As a presentation on stigma at the 2025 NACCHO360 conference was coming to a close, one of the attendees came up to research scientist Samantha Pinzl seeking resources. Samantha recalled with pride how she was able to connect this person to FASD United’s Family Navigator resources, as well as the resources of other organizations, including CDC’s living experience video series. “That was a small moment, yet an important moment,” as Samantha puts it. This moment powerfully illustrates the impact of the ongoing work of CDC’s National Partner Network (NPN) and how it is empowering professionals in the field to build connections that are making a difference.
FASD United is spotlighting each of the organizations that are part of the CDC’s National Partner Network and in our latest piece, we are proud to feature the National Association of County and City Health Officials (NACCHO) and Montana State University (MSU), close partners and key members of the NPN that are advancing the FASD field by promoting substance-free pregnancies and addressing FASDs. The team is ensuring that local health departments (LHDs) are FASD-informed and empowered to work effectively to promote substance-free pregnancies and support clients impacted by prenatal alcohol exposure (PAE).
The NPN is a collaborative coalition of organizations dedicated to advancing key goals, including reducing PAE and substance use, enhancing support services and access to care, and improving the identification and health of children and families affected by FASDs. As a proud participant in this collaborative effort from 2022 to 2026, FASD United is excited to contribute to public education on FASD and prenatal substance exposure alongside these exceptional partners.
I spoke with two incredible members of the team: Samantha Pinzl, Research Scientist at the Center for Health and Safety Culture at Montana State University (MSU) and Elana Filipos, Senior Program Analyst on the Maternal, Child, and Adolescent Health team at the National Association of County and City Health Officials (NACCHO).
It was great to catch up with Samantha and Elana after interviewing them and featuring their work last year as part of our NPN feature project. A lot of exciting new developments have occurred over the course of the past year, including the launch of new resources and a major expansion of the project’s partnerships and communications capacities.
A passion for empowering health professionals at the local level
Samantha and Elana share a deep passion for empowering public health professionals at the local level. As the Project Coordinator for the CDC-funded NPN project, Samantha is proud of the interdisciplinary research at the Center for Health and Safety Culture, which serves communities through research, training, and technical assistance. “Our main aim is to cultivate healthy and safe cultures,” Samantha says. “A few of the Center’s focus areas are child well-being and substance use prevention, which align well with our FASD project.” With a background in public health and community health education, Samantha spoke of her enjoyment working on this CDC project. Samantha worked for a county health department for almost six years prior to starting at the Center.
Elana has been with NACCHO for three and a half years now, with a background in maternal and child health as well as public health communications, both of which set her up for success on this FASD project. “NACCHO is the voice of over 3,300 local health departments across the country,” Elana explains, “and our work is centered around improving the health of communities by strengthening and advocating for public health agencies at the local level.” Elana leads NACCHO’s substance-exposed pregnancy prevention efforts on the Maternal, Child, and Adolescent Health team, working closely with Samantha. “I work with the MSU team to prevent PAE and address FASDs and promote substance-free pregnancies,” Elana told me. “It’s hard to believe that it’s been almost three years since the start of the project. It has been great!”
A growing network of partners and collaborators
Samantha was excited to talk about their partner network, Partners for Substance-Free Pregnancies, made up of NACCHO members, including local health departments (LHDs), and other public health organizations. “When we last talked with FASD United for this NPN feature, we were a relatively new group,” Samantha says. “We had only been meeting for one year at that time. Our partner network has really grown, both in number and in collaboration. There is more resource-sharing, and it now occurs as a two-way street, so I have partners sharing information with me and asking to get it shared within the network.”
Elana and Samantha work together to facilitate this collaborative network, in which LHDs learn from each other, share helpful tools, and provide feedback to improve the project. “We have made big strides in the number of health departments we have engaged with and how they are collaborating and sharing with each other,” Samantha points out.
Elana characterizes the growth of the partner network over the past year as “simply incredible,” adding, “We have launched a host of new tools and resources and worked hard to show how this work can be integrated into what LHDs are already doing. Every LHD is at a different starting point, with some agencies doing a lot in this space and others that are interested in asking questions and learning more. I believe this shows us the value of connecting LHDs, as they can learn from each other and problem solve. That connection is so impactful.”
New tools to make addressing FASD more accessible
Elana and Samantha were quick to point out the new tools that are available to help LHDs map out their current work so they can see where FASD intervention strategies can best be incorporated into their existing programs. “We are finding those natural points of connection, which brings a level of accessibility and approachability to substance-exposed pregnancy prevention work,” Elana says. “We want agencies to know that they don’t have to start from scratch with a completely new program in order to incorporate FASD work into what they are already doing on a day-to-day basis.”
Elana highlighted the team’s portfolio mapping tool, which is an activity for LHDs to identify opportunities to promote substance-free pregnancies within their work. “We have an example map on our website, as well as a blank map that LHDs can use,” Elana says. “Once completed, these maps highlight ways to maximize staff time and resources.” Organizations can use this tool to figure out where they can integrate FASD work into their existing programming.
Samantha talked about feeling proud of how the team approaches the FASD topic as an “all of us” issue. “We know this issue is not caused by pregnant people alone, to be solved by only one sector,” Samantha points out. “Every one of us contributes to this issue and can also address it.” The team has been intentional to tailor their tools with that lens, developing messages to family members, partners, close loved ones, as well as the community. “I’m proud of the way our tools are attempting to work across the social ecology,” Samantha says.
The power of language and communication
Sam and Elana both spoke to the challenges that arise when communicating about FASDs and how they as a team have worked to address this. “We knew we wanted our messages to have plain language and be easy to understand. At times, that can conflict with having non-stigmatizing language,” Samantha says. “When you use terms like prenatal alcohol exposure, that can remove stigma from the person, though it can then sound like medical jargon. We tried to think through all of those challenges very carefully. We wanted gender-inclusive, non-stigmatizing language, so we started crafting language with those filters.”
The result of these efforts is a powerful communication guide for LHDs: Messages to Promote Substance-Free Pregnancies and Prevent FASDs. Samantha and Elana were especially excited to talk about this, given that it launched right after we spoke with them for our feature interview last year. The guide is tailored to various audiences, including those who are currently pregnant, as well as those who are not intending to be pregnant and those diagnosed with an FASD. “This is not a topic where your communication can be a one-size-fits-all,” Samantha emphasizes.
The Communication Guide is already being well-received. Elana points out that through the course of the FASD project, it became clear from talking with LHDs that concerns around communication was a major barrier. LHDs expressed not knowing how to talk to their communities about topics around FASD and PAE. “We created our Communication Guide because we knew we had to develop strategies on how LHDs can initiate these conversations with communities,” Elana says. Stigma plays a big part in that barrier. “Being able to pinpoint what LHDs really need has been key for us, and the guide is a good example of being able to provide language LHDs can use, not necessarily verbatim, but as a guide for having these conversations.”
The value of incorporating partner feedback
The team found it extremely helpful to have their partner network review the language and provide input, especially providers on the ground who would make direct use of it in different situations. “This feedback is so helpful, because every LHD is different in terms of staff and how they are configured,” Elana points out. “We were able to tailor the guide to a wide range of different audiences.
As part of the product’s development, the team showed draft messages to many partners, including nurses that have these conversations with actual patients and have such a great perspective on how to say things. “As an example, we have a section on how parents can talk to their kids about alcohol use, and I remember one of our partner members provided such good input on that section,” Elana says.
Elana described launching the guide at NACCHO 360 in 2024 and being struck by all the great feedback she was getting in the moment. “Providers told us the Communication Guide is something that they have been badly needing, that they didn’t know before how to talk with community members and families about FASD-related issues. They expressed how meaningful the guide is to their work, how helpful it is to have a tool like this to work from.”
Samantha and Elana shared with me the following direct quotes from LHDs in response to the guide: “These messages are incredibly helpful. I’m constantly thinking about how to talk about this with providers and people in the community. Some groups have resistance because it’s too hard of a topic.” Another quote describes the messages as “straightforward and easy to understand and communicate.”
Highlighting stigma at upcoming interactive training
The team is excited about the development of an interactive training “Reducing Stigma Associated with Fetal Alcohol Spectrum Disorders.” The new training has been given to local health departments a few times this year to show the impact of stigma specifically associated with FASDs. “We are aiming to teach LHDs ways to reduce stigma in their work and apply specific strategies to promote substance-free pregnancy,” Samantha says. “We have piloted this training twice already and received helpful feedback and we continue to refine the training.”
The training is interactive, building skills as well as providing education. The 2-hour training features participatory breakout sessions where people converse with others and learn more about stigma. “The learning objectives include skills on how public health professionals can actually reduce stigma in their work,” Samantha explains. “We talk about four different types of stigma and provide examples of how stigma shows up for people impacted by FASDs. LHDs also learn how they can support families who already have a diagnosis as well as how they can promote substance-free pregnancies within their strategies and activities.”
The stigma training covers language, including specific ways to say things in a less stigmatizing way. “This is something that everyone in the training can start that very day, and there are a lot of resources to help with this, including our communication guide,” Samantha says.
Elana points out how the team’s work is always centered around recognizing the critical role that LHDs play in uplifting public health at the local level. “We think of them as local leaders in prevention and care, uniquely positioned to address the needs of their communities through direct services as well as providing information,” Elana says. “In those situations, language really matters. How LHDs talk about FASD-related topics is so important, whether they are meeting with a client on substance use issues or engaging with a client with an FASD. LHDs are in the position to implement strategies directly within their communities.”
Applying lessons learned from the harm reduction approach
A new resource the team just launched is Preventing Substance-Exposed Pregnancies with Contraception – Applying Harm Reduction Principles. “This is a unique tool because traditional prevention approaches focus on stopping or reducing the use of substances,” Samantha points out. “We have a whole other avenue for prevention when it comes to people who do not intend to become pregnant. It has been engaging and even fun this year to think critically in this avenue of prevention and to work through how we can elevate contraception in the work we are doing around substance use prevention and harm reduction.”
Samantha has been learning more about the principles of harm reduction over the past year and seeing how we can use this approach “rooted in compassion, dignity, and autonomy” as she puts it. “I get goosebumps thinking about it, because you can’t deny that this is an effective way to approach this work,” Samantha told me. “I am very passionate about providing people with an understanding of the social determinants of health as well as compassionate ways to approach people and our communities. The issues around FASD have a lot to do with our social environment and we all play a role.”
The new tool is designed to help LHDs integrate lessons from harm reduction into their work with people at risk for substance-exposed pregnancies. By offering effective contraception options along with a harm reduction approach, the team is working to help close the gap of people who may have unintended pregnancies. “This tool features different harm reduction concepts and provides conversation examples and other applications,” Samantha says. “We offer tips in getting the conversation started and applying best practices for referrals.” The tool includes featured resources and quick tips so people can learn more from other organizations. Samantha talked about how great an experience she had working on this and was particularly excited that it just launched in July, saying, “I am very excited to put this resource out there for people to use.”
Elana feels truly proud of the harm reduction resource and says, “It was really exciting to see that new area of harm reduction and contraception incorporated into this work, to capture this population of people who are using substances and do not intend to get pregnant. You can see how the harm reduction tool and the communication guide have different immediate purposes, yet they complement each other very well.” Both of these resources are the products of taking an approach that is non-stigmatizing, person-centered, and trauma-informed. “I am excited to get these tools out there and see how LHDs will use them,” Elana says. “I am proud of the fact that these tools and guides were very intentionally created based on feedback we received from our LHD members on what would be helpful for them and what resources they need and would benefit from.”
A well of gratitude for the value of the NPN
“Being a part of the NPN truly has been a highlight of my career so far,” Samantha emphasized. “I take great joy in being a part of the network. I value being a part of it because I am connected not only to those working to prevent PAE but also to those working to improve support services and access to care for people living with FASD. When we are aware of each other’s work and integrate that collaborative spirit into our project activities, we can all provide a more well-rounded and effective approach to make a greater impact with the communities we serve.” Samantha spoke of her joy in getting to know the people in the NPN on a personal and professional level, saying, “I am so excited to meet in person in Washington, DC in September for National FASD Impact Week, and I can’t wait to see everyone. I just love working with the NPN.”
Elana spoke about the tremendous value she gets from engaging with people across all of the organizations in the NPN and the opportunity to learn from all of these groups when they get together in a shared space with common goals. “It has been rewarding to work together in a collaborative environment that hinges on uplifting one another’s work and see how we all are collectively impacting maternal and child populations in positive ways,” Elana says. “I am so excited to meet everyone in person this September. I attended an NPN meeting virtually in Atlanta previously, so I am excited to see and meet everyone in person in DC for Impact Week.”
*This project is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.