Transcript Emerging Issues about FASD in Detroit, Michigan

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
Michigan FASD Program
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.
Michigan FASD Program
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.
Michigan FASD Program
FASPP – Community Partners (cont’d):
Our Community Partnerships extend into and
beyond the following entities :
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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)
Michigan FASD Program
FASPP – Community Partners (cont’d):
 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.
Michigan FASD Program
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
Michigan FASD Program
The Intervention: A Service Program
The Personal CHOICES intervention strategy
is based upon the Project CHOICES model
which stands for:
C – changing
H – high risk
alcOhol –consumption, and
I – increasing
C – contraceptive
E – effectiveness
S – study
Michigan FASD Program
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.
Michigan FASD Program
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.
Michigan FASD Program
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.
Michigan FASD Program
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.
Michigan FASD Program
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:
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recognition of risky behavior
empower herself
improve herself, and
reduce her risk of having an alcohol exposed
pregnancy.
Michigan FASD Program
FASPP - Project Incentives
 A four-tier level of increasingly more valuable
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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
Michigan FASD Program
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.
Michigan FASD Program
The Community Level Intervention (cont’d):
 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:
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
Michigan FASD Program
The Community Level Intervention (cont’d):
After the initial call, eligible women who have been
administered the assessment will be mailed the following:
 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
Michigan FASD Program
The Community Level Intervention (cont’d):
 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.
Michigan FASD Program
Media Campaign – Recruitment
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:
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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
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Tailored FASD Presentations
Health Fairs
Faith-based Organizations/Agencies
Students
Impromptu Presentations
Exhibits
Michigan FASD Program
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
Michigan FASD Program
Emerging Issues about FASD in Detroit, Michigan
For more information, please contact:
Sandra L. King, MSA, Project Coordinator
Detroit Department of Health and Wellness Promotion
Fetal Alcohol Syndrome Prevention Project
1151 Taylor Street, Room 235-C
Detroit, Michigan 48202
Phone: (313) 876-4733 Fax: (313) 876-4658
[email protected]
Ellen Podeszwa, MSW, Clinic Coordinator
FAS Diagnostic Clinic, Division of Genetics
Children’s Hospital of Michigan
3901 Beaubien Blvd.
Detroit, Michigan 48201
Phone: (313) 993-3891 Fax: (313) 745-4827
[email protected]
Michigan FASD Program