Background: Alcohol consumption by people who are pregnant can result in fetal alcohol spectrum disorders (FASDs), which have a variety of negative impacts on children, families, and communities. Prenatal use of other substances is also of concern, given demonstrated negative consequences (such as with opioids) or lack of clear safety evidence (such as with marijuana). Individuals and communities receive mixed messages about the safety of substances, especially alcohol and marijuana, even during pregnancy. While many healthcare professional organizations have clear recommendations to avoid substances during pregnancy, some individual healthcare professionals continue to dispense advice that does not align with evidence-based messages to abstain. And for people experiencing substance use disorders, stigma and limited access to treatment can make quitting nearly impossible. Opportunities exist to leverage public health in conjunction with clinical healthcare professionals to spread evidence-based messages and information about prenatal substance exposure and to provide information and resources about FASDs.
Partnership: With this project, the Center for Health and Safety Culture (CHSC) at Montana State University will partner with the National Association of County and City Health Officials (NACCHO). CHSC is an interdisciplinary center serving communities and organizations through research, training, and support services to cultivate healthy and safe cultures. NACCHO is a national organization serving every local health department (LHD) in the nation.
Purpose: Applying for Component B, the “Preventing and Addressing FASDs With NACCHO and Local Health Departments” project will directly reach LHD staff with messages, educational opportunities, and evidence-based practice recommendations aimed at preventing prenatal substance exposure and identifying and supporting children and families experiencing FASDs. Additionally, we will fully collaborate with other grantees, LHDs across the country, and other relevant organizations and stakeholders to increase capacity to prevent and address FASDs and increase access to care and health information for underserved individuals. We will engage in utilization evaluation activities and continuous quality improvement to monitor progress, refine activities as needed to ensure reach to the target population and achievement of project goals, and understand impact.
Outcomes: Project activities will lead directly to achievement of the identified short-term outcomes. Specifically, we will:
• collaborate between clinical and public health partners to address prenatal substance use and increase FASD-related screenings and services;
• disseminate evidence-based messages and tools and track their use, anticipating increased use of evidence-based information among NACCHO members;
• conduct surveys and other data collection activities to identify NACCHO members’ knowledge and current practices related to prenatal substance use and FASD services as well as understand their organizational needs; and
• build capacity among state and local networks to reach people who are or could be pregnant, and parents, caregivers, and families with accurate information about prenatal substance use and FASDs and provide services and resources.
Subsequently, project activities will lead to achievement of the intermediate outcomes, including increased knowledge and confidence among NACCHO members and LHD staff, increased use of evidence-based strategies for prevention and identification of FASDs, increased incorporation of prenatal substance exposure-related content into LHD policies and into recommendations made by NACCHO and their partners, and increased capacity for healthcare and other services to individuals at risk of prenatal substance use and children and families who may experience FASDs.
