A special section, “Fetal Alcohol Spectrum Disorders Prevention and Intervention,” was included in a recent issue of Substance Use & Addiction Journal (SAj)—the official journal of the Association for Multidisciplinary Education and Research in Substance use and Addiction. The articles represent the work of 11 cooperative agreements formerly funded by CDC to explore and describe the rationale, approaches, and challenges in implementing FASD prevention and intervention strategies and practices.
Links are available below to public access versions of the papers. Our project partner Elizabeth Dang at CDC has provided descriptions of each paper.
Summary of the special section:
The journal represents the ongoing work of eleven CDC-supported projects and their partners to demonstrate the rationale for FASD intervention and PAE (prenatal alcohol exposure) prevention. This National Partner Network engages health care disciplines to expand prevention messaging and education for providers, develops practical approaches for implementing alcohol screening and brief intervention (SBI) in clinical settings, and develops strategies for preventing alcohol use during pregnancy.
The journal opens with a commentary focused on prevention and intervention services, which summarizes the background of the FASD issue and the public health response, offers a historical perspective on alcohol and pregnancy, and summarizes the public health guidance and its reception, including the resulting public backlash to these recommendations. The commentary goes into the role of stigma, bias, and discrimination. FASD United wishes to acknowledge our partners and collaborators at the Alaska Center on FASD, American Academy of Pediatrics, and Centers for Disease Control and Prevention.
The articles on FASD in this special section describe the joint effort to meet the aims of the CDC-funded projects. The authors describe strategies to address stigma and educate health care providers. The papers describe effective interventions for addressing prenatal alcohol and other substance exposure and FASDs, including through specialized training and message delivery.
Authors go into great detail about the evidence base supporting targeted prevention programs, especially alcohol screening and brief intervention and how to identify patients at risk of an alcohol-exposed pregnancy as well as how to best implement this screening into systems of care.
Public access links to each paper:
An introductory commentary provides background on the importance of FASD prevention and intervention, including strategies to address barriers such as stigma related to this topic. It also describes the collaborative approach of CDC-funded efforts and discusses gaps in the field and implications for future work.
- Importance of Fetal Alcohol Spectrum Disorders Prevention and Intervention
Authors: Tom Donaldson, Elizabeth P. Dang, Marilyn Pierce-Bulger, Kathleen T. Mitchell, Andy R. Kachor, Rosa Arvizu
Papers 2-3 describe approaches to reach healthcare providers, including strategies to target specific healthcare disciplines, in promoting FASD prevention and intervention. The articles assess various training and education approaches and practical modifications to content and delivery modality based on the needs of healthcare professionals, clinical setting, and patient and clinician perspectives.
- Answering a Call to Action: Reducing Fetal Alcohol Spectrum Disorders Using a Healthcare Champion Model
Authors: Courtney Townsel, Vincent C. Smith, Hemalatha Senthilkumar, Lily R. Bastian, Miranda Sanks, Diana Ling, Joshua Benke, Alexandra Edwards, Nancy Roget, Kimberly Prokosch, Mary M. Velasquez, Kimi Yonamine, Kirk von Sternberg, Tonya McFadden, Antoinette Abou Haidar, Karen E. Harris
- Multi-Level Approaches to Fetal Alcohol Spectrum Disorders Prevention Education and Training for Health Professionals
Authors: Faith Ozer Green, Amy K. Harlowe, Alexandra Edwards, Daniel P. Alford, Hetal Choxi, Jacqueline S. German, Diana Ling, Iwona Pawlukiewicz, Reshana Peterson, Kirk von Sternberg, Mary M. Velasquez
Papers 4-6 describe approaches for promoting the implementation of alcohol screening and brief intervention as an evidence-based strategy for the prevention of alcohol use during pregnancy and FASDs. The articles explore barriers to implementation, strategies to adapt workflows and systems, modifications to training content, logistics, and electronic health records systems, and the expansion of alcohol SBI services to include patients drinking at levels below AUD criteria. Lastly, the section considers the impact of alcohol SBI activities on systems-level and provider-level outcomes to inform best-practice recommendations. Reflecting on what was learned as well as what gaps remain will help illuminate potential opportunities to advance the field and inform future directions.
- Using Planned and Unplanned Adaptation to Implement Universal Alcohol Screening and Brief Intervention to Prevent Alcohol-Exposed Pregnancies in Four Primary Care Health Systems
Authors: Diane K. King, Steven J. Ondersma, Bonnie G. McRee, Jacqueline S. German, Amy M. Loree, Amy Harlowe, Daniel P. Alford, Robyn N. M. Sedotto, Mary Kate Weber
- Identifying Patients at Risk for Alcohol-Exposed Pregnancies: The Importance of Addressing Multiple Risk Factors
Authors: Bonnie G. McRee, Bridget L. Hanson, Janice Vendetti, Diane K. King, Iwona Pawlukiewicz, Erin Berry, Jessica Johnson, Deanna Marshall, Lauren Rosato, Karen Steinberg Gallucci, Corrie Whitmore
- Cross-Site Evaluation of Alcohol Screening and Brief Intervention Implementation Programs in Healthcare Systems Serving Individuals of Reproductive Age
Authors: Janice Vendetti, Candice Bangham, Melissa Riba, Corrie Whitmore, Karen Steinberg Gallucci, Bridget L. Hanson, Jacey A. Greece