A brief physician intervention to reduce prenatal alcohol exposure: from formative evaluation to testing outcomes in community settings in Russia

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Balachova T1, Bonner B1, Chaffin M1, Isurina G2, Tsvetkova L2, Volkova E2,3, and Prevent FAS Research Group

1University of Oklahoma Health Sciences Center, Oklahoma City, USA
2St. Petersburg State University, St. Petersburg, Russia
3Nizhny Novgorod State Pedagogical University, Nizhny Novgorod, Russia

Alcohol consumption during pregnancy is associated with a range of adverse pregnancy outcomes, e.g., still and premature birth and Fetal Alcohol Spectrum Disorders (FASD) in children. This presentation describes a line of international studies aimed at developing prevention to reduce the risk for prenatal alcohol exposure (PAE) in Russia, a country with one of the highest levels of alcohol consumption in the world. The objective of this presentation is to analyze the process of developing a prevention model from formative evaluation to designing an intervention and evaluating outcomes in community settings. Method: The presentation will answer a set of questions to identify how and why the prevention intervention was designed, including 1) defining the risk, 2) specifying the targeted population, 3) selecting a promising prevention approach, 4) identifying a culturally acceptable prevention delivery method, 5) selecting an intervention format that could be integrated into existing health care system and feasible, and 6) evaluating outcomes in a clinical trial. This assessment driven translational research included mixed qualitative and quantitative methods and involved 1) formative assessment, 2) evaluation of FASD education in randomized educational trials, and 3) designing and evaluating a prevention intervention in a randomized controlled trial. The first study included focus groups with non-pregnant and pregnant women, partners, women with alcohol dependency, pediatricians, OB/GYN physicians, and substance abuse treatment physicians and surveys to assess knowledge and attitudes related to alcohol use during pregnancy among women and physicians and evaluate alcohol consumption among women during the times surrounding pregnancy. Results of Study I were utilized in Study II to address identified needs, develop education for women and physicians, and design a prevention intervention. Study III determined efficacy of the intervention in reducing the risk for PAE in a two-arm site-randomized clinical trial. Results supported the feasibility and efficacy of the intervention. A total of 1,790 women and 341 physicians have participated in the studies. Research described in the presentation was supported by the NIAAA and Fogarty International Center research grants R21TW006745 and R01AA016234 and AUCD/CDC, NCBDDD research grants RTOI 2005-999-01 and 2007-999-02 to Balachova and Bonner at OUHSC.