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Prevention of Fetal Alcohol Spectrum Disorders in Primary Care: Use of Office Champions Model to Address Alcohol Use
Rajani Bharati1, Julie Wood2, Antoinette Abou Haidar3
1American Academy of Family Physicians, Leawood, Kansas.
Purpose:
Alcohol use during pregnancy can cause miscarriage, stillbirth, and fetal alcohol spectrum disorders. Despite no safe level of alcohol consumption during pregnancy, 13.5% of pregnant adults reported drinking, and 5.2% reported binge drinking during 2018-2020. This study aimed to improve alcohol screening and brief intervention (ASBI) practices in primary care settings using the Office Champions Quality Improvement Model.
Methods:
Seventeen family medicine practices participated. Champions led system-level changes, including workflow redesign, staff training, and electronic health record modifications. Chart reviews were conducted at 3 stages (ie, baseline, post-intervention, and sustainability) to assess change in ASBI efforts. A sustainability survey assessed likelihood of continued ASBI efforts after study completion.
Results:
A total of 2,725 chart reviews were completed. For the first 2 stages 17 practices submitted data, and 14 practices completed the third stage. Alcohol use screening rate increased from 61% to 81% (P <.001) and intervention rates increased from 22% to 67% (P <.001). Identification of pregnancy intention increased from 3% to 66% (P <.001) and use of the Alcohol Use Disorders Identification Test-Consumption tool increased from 3% to 48% (P <.001). Most interventions involved brief counseling and goal setting. Nineteen individual respondents completed the sustainability survey, and most reported confidence in continuing ASBI efforts.
Conclusion:
The Office Champions Quality Improvement Model enhanced ASBI implementation in primary care settings. System-level integration, validated screening tools, education, and a team-based approach supported improvements in ASBI.
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