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Maternal and Child Health Journal

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17-10-2023 | Fetal Alcohol Spectrum Disorder | From the Field

Combining Physician Expertise and Women’s Lived Experience to Educate Health Professionals about Preventing Fetal Alcohol Spectrum Disorders

Authors: Saloni Sapru, Kathleen Mitchell, Tonya McFadden

Published in: Maternal and Child Health Journal | Issue 2/2024

Abstract

Introduction

Physician Champions from the American College of Obstetricians and Gynecologists (ACOG) and trained women Speakers from FASD United, who have given birth to a child with a fetal alcohol spectrum disorder (FASD), co-present to healthcare providers (HCPs) in medical residency programs as part of an educational intervention. They present FASDs as a biological and social problem surrounded by stigma that prevent pregnant women from talking openly to their HCPs about their alcohol use or alcohol use disorder (AUD) and getting the medical help they need.

Methods

Semi-structured interviews were conducted with 10 ACOG Champions and nine FASD United Speakers and a thematic analysis assessed how the co-presentations can enhance HCPs’ understanding about FASDs and address stigma associated with alcohol use during pregnancy.

Results

Interview findings indicated that both Champions and Speakers emphasized the need for HCPs to be nonjudgmental and create a safe space for open dialogue. They reported that residents were moved by mothers’ personal stories, wanted to understand AUD better, and asked about the type of help HCPs can offer women.

Discussion

Combining physicians’ expertise with mothers’ personal stories of lived experiences of FASDs directed at residents, who are more reflective and open at this phase of their careers, moved them from a fact-based to an empathy-based approach to learning that is critical to address the stigma surrounding women who may be using alcohol or struggling with an AUD during pregnancy. Collaboration between national organizations allowed this intervention to be widely implemented across the country.

Bakhireva, L. N., Sharkis, J., Shrestha, S., Miranda-Sohrabji, T. J., Williams, S., & Miranda, R. C. (2017). Prevalence of prenatal alcohol exposure in the state of Texas as assessed by phosphatidylethanol in newborn dried blood spot specimens. Alcoholism, Clinical and Experimental Research, 41(5), 1004–1011. https://doi.org/10.1111/acer.13375CrossRefPubMed

Barry, K. L., Blow, F. C., Willenbring, M. L., McCormick, R., Brockmann, L. M., & Visnic, S. (2004). Use of alcohol screening and brief interventions in primary care settings: Implementation and barriers. Substance Abuse, 25(1), 27–36. https://doi.org/10.1300/J465v25n01_05CrossRefPubMed

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oaCrossRef

Broyles, L. M., Rodriguez, K. L., Kraemer, K. L., Sevick, M. A., Price, P. A., & Gordon, A. J. (2012). A qualitative study of anticipated barriers and facilitators to the implementation of nurse-delivered alcohol screening, brief intervention, and referral to treatment for hospitalized patients in a Veterans Affairs medical center. Addiction Science and Clinical Practice, 7(1), 7. https://doi.org/10.1186/1940-0640-7-7CrossRefPubMedPubMedCentral

Colbert, C. Y., Graham, L., West, C., White, B. A., Arroliga, A. C., Myers, J. D., Ogden, P. E., Archer, J., Mohammad, Z. T., & Clark, J. (2014). Teaching metacognitive skills: Helping your physician trainees in the quest to “know what they don’t know.” The American Journal of Medicine, 128(3), 318–324. https://doi.org/10.1016/j.amjmed.2014.11.001CrossRefPubMed

Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014a). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest: A Journal of the American Psychological Society, 15(2), 37–70. https://doi.org/10.1177/1529100614531398CrossRefPubMed

Corrigan, P. W., Lara, J. L., Shah, B. B., Mitchell, K. T., Simmes, D., & Jones, K. L. (2017). The public stigma of birth mothers of children with fetal alcohol spectrum disorders. Alcoholism Clinical and Experimental Research, 41(6), 1166–1173. https://doi.org/10.1111/acer.13381CrossRefPubMed

Corrigan, P. W., Michael, P. J., Vega, E., Gause, M., Larson, J., Krzyanowksi, R., & Botchova, L. (2014b). Key ingredients to contact-based stigma change. Psychiatric Rehabilitation Journal, 37(1), 62–64. https://doi.org/10.1037/prj0000038CrossRefPubMed

Corrigan, P. W., Shah, B. B., Lara, J. L., Mitchell, K. T., Combs-Way, P., Simmes, D., & Jones, K. L. (2019). Stakeholder perspectives on the stigma of fetal alcohol spectrum disorder. Addiction Research & Theory, 27(2), 170–177. https://doi.org/10.1080/16066359.2018.1478413CrossRef

Corrigan, P. W., Shah, B. B., Lara, J. L., Mitchell, K. T., Simmes, D., & Jones, K. L. (2018). Addressing the public health concerns of fetal alcohol spectrum disorder: Impact of stigma and health literacy. Drug and Alcohol Dependence, 185, 266–270. https://doi.org/10.1016/j.drugalcdep.2017.12.027CrossRefPubMed

Dewsnap, M. A., Arroliga, A. C., & Adair-White, B. A. (2021). The lived experience of medical training and emotional intelligence. Baylor University Medical Center Proceedings, 34(6), 744–747. https://doi.org/10.1080/08998280.2021.1941582CrossRefPubMedPubMedCentral

Gosdin, L. K., Deputy, N. P., Kim, S. Y., Dang, E. P., & Denny, C. H. (2022). Alcohol consumption and binge drinking during pregnancy among adults aged 18–49 years—United States, 2018–2020. MMWR Morbidity and Mortality Weekly Report, 71(1), 10–13. https://doi.org/10.15585/mmwr.mm7101a2CrossRefPubMedPubMedCentral

Haffajee, R. L., Fahert, L. J., & Zivin, K. (2021). Pregnant women with substance use disorders—The harm associated with punitive approaches. New England Journal of Medicine, 384(25), 2364–2367. https://doi.org/10.1056/NEJMp2101051CrossRefPubMed

Haller, D. M., Meynard, A., Lefebvre, D., Ukoumunne, O. C., Narring, F., & Broers, B. (2014). Effectiveness of training family physicians to deliver a brief intervention to address excessive substance use among young patients: A cluster randomized controlled trial. CMAJ: Canadian Medical Association Journal, 186(8), E263–E272. https://doi.org/10.1503/cmaj.131301CrossRefPubMedPubMedCentral

Hull, A. L., Cullen, R. J., & Hekelman, F. P. (1989). A retrospective analysis of grand rounds in continuing medical education. Journal of Continuing Education in Health Professionals, 9, 257–266.CrossRef

Kendall-Taylor, N., & Fond, M. (2017). Reframing fetal alcohol spectrum disorder: Studying culture to identify communication challenges and opportunities. Studies in Media and Communication, 5(2), 105. https://doi.org/10.11114/smc.v5i2.2687CrossRef

Mattson, S. N., Bernes, G. A., & Doyle, L. R. (2019). Fetal alcohol spectrum disorders: A review of the neurobehavioral deficits associated with prenatal alcohol exposure. Alcohol: Clinical and Experimental Research, 43(6), 1046–1062. https://doi.org/10.1111/acer.14040CrossRef

Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.

Moen, C., & Prescott, P. (2016). Embedding a patchwork text model to facilitate meaningful reflection within a medical leadership curriculum. International Journal of Medical Education, 7, 372–374. https://doi.org/10.5116/ijme.580b.2702CrossRefPubMedPubMedCentral

Nilsen, P. (2010). Brief alcohol intervention–where to from here? Challenges remain for research and practice. Addiction, 105(6), 954–959. https://doi.org/10.1111/j.1360-0443.2009.02779.xCrossRefPubMed

Nordqvist, C., Johansson, K., Lindqvist, K., & Bendtsen, P. (2006). Attitude changes among emergency department triage staff after conducting routine alcohol screening. Addictive Behaviors, 31(2), 191–202. https://doi.org/10.1016/j.addbeh.2005.04.021CrossRefPubMed

Office of the Surgeon General (US). (2005). U.S. Surgeon General releases advisory on alcohol use in pregnancy. Retrieved February 21, 2005, from http://come-over.to/FAS/SurGenAdvisory.htm

Patton, M. Q. (2011). Developmental evaluation. Applying complexity concepts to enhance innovation and use. Guilford Press.

Roozen, S., Stutterheim, S. E., Bos, A. E. R., Kok, G., & Curfs, L. M. G. (2022). Understanding the social stigma of fetal alcohol spectrum disorders: From theory to interventions. Foundations of Science, 27, 753–771. https://doi.org/10.1007/s10699-020-09676-yCrossRef

Schomerus, G., Corrigan, P. W., Klauer, T., Kuwert, P., Freyberger, H. J., & Lucht, M. (2011). Self-stigma in alcohol dependence: Consequences for drinking-refusal self-efficacy. Drug and Alcohol Dependence, 114(1), 12–17. https://doi.org/10.1016/j.drugalcdepCrossRefPubMed

Sparkes, D., Leong, C., Sharrocks, K., Wilson, M., Moore, E., & Matheson, N. J. (2021). Rebooting medical education with virtual grand rounds during the COVID-19 pandemic. Future Healthcare Journal, 8(1), e11–e14. https://doi.org/10.7861/fhj.2020-0180CrossRefPubMedPubMedCentral

Stites, S. D., & Warholic, C. L. (2014). Multicultural grand rounds: Competency-based training model for clinical psychology graduate students. Psychology Learning and Teaching, 13, 261–269.CrossRef

Stolzenburg, S., Tessmer, C., Corrigan, P. W., Böttge, M., Freitag, S., Schäfer, I., Freyberger, H. J., & Schomerus, G. (2018). Childhood trauma and self-stigma of alcohol dependence: Applying the progressive model of self-stigma. Stigma and Health, 3(4), 417–423. https://doi.org/10.1037/sah0000112CrossRef

US Preventive Services Task Force, Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., Doubeni, C. A., Epling, J. W., Jr., Kemper, A. R., Kubik, M., Landefeld, C. S., Mangione, C. M., Silverstein, M., Simon, M. A., Tseng, C. W., & Wong, J. B. (2018). Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA: Journal of the American Medical Association, 320(18), 1899–1909. https://doi.org/10.1001/jama.2018.16789CrossRef

Title: Combining Physician Expertise and Women’s Lived Experience to Educate Health Professionals about Preventing Fetal Alcohol Spectrum Disorders
Authors: Saloni Sapru
Kathleen Mitchell
Tonya McFadden
Publication date: 17-10-2023
Publisher: Springer US
Keywords: Fetal Alcohol Spectrum Disorder
Expert Opinion
Expert Opinion
Published in: Maternal and Child Health Journal / Issue 2/2024
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-023-03786-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Combining Physician Expertise and Women’s Lived Experience to Educate Health Professionals about Preventing Fetal Alcohol Spectrum Disorders

Abstract

Introduction

Methods

Results

Discussion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion

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