Association of Substance Use Discussion by Pediatric Providers With the Parent–Provider Relationship and Maternal Behavior Change

A cross-sectional study of data from a randomized, controlled trial was conducted to determine (1) provider and parent attributes associated with discussion of maternal substance use, (2) how substance use discussion related to the parent–provider relationship, and (3) whether discussion was associated with maternal attempts at behavior change. Of the 482 mothers, 34 % reported discussing all 3 substance use items (smoking, alcohol, and drug use) with their child’s provider. Mothers who discussed smoking were more likely to report discussing alcohol and other drug use (P <.001). Parent–provider relationship scores, measured by a modified version of the Primary Care Assessment Survey, were positively associated with discussion of each substance (P <.001). Discussion of smoking and drug use were significantly associated with attempted behavior change. Our findings suggest that discussion of parental substance use by pediatricians is positively associated with the parent–provider relationship and may lead to behavior change. Keywords substance use, pediatrician, discussion, mothers, parent–provider relationship In the United States, 43 % of children are exposed to environmental tobacco smoke in their home,1 and 28