Prevention of FASDs through National Nursing Organizations - Despite more than thirty years of research linking alcohol-exposed pregnancies (AEP) with birth defects, alcohol use during pregnancy continues as a major public health problem and cause of fetal alcohol spectrum disorders (FASDs). The U.S. Preventive Services Task Force recommends that clinicians screen all adult patients for alcohol misuse at least annually by using a standardized screening tool to assess alcohol consumption patterns and by providing brief behavioral counseling for patients identified as drinking at unhealthy or risky levels. Additionally, the Centers for Disease Control and Prevention (CDC) recommend pregnant women abstain from any alcohol consumption throughout pregnancy. As providers of primary and women’s health services, women’s health nurse practitioners (WHNPs), certified nurse-midwives (CNMs), and perinatal nurses, are ideally positioned to identify and help to change the behaviors of both women and men to prevent AEPs, FASDs, and health issues associated with alcohol misuse. CDC funds beginning in 2014 supported the University of Alaska Anchorage, Center for Behavioral Health Research and Services (CBHRS) to establish an FASD Practice and Implementation Center. The project resulted in strong partnerships with the National Association of Nurse Practitioners in Women’s Health (NPWH), the American College of Nurse-Midwives (ACNM), and the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) to address FASD prevention among women’s health nurses, including WHNPs, CNMs, and perinatal providers. Through collective efforts, we developed clinician-led training, position statements, articles, conference presentations, webinars, and membership surveys to assess and increase members’ awareness and knowledge of alcohol use during pregnancy and the role nurses can play in providing clinical services to prevent AEPs and address alcohol misuse. This proposal is to support ongoing activities for CBHRS to collaborate with NPWH, ACNM, and AWHONN in order to reach their combined membership of over 30,000 women’s health nursing professionals, and continue to disseminate knowledge, tools, and evidence-based resources necessary to provide clinical preventive services aimed to reduce AEPs and FASDs. With these national partners we will accomplish the following project goals: (1) assess member knowledge, attitudes, practices and training needs related to risky alcohol use, including any alcohol use during pregnancy; (2) promote awareness of risky alcohol use, including any use during pregnancy; (3) build/expand our existing champions network to include regional and setting representation (e.g., settings targeting underserved communities) in order to extend reach; (4) develop and implement recertification requirements with alcohol/alcohol screening and brief intervention (SBI)/AEP content; (5) promote clear, consistent, science-based messages for targeted nurses to deliver to patients; (6) promote clinical guidelines and policies that support implementation of alcohol SBI; and (7) conduct a comprehensive evaluation using outcome and process measures informed by RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), an evidence-based, theoretically supported implementation and dissemination framework. Outcome data will include national partner members’ characteristics and survey data used to assess member knowledge, role acceptance, and practice behaviors relevant to preventing and addressing risky alcohol use, and any use during pregnancy. Process data will include monitoring member uptake of trainings, professional resources, and CDC communication products through website and media tracking in collaboration with our national partners and other CDC grantees. Documented processes, including changes to champion network composition and their activities; policy accomplishments; and the outcomes of alcohol, alcohol SBI, and AEPs in our target population’s recertification requirements
