PDF(Pubmed)
Abstract：
Health care providers are a key source of reports of infants to child welfare related to birthing people\'s substance use. Many of these reports are overreports, or reports that exceed what is legally mandated, and reflect racial bias. We developed and evaluated a webinar for health professionals to address overreporting related to birthing people\'s substance use.
This evaluation study collected data from health professionals registering to participate in a professional education webinar about pregnancy, substance use, and child welfare reporting. It collected baseline data upon webinar registration, immediate post-webinar data, and 6 month follow-up data. Differences in both pre-post-and 6 month follow-up data were used to examine changes from before to after the webinars in beliefs, attitudes, and practices related to pregnant and birthing people who use drugs and child welfare reporting.
592 nurses, social workers, physicians, public health professionals, and other health professionals completed the baseline survey. More than half of those completing the baseline survey (n = 307, 52%) completed one or both follow-up surveys. We observed statistically significant changes in five of the eleven opioid attitudes/beliefs and in four of the nine child welfare attitudes/beliefs from baseline to follow-ups, and few changes in \"control statements,\" i.e. beliefs we did not expect to change based on webinar participation. All of the changes were in the direction of less support for child welfare reporting. In particular, the proportion agreeing with the main evaluation outcome of \"I would rather err on the side of overreporting to child welfare than underreporting to child welfare\" decreased from 41% at baseline to 28% and 31% post-webinar and at 6-month follow up (p = 0.001). In addition, fewer participants endorsed reporting everyone at the 6 month follow-up than at baseline (12% to 22%) and more participants endorsed reporting no one at the 6-month follow-up than at baseline (28% to 18%), p = 0.013.
Webinars on the legal, scientific, and ethical aspects of reporting that are co-developed with people with lived experience may be a path to reducing health professional overreporting to child welfare related to birthing people\'s substance use.
This evaluation study collected data from health professionals registering to participate in a professional education webinar about pregnancy, substance use, and child welfare reporting. It collected baseline data upon webinar registration, immediate post-webinar data, and 6 month follow-up data. Differences in both pre-post-and 6 month follow-up data were used to examine changes from before to after the webinars in beliefs, attitudes, and practices related to pregnant and birthing people who use drugs and child welfare reporting.
592 nurses, social workers, physicians, public health professionals, and other health professionals completed the baseline survey. More than half of those completing the baseline survey (n = 307, 52%) completed one or both follow-up surveys. We observed statistically significant changes in five of the eleven opioid attitudes/beliefs and in four of the nine child welfare attitudes/beliefs from baseline to follow-ups, and few changes in \"control statements,\" i.e. beliefs we did not expect to change based on webinar participation. All of the changes were in the direction of less support for child welfare reporting. In particular, the proportion agreeing with the main evaluation outcome of \"I would rather err on the side of overreporting to child welfare than underreporting to child welfare\" decreased from 41% at baseline to 28% and 31% post-webinar and at 6-month follow up (p = 0.001). In addition, fewer participants endorsed reporting everyone at the 6 month follow-up than at baseline (12% to 22%) and more participants endorsed reporting no one at the 6-month follow-up than at baseline (28% to 18%), p = 0.013.
Webinars on the legal, scientific, and ethical aspects of reporting that are co-developed with people with lived experience may be a path to reducing health professional overreporting to child welfare related to birthing people\'s substance use.
摘要：
背景：卫生保健提供者是婴儿对儿童福利的报告的主要来源，这些报告涉及到分娩者的物质使用。这些报道很多都是多报的,或超过法律规定的报告，反映种族偏见。我们为卫生专业人员开发并评估了网络研讨会，以解决与分娩人员使用药物有关的过度报告。
方法：这项评估研究收集了注册参加有关怀孕的专业教育网络研讨会的卫生专业人员的数据，物质使用,和儿童福利报告。它在网络研讨会注册时收集了基线数据，网络研讨会后的即时数据，6个月随访数据。使用前和后6个月随访数据的差异来检查信念研讨会前后的变化，态度，以及与使用药物和儿童福利报告的孕妇和分娩者有关的做法。
结果：592名护士，社会工作者,医师,公共卫生专业人员,和其他卫生专业人员完成了基线调查。超过一半的完成基线调查的人（n=307，52％）完成了一项或两项后续调查。从基线到随访，我们观察到11种阿片类药物态度/信念中的5种和9种儿童福利态度/信念中的4种具有统计学意义的变化，控制语句几乎没有变化，“即我们不希望基于网络研讨会的参与而改变的信念。所有的变化都是朝着减少对儿童福利报告的支持的方向发展。特别是,与“我宁愿多报儿童福利而不是少报儿童福利”的主要评估结果一致的比例从基线时的41%下降到网络研讨会后和6个月随访时的28%和31%(p=0.001)。此外,支持在6个月随访中报告所有人的参与者少于基线（12％至22％），支持在6个月随访中报告无人的参与者多于基线（28％至18％），p=0.013。
结论：关于法律，科学,与有生活经验的人共同开发的报告的道德方面可能是减少健康专业人员对与分娩人的物质使用有关的儿童福利的过度报告的途径。
方法：这项评估研究收集了注册参加有关怀孕的专业教育网络研讨会的卫生专业人员的数据，物质使用,和儿童福利报告。它在网络研讨会注册时收集了基线数据，网络研讨会后的即时数据，6个月随访数据。使用前和后6个月随访数据的差异来检查信念研讨会前后的变化，态度，以及与使用药物和儿童福利报告的孕妇和分娩者有关的做法。
结果：592名护士，社会工作者,医师,公共卫生专业人员,和其他卫生专业人员完成了基线调查。超过一半的完成基线调查的人（n=307，52％）完成了一项或两项后续调查。从基线到随访，我们观察到11种阿片类药物态度/信念中的5种和9种儿童福利态度/信念中的4种具有统计学意义的变化，控制语句几乎没有变化，“即我们不希望基于网络研讨会的参与而改变的信念。所有的变化都是朝着减少对儿童福利报告的支持的方向发展。特别是,与“我宁愿多报儿童福利而不是少报儿童福利”的主要评估结果一致的比例从基线时的41%下降到网络研讨会后和6个月随访时的28%和31%(p=0.001)。此外,支持在6个月随访中报告所有人的参与者少于基线（12％至22％），支持在6个月随访中报告无人的参与者多于基线（28％至18％），p=0.013。
结论：关于法律，科学,与有生活经验的人共同开发的报告的道德方面可能是减少健康专业人员对与分娩人的物质使用有关的儿童福利的过度报告的途径。
