addressing perinatal substance use, intimate partner violence & mood disorder screening in a...

Addressing Perinatal Substance Use, Intimate Partner Violence & Mood Disorder Screening

in a CPSP SettingUsing a Collective Impact Model

SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH

CityMatCH

• What is CityMatCH?• How your program might benefit?

http://www.citymatch.org/

http://www.citymatch.org/


CityMatCH Practice Collaborative to Prevent Substance Exposed Pregnancies

• Funded by CDC - National Center on Birth Defects and Developmental Disabilities

• Increase awareness of risks among health care providers

• Increase capacity to deliver screening & brief intervention services to women of reproductive age

• Six Teams: Baltimore, Dayton, Tampa, Denver, Portland, Sonoma

SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH


Sonoma County Selected 3 Strategies

1. Screening & brief intervention of women seeking reproductive health services at 4 clinical sites

2. Decrease unintended pregnancy among women at high risk for continued use

3. Development of a community plan to address prescription drug misuse among women of reproductive age


Adverse Childhood Experiences

• Context is key to successfully addressing perinatal substance us, IPV & mood disorder

http://www.cdc.gov/violenceprevention/acestudy/http://www.acesconnection.com/

http://www.cdc.gov/violenceprevention/acestudy/

http://www.acesconnection.com/


Collective Impact

• Public Health as the backbone organization in the collective impact process

• http://www.fsg.org/OurApproach/CollectiveImpact.aspx• http://www.ssireview.org/articles/entry/collective_impact

http://www.fsg.org/OurApproach/CollectiveImpact.aspx

http://www.ssireview.org/articles/entry/collective_impact


Collective impact provide a structure for cross-sector leaders to forge a common agenda for solving a specific social problem


Plan-Do-Study-Act

• Process matters – buy-in from team essential to success

• http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx• https://innovations.ahrq.gov/qualitytools/plan-do-study-act-pdsa-cycle

http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

https://innovations.ahrq.gov/qualitytools/plan-do-study-act-pdsa-cycle


Bundling Evidence Based Tools

• Preventing missed screening opportunities

• http://www.citymatch.org/sites/default/files/documents/bookpages/PESP%20final%20report.pdf

http://www.citymatch.org/sites/default/files/documents/bookpages/PESP%20final%20report.pdf

http://www.citymatch.org/sites/default/files/documents/bookpages/PESP%20final%20report.pdf


• Women screened for risky ETOH - 59% experienced DV/SA• Physically abused women - >7x risk of ETOH in pregnancy• Women with IPV - 20-38% have symptoms of depression• Teens in physically abusive relationships - 3-5x risk of pregnancy

Source: Family Violence Prevention Fund

Substance Use

Depressive

Disorders

Intimate Partner

Violence


Local Pilot Results

70% of women screened for 1 or more areas• 20% ETOH - one third were < 21 yrs• 20% depressive disorder• 6% intimate partner violence• 18% marijuana• 42% of non-pregnant women reported using either

tobacco or marijuana • < ¼ providers assessed birth control

15


Learnings

Marijuana, prevalence of IPV, and access to services for mood disorder

http://www.cdph.ca.gov/DATA/SURVEYS/Pages/default.aspxhttp://www.cdph.ca.gov/data/surveys/MIHA/Pages/MaternalandInfantHealthAssessment(MIHA)survey.aspx

http://www.cdph.ca.gov/DATA/SURVEYS/Pages/default.aspx

http://www.cdph.ca.gov/data/surveys/MIHA/Pages/MaternalandInfantHealthAssessment(MIHA)survey.aspx

http://www.cdph.ca.gov/data/surveys/MIHA/Pages/MaternalandInfantHealthAssessment(MIHA)survey.aspx


24,874 women - over a 7 year period of time …


The U.S. Surgeon General reported that smoking during pregnancy is responsible for 10% of all perinatal deaths. National Partnership to Help Pregnant Smokers Quit

Tobacco


Partners Matter!

http://www.naccho.org/topics/environmental/pullingtogether/sectiontwo.cfm

http://www.naccho.org/topics/environmental/pullingtogether/sectiontwo.cfm


Sustainability

• Fit within CPSP! • Billable opportunities – demonstrated need

for behavioral health staff!

• http://www.cdph.ca.gov/programs/NutiritionandPhysicalActivity/Pages/MO-NUPA-SystemsandEnvironmentalChange.aspx

http://www.cdph.ca.gov/programs/NutiritionandPhysicalActivity/Pages/MO-NUPA-SystemsandEnvironmentalChange.aspx

http://www.cdph.ca.gov/programs/NutiritionandPhysicalActivity/Pages/MO-NUPA-SystemsandEnvironmentalChange.aspx


Leveraging Data

• Leverage data to drive program change and resources

http://www.cdph.ca.gov/data/pages/default.aspx

http://www.cdph.ca.gov/data/pages/default.aspx


Pregnant women in Sonoma County don’t smoke & drink … right?


FAS and the Brain

A B C

MRI of the corpus callosum of A. a 14-year-old with a normal corpus callosum; B. a 12-year-old with FAS and a thin corpus callosum; C. a 14-year-old with FAS and agenesis (absence due to abnormal

development) of the corpus callosum.Source: Mattson, S.N.; Jernigan, T.L.; and Riley, E.P. 1994. MRI and prenatal alcohol exposure: Images provide insight into FAS. Alcohol Health & Research World 18(1):49–52.


Ongoing …

• Printing, quality assurance …


Thank You!

Next ….

SBIRT Implementation ….

addressing perinatal substance use, intimate partner violence & mood disorder screening in a...

Documents

sonoma slide

reproductive health

health care providers

collective impact model

pdsacyc slide

pregnancy women

abused women

specific social problem