Prenatal Providers Awareness of Information Sources Regarding Syphilis Screening Guidelines




Johnson, Kaeli
Kinard, Ashlyn
Griner, Stacey


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Purpose: Syphilis infections during pregnancy are associated with miscarriage, stillbirth, birth defects, and infant death. Since 2012, rates of syphilis during pregnancy and congenital syphilis have been increasing, with many cases occurring among pregnant people who have accessed prenatal care but were not screened. State-level policies and national guidelines recommend the testing of all pregnant people for syphilis infections to prevent the numerous negative health outcomes, including stillbirth. However, providers receive screening guidelines from various sources, including their professional organizations, which culminates in varying recommendations. The purpose of this study was to evaluate provider awareness of and the information sources from which they receive prenatal syphilis screening guidelines. Methods: Prenatal providers (MD/DO; n=201) were recruited via Dynata, an online survey panel. We assessed awareness of professional organization screening guidelines (Does your professional organization have recommendations or guidelines about syphilis screening during pregnancy? Yes, no, I don't know), and where they received their screening guidelines (Where did you learn about the prenatal syphilis screening guidelines?). For those who reported their organizations did not currently have prenatal syphilis screening guidelines, we assessed where they would like to be notified of the guidelines if their organization did (If your professional organization did have policies or guidelines about prenatal syphilis screening, where would you want to learn about them?). Response options for the source of guideline information included twelve sources: colleagues within organization, colleagues outside of organization, conferences, continuing education, curriculum in training, practice bulletins, journal articles, professional organizations, residency programs, social media, websites, and another source, where providers were asked to list the source. Frequencies, descriptive statistics, and bivariate analyses were conducted in SPSS. Results: The majority of prenatal providers were Doctors of Medicine (MDs, 96%), and most (65%) worked in a private practice setting. A large proportion of prenatal providers were aware of prenatal syphilis screening guidelines (87%), with most of them learning these guidelines through practice bulletins (23%), their professional organization (21%), residency programs (14%), and continuing education (10%). The prenatal providers who were unaware (13%) wanted to learn about guidelines from their professional organization (20%), continuing education (18%), practice bulletins (18%), or conferences (15%). Overall, prenatal providers wanted to learn of any changes within prenatal syphilis screening guidelines through practice bulletins (28%), their professional organizations (23%), and continuing education (14%). Conclusions: Professional organizations, practice bulletins, and continuing education were the preferred sources of information for those who were both aware and unaware of screening guidelines. These sources were also favored by prenatal providers wanting to learn of any changes in syphilis screening guidelines, suggesting that these dissemination sources are important for provider awareness but are not reaching the entirety of their target audience. Targeted dissemination strategies utilizing these information sources could help increase provider awareness. Future studies should develop guideline and policy dissemination strategies to inform providers of recommended prenatal screening practices. Widespread dissemination of these recommendations could improve prenatal syphilis screening practices and by proxy reduce prenatal syphilis rates.