Boston Medical Center (BMC) is the recipient of a Health Resources and Services Administration cooperative agreement to fund a program aimed at reducing the incidence of prenatal alcohol exposure and improving the outcomes in children with suspected or diagnosed fetal alcohol spectrum disorders (FASD). In collaboration with a key partner, Minnesota-based Proof Alliance, they will use a virtual education platform where primary care providers will learn from experts about FASD and how to screen for and counsel women about the risks of alcohol use during pregnancy.  Pediatric providers will receive training on identifying and caring for children and adolescents with suspected or diagnosed FASD. 

The three-year, $2.9 million grant will utilize the Extension for Community Healthcare Outcomes (ECHO®) virtual education model to engage healthcare providers at community health centers in New England and the Upper Midwest, which will allow healthcare teams to play a larger role in addressing this underappreciated major public health problem.

According to the National Institute on Alcohol Abuse and Alcoholism, prenatal alcohol exposure is a leading preventable cause of birth defects and neurodevelopmental abnormalities in the U.S. This exposure can have long-term developmental, cognitive and behavioral impacts on children. According to the Centers for Disease Control and Prevention up to 2% to 5% of school-aged children in certain areas of the U.S. have FASD.  “Given that the effects of prenatal alcohol exposure are completely preventable, this initiative has potential to help prevent future exposed pregnancies,” said Vincent C. Smith, MD, MPH, a neonatologist at BMC, the medical director for the American Academy of Pediatrics FASD program and faculty for this program.

Named The SAFEST Choice Learning Collaborative, the program is a joint effort between BMC, Boston University Schools of Medicine and Public Health, and Proof Alliance. Working with state primary care associations in New England and the Upper Midwest, community health center practices will be recruited to participate in the ECHO learning collaboratives. Participants will learn FASD core competencies in pediatrics and perinatal care as well as the impact of the social determinants of health.

“Primary care providers and their teams can play a vital role in FASD prevention and ensuring that those affected get needed services,” said Daniel Alford, MD, MPH, the program director for the grant, director of the Clinical Addiction Research and Education Unit, and an internal medicine physician at BMC. “This training will help bridge a knowledge gap among providers and their teams about the prevalence and impact of FASD, as well as how to screen and counsel patients regarding this issue.”

Throughout the program and immediately following, all healthcare participants will have access to resources to help them integrate new tools and workflows into their practice, which includes using quality improvement strategies to overcome any implementation challenges.  An evaluation of the programs will include a comparison of two cohorts using an interrupted time-series design that will measure changes in provider knowledge, self-efficacy and practice and provide best practices for the field.

It is fitting this grant award is being announced on September 9 which is International Fetal Alcohol Spectrum Disorders Awareness Day, educating the public that there is no “safe” level of drinking during pregnancy and raising awareness about the range of conditions that can result from prenatal alcohol exposure.


About Boston Medical Center

Boston Medical Center is a private, not-for-profit, 514-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. It is the largest and busiest provider of trauma and emergency services in New England. Boston Medical Center offers specialized care for complex health problems and is a leading research institution, receiving more than $97 million in sponsored research funding in fiscal year 2018. It is the 15th largest funding recipient in the U.S. from the National Institutes of Health among independent hospitals. In 1997, BMC founded Boston Medical Center Health Plan, Inc., now one of the top ranked Medicaid MCOs in the country, as a non-profit managed care organization. Boston Medical Center and Boston University School of Medicine are partners in Boston HealthNet – 14 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit

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