CBHRS researchers, as part of a Centers for Disease Control and Prevention (CDC) national effort, collaborated with healthcare professionals and healthcareorganizations to implement evidence-based practices found to reduce unhealthy alcohol use and alcohol-exposed pregnancies. Alcohol-exposed pregnancies can lead to fetal alcohol spectrum disorders (FASDs)–one of the most common preventable causes of lifelong intellectual and developmental disabilities in the U.S. Healthcare teams can play a critical role in addressing unhealthy alcohol use, and providing timely, evidence-based information and counseling to prevent FASDs.
The United States Preventive Services Task Force recommends that all adults, including pregnant people, be screened annually in primary care settings for unhealthy alcohol use and offered education and/or brief behavioral counseling as indicated. Implementing universal delivery of alcohol screening and brief intervention (alcohol SBI) has proven challenging for practices to adopt, given barriers to changing procedures, systems, and provider behavior. Three recently published papers discuss the multi-level challenges of implementing alcohol SBI in “real world” practice. [Note: This is part of a body of CBHRS research on FASD prevention that spans over 15 years and multiple projects.]
The first article, Green et al., explores different approaches to the education and training of healthcare providers around FASD prevention used by six CDC-funded programs, and how they have been adapted to (1) the specific needs of the healthcare professionals and/or the clinical setting and (2) the challenges posed by the COVID-19 pandemic.
Green FO, Harlowe AK, Edwards A, et al. Multi-Level Approaches to Fetal Alcohol Spectrum Disorders Prevention Education and Training for Health Professionals. Substance Use & Addiction Journal. 2024;0(0).
The second article, King et al., presents case studies describing the practice-change strategies used by 4 academic-health system teams that were funded by the CDC to implement alcohol SBI within regional healthcare systems, to reach patients for prevention of alcohol-exposed pregnancies. CBHRS researchers partnered with Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky to successfully implement routine alcohol SBI in its 35 health centers, including
Fairbanks, Anchorage and Juneau.
King DK, Ondersma SJ, McRee BG, German JS, Loree AM, Harlow A, Alford DP, Sedotto RNM, Weber MK. Using Planned and Unplanned Adaptation to Implement Universal Alcohol Screening and Brief Intervention to Prevent Alcohol-Exposed Pregnancies in Four Primary Care Health Systems. Substance Use & Addiction Journal. 2024;0(0).
The third article, McRee et al., analyzed data from two of the participating health systems that successfully implemented alcohol SBI, to determine the extent that patients who screened negative for unhealthy alcohol use (i.e., low-risk drinkers) were still at elevated risk for alcohol exposed pregnancy due to their use of less effective contraception and consumption of some alcohol. Findings were that almost 14% of patients at elevated risk for an alcohol exposed pregnancy did not receive a brief intervention during their visit.
McRee BG, Hanson BL, Vendetti J, King DK, Pawlukiewicz I, Berry E, Johnson J, Marshall D, Rosato L, Steinberg Gallucci K, Whitmore C. Identifying Patients at Risk for Alcohol-Exposed Pregnancies: The Importance of Addressing Multiple Risk Factors. Subst Use Addctn J. 2024 Aug 3:29767342241267086. Epub ahead of print. PMID: 39096200.
