Abstract
OBJECTIVES: To assess the impact of the SBIRT And FASD Education, Support and Treatment (SAFEST) Choice Learning Collaborative on US pediatric health care teams' knowledge, confidence, and clinical practices related to the identification and management of children with possible or diagnosed fetal alcohol spectrum disorders (FASD). STUDY DESIGN: The SAFEST Choice program included 2 year-long 10-session virtual learning collaboratives based on the Project ECHO (Extension for Community Healthcare Outcomes) model, which included participant case presentations highlighting clinical challenges. Using a pre-/posttest evaluation design, program outcomes included changes in participant FASD-related knowledge, confidence, and practice. Participant case clinical challenges were documented and analyzed for common themes. RESULTS: The program enrolled 105 participants from 23 clinics in 8 states. Clinics attended a median of 9 of 10 ECHO sessions, whereas individual participants attended a median of 5 of 10. Participants were mostly physicians, nurse practitioners, and nurses. Upon program completion, participants reported increased FASD-related knowledge and significant increases in confidence and self-reported practices in screening for prenatal alcohol exposure and counseling families about, and managing patients with, prenatal alcohol exposure and FASD. Participant case clinical challenge themes included when to consider an FASD diagnosis, managing the care of patients with FASD, and addressing FASD-related stigma and bias. CONCLUSIONS: The SAFEST Choice program successfully trained pediatric health care teams in 2 year-long FASD learning collaboratives with high levels of participation. Participants had increased self-reported knowledge, confidence, and practice change related to FASD identification and care. This program offers a promising educational model to improve the care of individuals with possible or diagnosed FASD.