The Alcohol and Substance-Exposed Pregnancy Prevention Initiative (AStEPP) offers training and technical assistance to increase Healthy Start grantees’ understanding of the impacts of fetal exposure to alcohol and other drugs, and strengthen their capacity to engage in effective prevention and early identification activities with pregnant women, mothers, and newborns. The initiative also aims to address social, environmental and broader behavioral health factors as they contribute to substance use before, during, and after pregnancy. The initiative takes a health equity approach by focusing efforts on populations at higher risk, including Native American and tribal communities, as well as building upon community strengths and resiliency factors.

New Materials from AStEPP

This infographic–based on discussion groups involving 35 Healthy Start programs representing rural, urban, tribal and border grantees–illustrates key trends and issues HS programs are seeing related to substance use among their participants.


The FASD Quick Start List provides links to selected resources for gaining a thorough understanding of fetal alcohol spectrum disorders (FASD), including their prevention, recognition and referral, issues for families and more.

Foundational Webinar Series on FASD

This webinar series provides a basic overview of fetal alcohol spectrum disorders (FASDs), prevention strategies including referral to treatment for pregnant women, and screening and assessment for FASDs in children. Click on the links below for webinar recordings and slides.

Addressing Fetal Alcohol Spectrum Disorders in the Context of Healthy Start: What do we need to know?   (Presented live 2/21/17)

Using SBIRT in Healthy Start: Destigmatizing Addiction and Cultural Considerations (Presented live 4/13/17)

Introduction to FASD Screening and Diagnosis (Presented live 5/25/17)

What are the Long-term Effects and Impacts of Fetal Alcohol Spectrum disorders (FASD) on Individuals and their Families? (Presented live 9/5/17)

Ask The Expert: How does prenatal exposure to alcohol, marijuana, opioids and other substances affect maternal and child health outcomes? (Presented live 12/12/17)

Tailored Technical Assistance

AStEPP provides TA on request to Healthy Start grantees to assist them in improving the education, services, and support they offer to participants with substance use and/or mental health challenges. Here are some issues that AStEPP TA can help your program to address:

  • Dealing with difficult issues in screening participants for substance use and mental health problems
  • Building a referral network and helping participants connect to substance use treatment and mental health services
  • Adopting evidence-based interventions such as Family Spirit and Project CHOICES
  • Helping CHWs/home visitors to recognize/identify families who may need referral for FASD diagnosis and treatment
  • Building effective approaches and systems for screening, supporting, and connecting to services Native American and tribal participants with substance use or mental health problems
  • TA around specific behavioral health topics including:  Fetal Alcohol Spectrum Disorders (FASD), trauma informed care, Mental Health First Aid and others
  • Other specific issues identified by the grantee

Get in touch with your Technical Assistance Coordinator (TAC) to request AStEPP TA, or request TA here.

Featured Resources

Education & Fetal Alcohol Syndrome Disorders Toolkit 

Opioid and Behavioral Health Resources: A Quick Start List for Healthy Start Grantees

ACOG/CDC FASD Prevention Program

Moms’ Mental Health Matters

Visit the Evidence-based Practices Inventory for additional resources and practices for addressing substance use and mental health with women and families.

For More Information

Please contact the Healthy Start EPIC Center, by email: or by phone: EPIC Helpline 1-844-225-3713.