Prevention of Fetal Alcohol Spectrum Disorders in Primary Care: Use of Office Champions Model to Address Alcohol Use

Rajani Bharati; Julie Wood; Antoinette Abou Haidar; Astrud Villareal; Hemalatha Senthilkumar; John D Gazewood; Jeffrey D Quinlan; Victoria Udezi

doi:10.1370/afm.240581

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Prevention of Fetal Alcohol Spectrum Disorders in Primary Care: Use of Office Champions Model to Address Alcohol Use

Journal article

Open access

Peer reviewed

Prevention of Fetal Alcohol Spectrum Disorders in Primary Care: Use of Office Champions Model to Address Alcohol Use

Rajani Bharati, Julie Wood, Antoinette Abou Haidar, Astrud Villareal, Hemalatha Senthilkumar, John D Gazewood, Jeffrey D Quinlan and Victoria Udezi

Annals of family medicine, Vol.24(1), pp.3-9

01/26/2026

DOI: 10.1370/afm.240581

PMID: 41587843

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Abstract

Alcohol use during pregnancy can cause miscarriage, stillbirth, and fetal alcohol spectrum disorders. Despite no safe level of alcohol consumption during pregnancy, 13.5% of pregnant adults reported drinking, and 5.2% reported binge drinking during 2018-2020. This study aimed to improve alcohol screening and brief intervention (ASBI) practices in primary care settings using the Office Champions Quality Improvement Model. Seventeen family medicine practices participated. Champions led system-level changes, including workflow redesign, staff training, and electronic health record modifications. Chart reviews were conducted at 3 stages (ie, baseline, post-intervention, and sustainability) to assess change in ASBI efforts. A sustainability survey assessed likelihood of continued ASBI efforts after study completion. A total of 2,725 chart reviews were completed. For the first 2 stages 17 practices submitted data, and 14 practices completed the third stage. Alcohol use screening rate increased from 61% to 81% ( <.001) and intervention rates increased from 22% to 67% ( <.001). Identification of pregnancy intention increased from 3% to 66% ( <.001) and use of the Alcohol Use Disorders Identification Test-Consumption tool increased from 3% to 48% ( <.001). Most interventions involved brief counseling and goal setting. Nineteen individual respondents completed the sustainability survey, and most reported confidence in continuing ASBI efforts. The Office Champions Quality Improvement Model enhanced ASBI implementation in primary care settings. System-level integration, validated screening tools, education, and a team-based approach supported improvements in ASBI.

Pregnancy

Adult

Alcohol Drinking - adverse effects

Alcohol Drinking - prevention & control

Family Practice

Female

Fetal Alcohol Spectrum Disorders - prevention & control

Humans

Mass Screening - methods

Primary Health Care - organization & administration

Quality Improvement

Details

Title: Subtitle: Prevention of Fetal Alcohol Spectrum Disorders in Primary Care: Use of Office Champions Model to Address Alcohol Use
Creators: Rajani Bharati - American Academy of Family Physicians
Julie Wood - American Academy of Family Physicians
Antoinette Abou Haidar - MetroHealth Medical Center
Astrud Villareal - Southwestern Medical Center
Hemalatha Senthilkumar - MetroHealth Medical Center
John D Gazewood - University of Virginia Health System
Jeffrey D Quinlan - University of Iowa
Victoria Udezi - Southwestern Medical Center
Resource Type: Journal article
Publication Details: Annals of family medicine, Vol.24(1), pp.3-9
DOI: 10.1370/afm.240581
PMID: 41587843
NLM abbreviation: Ann Fam Med
ISSN: 1544-1709
eISSN: 1544-1717
Publisher: ANNALS FAMILY MEDICINE
Grant note: Centers for Disease Control and Prevention (CDC) of the US Department of Health and Human Services (HHS)
This study was supported by the Centers for Disease Control and Prevention (CDC) of the US Department of Health and Human Services (HHS) as part of an award totaling $994,556 with 100% funded by CDC/HHS. The interpretations in this report are those of the authors and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS or the US government.
Language: English
Date published: 01/26/2026
Academic Unit: Family and Community Medicine
Record Identifier: 9985132068302771

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