A Pregnant Woman Never Drinks Alone. Visit zeroexposure.org

The Zero Exposure The Zero Exposure ProjectProject

Presented by Lisa Colen, MHAZEP Director

The vision of ZEPThe vision of ZEP

• Hillsborough County will be a community where

every child is born substance free and lives in a family that promotes

healthy growth and development.

Why do we need ZEP?Why do we need ZEP?• According to 2003 National Survey on Drug

Use and Health:

• -4.3 % of pregnant women aged 15 to 44 used illicit drugs during the last month.

• -4.1% reported binge alcohol use(5+)

• -18% reported smoking cigarettes

Why do we need ZEP?Why do we need ZEP?• In 2004, Hillsborough County had 15, 414 births to mothers aged 15-44.

• By NSDUH survey prediction:– 663 used illicit drugs

– 632 would have binged on alcohol– 2775 would have smoked

cigarettes

Another type of needAnother type of need• According to risk behavior survey results, the woman most likely to be a social drinker before and during pregnancy is 35+, white, college educated, professionally employed and married.

Goals of Zero ExposureGoals of Zero Exposure

• Raise community awareness about the

impact of substance use during pregnancy in

order to improve positive birth outcomes.

Goals of Zero Exposure Goals of Zero Exposure Pregnant women who are

identified early in pregnancy as substance

users are linked with appropriate education,

services and treatment in order to improve positive

birth outcomes.

Goals of Zero ExposureGoals of Zero Exposure

Incorporate evaluation component in all areas of screening, campaign and outreach in order to

enhance continuous quality improvement of

the project.

Partners of ZEPPartners of ZEPThe Children’s Board of Hillsborough County

Hillsborough Kids, Inc.Central Hillsborough Healthy Start

DACCOHealthy Start Coalition of Hillsborough County

Healthy Families HillsboroughDepartment of Children and Families

Tampa Bay Women’s CareSt. Joseph’s Women’s Hospital

Hillsborough County Health DepartmentHumana Health Plans

Central Behavioral Health NetworkChild Abuse Council

Operation PAR

Partners in FundingPartners in Funding• Children’s Board

of Hillsborough County, Inc.

– Three Year Funding

– Focus on public awareness and education

– Improved birth outcomes as a goal for community

• DACCO

– CBR/Two years– Provide 4

liaisons for screening, assessment and referral

– Evaluation

Community CoordinatorCommunity Coordinator• Oversees liaison activities• Builds community partnerships• Builds relationships with universities,

schools and hospitals• Acts as resource for jail and TOPWA

(Targeted Outreach to Pregnant Women at Risk)

• Stays current on treatment options• Oversees evaluation of program• Seeks additional funding• Advocates on all relevant legislative issues

Community CommitteesCommunity Committees• Partnership

Resource• Education Evaluation

Committee ReportingCommittee Reporting

Partnership

Resource Education Evaluation

Education CommitteeEducation Committee

• Comprehensive literature• Presentations/Provide Speakers• Insurance Referrals for providers• Physician Spokesperson• Screening tool training• Healthy Pregnancy Class• Private Provider Focus

Groups/Outreach

Media and MessagesMedia and Messages• Prevention

messages aimed at youth

• Public Service Announcement

• To date, media aimed at 35+ social drinker

• Messages aimed at support network

• Website• Phoneline• Newspaper

Website informationWebsite information

• www.zeroexposure.org• Community can contribute• Interactive/download materials

• National and local information

• Several phases

Website StatisticsWebsite Statistics

• Numbers for July-October, 2005– 2,202 Visits to website– 39,758 “hits” on the site– Visitors spent an average

of 9.5 minutes on the siteWhy is this important?

Community Alcohol SurveyHow much can a pregnant woman drink?

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• Should places that sell alcoholic beverages be required to post warnings to pregnant women?

Community OutreachCommunity Outreach

• Statewide conference • Trainings statewide for other communities

• Coordinate and conduct monthly community committee meetings

Resource CommitteeResource Committee

• Networking• Multiple disciplines• Case Management• Feedback and reporting• Referrals

Jail OutreachJail Outreach• Providing education to all pregnant

women in jail (avg. 40/day)• Healthy Start Passports to all women• Relationships for referral• Liaison working with women• Participation in community referrals• Approved new position for discharge

planning

Resource Committee Resource Committee ProjectsProjects

• Documentary• Jail Outreach and Education• Networking Event in February

2006• Transportation• Medication Issues• Communication• Referral process for substance

abuse treatment and prenatal care

Evaluation CommitteeEvaluation Committee

• Screening tools• Data Collection• Acts as a consultant to all projects

• Develops impact studies/tools

Screening toolsScreening tools

• 4 P’s Plus• TWEAK• T-Ace

4 P’s Plus Questions4 P’s Plus QuestionsParents-Did either of your parents have any problems with drugs or

alcohol?Partner-Does your partner have any problems with drugs or alcohol?-Is your partner’s temper ever a problem for you?Past-Have you ever drunk beer/wine/liquor?Pregnancy-In the month before you knew you were pregnant, how many

cigarettes did you smoke?-In the month before you knew you were pregnant, how much

beer/wine/liquor did you drink?

Results to date of 4 P’sResults to date of 4 P’s• Parents? 18% yes• Partner? 2.4% yes• Partner’s temper? 1%• Ever drink? 93.5% yes• Smoke month before? 12.1%• Drink month before? 37%• *total of 1231 screened

women

Challenges to dateChallenges to date• Multiple providers as partners• Evaluation• Validity of 4 P’s Plus• Screening administration (interview vs.

self-assessment)• Community Resources• Private Referrals• No solid numbers on substance exposed

newborns• Comprehensive range of needs from social

drinker to illicit drug addicted mom• Sensitive topic that is easily avoided and

hidden

Successes of ZEP to DateSuccesses of ZEP to Date• New partnerships with substance

treatment agencies• Increased awareness community wide• Private OB relationships• Statewide interest in campaign• Substance exposed newborn issues/FAW

referrals• Jail initiative with new position• Media interest• Dependency drug court• School system support

What is next for ZEP?What is next for ZEP?• Saturate community with prevention messages and expand

target group• Develop messages aimed at partners and support systems• Include Interconceptional mesages• Focus on younger audiences with prenatal messages• Finalize decision on screening tools and utilization• Statewide trainings for other communities• Continued training for all ZEP members• Expand number of pilot sites of private OB offices• Engage Pediatric community• Increase attention on smoking and smoking cessation• Advocate for mandatory messages at points of sale for

alcohol• Seek future funding• Evaluate impact on community attitudes

How can I get involved?How can I get involved?• Join a committee• Contribute to the website• Network, network, network• Email suggestions, contacts or any relevant information

• Attend trainings and events

Contact informationContact information

• www.zeroexposure.org• Phone line877-233-5656

Lisa Colen, Project DirectorLcolen@hstart.org

813-233-2800, ext. 133

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