Looking Back at the ActNow Initiative in British Columbia: How Policy Moments Can Support Efforts to Reduce Alcohol Use in Pregnancy

A resource developed as part of the Healthy Choices in Pregnancy initiative.
A resource developed as part of the Healthy Choices in Pregnancy initiative.

Nancy Poole and Lorraine Greaves have a short commentary in the March/April issue of the Canadian Journal of Public Health on the Healthy Choices in Pregnancy Program developed in British Columbia as part of the ActNow Initiative that led up to the Olympics in 2010. The article is an interesting case study on building support for FASD prevention work at the level of government and looking at system-level strategies for increasing awareness of FASD.

In 2003, the Canadian province of British Columbia won the bid to host the 2010 Winter Olympic and Paralympic Games. The government of the day saw this achievement as a window of opportunity to establish a health promotion legacy.

In 2005, the BC government launched ActNowBC, a intersectoral initiative that integrated activities across government with civil society initiatives to achieve five health promotion targets by 2010. Among its several components and streams, ActNow had a focus on the reduction of alcohol (and tobacco) use during pregnancy called Healthy Choices in Pregnancy (HCIP).


The Healthy Choices in Pregnancy initiative took a unique approach to addressing alcohol use during pregnancy by focusing on helping healthcare and social service practitioners to change the ways in which they engage with women. Rather than focusing on the development and dissemination of information about the risks of alcohol use in pregnancy targeted at women directly, the program aimed its resources at providers.

This approach was intended to relieve the burden of change from individuals and allowed women—who are often highly stigmatized for drinking and smoking when pregnant—to experience health care and social service systems as welcoming and helpful.

Collaboration across a range of groups, professions and services was encouraged. Researchers, health system planners, service providers, policy-makers, and women themselves worked collaboratively on the initiative. In shifting from individual to systemic change, the program created a shift in attitude and focus from blaming individual women for drinking during pregnancy, to creating systemic change and action based on effective and supportive approaches to reducing alcohol use during pregnancy.


Poole, N. and Greaves, L. (2013). Alcohol Use During Pregnancy in Canada: How Policy Moments Can Create Opportunities for Promoting Women’s Health. Canadian Journal of Public Health, 104(2): e170-e172.

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