A National Fetal Alcohol Spectrum Disorders Learning Collaborative for Pediatric Care Teams

To assess the impact of the SAFEST Choice Learning Collaborative on U.S. 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). The SAFEST Choice program included two year-long 10-session virtual learning collaboratives based on the Project ECHO® model, which included participant case presentations highlighting clinical challenges. Using a pre-/post-test 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. The program enrolled 105 participants from 23 clinics in 8 states. Clinics attended a median of 9 out of 10 ECHO sessions, while individual participants attended a median of 5 out 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 (PAE), and counseling families about, and managing patients with, PAE 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. The SAFEST Choice program successfully trained pediatric healthcare teams in two 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.