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FASD Research Review

Screening and Intervention Programs

Texas Office for Prevention of Developmental Disabilities

Intervention Type

FASD Prevention Subcontractors
(Project CHOICES)

Project Contact Information

Texas Office for Prevention of Developmental Disabilities
Leah Davies, LMSW, Director Texas CHOICES Project
909 West 45th Street, MC 2100
Austin, TX 78751
Phone: 512-206-5506
Fax: 512-206-5211
E-mail: Leah.Davies@hhsc.state.tx.us

Project Summary Statement

The Texas Office for Prevention of Developmental Disabilities (TOPDD) serves as a subcontractor to the Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence (CFE), a subsidiary of Northrop Grumman Corporation, to develop and implement CHOICES alcohol abuse intervention and treatment services for women enrolled in residential treatment programs in the state of Texas. The purpose of this intervention is to reduce the risk for prenatal alcohol exposure in the women’s subsequent pregnancies.

Approach

All women enrolled in one of five substance abuse treatment programs were eligible for initial screening into Texas CHOICES: Serenity Foundation Santa Maria Bonita House Santa Maria Jacquelyn House Volunteers of America Managed Care Each woman underwent a pre-screening to determine preliminary eligibility. If the prescreening process indicated that the woman was capable of becoming pregnant, sexually active, had evidence of inadequate use of birth control methods, and was determined to be a risky drinker, she underwent the full intake assessment. If found eligible, the woman had the opportunity to enroll in Texas CHOICES and to receive four intervention sessions as well as a contraception counseling visit.

Outcome

A total of 2,150 women entered the five residential drug treatment programs during the designated time period. Among this population, after prescreening for eligibilty, 179 women qualified for intake screening. The great majority of women who underwent prescreening did not qualify for a variety of reasons, including relatively light current alcohol intake, having been sterilized, or not being sexually active. Of the 179 women who underwent the full screening process, 125 (69.8%) were found to be eligible for Texas CHOICES. All 125 eligible women were offered the services, and 113 women (90.4%) agreed to enroll in the program. Of the women 125 women who screened as eligible for Texas CHOICES, baseline data are available for 123 women.

Among this population, the median number of days the women drank alcohol over the previous 30 days was 3 days. The median number of drinks consumed on a typical day when drinking alcohol was 3, and 70 (56.9%) of the women with a positive screen had 4 or more drinks in a single day. Based on these data, the population enrolled in Texas CHOICES is a very high-risk population with a high frequency and amount of alcohol consumption. Of the 113 eligible women who agreed to participate in the Texas CHOICES program, intervention data are available on 111.

Of the 111 women, 53 (47.7%) completed 4 motivational interviewing sessions and 1 contraceptive visit. Of the 53 eligible women who participated in 4 motivational interviewing sessions and 1 contraceptive visit 50 completed the end of program questionnaire. Among the 38 women in this group who reported drinking alcohol on at least 1 day in the past 30 days at screening, all 38 (100%) of the women decreased their alcohol use in the past 30 days at the time of end of program assessment.

During the screening, 12 women reported no alcohol use in the 30 days prior to intake. According to their end of program assessment, 100% of them had maintained their alcohol-free status over the past 30 days (30 days prior to exiting CHOICES) During the screening 39 women reported drinking 1 or more drinks on a typical day in the past 30 days. The end of program assessment indicated that 38 (974%) of them had decreased the number of drinks consumed on a typical day over the past 30 days (30 days prior to exiting CHOICES).

Binge drinking rates also exhibited significant improvement. Binge drinking was defined as 4 or more drinks in a day. During the screening, 31 women reported binge drinking at least once in the previous 30 days, Their End of Program Assessment indicated that 100% of them had decreased the number of days they engaged in binge drinking in the previous 30 days.

The overall decrease in risky drinking patterns is exhibited by data regarding abstention from alcohol. Of the 50 eligible women who agreed to participate and completed the questionnaire, 46 (93.9%) of 49 women who answered the question regarding ongoing alcohol use had not had any alcohol since the first session when the need to abstain from alcohol was discussed.

Six month outcomes on women enrolled in Texas CHOICES also demonstrated significant effects on alcohol use patterns. 25 of the 33 women (75.8%) who had enrolled in and completed the 4 motivational interviewing sessions and 1 contraceptive visit and were due for a six month follow up completed a six month follow-up questionnaire. Among these women, 25 had reported drinking alcohol on at least one day in the 30 days prior to screening; at six month follow-up 22 (88%) women had decreased their alcohol use in the 30 days prior to exit from the program. Among the 11 women who at intake reported no use of alcohol, 9 (81.8%) maintained their non-use of alcohol.

Of the 24 women who reported drinking one or more drinks on a typical day when drinking alcohol in the past 30 days at screening, 22 (91.7%) had decreased the number of drinks consumed on a typical day in the 30 days prior to completion of the CHOICES program.

From a binge drinking perspective, among the 13 women who completed a six month follow-up questionnaire and at intake reported having 4 or more drinks in 1 day at least once in the previous 30 days, 12 (92.3%) at exit reported having decreased the number of days they had drunk 4 or more drinks in the previous 30 days.

Finally, of the eligible women who agreed to participate and completed the six month follow-up questionnaire, 85.7% had not had any alcohol since the first CHOICES session when the importance of abstinence from alcohol was discussed. Among the 50 eligible women who enrolled in Texas CHOICES and completed the end of program questionnaire, 40 (80%) reported using contraception effectively at the end of program assessment. At six month followup, 34 of 37 women (91.9%) who agreed to participate and completed the questionnaire reported using contraception effectively.

Annual Evaluation Report 2010-2011 [ 225 KB PDF icon ]