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FASD Research Review

Screening and Intervention Programs

Texas Office for Prevention of Developmental Disabilities

Intervention Type

FASD Prevention Subcontractors
(Project CHOICES - Funded in 2008 and 2012*)
*Projects funded in 2012 were unable to complete their programs due to funding cuts after the first year.

Project Contact Information

Texas Office of Prevention of Developmental Disabilities (TOPDD)
Amanda Toohey Project Director
909 West 45th Street, MC2100
Austin, TX 78751
Phone: 512-206-4683
Fax: 512-206-5211
E-mail: Amanda.Toohey@hhsc.state.tx.us

Project Summary Statement

The mission of the Texas Office for Prevention of Developmental Disabilities (TOPDD) is to minimize the economic and human costs associated with preventable developmental disabilities. Established in 1989 by the Texas state legislature, TOPDD is an independent state agency designed to be a public-private partnership. TOPDD is governed by an executive committee composed of Texas’ foremost leaders in prevention and disabilities, including medical professionals and legislators.

The agency collaborates with non-profit organizations, state agencies, consumers and leaders from across the state to assess needs, develop solutions and build coordinated systems of care to prevent developmental disabilities. While TOPDD has tackled many different issues in its history, traditionally its main initiative is Fetal Alcohol Spectrum Disorders prevention. TOPDD is the center for state planning on FASD. It convenes and facilitates the Texas FASD collaborative, which consists of over 50 agency partner representatives. Through this active leadership, the agency identifies service gaps and policy priorities to build on the strengths of the collaborative in partnership with communities throughout the state systems. As a result, TOPDD and its allies are able to develop proactive solutions to improve state FASD prevention and intervention efforts.

The Texas Office for Prevention of Developmental Disabilities (TOPDD) is building on its extensive experience of successfully implementing Fetal Alcohol Spectrum Disorders (FASD) prevention services with women of childbearing age in the state of Texas by expanding Project CHOICES to serve women in outpatient substance abuse treatment programs in three regions of the state: Houston, El Paso, and San Antonio. From 2008-2012, TOPDD successfully implemented Project CHOICES. Results included 96% of women who reported drinking on the screening decreasing alcohol use and 73.4% of women reported effective contraceptive use at the end (TOPDD, 2012).

With the support of the FASD Knowledge Base Expansion and Services subcontract, the Texas CHOICES program will serve women receiving outpatient substance abuse treatment services who meet the eligibility requirements:

  • ages18 to 44
  • not pregnant or planning to conceive
  • sexually active with a male partner with ineffective use of contraception
  • presenting an alcohol risk or binge drinking risk and/or in outpatient alcohol treatment

For this period of implementation of the CHOICES model, the TOPDD subcontractors will be utilizing a two session CHOICES model in addition to the well woman’s health visit. The project’s goal is to screen an estimated 840 women and provide intervention services to 350 people and have approximately 210 women complete the intervention over the full project period (August 15, 2013 – April 21, 2015).

At Aliviane Inc’s three participating outpatient clinics in El Paso, which serve a combined total of 240 women annually, 34 to 43% of individuals admitted indicated that alcohol is their primary drug of choice. Many more women use alcohol in addition to other drugs of choice. The women served at Aliviane Inc. are predominantly minority including 73% Hispanic, 11% African American, 2% American Indian or Alaskan Native and 15% White. The population is also very young, with 77% of the women between the ages of 18 and 35. The vast majority of women are low income with 36% reporting they are unemployed, and 42 % not in the work force.

At the Center for Health Care Services in San Antonio, 477 women ages 18-44 are served annually in outpatient settings. Ten percent are 18-25, 67% are 26-35 and 22% are 36-44. The women are predominantly from a minority status population where 85% are Hispanics, 15% are White and 2% are African American. Twenty percent report alcohol as the primary drug of choice and 30% report using any alcohol.

At Santa Maria Hostel in Houston, 240 women are served in the three outpatient clinic sites proposed for the project. Of the women served last year, 55% of women were 18-26, 39% were 27-45, and 6% were 46-59. The ethnicity of the women in Houston was varied with 42% Caucasian, 33% African American, 24% Hispanic and 1% other. Approximately 15% of women served at Santa Maria have a primary diagnosis of alcohol dependence, and between 75%-80% use some alcohol.

The subcontracting agencies plan to integrate CHOICES in their programs and utilize their relationships with local agencies to provide a contraceptive visit for the participants. All of these organizations are familiar with data collection and implementing evidence-based interventions, with two of the three agencies having been previous participants in this project. Thus, the subcontracting agencies and TOPDD are well positioned to implement Project CHOICES.