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4P’s Plus© Testimonials

The First 1,000 Women: Using the 4P's Plus© in Hawaii

“The 4P’s Plus, we use it here for initial prenatal clients.  It is for screening of substance abuse, depression and we do it on their very first visit.”

– D. C., Nurse Manager, Luna County Department of Health

 “Using the 4P’s Plus has been a very good tool for the program.  Especially because we can assess the client as they come in and see where they stand.  If they’re using drugs and what kind of client we’re servicing at that time.”

– A. B., Program Director Healthy Start

“We do pregnancy tests and every client that comes in gets the 4P’s Plus.  At that first moment, we can see if the client is using marijuana or cocaine or if the client has been smoking and according to what they score on the 4 P’s Plus, we’ll go ahead and do the early intervention that we do.  And I think it is a very good tool for the program because we can see where the client stands and what we can do to help that client.”

– Dr. K. R., Ob/Gyn, Deming Women’s Center

 “From using the 4P’s Plus you learn if the patient is abusing any kind of substance: she smokes cigarettes, she drinks alcohol on a regular basis, she has taken prescription medication in the last month or so and what kind of lifestyle.  This new 4 P’s Plus asks questions on how they relieve stress, weather that’s talking with friends, drinking, smoking, doing drugs.  Things like that.”

Z. P., Parent Educator, Healthy Start


“What the 4P’s Plus allows us to do here as people and clinicians screening women who are positive for pregnancy allows us to discuss with them in a gentle and non-threatening way are better choices around a healthy pregnancy.”

K. S., Nurse Practitioner


“Using the 4P’s Plus helps you to open the doors of communication when you’re trying to develop a trusting relationship with a new patient.  It lends a safe period, a safe place where we can talk about alcohol exposure, any kind of substance abuse and we look at that every time we see the patient.”

R. E., Certified Nurse Midwife


"The 4Ps Plus screen, in conjunction with motivational interviewing trainings by the NTI team, provides for a non-threatening way in which prenatal care providers across the State of Louisiana successfully evaluate pregnant women for alcohol, tobacco and illicit drug use, depression, and domestic violence."

Mary Craig, Louisiana Director of Perinatal Services (ret.)


"The 4P’s Plus screening tool is the preferred tool for prenatal providers since it allows for quick screening for multiple behavioral risks using a single instrument and is validated for use in pregnancy.  The tool is very sensitive in identifying not only women with heavy substance use, but also lighter use that can have a major impact on birth outcomes.  Pregnant women in our community have benefited from identification of substance use, depression and domestic violence problems that were addressed through education, support, and referral. The ease of integration of the 4P’s Plus screening with the brief intervention process in prenatal settings is extremely valuable in promoting the health of women and children."

Jan Kasofsky, PhD, Executive Director, Capital Area Human Services District, Baton Rouge, Louisiana


"Ventura County has been using the 4Ps Plus Screening Tool for several years with increasing success. Our medical providers and their staff feel empowered to educate women about the dangers of substance use during pregnancy. We are working toward universal screening in our county and hope to achieve it in the near future." 

Seleta Dobrosky, RN, BSN, PHN, Program Coordinator with Ventura County Public Health.