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Carla Bruguera, Lidia Segura and Katarzyna Okulicz-Kozaryn,
Emanuele Scafato, Claudia Gandin, Fleur Braddick.
On behalf of the FAR SEAS partners
Acknowledgement: The FAR SEAS project has been funded by the EU Health Programme 2014-2020 under a service contract 20187106 with the
Health and Digital Executive Agency (HaDEA) acting under the mandate from the European Commission (DG SANTE). Disclaimer: Views
expressed in this presentation does not necessarily reflect the views of the Commission and/or HaDEA or any other body of the European Union.
FAS/FASD prevention, the FAR SEAS experience
Workshop
FAR SEAS is a tendered EC service contract awarded to a tendering group lead by the CLÍNIC
Foundation for Biomedical Research (FCRB, Spain).
Objectives: FAR SEAS will:
• Promote regional strategies to reduce and prevent fetal alcohol syndrome and fetal alcohol
spectrum disorder (FAS/FASD)
• knowledge exchange and capacity building among EU Member States
• Best practices in Europe
• Guidelines to prevent FASD
• Training Package
• Mazovian Pilot Study (Poland)
• Dissemination workshop in EUFASD 2022 Arendal (Norway)
Index
• In general, practices were funded by governments or
public institutions
• Almost half of practices were implemented at regional
level
• The majority of practices took place in health services
• In general, practices were single component
• Half of the practices targeted pregnant women and a
quarter child-bearing age women
• Practices focused mainly on screening and brief or
extended interventions
• Most common elements (in this order): SBI, training,
communication campaigns, psychoeducational tools,
Best practices in Europe
• Literature research: Mixed methods compilation strategy –literature reviews, grey literature
and repositories reviews and experts and key informants consultation
• Inclusion criteria: From 2010; All geographical areas; All languages; Evaluated; Equity and
bioethical principles
• Evidence analysis: Performed by two researchers
• Guidelines: Rigour of Development criteria section of the AGREE II instrument. Inclusion =
Score >70%
• RCT: ROB2 (Cochrane). Inclusion = 0 high-risk domain
• Systematic reviews: AMSTAR. Inclusion = Score > 4
• Experts consensus on the guidelines topics and questions and recommendations
Guidelines to reduce alcohol consumption in women of child-bearing age,
particularly in pregnant women
Methods
Organizational, strategic and policy changes to reduce alcohol exposed pregnancies
Best practices to raise awareness among the general population of the risks of drinking alcohol
during pregnancy.
Screening tools for alcohol and psychosocial risks for women of child-bearing age
Preventive interventions for child-bearing age women at risk of having alcohol related problems
Treatment interventions for child-bearing age women at risk of having alcohol related problems
Social measures for child-bearing age women at risk of having alcohol related problems
Implementation, training and evaluation strategies of preventive activities
1
2
3
4
5
6
7
Guidelines topics
Training package
• Three-fold strategy: revision of existing training packages, expert consensus, and testing a
pilot in Poland
• Training of trainers model:
• Trainers: Any professional with interest in the prevention of AEPs or with enough
background training in the key areas of alcohol, pregnancy, brief interventions and
motivational interviewing.
• Target audience: Professionals from a variety of areas including gynaecology, primary
health care, paediatrics, nursing, midwifery, and social work.
• Training Package elements: manuals, slides, clinical cases, FAQs, know more documents,
materials for professional practice, evaluation tools, etc.
• Introduction and main aims and objectives
• Importance of preventing alcohol-exposed pregnancies and effective interventions
• Gender-specific aspects and factors
• What to do? Effective interventions
• How to do it?
o Part I. Ask, Assess & Provide Feedback
o Part II. Advise and Assist
o Part III. Arrange and Follow-up
• Recruitment, intervention and registration. Tools for pilot implementation, monitoring and
evaluation.
• Post-training evaluation and closing
Training Package contents and structure
Aim
➢ to test the implementation of a
multi-component evidence-based
community intervention aimed at
preventing alcohol consumption
among pregnant women and women
in child-bearing age, to prevent
FASD.
➢ in a regional-level implementation
study in mazovieckie voivodeship
Mazovian pilot study
Mazovian Pilot Study
General scheme of FASD prevention approaches
Organizational structure of the pilot project
Recruitment of the local staff
Plan Execution
Selection of the localities 5 6 recruited – 4 active
Recruitment of providers
of services
N=25, including:
Doctors
Nurses/midwives
Social workers/family assistants
Psychologists
Pedagogues
Addiction therapists
Abstainers’ Associatons
31 recruited – 25 active:
0
2
11
5
2
4
1
Implementers' tasks
• Participation in training
• Recruiting women
• Conducting screening tests  Referring women to the appropriate group
• Conducting activities adequate to the needs of a given group:
• Low risk - brief intervention
• Medium risk - 2-4 individual sessions (based on a motivational interviewing)
• High Risk - Individual support plans, including home visits
• Organization and coordination of work with clients
• Registration of activities carried out (including registration of project participants)
• Participation in the evaluation study
• Cooperation with project coordinators in the city / district
1%
62%
34%
3%
Recruited women
(n=441)
Ursus Płock Radom Pruszków
Mean age 33 (SD=8,46)
min. 16, max 49
N=42 (9,5%)
49%
35%
14%
2%
0%
married/constant
relationship
single
divorsed
widow
student
7%
unemployed
20%
child
care
12%
employed
61%
WORK STATUS
13%
11%
38%
37%
1%
EDUCATION
primary vocational secondary
high ?
69%
23%
7%
1%
RISK OF PAE/FASD
low moderate high ?
Risk factor
Indicator
Pregnant
Not
Pregnant
AUDIT-P (before
pregnancy)
4+
AUDIT-P (during
pregnancy)
1+
AUDIT-C 4+
Contraseption no
Cigarettes – current use yes yes
Ilicit drugs – current use yes yes
Domestic violence yes yes
Depression (PHQ9) 10+ 10+
95,4% 95,0% 96,8% 94,8%
7,2%
75,0%
83,9%
27,9%
0,7%
15,0%
35,5%
6,3%
0,0%
10,0%
20,0%
30,0%
40,0%
50,0%
60,0%
70,0%
80,0%
90,0%
100,0%
low risk moderate risk high risk all
Number of interventions per risk level
1+ 2+ 3+
0 50 100 150 200 250 300 350
feedback
BI
MI
referral
individual care plan
home visitis
Types of interventions (n)
0,0%
10,0%
20,0%
30,0%
40,0%
50,0%
60,0%
70,0%
low risk moderate risk high risk
First choice intervention
? feedback
feedback + BI individualized package
BI MI
0,0%
10,0%
20,0%
30,0%
40,0%
50,0%
60,0%
70,0%
80,0%
low risk moderate
risk
high risk
Second choice intervention
feedback feedback + BI BI MI referral
,0%
5,0%
10,0%
15,0%
20,0%
25,0%
30,0%
35,0%
low risk moderate
risk
high risk
Third choice intervention
MI referral
Task 2 – Thematic Capacity-Building workshops in alcohol
policy topics + briefing documents
(with DEEP SEAS & AlHaMBRA Project contracts)
Workshop title, host country/ institutions Broad areas covered (contract of topic) DS, FS, ALH Experts / peer reviewers Date Format
WS1. Alcohol Advertising and Sponsorship in Traditional
and Digital Media – regulating to reduce harm. Czech
Republic (CZ) - CUNI / Bureau of CZ Government
Traditional Alcohol Marketing (DS) Wim van Dalen / Gerard Hastings
9th, 14th, 16th, 21st
Dec 2020
(4 online sessions)
Consumer information (linked ALH)
Digital Media Marketing (FS + linked ALH) Wim van Dalen / Emmi Kupala
Regulating low-strength alcohol (linked ALH)
WS2. Alcohol and its relation to Socioeconomic
Inequalities, Nutrition & Obesity and Cancer. Portugal
(PT) - SICAD
Cancer (cross-cutting topic requested) Jürgen Rehm / Isabelle Soerjomataram
9th, 12th & 16th
Mar 2021
(3 online sessions)
Socioeconomic Inequalities (DS) Charlotte Probst / Pia Mäkelä
Nutrition/Obesity (DS) Laura Rossi / Joao Breda
WS3. Alcohol Taxation and Pricing Policies, including
Cross-Border and Unrecorded issues. Lithuania (LT) -
NTAKK / NTAKD - LT Drugs, Tobacco and Alcohol Control
Dept
Taxation & pricing policy (DS) Colin Angus / Clare Beeston
8th, 11th & 15th
Jun 2021
(3 online sessions)
Cross-border purchasing (FS) Nijole Gostautaite Midttun / Thomas Karlsson
Unrecorded alcohol (AlHaMBRA Project) Jürgen Rehm / Artyom Gil
WS4. Alcohol Agricultural Policy to Protect Health.
Slovenia (SI) - NIJZ
Agricultural policy and alcohol production
Laura Rossi / Nikolai Pushakerv
4th & 9th Nov 2021
(2 online sessions)
Agricultural promotion policy and alcohol (DS)
WS5. Digital approaches to reduce alcohol harm – focus
on schools and vulnerable groups
e-Health tools (AlHaMBRA Project) Silvia Matrai & Silvia Grothe / Paul Wallace 15th & 17th Feb 2022
WS6. Tackling Alcohol in the Workplace. Spain (ES) –
MSCBS / ILO
Alcohol and Workplace (AlHaMBRA Project)
Gemma Rabal & Lidia Segura / Guiseppe
Masanotti
12th, 17th, 20th
May 2022
WS7. Policy to tackle Fetal Alcohol Spectrum Disorder.
Part of EUFASD Conference – Co-hosted by KCPU
Assessing national prevalence of FAS/FASD (FS) Svetlana Popova & Jürgen Rehm 13th Sept 2022
EUFASD Conference
Guidelines for FASD prevention Lidia Segura & Katarzyna Okulicz-Kozaryn
• Tuesday 13th September 2022 (9h – 17h), Arendal, Norway.
• within programme of EUFASD 2022 Conference
• 45 invited policy-makers, scientists, stakeholders
• Supported through background documents based on scientific
review
SAVE THE DATE – FINAL WORKSHOP
Thematic Alcohol Policy Capacity-Building Workshop #7
Policy and Practice to Tackle
Fetal Alcohol Spectrum Disorders
Event co-hosted by the Polish National Center for the Prevention of Addictions (KCPU),
with support from the Institute of Mother and Child, Warsaw, Poland
• Aim: to exchange knowledge and experiences, discuss barriers and solutions
• Focus: 1) National prevalence estimates of FASD, 2) Effective prevention initiatives
If you are interested in participating in this event, please write to the FAR SEAS
coordinating team at DEEP_SEAS@clinic.cat , or…
Scan the QR code (on posters around the conference)
or visit www.far-seas.eu/capacity-building/
for more information.
This workshop is produced under the FAR SEAS Service Contract funded by the EU Health Programme 2014-2020 (20187106) with Health and
Digital Executive Agency (HaDEA) acting under the mandate from the European Commission. The information and views presented in the
sessions are those of the speakers, and cannot be considered to reflect the views of the European Commission and/or HaDEA or any other
body of the European Union.
Thank you for your attention!
lidia.segura@gencat.cat
Acknowledgement: The FAR SEAS project has been funded by the EU Health Programme 2014-2020 under a service contract 20187106 with the
Health and Digital Executive Agency (HaDEA) acting under the mandate from the European Commission (DG SANTE). Disclaimer: Views
expressed in this presentation does not necessarily reflect the views of the Commission and/or HaDEA or any other body of the European Union.

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Lidia Segura_FAR SEAS_workshop.pdf

  • 1. Carla Bruguera, Lidia Segura and Katarzyna Okulicz-Kozaryn, Emanuele Scafato, Claudia Gandin, Fleur Braddick. On behalf of the FAR SEAS partners Acknowledgement: The FAR SEAS project has been funded by the EU Health Programme 2014-2020 under a service contract 20187106 with the Health and Digital Executive Agency (HaDEA) acting under the mandate from the European Commission (DG SANTE). Disclaimer: Views expressed in this presentation does not necessarily reflect the views of the Commission and/or HaDEA or any other body of the European Union. FAS/FASD prevention, the FAR SEAS experience Workshop
  • 2. FAR SEAS is a tendered EC service contract awarded to a tendering group lead by the CLÍNIC Foundation for Biomedical Research (FCRB, Spain). Objectives: FAR SEAS will: • Promote regional strategies to reduce and prevent fetal alcohol syndrome and fetal alcohol spectrum disorder (FAS/FASD) • knowledge exchange and capacity building among EU Member States
  • 3. • Best practices in Europe • Guidelines to prevent FASD • Training Package • Mazovian Pilot Study (Poland) • Dissemination workshop in EUFASD 2022 Arendal (Norway) Index
  • 4. • In general, practices were funded by governments or public institutions • Almost half of practices were implemented at regional level • The majority of practices took place in health services • In general, practices were single component • Half of the practices targeted pregnant women and a quarter child-bearing age women • Practices focused mainly on screening and brief or extended interventions • Most common elements (in this order): SBI, training, communication campaigns, psychoeducational tools, Best practices in Europe
  • 5. • Literature research: Mixed methods compilation strategy –literature reviews, grey literature and repositories reviews and experts and key informants consultation • Inclusion criteria: From 2010; All geographical areas; All languages; Evaluated; Equity and bioethical principles • Evidence analysis: Performed by two researchers • Guidelines: Rigour of Development criteria section of the AGREE II instrument. Inclusion = Score >70% • RCT: ROB2 (Cochrane). Inclusion = 0 high-risk domain • Systematic reviews: AMSTAR. Inclusion = Score > 4 • Experts consensus on the guidelines topics and questions and recommendations Guidelines to reduce alcohol consumption in women of child-bearing age, particularly in pregnant women Methods
  • 6. Organizational, strategic and policy changes to reduce alcohol exposed pregnancies Best practices to raise awareness among the general population of the risks of drinking alcohol during pregnancy. Screening tools for alcohol and psychosocial risks for women of child-bearing age Preventive interventions for child-bearing age women at risk of having alcohol related problems Treatment interventions for child-bearing age women at risk of having alcohol related problems Social measures for child-bearing age women at risk of having alcohol related problems Implementation, training and evaluation strategies of preventive activities 1 2 3 4 5 6 7 Guidelines topics
  • 7. Training package • Three-fold strategy: revision of existing training packages, expert consensus, and testing a pilot in Poland • Training of trainers model: • Trainers: Any professional with interest in the prevention of AEPs or with enough background training in the key areas of alcohol, pregnancy, brief interventions and motivational interviewing. • Target audience: Professionals from a variety of areas including gynaecology, primary health care, paediatrics, nursing, midwifery, and social work. • Training Package elements: manuals, slides, clinical cases, FAQs, know more documents, materials for professional practice, evaluation tools, etc.
  • 8. • Introduction and main aims and objectives • Importance of preventing alcohol-exposed pregnancies and effective interventions • Gender-specific aspects and factors • What to do? Effective interventions • How to do it? o Part I. Ask, Assess & Provide Feedback o Part II. Advise and Assist o Part III. Arrange and Follow-up • Recruitment, intervention and registration. Tools for pilot implementation, monitoring and evaluation. • Post-training evaluation and closing Training Package contents and structure
  • 9. Aim ➢ to test the implementation of a multi-component evidence-based community intervention aimed at preventing alcohol consumption among pregnant women and women in child-bearing age, to prevent FASD. ➢ in a regional-level implementation study in mazovieckie voivodeship Mazovian pilot study Mazovian Pilot Study
  • 10. General scheme of FASD prevention approaches
  • 11. Organizational structure of the pilot project
  • 12. Recruitment of the local staff Plan Execution Selection of the localities 5 6 recruited – 4 active Recruitment of providers of services N=25, including: Doctors Nurses/midwives Social workers/family assistants Psychologists Pedagogues Addiction therapists Abstainers’ Associatons 31 recruited – 25 active: 0 2 11 5 2 4 1
  • 13. Implementers' tasks • Participation in training • Recruiting women • Conducting screening tests  Referring women to the appropriate group • Conducting activities adequate to the needs of a given group: • Low risk - brief intervention • Medium risk - 2-4 individual sessions (based on a motivational interviewing) • High Risk - Individual support plans, including home visits • Organization and coordination of work with clients • Registration of activities carried out (including registration of project participants) • Participation in the evaluation study • Cooperation with project coordinators in the city / district
  • 14. 1% 62% 34% 3% Recruited women (n=441) Ursus Płock Radom Pruszków Mean age 33 (SD=8,46) min. 16, max 49 N=42 (9,5%) 49% 35% 14% 2% 0% married/constant relationship single divorsed widow
  • 16. 69% 23% 7% 1% RISK OF PAE/FASD low moderate high ? Risk factor Indicator Pregnant Not Pregnant AUDIT-P (before pregnancy) 4+ AUDIT-P (during pregnancy) 1+ AUDIT-C 4+ Contraseption no Cigarettes – current use yes yes Ilicit drugs – current use yes yes Domestic violence yes yes Depression (PHQ9) 10+ 10+
  • 17. 95,4% 95,0% 96,8% 94,8% 7,2% 75,0% 83,9% 27,9% 0,7% 15,0% 35,5% 6,3% 0,0% 10,0% 20,0% 30,0% 40,0% 50,0% 60,0% 70,0% 80,0% 90,0% 100,0% low risk moderate risk high risk all Number of interventions per risk level 1+ 2+ 3+
  • 18. 0 50 100 150 200 250 300 350 feedback BI MI referral individual care plan home visitis Types of interventions (n)
  • 19. 0,0% 10,0% 20,0% 30,0% 40,0% 50,0% 60,0% 70,0% low risk moderate risk high risk First choice intervention ? feedback feedback + BI individualized package BI MI 0,0% 10,0% 20,0% 30,0% 40,0% 50,0% 60,0% 70,0% 80,0% low risk moderate risk high risk Second choice intervention feedback feedback + BI BI MI referral ,0% 5,0% 10,0% 15,0% 20,0% 25,0% 30,0% 35,0% low risk moderate risk high risk Third choice intervention MI referral
  • 20. Task 2 – Thematic Capacity-Building workshops in alcohol policy topics + briefing documents (with DEEP SEAS & AlHaMBRA Project contracts) Workshop title, host country/ institutions Broad areas covered (contract of topic) DS, FS, ALH Experts / peer reviewers Date Format WS1. Alcohol Advertising and Sponsorship in Traditional and Digital Media – regulating to reduce harm. Czech Republic (CZ) - CUNI / Bureau of CZ Government Traditional Alcohol Marketing (DS) Wim van Dalen / Gerard Hastings 9th, 14th, 16th, 21st Dec 2020 (4 online sessions) Consumer information (linked ALH) Digital Media Marketing (FS + linked ALH) Wim van Dalen / Emmi Kupala Regulating low-strength alcohol (linked ALH) WS2. Alcohol and its relation to Socioeconomic Inequalities, Nutrition & Obesity and Cancer. Portugal (PT) - SICAD Cancer (cross-cutting topic requested) Jürgen Rehm / Isabelle Soerjomataram 9th, 12th & 16th Mar 2021 (3 online sessions) Socioeconomic Inequalities (DS) Charlotte Probst / Pia Mäkelä Nutrition/Obesity (DS) Laura Rossi / Joao Breda WS3. Alcohol Taxation and Pricing Policies, including Cross-Border and Unrecorded issues. Lithuania (LT) - NTAKK / NTAKD - LT Drugs, Tobacco and Alcohol Control Dept Taxation & pricing policy (DS) Colin Angus / Clare Beeston 8th, 11th & 15th Jun 2021 (3 online sessions) Cross-border purchasing (FS) Nijole Gostautaite Midttun / Thomas Karlsson Unrecorded alcohol (AlHaMBRA Project) Jürgen Rehm / Artyom Gil WS4. Alcohol Agricultural Policy to Protect Health. Slovenia (SI) - NIJZ Agricultural policy and alcohol production Laura Rossi / Nikolai Pushakerv 4th & 9th Nov 2021 (2 online sessions) Agricultural promotion policy and alcohol (DS) WS5. Digital approaches to reduce alcohol harm – focus on schools and vulnerable groups e-Health tools (AlHaMBRA Project) Silvia Matrai & Silvia Grothe / Paul Wallace 15th & 17th Feb 2022 WS6. Tackling Alcohol in the Workplace. Spain (ES) – MSCBS / ILO Alcohol and Workplace (AlHaMBRA Project) Gemma Rabal & Lidia Segura / Guiseppe Masanotti 12th, 17th, 20th May 2022 WS7. Policy to tackle Fetal Alcohol Spectrum Disorder. Part of EUFASD Conference – Co-hosted by KCPU Assessing national prevalence of FAS/FASD (FS) Svetlana Popova & Jürgen Rehm 13th Sept 2022 EUFASD Conference Guidelines for FASD prevention Lidia Segura & Katarzyna Okulicz-Kozaryn
  • 21. • Tuesday 13th September 2022 (9h – 17h), Arendal, Norway. • within programme of EUFASD 2022 Conference • 45 invited policy-makers, scientists, stakeholders • Supported through background documents based on scientific review SAVE THE DATE – FINAL WORKSHOP Thematic Alcohol Policy Capacity-Building Workshop #7 Policy and Practice to Tackle Fetal Alcohol Spectrum Disorders Event co-hosted by the Polish National Center for the Prevention of Addictions (KCPU), with support from the Institute of Mother and Child, Warsaw, Poland • Aim: to exchange knowledge and experiences, discuss barriers and solutions • Focus: 1) National prevalence estimates of FASD, 2) Effective prevention initiatives
  • 22. If you are interested in participating in this event, please write to the FAR SEAS coordinating team at DEEP_SEAS@clinic.cat , or… Scan the QR code (on posters around the conference) or visit www.far-seas.eu/capacity-building/ for more information. This workshop is produced under the FAR SEAS Service Contract funded by the EU Health Programme 2014-2020 (20187106) with Health and Digital Executive Agency (HaDEA) acting under the mandate from the European Commission. The information and views presented in the sessions are those of the speakers, and cannot be considered to reflect the views of the European Commission and/or HaDEA or any other body of the European Union.
  • 23. Thank you for your attention! lidia.segura@gencat.cat Acknowledgement: The FAR SEAS project has been funded by the EU Health Programme 2014-2020 under a service contract 20187106 with the Health and Digital Executive Agency (HaDEA) acting under the mandate from the European Commission (DG SANTE). Disclaimer: Views expressed in this presentation does not necessarily reflect the views of the Commission and/or HaDEA or any other body of the European Union.