Emerging Issues about FASD in Detroit, Michigan Sandra L. King, MSA Project Coordinator Fetal Alcohol Syndrome Prevention Project E-MCH Audio-conference

Emerging Issues about FASD in Detroit, Michigan

Sandra L. King, MSA

Project Coordinator

Fetal Alcohol Syndrome Prevention Project

E-MCH Audio-conference Sept. 2006

FAS Prevention Project Background

Cheryl Lauber, DPA, MSN, Principal Investigator, in conjunction with William Ridella, Detroit Department of Health and Wellness Promotion (DHWP) Deputy Director, recognized the importance and sustainability of this initiative being conducted in Detroit at the DHWP in light of the population of women served during the year 2000 totaling over 50,000 patient encounters.

Dr. Lauber submitted the RFP to the Centers for Disease Control and Prevention in Atlanta, Georgia and received the grant award to implement the Michigan Fetal Alcohol Syndrome Prevention Project.

Michigan FASD Program

FAS Prevention Project Background (cont’d):

Michigan is one of seven state-projects funded by the CDC with the overall goal of reducing FASD in their respective states

The states involved are: Colorado, Minnesota, Missouri, Michigan, North and South Dakota, Wisconsin and Oregon

This project is composed of three major components: Surveillance, Linking Children to Services/Diagnostics, and Intervention


FAS Prevention Project Background (cont’d):


The FASPP Staff Members

Sandra L. King, MSA, Project Coordinator

Jewell Akins, BS, FAS Prevention Specialist

Dranoel Knox, MA, LLPC, FAS Prevention Specialist

Lisa Ficker, MA, TLLP, Motivational Interviewer

With the staff onboard, the wheels of progress moved slowly initially, but we’re now up to a steady pace, and we are extremely proud and humbled to be able to share information about our progress.

FASPP-Community Partners

Although we are “new kids on the block” at DHWP, we did not have to start from scratch to build a network of community partners.

We have been able to take advantage of the alliances already formed by the various departments within the DHWP by making our presence known here as well as promoting the project.

We have received valuable input from the FASPP Steering Committee composed of internal and external community stakeholders.


FASPP – Community Partners (cont’d):

Our Community Partnerships extend into and beyond the following entities :

The Bureau of Substance Abuse Prevention, Treatment & Recovery at the DHWP (access to vast network of citywide Preventionists)

Positive Images Residential Treatment Facility for women with substance abuse concerns (clients and referrals, recruitment)

Communicable Diseases Division at the DHWP (recruitment, project promotion)


Family Planning Program at the DHWP (support services)

Nurse Family Partnership (program partners), and

The general staff at-large have been accepting and available for input and opinions about the quality of our printed materials, i.e. the Assessment tool, our array of fliers, posing as clients to test materials, etc.

Faith-based organizations buy-in for community outreach activities.

FASPP – Community Partners (cont’d):


The Intervention: A Service Program

The service program offered to eligible women is called Personal CHOICES.

This program model is being replicated pursuant to the CDC’s determination that it is an effective one-on-one approach to reducing alcohol consumption and increasing contraceptive effectiveness among fertile women of childbearing age


The Intervention: A Service Program

The Personal CHOICES intervention strategy is based upon the Project CHOICES model which stands for: C – changing H – high riskalcOhol –consumption, and I – increasing C – contraceptive E – effectiveness S – study


The Intervention: A Service Program (cont’d):

The overall goal of the Michigan Fetal Alcohol Syndrome Prevention Project is to reduce the incidence and prevalence of alcohol-exposed pregnancies in Detroit and Wayne County.

Personal CHOICES is a useful model to help achieve this goal.


The Intervention: A Service Program (cont’d):

Personal CHOICES has two components: Individual Level Intervention and Community Level

Intervention. Target population for both components are fertile

women of childbearing age, between 18-44 years old, who are drinking at risky levels* AND who are not using an effective contraceptive consistently. These women are considered at high risk for having an alcohol exposed pregnancy.

*Risky drinking levels are considered to be consuming 7 or more drinks per week, or 4 or more drinks on one occasion.


The Individual Level Intervention

Individual Level Intervention (ILI) consists of women who are screened as eligible participating in two face-to-face interviews with a Motivational Interviewer or FAS Prevention Specialist, followed by two follow-up telephone calls.

The premise of the ILI is to utilize motivational interviewing techniques to prompt behavioral change by highlighting ambiguities of where a woman is, and where she would like to be in terms of her alcohol consumption and birth control use.


The Individual Level Intervention (cont’d):

Women are educated about Fetal Alcohol Spectrum Disorders by viewing the Recovering Hope video and via discussions with the M.I. or Prevention Specialist.

Clients are given a Personal CHOICES Daily Journal to record their alcohol and birth control use between the1st and 2nd sessions, and are encouraged to have a Family Planning clinic visit prior to returning for the 2nd session in 6-8 weeks.


The Individual Level Intervention (cont’d):

Utilizing the Personal CHOICES workbook, and motivational interviewing techniques, the Motivational Interviewer or FAS Prevention Specialist highlights and guides the client to:

recognition of risky behavior empower herself improve herself, and reduce her risk of having an alcohol exposed pregnancy.


FASPP - Project Incentives

A four-tier level of increasingly more valuable incentives are incorporated into the project. For each of the four sessions a client completes, she will receive one of the following:

1st Session: Customized FASPP tote bag, lunch cooler, ink pen, emery boards. condom key chain, condom refills, and FASD literature.

2nd Session: Relaxation Kit – We have an attractive assortment in stock

3rd Session: $20 Target Gift Card 4th Session: $25 Payless Shoe Store Gift Card


The Community Level Intervention

The Community Level Intervention (CLI) utilizes the same project materials and incentives as the ILI , however, it is unique in the way that it is administered.

The premise of the CLI is based on Dr. Linda Sobell’s Self-Guided Change model whereby in response to media advertisements, women call in for additional information if they are concerned about their alcohol consumption.


The Community Level Intervention (cont’d):

Demographics Fertility Sexual Activity

Contraceptive Use

Alcohol Use

Readiness to Change Drinking Behavior

Readiness to Change

Birth Control

Use

Health History / Status

FASD Knowledge

FASD Attitudes

and Beliefs


Women who call in response to media ads are informed about the project and screened to determine their eligibility.

Eligible women who agree to participate are administered an assessment questionnaire which documents information on the following topics:


The Personal CHOICES Client Workbook and Journal The first two tiers of incentives (in light of receiving only

two more follow-up calls to re-administer the assessment tool at three months intervals)

A confirmation letter regarding the next call date, and Literature on FASD, the FAStar clinic, an FASD

Prescreening form, and any other resource material deemed appropriate by the FAS Prevention Specialists based on their conversation with the client

After the initial call, eligible women who have been administered the assessment will be mailed the following:



At the present time, we have postponed sending out Personal CHOICES project materials until we refine the verbiage in the client workbook.

We anticipate this to be a very short-lived postponement.

To-date, we have intervened with 81 women enrolled in the Personal Choices service program.


Media Campaign – Recruitment

Metro Times – a weekly newspaper; enormous readership Metro Times.com – the on-line version of the printed newspaper African American Family Magazine – local free magazine Flyers Community Outreach Activities

Tailored FASD Presentations Health Fairs Faith-based Organizations/Agencies Students Impromptu Presentations Exhibits

The media campaign to recruit eligible women is a component of the FASPP which has grown substantially in breadth and depth over the past two years. Our media outlets and recruitment strategies include the following:


Linking Children to Services

Fetal Alcohol Syndrome Treatment and Referral Service at CHM

Linking Children to Services

Fetal Alcohol Syndrome Treatment and Referral Service at CHM

FASD Activities in Detroit, Michigan

SUMMARY The Intervention-Service Program offered at

the Detroit Department of Health and Wellness Promotion

The FAStar (Fetal Alcohol Syndrome Treatment and Referral Service) clinic located at the Children’s Hospital of Michigan


Emerging Issues about FASD in Detroit, Michigan


For more information, please contact:

Sandra L. King, MSA, Project CoordinatorDetroit Department of Health and Wellness PromotionFetal Alcohol Syndrome Prevention Project1151 Taylor Street, Room 235-CDetroit, Michigan 48202Phone: (313) 876-4733 Fax: (313) [email protected]

Ellen Podeszwa, MSW, Clinic CoordinatorFAS Diagnostic Clinic, Division of GeneticsChildren’s Hospital of Michigan3901 Beaubien Blvd.Detroit, Michigan 48201Phone: (313) 993-3891 Fax: (313) [email protected]

Documents

Emerging Issues about FASD in Detroit, Michigan Sandra L. King, MSA Project Coordinator Fetal Alcohol Syndrome Prevention Project E-MCH Audio-conference