The Alcohol and Substance-Exposed Pregnancy Prevention Initiative (AStEPP) offers training and technical assistance to increase Healthy Start grantees’ understanding of the impacts of fetal exposure to alcohol and other drugs, and strengthen their capacity to engage in effective prevention and early identification activities with pregnant women, mothers, and newborns. The initiative also aims to address social, environmental and broader behavioral health factors as they contribute to substance use before, during, and after pregnancy. The initiative takes a health equity approach by focusing efforts on populations at higher risk, including Native American and tribal communities, as well as building upon community strengths and resiliency factors.


New Materials from AStEPP

State Legislation on Substance Use During Pregnancy Study Guide

This study guide aims to deepen your understanding of state laws and policies that establish legal consequences for women who use substances during pregnancy. The guide highlights state by state policies related to substance use during pregnancy and offers talking points for communicating the implications of such laws and policies to program staff, partners, policy makers, and stakeholders.


Alcohol and Substance-Exposed Pregnancies: A Growing Public Health Problem

This e-learning mini-course provides a self-study option for maternal and child health program staff working with pregnant women and their families. It gives a basic overview of the scope and impacts of alcohol and drug use during pregnancy, as a necessary foundation for supporting women and connecting them to prevention, screening, treatment and recovery resources.


AStEPP Staff Meeting Training Packages

photo of a staff meeting These AStEPP Staff Meeting Training Packages provide everything you need for a short (under an hour) staff development activity that you can do with your entire Healthy Start or Home Visiting team during a staff meeting or other team meeting. Each package contains an audio or video presentation on the subject and questions for group discussion, along with links to web-based and print resources for further exploration of the topic.


This Healthy Start Team Discussion Guide provides Healthy Start and home visiting staff with materials to facilitate a group discussion on opioid use among pregnant women. It provides information on what opioids are, how they affect women and their families, and the treatment options available to pregnant women with opioid use disorder. After completing this guide, Healthy Start and Home Visiting staff will have the knowledge and tools to help address opioid use among pregnant program participants in their community.


The Healthy Start EPIC Center’s Alcohol and Substance- Exposed Pregnancy Prevention (AStEPP) Initiative has developed this compendium for Tribal Healthy Start and home visiting programs, as well as others that work with Native American communities. Native Americans have complex risk factors for substance-exposed pregnancies, including high rates of substance abuse and teen pregnancy, poverty and lack of access to healthcare. While Native Americans face these health disparities, they also have many strengths to draw from, including cultural pride, traditions around holistic health and wellness, and higher rates of abstinence from alcohol, compared to Whites. This compendium lists the latest (last 10 years) resources pertaining to these behavioral health topics in Tribal communities. These resources can be helpful to support the behavioral health work of your program and/or partners, specifically with Native and Tribal communities.


Social Determinants of Substance Use During Pregnancy in Tribal Communities (Infographic)

Graphic depictions of the individual, interpersonal, community, and societal social determinants of substance use during pregnancy in tribal communitiesWhere we live, work, play, and pray are significant to our well-being. These personal and environmental factors, known as social determinants of health, impact our behavior and health outcomes, including substance use during pregnancy. In this infographic, we outline the social determinants of substance use during pregnancy that are found in several Tribal communities into the Social Ecological Model (SEM) levels of influence: individual, interpersonal, community and societal. This infographic can be used to examine the social determinants of health that affect Healthy Start participants living in Tribal communities.


AStEPP is Proud to Present Two Videos Exploring Substance Use During Pregnancy in Tribal Communities

Through a partnership with the Northern Plains Tribal Healthy Start Project, AStEPP developed two short films examining factors that contribute to substance use, as well as those that help to prevent it: “The Importance of Trust in Substance Use Disclosure During Pregnancy” and “Social Determinants of Substance Use During Pregnancy”.


Foundational Webinar Series on FASD

This webinar series provides a basic overview of fetal alcohol spectrum disorders (FASDs), prevention strategies including referral to treatment for pregnant women, and screening and assessment for FASDs in children. Click on the links below for webinar recordings and slides.

Addressing Fetal Alcohol Spectrum Disorders in the Context of Healthy Start: What do we need to know?   (Presented live 2/21/17)

Using SBIRT in Healthy Start: Destigmatizing Addiction and Cultural Considerations (Presented live 4/13/17)

Introduction to FASD Screening and Diagnosis (Presented live 5/25/17)

What are the Long-term Effects and Impacts of Fetal Alcohol Spectrum disorders (FASD) on Individuals and their Families? (Presented live 9/5/17)

Ask The Expert: How does prenatal exposure to alcohol, marijuana, opioids and other substances affect maternal and child health outcomes? (Presented live 12/12/17)


Featured Resources

Fetal Alcohol Spectrum Disorders (FASD) Resources: A Quick Start List for Healthy Start Grantees

Healthy Start Grantee Perspectives: Alcohol and Substance Exposed Pregnancies (Infographic)

Education & Fetal Alcohol Syndrome Disorders Toolkit 

Opioid and Behavioral Health Resources: A Quick Start List for Healthy Start Grantees

ACOG/CDC FASD Prevention Program

Moms’ Mental Health Matters

Visit the Evidence-based Practices Inventory for additional resources and practices for addressing substance use and mental health with women and families.


For More Information

AStEPP provides TA on request to Healthy Start grantees to assist them in improving the education, services, and support they offer to participants with substance use and/or mental health challenges. Get in touch with your Technical Assistance Coordinator (TAC) to request AStEPP TA, or request TA here.