Inventory of Evidence-Based Practices (EBPs) for Healthy Start Programs
Evidence-based practices include actions, activities, strategies, or approaches that improve the health of women, before, during, and after pregnancy in order to improve birth outcomes and give infants up to age two years a healthy start. Also included in the collection are informational materials and tools that make it easier to implement evidence-based practices. To search by title, use the main search box located at the top of this page.
Screening and brief intervention (SBI) is a structured set of questions designed to identify individuals at risk for alcohol use problems, followed by a brief discussion between an individual and a service provider, with referral to specialized treatment as needed. This manual is designed to provide public health professionals, such as health educators and community health workers, with the information, skills, and tools needed to conduct SBI so that they can help at-risk drinkers reduce their alcohol use to a safe amount or stop drinking. The manual offers background information and practical steps for conducting SBI in a variety of public health settings, including trauma centers, emergency departments, other clinical settings, home visits, and public events.
Topics:
Alcohol/Drug Services Case Management/Care Coordination Risk Assessment
Approaches:
Improve Women's Health
Benchmarks:
Well Woman Visits
Evidence Rating:
II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.
The CRAFFT is a short, validated behavioral health tool developed to screen adolescents under age 21 for high risk alcohol and drug use. Recommended by the American Academy of Pediatrics, it consists of 6 questions involving Car, Relax, Alone, Forget, Friends, and Trouble. The tool is meant to assess whether a longer conversation about the context of use, frequency, and other risks and consequences of alcohol and/or drug use is warranted. It is available in 13 languages.
Topics:
Alcohol/Drug Services Risk Assessment
Approaches:
Benchmarks:
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
The Fetal Alcohol Spectrum Disorders (FASD) Prevention Program is a collaboration between ACOG and the CDC designed to empower healthcare providers to speak with their patients about abstaining from alcohol use during pregnancy. The program includes evidence-based ACOG Committee Opinions regarding ethics, alcohol use in pregnancy, and motivational interviewing techniques, as well as videos and free downloadable materials for both providers and patients.
Topics:
Alcohol/Drug Services
Approaches:
Benchmarks:
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
Failure to address IPV among women who use alcohol or other drugs has been found to increase the likelihood of continued drug use, relapse, attrition from drug treatment and a host of other negative physical and mental health consequences. WINGS is a single-session intervention that aims to address a critical gap in IPV services for women by identifying women in the community at risk of IPV, enabling them to develop social support and safety planning skills to reduce their risks for IPV and linking them to IPV-related services and substance use treatment. The intervention may be delivered in-person or via a computerized self-paced version.
Topics:
Alcohol/Drug Services Intimate Partner Violence
Approaches:
Strengthen Family Resilience
Benchmarks:
Intimate Partner Violence
Evidence Rating:
II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.
This brief, self-administered Social Support Survey instrument was developed for patients in the Medical Outcomes Study (MOS), a two-year study of patients with chronic conditions. It is thought to also be appropriate for use with other populations. The instrument was designed to be comprehensive in terms of recent thinking about the various dimensions of social support – emotional/informational, tangible, affectionate, and positive social interaction. It is easy to administer and the items are short, simple, and easy to understand.
Topics:
Life Course Model Risk Assessment
Approaches:
Benchmarks:
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
There is convincing research evidence that people experiencing greater discrimination in day-to-day life tend to have poorer physical and mental health outcomes than their counterparts. The Everyday Discrimination Scale (EDS) is a validated screen widely used to measure perceived discrimination. An original version of the EDS consists of nine items on a 6-point Likert-type response format, and a short version has been modified to five items.
Topics:
Life Course Model Risk Assessment
Approaches:
Benchmarks:
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
The NIDA Quick Screen is a validated instrument designed to assist providers in screening adults for substance use. The screen simply inquires whether a participant has used drugs (mood-altering, illegal, or prescription for nonmedical reasons), alcohol, or tobacco products within the past year and how often these substances have been used. The NIDA website also provides guidelines for brief intervention and/or treatment referral for patients who may have or be at risk of developing a substance use disorder.
Topics:
Alcohol/Drug Services Risk Assessment Tobacco Cessation
Approaches:
Promote Quality
Benchmarks:
Smoking Abstinence
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
The 4Ps (Parents, Partners, Past and Pregnancy) was developed for use with pregnant women and women of child bearing age. The tool has 4 questions intended to facilitate discussion regarding substance use.
Topics:
Alcohol/Drug Services
Approaches:
Promote Quality
Benchmarks:
Smoking Abstinence
Evidence Rating:
I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.
The UNCOPE consists of six questions and may be used free of charge for oral administration in any medical, psychosocial, or clinical interview to provide a simple and quick means of identifying risk for abuse and dependence for alcohol and other drugs.
Topics:
Alcohol/Drug Services
Approaches:
Improve Women's Health
Benchmarks:
Well Woman Visits
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
The DAST is a 20-item instrument for clinical and nonclinical screening to detect drug abuse or dependence disorders. It is most useful in settings in which seeking treatment for drug use problems is not the patient’s stated goal.
Topics:
Alcohol/Drug Services
Approaches:
Improve Women's Health
Benchmarks:
Well Woman Visits
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
The TWEAK (Tolerance, Worry, Eye-Opener, Amnesia, Cut-Down) is a five-item scale originally developed to screen for risk drinking during pregnancy. The items are not gender specific, however, and the scale can be used with either women or men.
Topics:
Alcohol/Drug Services
Approaches:
Improve Women's Health
Benchmarks:
Well Woman Visits
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
The ASSIST (Alcohol, Smoking, and Substance Involvement Screening Test) is an 8-item questionnaire designed to be administered by a health worker to a client using paper and pencil, and takes about 5-10 minutes to administer. The ASSIST provides information about the substances people have ever used in their lifetime; those used in the past three months; problems related to substance use; risk of current or future harm; dependence; and injecting drug use. The ASSIST was designed to be culturally neutral and usable across a variety of cultures.
Topics:
Alcohol/Drug Services Tobacco Cessation
Approaches:
Promote Quality
Benchmarks:
Smoking Abstinence
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
Commonly used, 5-question tool that screens for drug and alcohol use/abuse. The CAGE-AID Assessment is a quick questionnaire to help determine if further assessment is needed. If a person answers yes to two or more questions, a complete assessment is advised. Included on the Healthy Start National Evaluation Program Survey.
Topics:
Alcohol/Drug Services
Approaches:
Improve Women's Health
Benchmarks:
Well Woman Visits
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
10-item questionnaire that screens for hazardous or harmful alcohol consumption. Developed by the World Health Organization (WHO), it correctly classifies 95% of people into either alcoholics or non-alcoholics. The AUDIT has been used with a variety of populations and cultural groups. It should be administered by a health professional or paraprofessional. Included on the Healthy Start National Evaluation Program Survey.
Topics:
Alcohol/Drug Services
Approaches:
Improve Women's Health
Benchmarks:
Well Woman Visits
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
Nine item questionnaire for patients to measure depressive symptoms over the past two weeks. Questions are linked to the DSM-IV depression criteria, and therefore scores can be used to track changes in depression as a response to treatment. Included on the Healthy Start National Evaluation Program Survey
Topics:
Depression
Approaches:
Strengthen Family Resilience
Benchmarks:
Perinatal Depression Screening
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
Two question screening tool to measure the frequency of depressed mood and anhedonia over the past two weeks. Includes the first two questions from the PHQ-9. Included on the Healthy Start National Evaluation Program Survey.
Topics:
Depression
Approaches:
Strengthen Family Resilience
Benchmarks:
Perinatal Depression Screening
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
A ten-item diagnostic questionnaire used with patients with mood disorders to measure severity of depressive episodes.
Topics:
Depression
Approaches:
Strengthen Family Resilience
Benchmarks:
Perinatal Depression Screening
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
One of the oldest and most frequently used screening questionnaires to measure the severity of and change in depressive symptoms among adults in an inpatient setting.
Topics:
Depression
Approaches:
Strengthen Family Resilience
Benchmarks:
Perinatal Depression Screening
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
The CESD-R is a screening test for depression and depressive disorder. The CESD-R measures symptoms defined by the American Psychiatric Association’ Diagnostic and Statistical Manual (DSM-V) for a major depressive episode. The scale is well known and remains as one of the most widely used instruments in the field.
Topics:
Depression
Approaches:
Strengthen Family Resilience
Benchmarks:
Perinatal Depression Screening
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.
The BDI-FastScreen is a 7-item self-reporting instrument used to quickly screen for depression in adolescents and adults. The screen can identify depression while excluding symptoms that might be related to medical problems, and was specifically designed for evaluating depression in patients whose behavioral and somatic symptoms attributable to biological, medical, alcohol and/or substance abuse problems may confound diagnosis.
Topics:
Depression
Approaches:
Strengthen Family Resilience
Benchmarks:
Perinatal Depression Screening
Evidence Rating:
III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.