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Detroit FAS Prevention Project

Detroit FAS Prevention Project. Building FASD State Systems Meeting May 2006. Cheryl Lauber, RN, MSN, DPA Michigan Department of Community Health. Challenges of FAS Prevention in Detroit. Surveillance Process. Substance Abuse Treatment.

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Detroit FAS Prevention Project

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  1. Detroit FAS Prevention Project Building FASD State Systems Meeting May 2006 Cheryl Lauber, RN, MSN, DPA Michigan Department of Community Health

  2. Challenges of FAS Prevention in Detroit

  3. Surveillance Process

  4. Substance Abuse Treatment • In Detroit and Wayne County 10,225 women age 14-54 were admitted to substance abuse treatment between 2000 and 2004. • 50% listed alcohol as the primary, secondary, or tertiary substance of abuse • 48% had previous substance abuse treatment episode • Average alcohol use: 10.33 days for 30-day period prior to admission

  5. Demographic Profile of Women in Substance Abuse Treatment • 66% African American, 30% White • 53% age 30-44, 44% age 21-29 • 50% with education 12+ years • 77% never-been married • 74% unemployed • 58% with 1+ dependents • 12% pregnant at the time of admission

  6. Birth Registry Match • 2,144 births to 1,680 women in substance abuse treatment • 88% born in Detroit and Wayne county • 49% males, 51% females • 48% matched to women who listed alcohol as the substance of abuse • <8% reported alcohol use during pregnancy in the birth certificate

  7. Birth Defects Registry Match • 562 out of 2,144 births found in MBDR 49% matched to women who listed alcohol as the substance of abuse • 8 out of 562 had FAS diagnostic code of 760.71 (3.7 – 7.8 per 1,000 births) • 7 extra had the diagnostic code of 742.1 (7.0 – 14.5 per 1,000 births) • 291 out of 562 (52%) had other maternal exposure affecting the fetus

  8. Detroit Children with Diagnosis Code 760.71 Identified through Medicaid Files, Hospital Discharge Data and Michigan Birth Defects Registry Databases, Births in 2000 - 2004

  9. Timing of Birth for Woman Who Listed Alcohol as Substance for Treatment • On average, 3 treatment episodes per women (range:1-24) • 16% of births occurred during SA treatment • 60% of births occurred before SA treatment, 32% within a year of treatment admission • 25% of births occurred after SA treatment, 16% within a year of treatment discharge

  10. Birth Defects of Michigan Children and Children of Alcohol Users in Substance Abuse Treatment in Detroit for 2000-2003

  11. Relative Risk of Birth Defects of Michigan Children and Children of Alcohol Users in Substance Abuse Treatment in Detroit for 2000-2003

  12. Project CHOICES

  13. Project CHOICES Overview M.I. FOLLOW-UP SESSIONS RECRUITMENT SCREENING OUTREACH REFERRALS M.I. SESSION 1 M.I. SESSION 2

  14. Outreach Methods • Three-panel board of information and pictures about FASD • Realityworks® simulator doll models of infants with FAS characteristics • PowerPoint shows for various audiences, from school children to medical providers • Literature on FASD: brochures, booklets, fact sheets, bookmarks and posters.

  15. Recruitment

  16. Screening

  17. Motivational Intervention

  18. Michigan Personal CHOICES supports you to Empower yourself. Improve yourself. Reduce the Risks in Your Life. Client Workbook Personal CHOICES Michigan Fetal Alcohol Syndrome Prevention Project Detroit Department of Health and Wellness Promotion 1151 Taylor Street, Room 235-C Detroit, Michigan 48202 (313) 876-4733 ph (313) 876-4658 fax

  19. Self Guided Change

  20. Media Messages • #1: If you think you have to drink to live, or feel you live to drink, this might be a problem . . . call for help at 1-800 . . • #2: Excuse me ladies, if you feel you have to take a drink everyday . . or . . can only have fun when you drink . . this just might be a problem. Call us at 1-800 . . . • #3: If you wake up in the morning and don’t know how you made it home from the party last night, call us . .we want to help you. Call 1-800 . . . • #4: If you think you’ve got a problem drinking . . . maybe . . . YOU DO! Please give us a call at 1-800 STOP NOW {786-7669}.

  21. Evaluation Process Objectives: • Recruit and screen 1,000 women of childbearing age in the city of Detroit. • Enroll 100 women in Personal CHOICES Intervention. • Screen 25 women through the Self-Guided Change Intervention.

  22. Evaluation Outcome Objectives: • Identify women drinking 8 or more drinks per week and/or 4 or more drinks in one day • Identify women not using contraceptives • Give FASD information to at-risk women • Give feedback on at-risk behavior • Give birth control information

  23. Linking to Services

  24. FAS Diagnostic Center • Genetics Clinic – Children’s Hospital • Outreach – “FAStar” • Diagnostic Team – Physician, Psychologist • Case Management – Social Worker • Evaluations • About 40 cases per year • 1/40 FAS; 17/40 FASD • 30/40 in foster care, adoption, kinship care

  25. State Systems Building

  26. Michigan’s FASD System • FASD State Coordinator – MDCH • State Task Force – Raising awareness among state agencies to improve service delivery • Program Advisory Group • Community prevention grants • Pilot screening project w/ foster care • 6 Diagnostic Centers • Community linking to services grants • Local parent support groups

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