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Screening and Intervention Programs

Child and Family Services of New Hampshire (Health Start)

Intervention Type

FASD Prevention Subcontractors
(Brief Intervention)

Project Contact Information

Child and Family Services of New Hampshire (Health Start)
Cherie LeBel, Program Manager
464 Chestnut Street
Manchester, NH 03101
Phone: 603-518-4198
Fax: 603-668-6260

Project Summary Statement

Child and Family Services of New Hampshire’s central location is in Manchester, NH with programs located throughout the state of New Hampshire. Child and Family Services is an independent non-profit agency dedicated to advancing the well-being of children by providing an array of social services to strengthen family life and by promoting community commitment to the needs of children. The Department of Public Health, Maternal Child Health Section, in the state of New Hampshire includes a number of home visiting programs throughout the state that are participating in the FASD project.

During the first implementation year there were between 8 and 12 participating agencies at any given time. Objective Women stop drinking during pregnancy Method The goal of this project is to incorporate the TWEAK assessment and Brief Intervention to all pregnant women who participate in the voluntary home visiting programs in order to eliminate alcohol consumption among pregnant women.

The target audience includes low income pregnant women who are experiencing such barriers as lack of transportation, poor housing conditions, lack of education and low self-esteem. These women live in different parts of the state of New Hampshire, some of which are urban and others rural. The FASD Project will help to identify those pregnant women who are drinking during their pregnancy with the goal being that they stop drinking as a result of the Brief Intervention. The project supports the agency goal of improved pregnancy outcomes.

Current Accomplishments

The project uses four major intervention strategies:

  1. Screen pregnant women to identify those who drink during pregnancy.
  2. Provide a brief intervention with women identified through the screening to be using alcohol.
  3. Refer women with alcohol use issues to treatment programs in the community.
  4. Ensure that babies whose mothers screen positive for alcohol use during pregnancy will have their FASD risk noted in the baby’s on-going pediatric records.

We use the TWEAK screening tool (Bertrand et al, 2004; National Institute on Alcohol Abuse and Alcoholism, 2002; Chang, 2001; Chepitel, 1997). The tool has a well documented track record of being used successfully with pregnant women. We use a brief intervention program developed by Mary O’Connor and Shannon Whaley (2007) which has been shown to be effective. The program is based on the 5-A’s approach (assess, advise, agree, assist, and arrange). We have identified a list of alcohol intervention resources and make this information available to all Home Visiting NH programs in the state.

If a mother screens positive for alcohol use during pregnancy, we ask her to give consent to have the baby’s FASD risk noted in the baby’s on-going pediatric record. During the first implementation year the project estimated that we would provide the TWEAK screening to 950 pregnant women, however after collecting the data is was determined that the estimation was too high and not based on the number of new pregnant women who join the program each year. The estimated numbers rather, were based on all women including post partum women who were enrolled.

Since then, problems with funding the program in NH have resulted in home visiting programs closing. Unfortunately, this has created less women enrolling in Home Visiting NH. The FASD Project is very important to the state of New Hampshire as there are no statistics at this time specifically about the number of people who have been diagnosed with FASD and how it affects these individuals as babies, children and even adults.

By participating in this FASD project, the hope is that people, including members of the medical profession, will be more aware of FASD and how it affects individuals. Although this project is a four-year project, the plan is that the state of New Hampshire has agreed to mandate that the FASD screening and brief intervention will continue to be a contract requirement of all the Home Visiting New Hampshire programs. The first implementation year proved to be a time for the State of NH to work out strategies for improvement and to help determine the plan for the second year implementation.