Inventory of Evidence-Based Practices (EBPs) for Healthy Start Programs

Evidence-based practices include actions, activities, strategies, or approaches that improve the health of women, before, during, and after pregnancy in order to improve birth outcomes and give infants up to age two years a healthy start. Also included in the collection are informational materials and tools that make it easier to implement evidence-based practices. To search by title, use the main search box located at the top of this page.


Alcohol Screening and Brief Intervention: A guide for public health practitioners

Screening and brief intervention (SBI) is a structured set of questions designed to identify individuals at risk for alcohol use problems, followed by a brief discussion between an individual and a service provider, with referral to specialized treatment as needed. This manual is designed to provide public health professionals, such as health educators and community health workers, with the information, skills, and tools needed to conduct SBI so that they can help at-risk drinkers reduce their alcohol use to a safe amount or stop drinking. The manual offers background information and practical steps for conducting SBI in a variety of public health settings, including trauma centers, emergency departments, other clinical settings, home visits, and public events.

Topics:

Alcohol/Drug Services Case Management/Care Coordination Risk Assessment

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

CRAFFT Screening Tool

The CRAFFT is a short, validated behavioral health tool developed to screen adolescents under age 21 for high risk alcohol and drug use. Recommended by the American Academy of Pediatrics, it consists of 6 questions involving Car, Relax, Alone, Forget, Friends, and Trouble. The tool is meant to assess whether a longer conversation about the context of use, frequency, and other risks and consequences of alcohol and/or drug use is warranted. It is available in 13 languages.

Topics:

Alcohol/Drug Services Risk Assessment

Approaches:

Benchmarks:

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

ACOG Fetal Alcohol Spectrum Disorders (FASD) Prevention Program

The Fetal Alcohol Spectrum Disorders (FASD) Prevention Program is a collaboration between ACOG and the CDC designed to empower healthcare providers to speak with their patients about abstaining from alcohol use during pregnancy. The program includes evidence-based ACOG Committee Opinions regarding ethics, alcohol use in pregnancy, and motivational interviewing techniques, as well as videos and free downloadable materials for both providers and patients.

Topics:

Alcohol/Drug Services

Approaches:

Benchmarks:

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

WINGS (Women Initiating New Goals of Safety)

Failure to address IPV among women who use alcohol or other drugs has been found to increase the likelihood of continued drug use, relapse, attrition from drug treatment and a host of other negative physical and mental health consequences. WINGS is a single-session intervention that aims to address a critical gap in IPV services for women by identifying women in the community at risk of IPV, enabling them to develop social support and safety planning skills to reduce their risks for IPV and linking them to IPV-related services and substance use treatment. The intervention may be delivered in-person or via a computerized self-paced version.

Topics:

Alcohol/Drug Services Intimate Partner Violence

Approaches:

Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

NIDA Quick Screen

The NIDA Quick Screen is a validated instrument designed to assist providers in screening adults for substance use. The screen simply inquires whether a participant has used drugs (mood-altering, illegal, or prescription for nonmedical reasons), alcohol, or tobacco products within the past year and how often these substances have been used. The NIDA website also provides guidelines for brief intervention and/or treatment referral for patients who may have or be at risk of developing a substance use disorder.

Topics:

Alcohol/Drug Services Risk Assessment Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

4Ps Plus©

4Ps Plus© is the first validated instrument that has been developed to screen for alcohol, tobacco, and illicit drug use; depression; and domestic violence, specifically in pregnant women. In addition, brief intervention strategies, grounded in motivational interviewing techniques, are integrated into the screening process. “I am concerned…” is an interactive, multisensory psychoeducational approach that takes about five minutes and is administered to all women who are found through the screening process to be using alcohol, tobacco, or illicit drugs.

Topics:

Alcohol/Drug Services Depression Intimate Partner Violence Prenatal Care and Education Risk Assessment Tobacco Cessation

Approaches:

Promote Quality Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence Perinatal Depression Screening Smoking Abstinence

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

4Ps

The 4Ps (Parents, Partners, Past and Pregnancy) was developed for use with pregnant women and women of child bearing age. The tool has 4 questions intended to facilitate discussion regarding substance use.

Topics:

Alcohol/Drug Services

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

UNCOPE – Used, Neglected, Cut Down, Objected Preoccupied, Emotional Discomfort

The UNCOPE consists of six questions and may be used free of charge for oral administration in any medical, psychosocial, or clinical interview to provide a simple and quick means of identifying risk for abuse and dependence for alcohol and other drugs.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

DAST – Drug Abuse Screening

The DAST is a 20-item instrument for clinical and nonclinical screening to detect drug abuse or dependence disorders. It is most useful in settings in which seeking treatment for drug use problems is not the patient’s stated goal.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

TWEAK – Tolerance, Worry, Eye-Opener, Amnesia, Cut-Down

The TWEAK (Tolerance, Worry, Eye-Opener, Amnesia, Cut-Down) is a five-item scale originally developed to screen for risk drinking during pregnancy. The items are not gender specific, however, and the scale can be used with either women or men.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

ASSIST – Alcohol, Smoking, and Substance Involvement Screening Test

The ASSIST (Alcohol, Smoking, and Substance Involvement Screening Test) is an 8-item questionnaire designed to be administered by a health worker to a client using paper and pencil, and takes about 5-10 minutes to administer. The ASSIST provides information about the substances people have ever used in their lifetime; those used in the past three months; problems related to substance use; risk of current or future harm; dependence; and injecting drug use. The ASSIST was designed to be culturally neutral and usable across a variety of cultures.

Topics:

Alcohol/Drug Services Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Neonatal Abstinence Syndrome: How States Can Help Advance the Knowledge Base for Primary Prevention and Best Practices of Care

Published by the Association of State and Territorial Health Officials (ASTHO), this document contains the most recent (2014) guidelines for the screening, referral, and treatment of Neonatal Abstinence Syndrome.

Topics:

Alcohol/Drug Services Other Risk Assessment

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

T-ACE

T-ACE is a measurement tool with four questions that are significant identifiers of risk drinking (i.e., alcohol intake sufficient to potentially damage the embryo/fetus). The T-ACE is completed at intake. The T-ACE score has a range of 0-5. The value of each answer to the four questions is totaled to determine the final T-ACE score. Included on the Healthy Start National Evaluation Program Survey.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

CAGE-AID

Commonly used, 5-question tool that screens for drug and alcohol use/abuse. The CAGE-AID Assessment is a quick questionnaire to help determine if further assessment is needed. If a person answers yes to two or more questions, a complete assessment is advised. Included on the Healthy Start National Evaluation Program Survey.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

AUDIT (Alcohol Use Disorders Identification Test)

10-item questionnaire that screens for hazardous or harmful alcohol consumption. Developed by the World Health Organization (WHO), it correctly classifies 95% of people into either alcoholics or non-alcoholics. The AUDIT has been used with a variety of populations and cultural groups. It should be administered by a health professional or paraprofessional. Included on the Healthy Start National Evaluation Program Survey.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.