Background: Prenatal alcohol exposure (PAE) resulting in fetal alcohol spectrum disorders (FASDs) is the most common preventable cause of permanent intellectual and developmental disabilities in the U.S. Healthcare teams play a critical role in preventing PAE and caring for individuals with suspected or diagnosed FASDs; however, they are often unprepared. During the COVID-19 pandemic, alcohol consumption increased, which amplified the need for virtual training and education of healthcare teams around PAE and FASDs. A mixed-methods approach focused on evaluating virtual educational methodologies was utilized to align with the new pandemic landscape and to reach more providers.

Methods: Participants across the United States (n=58) were virtually trained to prevent, identify, and manage FASDs over one year (10 sessions) using the evidence-based Extension for Community Health Outcomes (ECHO)® model from June of 2021 through April 2022. Enrolled community health centers (n=15) received curriculum that included an FASD foundational science webinar, core content modules, and case discussions. The mixed-methods evaluation measured knowledge, skill, and self-efficacy. Pre- (n=58), mid- (n=39), post- (n=36) and 6-month follow-up (n=35) surveys assessed shifts in outcomes along with provider burnout, training satisfaction, and sense of community. Quantitative findings informed qualitative data collection (i.e., interviews/focus groups, n=10) for practice-based application.

Results: At post-test, a high proportion of participants reported increased knowledge about screening for PAE both during pregnancy (100%) and among children with possible FASD (92%). From pre-test to post-test there were significant increases in self-efficacy, confidence, and self-reported practice change in FASD indicators. Results demonstrated increases in knowledge and skills, identified facilitators/barriers to changing practice as well as lessons learned for future trainings.

Conclusion: The mixed-methods data suggests that this mode of learning – training providers virtually using a combination of didactic instruction and case-based discussion – increases provider FASD knowledge and self-efficacy and promotes improvements in clinical practice.