How-To 2.4How to Identify a Specific Outcome to Target for Change (Figure 2.1, Step F)

1. Begin with the issue or problem identified in Step A of Figure 2.1, and determine a specific variable that can be measured that is directly related to improving the management of FASD. For example, in terms of prevention, the variable may be to “Add FASD awareness as an element of client education with all female clients of childbearing age, whether pregnant or not.” In terms of intervention, the variable may be to “Increase staff ability to identify signs of a client who may have an FASD.”

   -

   Identify a way to measure “identify signs of a client who may have an FASD.” For example, there is a list of common physical and behavioral manifestations of FASD in Part 1, Chapter 2 of this TIP, and repeated later this chapter, that can be used as a checklist.

   -

   Identify a way to measure “client education with all female clients of childbearing age, whether pregnant or not.” For example, tracking instances of client education on the topic of alcohol-exposed pregnancies, and/or rates of abstention among pregnant clients.

2. Measure a baseline prior to implementing FASD prevention or intervention. For example, determine how many women of childbearing age you see at your agency in a given month. In terms of intervention, review cases of client noncompliance, particularly where no specific cause of the noncompliance is known. Did these clients forget appointments? Not follow directions? Act out? Exhibit family instability and/or have a history of multiple foster care placements? These can become cues for identifying case of possible FASD in the future.
3. Identify which outcome you are most interested in measuring to determine whether implementing FASD prevention or intervention is working. For example:
   • Intervention
     • Number of staff trained in FASD intervention methods
     • Rates of identifying potential cases of an FASD
     • Rates of conducting FASD evaluations/assessments
     • Rates of finding/filling FASD assessment slots
     • Diagnoses achieved
     • Follow-up/Aftercare: Family stability over time
     • Multiple foster placements reduced
   • Prevention
     • Number of staff trained in FASD prevention
     • Implementation of alcohol screening with all women of childbearing age, whether pregnant or not
     • Treatment planning adaptation based on this screening
     • Achieving abstinence/reduction of at-risk drinking
     • Use of effective contraception by the client