Evaluation of an Authority Innovation-Decision: Brief Alcohol Intervention for Pregnant Women Receiving Women, Infants, and Children Services at Two Illinois Health Departments

Abstract

Despite the availability of clinical tools and evidence-based screening recommendations, there has been little discussion regarding screening of prenatal alcohol exposure in community-based settings, including adoption and implementation. This study's aim is to evaluate and validate—through surveys and focus groups—obstacles and challenges that shape efficacious implementation of the BAI at two Illinois health departments. Results suggest that BAI implementation is facilitated by staff perceptions of its benefits, readiness to implement the intervention, and organizational support for it. Limitations of the management information system, ambiguous screening questions, and high case-loads present barriers to effective BAI implementation.

Keywords :

• fetal alcohol spectrum disorder (FASD)
• focus groups
• brief alcohol intervention (BAI)
• diffusion of innovations
• evaluation

THE AUTHORS

Imelda K. Moise, Ph.D., a health geographer, is a Research Program Specialist with the Center for Prevention Research and Development at the University of Illinois at Urbana-Champaign. Her research focuses on application of GIS to public health, health disparities, and neighborhood influences on health and disease. Her areas of research have included HIV, food environments, brief intervention for at-risky drinking, as well as more general public health issues such as modeling and understanding accessibility to primary healthcare and disease risk in underserved and at-risk populations, and in the context of community recovery following a disaster event. She coordinates state and federal agencies providing program evaluation, reporting performance measures for assessing capacity, process and outcomes for prevention, and continuous quality improvement.

David Green, Ph.D., received his doctorate in Social Foundations of Education from the University of North Carolina at Chapel Hill in 1987. Since 2006 he has been a Resource and Policy Analyst at the Center for Prevention Research and Development, University of Illinois at Urbana-Champaign.

Janine Toth, MSSW, is a Research Program Specialist with the Center for Prevention Research and Development at the University of Illinois at Urbana-Champaign. Ms. Toth coordinates foundation and federally funded research projects and program evaluation for state agency initiatives and ongoing programs. Recently, her research with the Robert Wood Johnson Foundation has focused on the role of governance in improving health outcomes.

Peter Mulhall, Ph.D., is the Director of the Institute of Government and Public Affairs’ Center for Prevention Research and Development at the University of Illinois. He has held that position since 1997 and has been with CPRD since 1991. Dr. Mulhall says the role of IGPA in service to the public is to “assist the state in addressing technical skills and knowledge to guide policy decisions and to present the government with real options. Also, it is very important to critique decisions that we see as improper or wrong.” Dr. Mulhall has a master's degree in health studies from Indiana University and a doctorate in community health from the University of Illinois at Urbana-Champaign. He has extensive experience in the fields of health education and prevention, and has worked on a number of federal, state, and local projects related to the evaluation of programs and interventions that target academic failure, substance abuse, and related problem behaviors.