conducted an evaluation of two Washington State programs: the Maternal Substance Abuse Screening Initiative for Providers and the Perinatal Partnership Against Domestic Violence Training Program. Together, these programs were designed to train and educate healthcare providers to effectively screen for, identify, and provide effective interventions for pregnant women with tobacco, alcohol, and/or drug use problems and those who are victims of domestic violence. Study topics examined provider attitudes related to their (1) perceptions of the importance of screening during pregnancy, (2) motivation for screening, (3) level of screening, (4) awareness of information and resources in Washington State, (5) strategies for increasing and improving provider screening, and (6) effectiveness of strategies to influence a change in practice.

As part of this evaluation, Insight conducted—

  • A literature review for background information on substance abuse and domestic violence, including prevalence, postnatal health outcomes, barriers to screening, and the effectiveness of various provider training initiatives
  • A survey of obstetric providers to identify the range and types of screening practices
  • Discussion groups with the medical community to provide recommendations on how the Washington State Department of Health (DOH) could improve providers’ skill and effectiveness in screening for substance abuse, tobacco use, and domestic violence

DOH used the study results to communicate effectively with healthcare providers to improve their skill and effectiveness in screening and intervention for substance abuse, tobacco use, and domestic violence. The topics included (1) the best ways to approach and communicate with physicians, (2) insight into the types of materials providers want, and (3) effective ways to modify existing materials to change screening behavior.


  • Final report, Prenatal Screening for Substance Abuse, Tobacco, and Domestic Violence: Assessing Effective Strategies for Improving Screening and Intervention (2004)
  • Article, Prenatal Screening for Substance Use and Violence: Findings From Physician Focus Groups (Maternal and Child Health Journal, 2006)
  • Fact sheet, Domestic Violence and Pregnancy Fact Sheet (Washington State DOH, 2004)