Does adopting a prenatal substance use protocol reduce racial disparities in CPS reporting related to maternal drug use? A California case study

J Perinatol. 2015 Feb;35(2):146-50. doi: 10.1038/jp.2014.168. Epub 2014 Sep 18.

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.

Study design: 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.

Result: 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.

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • California / epidemiology
  • Delivery Rooms / statistics & numerical data*
  • Ethnicity / statistics & numerical data
  • Female
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Infant Welfare / statistics & numerical data
  • Infant, Newborn
  • Interrupted Time Series Analysis
  • Patient Care Management / methods*
  • Pregnancy
  • Pregnancy Complications* / ethnology
  • Pregnancy Complications* / prevention & control
  • Prenatal Care / methods*
  • Preventive Health Services / methods
  • Preventive Health Services / organization & administration
  • Socioeconomic Factors
  • Substance-Related Disorders* / ethnology
  • Substance-Related Disorders* / prevention & control