Increasing Access to FASD-Informed Care: Bringing an Adapted Intervention to Mental Health Providers

An estimated 1 in 4 children seeking mental health care have an undiagnosed fetal alcohol spectrum disorder (FASD). Few mental health providers receive training or feel competent to serve this population. Evidence-based interventions (EBIs) for FASD have low uptake across mental health settings.

This study aimed to systematically adapt an EBI to increase access to care for youth with FASD in mental healthcare settings, resulting in the innovative Families Moving Forward (FMF) Connect Pro program.

A multidisciplinary planning group employed the theoretically-driven implementation science framework, Intervention Mapping-Adapt (IM-Adapt). This 6-step process incorporated multiple information sources, including literature review, theory, clinical wisdom, and focus groups. 18 community mental health providers participated in focus groups to assess the fit of the adapted program. Data were analyzed with rapid qualitative methods using the COM-B model (Capability, Opportunity, Motivation) of behavior change and Theoretical Domains Framework (TDF) for coding and interpretation.

Step 1: Planning group developed a logic model of change. Step 2: Review of EBIs, selecting the Families Moving Forward (FMF) intervention and two training methods: Extension of Community Healthcare Outcomes (ECHO) and Self-Directed modular approaches. Steps 3&4: Planning group identified needed adaptations for providers with low utilization of FASD-informed care and flexible use in diverse settings. Focus group participants reviewed prototypes of the resulting FMF Connect Pro program, endorsing high acceptability. TDF determinants across domains of capability, opportunity, and motivation were highlighted as contributing factors to provider behavior change. Step 5: Implementation/evaluation plans were developed.

Results reveal the FMF Connect Pro program was deemed acceptable and appears a promising method to expand FASD-informed care. A clinical trial is now underway (Step 6). Additionally, this study models an IM-Adapt approach that could be applied to increase broader adoption and implementation of EBIs.