SUBSTANCE USE AMONG PREGNANT ADOLESCENTS - A COMPARISON OF SELF-REPORTED USE AND PROVIDER PERCEPTION

Purpose: This study describes, from both client and provider perspecti ves, the ethnic differences (African-American and white) in cigarette, alcohol, marijuana, and other drug (cocaine and crack) use among preg nant adolescents attending public prenatal clinics in one county. Meth ods: Client information was based on a cross-sectional survey of 248 c onsecutive adolescent, public prenatal clients. The sample represented 79% of pregnant adolescents in the country at the time of the study. Ethnic groups were compared through the use of appropriate bivariate s tatistics regarding (a) number, type(s), and frequency of substance(s) used; (b) mean age of first use; (c) change in use 6 months prior to pregnancy and first trimester; and (d) use among family and friends. P rovider information was based on open-ended interviews among 23 indivi duals (91% of all providers) covering the same themes. Results: The ma jority of clients were African-American (61%), single (81%), and prima parous (72%). Many reportedly used at least one substance prior to pre gnancy (79%) and during their first trimester (49%). The most common s ubstances were cigarettes and alcohol. Overall, use of each substance during both time periods was higher among whites; yet African-American s were more likely to report discontinued use. Substance use was commo n among adolescents' family members and friends. The provider survey r evealed a wide range of perceptions about substance use among pregnant adolescents. Conclusions: Pregnant adolescents' self-reported substan ce use patterns differed by ethnicity, and providers' perceptions of s ubstance use among their adolescent prenatal population differed from what was obtained from patients' self-reports. Additional research is needed to understand the role ethnicity plays in high-risk behaviors a mong adolescent prenatal clients, as well as its role in client-provid er communication. (C) Society for Adolescent Medicine, 1998.