Understanding the Beliefs, Concerns, and Needs of Pregnant Patients Who Use Marijuana and of the Obstetrics Providers Caring for Them

了解使用大麻的孕妇以及照顾她们的产科提供者的信念、担忧和需求

• 批准号: 9310559
• 负责人: JUDY C CHANG
• 金额: $ 28.51万
• 依托单位: MAGEE-WOMEN'S RES INST AND FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9310559
• 关键词: Address; Adolescent; Adult; Alaska; Alcohol or Other Drugs use; Alcohols; Area; Arizona; Attention; Attitude; Behavior; Behavioral; Belief; California; Caring; Characteristics; Child; Clinical; Cognitive; Colorado; Communication; Counseling; Data; Data Analyses; Data Collection; Decision Making; Development; Discipline of obstetrics; Education; Educational Intervention; Future; Guidelines; Health; Health Personnel; Health system; Infant; Information Services; Interview; Knowledge; Laws; Learning; Low Birth Weight Infant; Maine; Marijuana; Medical; Medical Records; Mental Health; National Institute of Drug Abuse; Neurocognitive Deficit; Nevada; Oregon; Outcome; Parents; Participant; Patient Care; Patients; Pennsylvania; Perinatal; Pharmaceutical Preparations; Policies; Positioning Attribute; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Prenatal care; Provider; Published Comment; Questionnaires; Recording of previous events; Recruitment Activity; Research; Resources; Risk; Services; Social Environment; Social Work; Structure; Surveys; Testing; Thinking; Tobacco; Training; Training Programs; Training Support; Visit; Washington; Woman; Work; behavior change; clinical practice; development policy; experience; illicit drug use; improved; marijuana use; marijuana user; perinatal intervention; pregnant; screening; stillbirth

 DESCRIPTION (provided by applicant): In November 2012, Colorado and Washington were the first states that passed referendums to legalize adult recreational marijuana use. Alaska and Oregon voters followed suit by supporting legalization of recreational marijuana in the 2014 elections. With a rapidly changing cultural and political landscape and growing public support of marijuana use, it is essential to quickly obtain information that will inform and prepare both patients and health providers in making decisions and promoting behaviors that reduce potential health risk associated with marijuana use. One area that has received little attention is the use of marijuana during pregnancy. Our prior work suggests that more women may be using marijuana during pregnancy than previously estimated and that the majority of these users are not currently telling their obstetric providers about this use. Several studies suggest that perinatal marijuana is associated with various negative pregnancy, infant and child outcomes including stillbirth, preterm delivery, neurocognitive deficits in infants and children, and behavioral, learning, and mental health problems among children and adolescents. To accelerate research on this topic and more expeditiously provide information to guide clinical practice and health system policies, this proposal intends to take advantage of rich, varied data collected from our parent study (NIDA 1R01DA026410). Our project has data from 469 pregnant patients and 81 obstetric providers recruited from 5 different obstetric practices in Pittsburgh, Pennsylvania. In this parent study, we found 29% of our pregnant patients either tested positive or admitted to current marijuana use during their first obstetric visit; however, only 36% of patients who tested positive for marijuana disclosed current use. Although our original study objectives did not specifically target marijuana, we were able to add questions in our data collection to both our surveys and semi-structured interviews that examined pregnant marijuana user's history of use, attitudes and beliefs regarding perinatal marijuana and obstetric care providers' attitudes, strategies, and concerns about addressing perinatal marijuana use. We will compare quantitative data from our patient participants who either disclosed or tested positive for marijuana use during pregnancy with those from patients who did not. We will analyze data from over 190 interviews to provide a deeper understanding of patients' and obstetric providers' perspectives on perinatal marijuana and what they perceive is needed to better address this in obstetric care. Findings from our study will inform future development of provider training interventions and patient information/counseling resources as well as clinical guidelines and health system policies.

 描述（由申请人提供）：2012年11月，科罗拉多和华盛顿是第一批通过公民投票使成人娱乐性大麻使用合法化的州。阿拉斯加州和俄勒冈州的选民也纷纷效仿，在2014年的选举中支持娱乐用大麻合法化。随着文化和政治环境的迅速变化以及公众对大麻使用的支持日益增加，必须迅速获得信息，以便为患者和医疗服务提供者提供信息，并为他们做出决策和促进减少与大麻使用相关的潜在健康风险的行为做好准备。一个很少受到关注的领域是怀孕期间使用大麻。我们以前的工作表明，更多的妇女可能在怀孕期间使用大麻比以前估计的，这些用户中的大多数目前没有告诉他们的产科医生这种使用。几项研究表明，围产期大麻与各种不良妊娠，婴儿和儿童结局有关，包括死产，早产，婴儿和儿童的神经认知缺陷，以及儿童和青少年的行为，学习和心理健康问题。为了加快对这一主题的研究，并更快地提供信息，以指导临床实践和卫生系统政策，本提案旨在利用从我们的母研究（NIDA 1 R 01 DA 026410）中收集的丰富多样的数据。我们的项目数据来自469名怀孕患者和81名产科提供者，他们来自宾夕法尼亚州匹兹堡的5个不同的产科实践。在这项家长研究中，我们发现29%的怀孕患者在第一次产科就诊时检测呈阳性或承认目前使用大麻;然而，只有36%的大麻检测呈阳性的患者透露目前使用大麻。虽然我们最初的研究目标并没有专门针对大麻，但我们能够在我们的数据收集中添加问题到我们的调查和半结构化访谈中，这些调查和半结构化访谈检查了怀孕大麻使用者的使用历史，对围产期大麻和产科护理提供者的态度和信念。我们将比较来自我们的患者参与者的定量数据，这些患者在怀孕期间使用大麻或检测呈阳性，而这些患者没有。我们将分析来自190多个访谈的数据，以更深入地了解患者和产科提供者对围产期大麻的看法，以及他们认为在产科护理中更好地解决这一问题所需的内容。我们的研究结果将为提供者培训干预措施和患者信息/咨询资源以及临床指南和卫生系统政策的未来发展提供信息。