background
Home visitors and community health workers (HV/CHW) develop strong ties with their clients. The Partnership proposed to leverage this trusting relationship to provide targeted education regarding the connection between alcohol use during pregnancy, Fetal Alcohol Spectrum Disorders and developmental disabilities, which would positively impact client intent to change behavior during current or subsequent pregnancy.

methods
A professional training was developed on the potential impact of alcohol use on pregnancy and the developing fetus, and the Screening, Brief Intervention, Referral to Treatment (SBIRT) model. The training was provided to HV/CHW staff and followed by a post-test to measure impact on comfort level with and intent to utilize SBIRT with clients. Toolkits containing educational materials were prepared for distribution to enhance client education. The HV/CHW provided one-to-one education to each of their pregnant and postpartum (up to one year) clients about the impact of alcohol use during pregnancy and the links between FASD and developmental disabilities. Pre- and post-tests were used to measure changes in knowledge and intent to abstain from alcohol consumption during current or subsequent pregnancy.

results
68 HV/CHW were trained with 98.4% reporting an increase in comfort level with using SBIRT and 92.2% asserting likelihood to use the method with clients. Subsequently, the HV/CHW screened and educated 503 clients with 90% of the clients describing an increase in knowledge and 87.2% stating a positive impact on their plans to abstain from alcohol use during pregnancy.

conclusion
Because of the unique and trusting relationships they develop with their clients, given the appropriate tools and training, HV/CHW were able to effectively implement the SBIRT model to screen and provide education which positively impacted client intent to change behavior.