We know that there is no safe amount of alcohol during pregnancy, yet alcohol use during pregnancy still happens. This research looked at a practical way to change that — not by relying on individual clinicians to “do more,” but by changing how entire clinics work.
The study focused on primary care settings and tested something called the Office Champions Quality Improvement Model. In simple terms, this model supports clinics to:
- Build alcohol screening into everyday care
- Use clear, consistent screening tools
- Share responsibility across the whole team (not just doctors)
- Create systems that make the right thing easier to do
Seventeen family medicine practices took part. Over time, these clinics significantly increased how often they asked about alcohol use, how often they used evidence-based screening tools, and how often they had brief, supportive conversations when alcohol use was identified. Importantly, they also became much better at identifying pregnancy intention, which is key for prevention.
What made the difference wasn’t a script or a single training. It was system-level change, supported by champions inside the clinic who helped lead, model, and sustain the work. The research shows that when prevention is built into routine practice, meaningful change is possible, even in busy, real-world settings.
Reflection for FASD Prevention Conversation Facilitators
This research really reinforces what Prevention Conversation Facilitators see every day: prevention works best when it’s part of normal practice, not a special or awkward add-on.
The clinics that made the biggest changes weren’t doing anything flashy. They built simple, consistent ways to ask about alcohol use, shared the responsibility across the team, and made space for brief, respectful conversations. When the system supported the conversation, people were more willing and more confident to have it.
What stands out is how closely this mirrors prevention conversations in the community. There’s no script. No perfect moment. Just everyday interactions grounded in trust, curiosity, and care. When people feel supported rather than judged, real change becomes possible.