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The Zero Exposure Project. Presented by Lisa Colen, MHA ZEP Director. The vision of ZEP . Hillsborough County will be a community where every child is born substance free and lives in a family that promotes healthy growth and development. Why do we need ZEP?.

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the zero exposure project

The Zero Exposure Project

Presented by Lisa Colen, MHA

ZEP Director

the vision of zep
The vision of ZEP
  • Hillsborough County will be a community where every child is born substance free and lives in a family that promotes healthy growth and development.
why do we need zep
Why do we need ZEP?
  • According to 2003 National Survey on Drug Use and Health:
  • -4.3 % of pregnant women aged 15 to 44 used illicit drugs during the last month.
  • -4.1% reported binge alcohol use(5+)
  • -18% reported smoking cigarettes
why do we need zep1
Why do we need ZEP?
  • In 2004, Hillsborough County had

15, 414 births to mothers aged 15-44.

  • By NSDUH survey prediction:
    • 663 used illicit drugs
    • 632 would have binged on alcohol
    • 2775 would have smoked cigarettes
another type of need
Another type of need
  • According to risk behavior survey results, the woman most likely to be a social drinker before and during pregnancy is 35+, white, college educated, professionally employed and married.
goals of zero exposure
Goals of Zero Exposure
  • Raise community awareness about the impact of substance use during pregnancy in order to improve positive birth outcomes.
goals of zero exposure1
Goals of Zero Exposure

Pregnant women who are identified early in pregnancy as substance users are linked with appropriate education, services and treatment in order to improve positive birth outcomes.

goals of zero exposure2
Goals of Zero Exposure

Incorporate evaluation component in all areas of screening, campaign and outreach in order to enhance continuous quality improvement of the project.

partners of zep
Partners of ZEP

The Children’s Board of Hillsborough County

Hillsborough Kids, Inc.

Central Hillsborough Healthy Start


Healthy Start Coalition of Hillsborough County

Healthy Families Hillsborough

Department of Children and Families

Tampa Bay Women’s Care

St. Joseph’s Women’s Hospital

Hillsborough County Health Department

Humana Health Plans

Central Behavioral Health Network

Child Abuse Council

Operation PAR

partners in funding
Children’s Board of Hillsborough County, Inc.

Three Year Funding

Focus on public awareness and education

Improved birth outcomes as a goal for community


CBR/Two years

Provide 4 liaisons for screening, assessment and referral


Partners in Funding
community coordinator
Community Coordinator
  • Oversees liaison activities
  • Builds community partnerships
  • Builds relationships with universities, schools and hospitals
  • Acts as resource for jail and TOPWA (Targeted Outreach to Pregnant Women at Risk)
  • Stays current on treatment options
  • Oversees evaluation of program
  • Seeks additional funding
  • Advocates on all relevant legislative issues
community committees
Community Committees
  • Partnership Resource
  • Education Evaluation
education committee
Education Committee
  • Comprehensive literature
  • Presentations/Provide Speakers
  • Insurance Referrals for providers
  • Physician Spokesperson
  • Screening tool training
  • Healthy Pregnancy Class
  • Private Provider Focus Groups/Outreach
media and messages
Media and Messages
  • Prevention messages aimed at youth
  • Public Service Announcement
  • To date, media aimed at 35+ social drinker
  • Messages aimed at support network
  • Website
  • Phoneline
  • Newspaper
website information
Website information
  • Community can contribute
  • Interactive/download materials
  • National and local information
  • Several phases
website statistics
Website Statistics
  • Numbers for July-October, 2005
    • 2,202 Visits to website
    • 39,758 “hits” on the site
    • Visitors spent an average of 9.5 minutes on the site

Why is this important?

community survey
Community Survey
  • Should places that sell alcoholic beverages be required to post warnings to pregnant women?
community outreach
Community Outreach
  • Statewide conference
  • Trainings statewide for other communities
  • Coordinate and conduct monthly community committee meetings
resource committee
Resource Committee
  • Networking
  • Multiple disciplines
  • Case Management
  • Feedback and reporting
  • Referrals
jail outreach
Jail Outreach
  • Providing education to all pregnant women in jail (avg. 40/day)
  • Healthy Start Passports to all women
  • Relationships for referral
  • Liaison working with women
  • Participation in community referrals
  • Approved new position for discharge planning
resource committee projects
Resource Committee Projects
  • Documentary
  • Jail Outreach and Education
  • Networking Event in February 2006
  • Transportation
  • Medication Issues
  • Communication
  • Referral process for substance abuse treatment and prenatal care
evaluation committee
Evaluation Committee
  • Screening tools
  • Data Collection
  • Acts as a consultant to all projects
  • Develops impact studies/tools
screening tools
Screening tools
  • 4 P’s Plus
  • T-Ace
4 p s plus questions
4 P’s Plus Questions


-Did either of your parents have any problems with drugs or alcohol?


-Does your partner have any problems with drugs or alcohol?

-Is your partner’s temper ever a problem for you?


-Have you ever drunk beer/wine/liquor?


-In the month before you knew you were pregnant, how many cigarettes did you smoke?

-In the month before you knew you were pregnant, how much beer/wine/liquor did you drink?

results to date of 4 p s
Results to date of 4 P’s
  • Parents? 18% yes
  • Partner? 2.4% yes
  • Partner’s temper? 1%
  • Ever drink? 93.5% yes
  • Smoke month before? 12.1%
  • Drink month before? 37%
  • *total of 1231 screened women
challenges to date
Challenges to date
  • Multiple providers as partners
  • Evaluation
  • Validity of 4 P’s Plus
  • Screening administration (interview vs. self-assessment)
  • Community Resources
  • Private Referrals
  • No solid numbers on substance exposed newborns
  • Comprehensive range of needs from social drinker to illicit drug addicted mom
  • Sensitive topic that is easily avoided and hidden
successes of zep to date
Successes of ZEP to Date
  • New partnerships with substance treatment agencies
  • Increased awareness community wide
  • Private OB relationships
  • Statewide interest in campaign
  • Substance exposed newborn issues/FAW referrals
  • Jail initiative with new position
  • Media interest
  • Dependency drug court
  • School system support
what is next for zep
What is next for ZEP?
  • Saturate community with prevention messages and expand target group
  • Develop messages aimed at partners and support systems
  • Include Interconceptional mesages
  • Focus on younger audiences with prenatal messages
  • Finalize decision on screening tools and utilization
  • Statewide trainings for other communities
  • Continued training for all ZEP members
  • Expand number of pilot sites of private OB offices
  • Engage Pediatric community
  • Increase attention on smoking and smoking cessation
  • Advocate for mandatory messages at points of sale for alcohol
  • Seek future funding
  • Evaluate impact on community attitudes
how can i get involved
How can I get involved?
  • Join a committee
  • Contribute to the website
  • Network, network, network
  • Email suggestions, contacts or any relevant information
  • Attend trainings and events
contact information
Contact information
  • Phone line


Lisa Colen, Project Director

813-233-2800, ext. 133

screening to date
Screening to date
  • Partner have problems with drugs or alcohol?
screening results
Screening Results
  • In the month prior to pregnancy, did you smoke cigarettes?
screening results1
Screening Results
  • In the month before, did you drink alcohol?
screening results2
Screening Results
  • How many days in the last month, did you drink alcohol?