A purple logo with a hand that says: B SMART Educate to Prevent FASD

 

B SMART is a CDC -funded program aimed to prevent fetal alcohol spectrum disorders (FASDs) by providing tailored education and technical assistance to Boston HealthNet Patient Care Teams (Boston Medical Center & 14 Community Health Centers).

About B SMART

B SMART (Boston Sustainable Models for unhealthy Alcohol use ReducTion) is a Centers for Disease Control and Prevention (CDC) cooperative agreement aimed to prevent fetal alcohol spectrum disorders (FASDs) and the risks associated with prenatal alcohol exposure (PAE). This aim will be accomplished by providing tailored education and technical assistance on Screening, Brief Intervention, and Referral to Treatment (SBIRT) for risky alcohol use to Boston HealthNet (Boston Medical Center and the associated 14 community health centers) healthcare teams.

About Prenatal Alcohol Exposure (PAE)

Prenatal exposure alcohol (PAE) is notably the most common preventable cause of intellectual and developmental disabilities in the US.1 Alcohol is a teratogen and exposure to alcohol in utero can result in a range of developmental and physical challenges across a spectrum of disorders- FASDs. Alcohol at any stage in a pregnancy can have negative impacts as alcohol readily crosses the placenta.2 Therefore, this is a considerable issue as alcohol use among pregnant people and before pregnancy occurs commonly. One challenge in gaining precise data and information is shame and stigma surrounding prenatal alcohol exposure.3 As nearly half of pregnancies are unplanned it is important to have a discussion about alcohol use before pregnancy.4 

About FASDs

Fetal alcohol spectrum disorders is an umbrella term and the impact of PAE exists across a spectrum of conditions within the umbrella of FASDs. These conditions include Fetal Alcohol Syndrome (FAS) and partial FAS (pFAS), Alcohol-Related Birth Defects (ARBD), Alcohol-Related Neurodevelopmental Disorder (ARND), and Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE).5 Each varies in characteristics and occurrence. FASD impact as much as 5% of school aged children.6  Diagnosis criteria can vary for each of the FASD.7

A purple and blue umbrella with FASD, pFASD, ARND, and NDPAE all as part of 5% of children

Why Now?

During the Covid-19 pandemic there are reports of increases in heavy drinking and increases in alcohol-related problems independent of consumption level. Participating in a B SMART training can provide skills and knowledge that will make an important impact on your patients.

 

A purple, gray, and blue image explaining drinking trends during Covid- 19% increase for adults aged 30-59, 41% increase in heavy drinking days for women, 10% of women had increased alcohol related problems independent of consumption level

What We Offer

Education & Technical Assistance

  • Trainings will provide up-to-date information about FASDs and skills in substance use screening, brief intervention and referral to treatment (SBIRT) including motivational interviewing (MI) techniques.
  • Continuing Medical Education (CME/CNE) credits offered for most trainings.
  • Podcast: This 3-part podcast features interviews with a variety of individuals to explore the many facets of FASDs. We meet with a medical expert in the field of FASDs, a patient advocate, a mother whose child is affected by prenatal alcohol exposure, and a public health social worker specializing in counseling patients in unhealthy alcohol use.  https://www.bucme.org/fasd-podcast

Communication Resources

  • Online and hardcopy FASD & SBIRT resources for providers, patients and clinic administrators.
    • Creation of infographics
    • SBIRT Cards

Reporting and Data

  • Real-time virtual feedback on provider training, SBIRT implementation and FASD prevention metrics.
  • Robust process and outcome evaluation based on a mixed-methods approach

Funding Source

Funding provided by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, cooperative agreement number NU84DD000002

Learn More

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Sources Cited

Text

  1. Popova S, Dozet D, Burd L. Fetal alcohol spectrum disorder: can we change the future? Alcohol Clin Exp Res. 2020;44(4):815-819. https://doi.org/10.1111/acer.14317
  2. Center for Disease Control and Prevention. Alcohol Use in Pregnancy. https://www.cdc.gov/ncbddd/fasd/alcohol-use.html. Accessed May 10, 2018.
  3. Tan C, Denny C, Cheal N, Sniezek J, Kanny D. Alcohol Use and Binge Drinking Among Women of Childbearing Age — United States, 2011–2013. Morb Mortal Wkly Rep. 2015;64(37):1042-1046. https://www.jstor.org/stable/24856791
  4. Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008-2011. N Engl J Med. 2016;374(9):843-52. https://www.nejm.org/doi/full/10.1056/nejmsa1506575
  5.  Centers for Disease Control and Prevention. Basics about FASDs. https://www.cdc.gov/ncbddd/fasd/facts.html. Accessed May 10, 2018.
  6.  Popova S, Dozet D, Burd L. Fetal alcohol spectrum disorder: can we change the future? Alcohol Clin Exp Res. 2020;44(4):815-819. https://doi.org/10.1111/acer.14317
  7. Proof Alliance. Diagnostic Terms: Fetal Alcohol Spectrum Disorders (FASD). https://www.proofalliance.org/resource/diagnostic-terms-fetal-alcohol-spectrum-disorders-fasd. 2021.

Images

  1. CDC Vital Signs. https://www.cdc.gov/vitalsigns/pdf/2016-02-vitalsigns.pdf ; 2016. 
  2. May PA, Chambers CD, Kalberg WO, et al. Prevalence of fetal alcohol spectrum disorders in 4 US communities. JAMA. 2018;319(5):474-482. doi:10.1001/jama.2017.21896
  3. SAMHSA. 2014.
  4. Centers for Disease Control and Prevention. Basics about FASDs. https://www.cdc.gov/ncbddd/fasd/facts.html. Accessed May 10, 2018.
  5. CDC, Denny CH, Acero CS, Naimi TS, Kim SY. Consumption of Alcohol Beverages and Binge Drinking Among Pregnant Women Aged 18–44 Years — United States, 2015–2017. MMWR Morb Mortal Wkly Rep 2019;68:365–368. DOI: http://dx.doi.org/10.15585/mmwr.mm6816a1
  6. http://www.fasdcenter.org/projects/educational-equity/1-in-20-more-common-than-autism

B SMART Team

Our Team:

Contact Person: Jacqueline German, MPH

Email: [email protected]

Daniel P Alford, MD, MPH

Professor of Medicine
Director, Clinical Addiction Research and Education (CARE) Unit
Director, Safe and Competent Opioid Prescribing Education (SCOPE of Pain) Program
Boston University School of Medicine

Chronic pain

BMC Internal Medicine 2013

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