Improving screening for alcohol use during pregnancy: the Massachusetts ASAP program.
OBJECTIVE
To motivate prenatal care staff in public and private settings to universally screen for risk of alcohol and drug use and to conduct a brief intervention with follow-up referral when appropriate during a routine office visit.


METHODS
The ASAP Project methods were engagement of site staff; staff training; self-administered questionnaires embedded with a relational and broad catch screening tool; a brief intervention protocol; unique clinical decision tree/protocols for each site; identification of treatment and referral resources; and ongoing technical assistance and consultation. Sites were located in four regions of the state and included four community health centers, a network of multi-specialty private practices and a teaching hospital.


RESULTS
Across 16 sites, 118 prenatal staff were trained on use of the screening tool and 175 staff on the brief intervention. The ASAP Project resulted in 95% of pregnant women being screened for alcohol use and 77% of those screening positive for at least one risk factor receiving a brief intervention during a routine office visit.


CONCLUSIONS
Screening and brief interventions for alcohol use can be delivered effectively within a routine prenatal care visit by prenatal staff by utilizing and building on existing office systems with practice staff, screening for any use not only at risk use, providing training with skills building sessions and information delivered by physicians, offering easy-to-access community treatment resources, and providing ongoing technical assistance.
Kennedy
Cheryl
C
Institute for Health and Recovery, Cambridge, Massachusetts 02139, USA. cherylkennedy@healthrecovery.org
Finkelstein
Norma
N
Hutchins
Ellen
E
Mahoney
Jeanne
J
D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000517:prevention & control*; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008404:Massachusetts; D011247:Pregnancy; D011248:Pregnancy Complications; D011295:Prenatal Care; D011297:Prenatal Exposure Delayed Effects; D016730:Program Development; D011795:Surveys and Questionnaires