Awareness, Acceptability, and Adoption of Prenatal Syphilis Screening Guidelines

Background: Congenital syphilis rates have been increasing since 2012 and are associated with adverse health outcomes. There is variability in screening guidelines, and little is known about provider knowledge of them. The purpose was to assess the awareness and acceptability of prenatal syphilis guidelines among physicians. Materials and Methods: We cross-sectionally assessed prenatal provider (MD/DO; n = 201) awareness and adoption of national guidelines. Feasibility was assessed through the feasibility of the intervention measure, acceptability using the acceptability of the intervention measure, and appropriateness using the intervention appropriateness measure. Each measure included four items on a five-point Likert scale from strongly disagree (1) to strongly agree (5). The final analysis compared relative advantage, compatibility, complexity, observability, and trialability across the guidelines. Data analysis was completed in SAS v9.4, and this study was approved by the university's IRB. Results: Providers discussed (84%) and recommended (91%) prenatal syphilis screening to their patients. Providers (87%) were aware of their professional organizations' prenatal syphilis screening recommendations and utilized the American Academy of Pediatrics/American Congress of Obstetrics and Gynecology guideline (74%). Universal screening (62%), pregnancy trimester (54%), and professional organizations' recommended guidelines (54%) were associated with recommending syphilis screening to prenatal patients. The most important factor was universal screening (33%). The Centers for Disease Control and Prevention guideline had the highest mean relative advantage score (3.56, p = 0.020), and the United States Preventive Services Task Force guideline was viewed as significantly clearer (9.76) compared to the other guidelines (p = 0.007). Conclusions: Participants discussed and recommended prenatal syphilis screening to their patients despite variability in screening guidelines. Future studies should analyze guideline dissemination to fully understand the adoption process.