Fetal Alcohol Spectrum Disorders (FASDs), resulting from prenatal exposure to alcohol, are among the most common developmental disabilities, occurring in as many as 1 in 100 children in the U.S. Alcohol-related physical and neuron developmental abnormalities in the fetus are completely preventable if the mother avoids alcohol during pregnancy. Despite widespread educational efforts regarding the fetal health risks associated with prenatal alcohol use, recent estimates from the U.S. Centers for Disease Control and Prevention indicate that among women who know that they are pregnant, 10% report alcohol use. Furthermore, many women do not recognize the pregnancy until the sixth week of gestation and therefore are at an elevated risk for an alcohol-exposed pregnancy. Thus, there is a need for more effective primary prevention and intervention programs aimed at reducing alcohol intake before conception and during pregnancy in underserved, high-risk populations. These needs are amplified among low-income women whose children are at higher risk of alcohol-related developmental abnormalities. The maximum benefit of these types of interventions can be gained when intervention occurs with women at the greatest risk for an alcohol-exposed pregnancy before they are pregnant. In research settings, selected face-to-face assessment and brief intervention strategies are effective in the reduction of alcohol use in women who have the potential of becoming pregnant;however, these labor-intensive methods are costly for use in primary care. Therefore, from a public health perspective, the use of health information technology to develop self-administered, cost-effective methods for efficiently conducting alcohol assessments and for delivering targeted interventions has broad-based appeal for integration into maternal and child primary care. Furthermore, if such methods could be applied to low-income populations, the recognized health disparities associated with alcohol use in pregnancy can be better addressed. The setting for this project involves non-pregnant women whose children are receiving services through the Women Infant and Children Special Supplemental Nutritional Program (WIC) in San Diego County, California. The primary objective of this project is to conduct a small-scale randomized trial to test an adapted version of a web-based intervention to reduce alcohol consumption in a subset of non-pregnant women who currently drink at risky levels. The secondary objective of this project is to evaluate the sustainability of reduction in alcohol consumption between women who receive the web-based feedback intervention and women who do not. Results of this project can be applied to WIC settings throughout the nation serving approximately 2,000,000 women a year, and may also be extrapolated for use in Maternal and Child Health (MCH) primary care settings
Despite knowledge of the fetal health risks associated with prenatal alcohol use, Fetal Alcohol Spectrum Disorders occur in as many as 1 in 100 children in the U.S. with approximately 10-12% of women who know that they are pregnant reporting alcohol use and approximately 50% of pregnant women do not recognizing the pregnancy until at least a month into the first trimester. The proposed project uses health information technology to develop a self-administered, cost-effective method to efficiently conduct alcohol assessments among women of childbearing potential and to deliver a targeted intervention with potential broad-based appeal for integration into maternal and child primary care. The findings of the proposed study may have policy implications as they could lead to expanded services of current WIC programs in order to more effectively prevent risky alcohol use behavior in women who are not yet pregnant but likely to become so and ultimately prevent FASD in children born to women who are currently pregnant.
