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FASD in Review

Screening and Intervention Programs

FASD Prevention Programs

A total of 25 programs were implemented using one of three identified evidence-based practices: Project CHOICES; Screening and Brief Intervention; and the Parent-Child Assistance Program (PCAP). Some programs were funded twice; once in 2008 and again in 2012. All programs funded in 2012 were unable to complete their programs due to funding cuts after the first year.


Project CHOICES targets women at risk of having an alcohol-exposed pregnancy before they become pregnant. Most women do not realize they are pregnant until well into the first trimester, and many drink alcohol during this time. Project CHOICES focuses on reducing drinking and preventing pregnancy through contraception with women 18 to 44 who are sexually active and drinking alcohol at risk levels (eight or more drinks per week or four or more drinks on one occasion). Project CHOICES uses a four-session intervention to achieve its results. The intervention uses motivational interviewing methods. In 2004, the organizers of Project CHOICES published the results of the pilot study (Project CHOICES Intervention Research Group, 2003). A more recent report presents the positive results of the randomized controlled trial (Floyd et al, 2007). Twelve programs were funded under this category, and included state and local agencies:



Screening and Brief Intervention

The U.S. Preventive Services Task Force (2004) reviewed the literature and concluded that brief alcohol interventions with more than one contact with the client are effective. The elements in effective brief interventions were generally consistent with the 5-A’s approach (assess, advise, agree, assist, arrange) to behavioral counseling interventions adopted by that same Task Force. The program developed by Mary O’Connor and Shannon Whaley (2007) with a grant from the National Institutes of Alcohol Abuse and Alcoholism (NIAAA) follows this model and has found significant results. The program uses a simple written assessment of alcohol use and a 10-15 minute intervention with pregnant women that report drinking. Assessment and an appropriate brief intervention are provided at follow-up visits. Eleven programs were funded under this category targeting pregnant women in Women, Infants and Children (WIC), Healthy Start, or other programs working with pregnant women at both State and local levels:



Parent-Child Assistance Program (P-CAP)

The Parent-Child Assistance Program (P-CAP) uses an intensive paraprofessional home visitation model to reduce risk behaviors in women with substance abuse problems over a three-year period. The program uses a case management approach, which is an effective complement to traditional substance abuse treatment. One case worker serves 15 women. The focus is not simply on reducing alcohol and drug use, but also on reducing other risk behaviors and addressing the health and social well being of mothers and their children. This program has been shown to be effective (Ernst et al, 1999; Grant et al, 2003; Grant et al, 2005). Two programs were funded under this category targeting pregnant or postpartum women in residential or outpatient alcohol treatment or drug treatment: