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Illinois Department of Human Services (WIC)
FASD Prevention Subcontractors
Project Contact Information
Illinois Department of Human Services (WIC)
Stephanie Bess, MS, RD, LDN, CLC, Program Director
815 East Monroe Street
Springfield, IL 62702
Project Summary Statement
The Illinois Department of Human Services is working to integrate alcohol screening and Brief Intervention within its Special Supplemental Nutrition Program for Women, Infants, and Children Program. The project was first piloted in Winnebago County, a county in Northern Illinois and expanded in OY2 to Macon County in Central Illinois. The project will be further expanded in OY3 to WIC clinics in the three remaining DHS regions.
The goal of the project is to increase the number of women who commit to completely abstaining from alcohol drinking during pregnancy. The target audience is all pregnant women receiving WIC services in Winnebago County, Macon County and, the three new pilot sites in Illinois. The project supports the state’s goal of improved pregnancy outcomes.
The strategy being used to accomplish the goal of increasing the number of pregnant WIC clients that abstain from alcohol consumption is implementation of the evidence-based intervention: M.J. O’Connor and S.E. Whaley “Brief Intervention for Alcohol Use by Pregnant Women” (American Journal of Public Health, 2007; 97 (2): 252-258). As reported in the article cited above, ...Brief Intervention is an effective methodology that has been empirically validated in a number of alcohol-related studies.
The approach uses 10 -15 minute sessions of counseling that can be delivered by personnel who are not specialists in the treatment of alcohol abuse or dependence. Most Brief Interventions include
- feedback aimed at increasing awareness of the negative consequences of drinking,
- advice focused on identifying risky situation and action aimed at reducing consumption, and
- assistance with formulating drinking reduction goals.
Brief Intervention has been shown to be a low-cost, effective treatment alternative for alcohol use problems. The methodology uses time-limited, self-help strategies to promote reductions in alcohol use in nondependent individuals, and in the case of dependent persons, to facilitate referral to specialized treatment programs (Connor and Whaley et al., 2007). This intervention is given to all pregnant women at WIC who acknowledge drinking alcohol during pregnancy or pregnant women who score 2 or more on the screening tool.
The following are the combination of methods, services and activities currently being implemented within the two pilot sites and as the three new sites come on board: The screening tool is integrated into the computer-based assessment tool, Cornerstone. The screening questions are asked in a seamless fit with the other WIC certification questions. The next steps are as follows:
- A WIC provider reviews the screening tool with the participant and clarifies as needed.
- After reviewing the screening tool, the Cornerstone system scores the screening.
- If the screening tool identifies the client as needing further intervention, the WIC provider prioritizes the FASD Brief Intervention and/or referral to additional alcohol assessment and treatment services is warranted.
- The WIC provider completes the Brief Intervention tool with the client.
- If a client has received a Brief Intervention, she receives one month of WIC coupons and is assessed again during her next month’s meeting.
- At the one month follow-up visit, staff are to use professional judgment to determine if the client should continue to be seen monthly (those who need a referral or do not meet their goal) or if they can be released to the general education group.
During Option Year 2, just over 2300 pregnant women were screened for alcohol use during pregnancy. One of the most unique aspects of the project in Illinois is the screening and brief intervention responses from the pregnant clients are entered into Cornerstone, a management information system.
Cornerstone is designed to allow a single point of enrollment for these programs. This complex computer system builds a comprehensive file on each individual as information is entered. The system generates over 200 pre- established administrative and outcome reports. At the local level, Cornerstone is a case management tool that helps health care professionals provide services to their clients. Through the modification of the Cornerstone system, the Department has been able to collect the data required for the process evaluation of the screening and brief intervention.
Training and Technical Assistance to the WIC staff has been identified as an important piece to this project. The initial training that was provided prior to implementing the project addressed the screening and Brief Intervention. However, little background information on FASD and why it is important to screen pregnant women for alcohol use was built into the project prior to launch of the first pilot site. Specific training on these topics were provided once the need was indentified at the initial pilot site. Prior to the pilot site in Macon County launching, a series of trainings were delivered to staff based on lessons learned at the first pilot site. As preparation is under way to launch additional pilots around the state, the additional trainings are planned prior to the SBI training.
Overall, the implementation of the screening and Brief Intervention itself has been fairly smooth once staff became familiar and comfortable with the tools. While there was initial hesitation from staff to add to their already overloaded caseloads, all staff now voice seeing the value and necessity of this project. There are still questions as to the appearance of repetitiveness of the screening questions, however staff is implementing as requested.