The Centers for Disease Control and Prevention funded cooperative agreements with seven states (Colorado, Missouri, Michigan, Minnesota, North Dakota, South Dakota, Oregon and Wisconsin) to participate in a Fetal Alcohol Syndrome (FAS) prevention project. The intervention project concentrated its FAS prevention activities in four metropolitan counties: Adams, Denver, Jefferson, and Larimer. Colorado’s project was named FAS-PACE – Fetal Alcohol Syndrome, Prevention Activities, Choices, and Empowerment, and used the slogan, “PartyWise.”
The Colorado Department of Public Health and Environment (CDPHE) program Colorado Responds to Children With Special Needs (CRCSN) partnered with the AHEC System Program Office and COFAS to implement a portion of the CDC grant FAS-PACE- PartyWise. Additional components of this grant were run out of CRCSN, including surveillance efforts and linking Identified FASD children to services.
The purpose of FAS-PACE- PartyWise was to develop, implement and evaluate population-based and targeted programs for FASD prevention. The goal was to prevent alcohol-exposed births by reducing alcohol use among women of childbearing age and increasing contraceptive knowledge and utilization.
This was accomplished by using a stepped care model, serving women at high risk for having alcohol-exposed pregnancy. Point of entry into the stepped care model was through either Personal CHOICES or Group CHOICES; in addition women could enter the program from Personal DECISIONS, a self-guided change intervention. The steps included:
- Brief intervention through Personal CHOICES, a client-centered approach to change, using goal-setting, monitoring of behaviors using a diary, and provider support for achieving and maintaining self-selected changes.
- Brief intervention through Personal DECISIONS using an adapted Personal CHOICES intervention that could be completed by the client on their own.
- Brief intervention through Group CHOICES, containing both educational and intervention components on risk drinking, effective contraceptive use, and the effects of alcohol on a women’s health and the health of a developing fetus.
- Moderate case management intervention called “Personal Skills” that lasted for 3 to 6 months.
- Intensive case management intervention called “Personal Support” that lasted for as many as 3 years.
The expected outcomes of this project were:
- Decrease in alcohol use among women of childbearing potential
- Decrease risk of alcohol exposed pregnancies
- Decrease in unintended pregnancies
- Increase in contraception
- Increase in self-efficacy and quality of life indices
- Increase awareness of FASD
- Prevention of another FASD birth
- Alcohol abstinence in pregnant women
Data results for this recently ended project are coming soon.
COFAS received funding from “March of Dimes Colorado State Chapter Community Grant Program Increase Availability of Prevention Services” category for a one-year “Rethink Your Drink” public service announcement educational campaign, an informational health clinic video, and informational Internet video podcasts.
“Rethink Your Drink” was designed to educate women about the health risks of drinking alcohol while pregnant, and the permanent affects alcohol can have on the developing fetus. The program is also for women who are not yet pregnant, but are drinking and engaging in unprotected intercourse, and for those who are drinking and do not realize they are pregnant.
SAMHSA/CSAP Service to Science Building Evaluation Capacity for Evidence-Based Interventions
COFAS staff are interested in learning whether COFAS training and technical assistance efforts are effective in changing long-term practice behaviors of health care professionals. Are shifts in knowledge, attitude and intent to change sustainable and/or implemented after the training?
COFAS is working with CPR, Inc. on behalf of Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Prevention (CSAP) and State Networks of Colorado Ambulatory Practices & Partners (SNOCAP) to study a proposed evaluation enhancement plan. The plan would implement a longitudinal, quasi-experimental research design with practitioners to determine the impact of training.
Multiple data points are proposed for this study. Baseline and post-training data is still being collected with the addition of two follow-up data collection. Both process and outcome data are being collected through the support of this contract.
Results from this type of study would assist COFAS staff in better understanding what is needed to implement at-risk drinking screenings and to move further on the continuum of achieving an evidenced-based status for the intervention. This intervention is still in process so data results are not yet available.
Reducing Risks for an Alcohol-Exposed Pregnancy (AEP) in High Risk Women Attending Sexually Transmitted Diseases (STD) Clinics in Urban Settings.
The original Funding Opportunity Announcement asked for proposals for a demonstration project implementing the 4-session CHOICES intervention to reduce the risk of Alcohol-Exposed Pregnancy (AEP), in the setting of an urban STD clinic. The intervention uses Motivational Interviewing techniques to help women of reproductive age make choices to decrease alcohol consumption below a less-risky threshold for alcohol during pregnancy, and/or to begin use of effective contraception to avoid pregnancy.
Meanwhile, however, a 2-session CHOICES intervention was being studied. As it was successful, the overall project was changed to the 2-session CHOICES intervention model after the awards had been made.
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