P3.067: A Virtual Interprofessional Collaborative to Improve Fetal Alcohol Spectrum Disorders Recognition and Management in Child Welfare Populations

Background: Fetal Alcohol Spectrum Disorders (FASD) are common in child welfare populations, but often un- or misdiagnosed, contributing to adverse life outcomes. Barriers include provider knowledge gaps, stigma, and fragmented healthcare. This project tested the feasibility of a grassroots inter-professional and inter-agency virtual collaborative within Los Angeles County to address these gaps.

Methods: The collaborative was developed using the COM-B (Capability, Opportunity, Motivation-Behavior) framework; specifically, we focused on improving the self-efficacy of clinicians to manage FASD by providing education and networking opportunities. Led by a pediatrician specializing in foster-adoptive care and a psychologist directing an FASD-informed intervention clinic, 1.5 hour monthly collaborative sessions included participant introductions, advocacy updates, and resource sharing. Complex case examples were shared to highlight key issues which provided opportunities for brainstorming and discussions related to diagnostic challenges, clinical and treatment information, and referrals between agencies. Program effectiveness was evaluated by a focus group and emailed 6-question survey.

Results: Between August 2022 and March 2025, 21 conferences were held. During this time, voluntary participants grew from 4 to an average of 15-20 (3.75 to 5-fold growth) attendees, with 41 on the listserv. Participants included physicians, psychologists, social workers, occupational therapists, educational consultants, school counselors, behavioral therapists, parent partners, a family disability liaison, and a national FASD program manager. 3 participants had living experiences with FASD. Agencies represented included county departments of health, mental health, child welfare, disability services, schools, and the national AAP FASD program. Table 1 details examples of topics discussed.

A single focus group of 12 regular participants revealed that most better understood the range of FASD presentations, treatment strategies, and family approaches to improve outcomes. Some felt more confident managing families without specialty referrals. Participants wanted more learning about frontline assessment tools, better interagency collaboration on screening and referrals, and increased advocacy. Clinical schedules were the main barrier to participation.

Of the 41 surveys sent, 20 were completed. Most respondents reported increased knowledge, confidence, support networks, and direct application of learning to clinical practice (Figure 1).

Conclusion: Growth in participation reflected organic, word-of-mouth community building. Practical, case-based learning and resource sharing sustained engagement. Consistent participants sought system improvement, while others focused on individual case learning. A loosely structured agenda with participant-driven discussions was effective and generalizable to other communities seeking to raise FASD awareness.

The virtual interagency space likely enhanced care coordination and improved patient outcomes. Of 15 cases discussed and followed, multiple interagency referrals and several IEP amendments for FASD eligibility were made. Two adoption dissolutions were averted, and a third child was placed with a disability-trained caregiver after a disrupted prospective adoption. Future evaluations should explore integrated service delivery and patient/client and family outcomes using theories like “relational coordination.”