Conference Abstract Compendium Examples from the ... - CityMatCH

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2009 CityMatCH Urban MCH Leadership ConferenceScreening for alcohol, tobacco and other drug (ATOD) use among pregnant women inComprehensive Perinatal Services Program (CPSP) Clinics: An innovative approach bythe Coalition for Alcohol & Drug Free Pregnancies (CADFP) in Santa Clara County,CaliforniaPRIMARY CONTACT:Rajvinder Gill, MPHPerinatal Substance Abuse CoordinatorSanta Clara County Public HealthDepartment614 Tully RoadSan Jose , CA, 95111Phone: (408) 494-7421Fax: (408) 494-7489Email: raj.gill@hhs.sccgov.orgWebsite: www.sccphd.org/psaCATEGORYPreconception health and health careBirth defectsFOCUSProgram Policy FocusCO-PRESENTER(S)/AUTHOR(S):Supriya Rao, supriya.rao@hhs.sccgov.org(Author, Presenter)Patti Bossert, pattiabossert-lcsw@yahoo.com(Author)Amanda Boniface, amanda.cadfp@yahoo.com(Author)ISSUEPrenatal exposure to alcohol, tobacco and other drugs (ATOD) is the leading preventable cause of birthdefects and developmental disabilities impacting babies throughout their lives. 50% of pregnancies areunplanned; 50% of women of childbearing age report alcohol use. Best practices require that all pregnantwomen are questioned at prenatal visits about ATOD use. However, few OB/GYN’s screen women foralcohol and the majority need assistance with training and resources. In a recent survey conducted byCADFP among OB/GYN providers in Santa Clara County (SCC), 98% of providers reported asking theirpregnant patients about tobacco use, but only 11% screened for alcohol use.Sixty seven percent of OB/GYN providers needed assistance in identifying ATOD users--validatingCADFP’s mission to raise the capacity of perinatal service providers to prevent and treat perinatalsubstance use.SETTINGIn our county, CADFP provides perinatal health professional’s with education, resources and capacitybuilding tools to implement a universal Screening, Brief Intervention, and Referral to Treatment (SBIRT)program. Other than the Kaiser network, there are no other public or private OB/GYN offices in SCC setup to implement SBIRT.PROJECTPhase I:Activity 1: Establish baseline prevalence of current ATOD use in pregnant women at a Pilot.Comprehensive Perinatal Services Program (CPSP) Clinic.130
2009 CityMatCH Urban MCH Leadership ConferenceActivity 2: Conduct SBIRT training at the pilot clinic to develop standardized office protocols.Phase II:Implement phased training at 6 CPSP clinics to integrate SBIRT protocols as part of the routineassessment by April, 2009. CADFP aims to expand training in all 26 CPSP sites in SCC within two years.ACCOMPLISHMENTS/RESULTSActivity 1 of Phase I has been completed. A survey of 399 pregnant women was conducted at a CPSPClinic in 2007. Results of our survey show that one in five respondents were currently using ATOD.However 45.4% of women were at-risk (any positive response for 5P’S screening tool assessing forparents, partner, past, present, peers along with smoking, adverse mental heatlh, and family violence) forsubstance use. CADFP has used these survey results in developing training curriculum for SBIRT at theCPSP clinics.Phase I: Activity 1 is currently being implemented. Two trainings within the month of April will beconducted by CADFP staff. The first training will provide the OB/GYN staff an overview of the SBIRTprogram. The second training will include step by step methodology to seamlessly integrate officeprotocols with SBIRT.Phase II: Evaluation of Activity 2 of Phase I will be used to integrate SBIRT protocols at all 26 CPSPsites by April 2011. Each of the CPSP sites will be trained to implement SBIRT to augment existingoffice protocols.BARRIERS• Social stigma around addiction issues.• Misconception among health care providers.• Limited Treatment options.• Existing economic climate affecting resources.• Lack of compassion and empathy from health care providers regarding addiction.LESSONS LEARNEDEach OB/GYN office has unique office procedures; being sensitive to existing office protocols and timeconstraints is critical for successful integration of SBIRT.INFORMATION FOR REPLICATIONKey partners/stakeholders who collaborated on this program were as follows:Santa Clara County Public Health Department, Santa Clara County Department of Alcohol and DrugServices, Santa Clara Valley Medical Center(county hospital), all of the local CPSP clinics, First 5 ofSanta Clara County, local March of Dimes, Santa Clara County Medical Association, Planned Parenthood(local), South Bay Children's Medical Group, and the FASD Task Force of Santa Clara County and manycommunity volunteers.131
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