Global Alcohol Policy Conference

Click here to listen to the blog (3:39).

We recently posted about the role of supportive alcohol policy as a key component in supporting women and children’s health and FASD prevention efforts. In October, Lindsay Wolfson, a researcher at the Centre of Excellence for Women’s Health and Canada FASD Research Network, attended the 7^th Global Alcohol Policy Conference in Cape Town, where she presented the findings of this work. You can find the paper she led on alcohol policy and FASD prevention here.

Considering gender, pregnancy, and FASD Prevention: Highlights from the conference

The bi-annual conference brought together constituents from across the globe. The conference addressed alcohol marketing and advertising controls; pricing and taxation; liquor law enforcement; and health and safety messaging. Linked to these policy domains was an emphasis on alcohols relationship to gender-based violence and community-based alcohol strategies.

The conference opened with a powerful plenary where Bongiwe Ndono of South Africa Alcohol Policy Alliance, emphasized the role of alcohol in gender justice and how, without appropriate laws and regulations and a shift in society’s relationship with alcohol, we will not be able to address the links between alcohol and violence.

The conference also featured leading researchers from South Africa, Australia, the United Kingdom, and the United States. Drs. Rachel Jewkes, Anne-Marie Laslett, and Natalie Blackburn described the complex relationship between alcohol and violence, including how alcohol is a contributor, cause, and trigger for abuse; gender transformative programs that focus on reducing alcohol use and gender-based violence; and how alcohol policies can be paired with other strategies to reduce intimate partner violence and alcohol use most effectively.

In another plenary presentation, Dr. Antonia Lyons from the University of Auckland, discussed the influential and addictive nature of digital alcohol marketing compared to previous marketing media. Her presentation emphasized how, by creating devices, products, and social media platforms all with addictive qualities and that allow for personalization, the alcohol and tech industries stand to maximize profits without regard for the harms they are causing. This is important, given the increasingly gendered nature of alcohol advertising and the impact that this marketing may have on alcohol use and alcohol use during pregnancy.

FASD prevention was often mentioned as a goal or an unanticipated outcome of policy efforts. For instance, in one presentation from Northeast England about developing a childhood alcohol-free strategy, the authors described how an estimated 47% of adults drank above the low risk drinking guidelines and 41% of women used alcohol during pregnancy. The strategy has been effective in reducing children’s exposure to parental alcohol use and has led to a reduction in alcohol use during pregnancy.

Canada on the global stage

Where FASD was highlighted, it often was done with Canada’s leadership at the forefront. For example, in the extensive discussions on alcohol warning labels, researchers and policymakers often cited the evidenced and successful nature of pregnancy and alcohol warning labels in the Yukon. And, there was global recognition of Canada’s efforts to amend warning labels on alcohol containers and to bring forth a National Framework on FASD. These discussions highlight the importance of continued investment in FASD prevention in Canada. Further, they offer an opportunity for us to continue to reflect, discuss, and promote supportive alcohol policy as a key FASD prevention strategy.

Supportive Alcohol Policy as a Key Component in FASD Prevention

Click here to listen to the blog (3:56).

In Canada, the Four-Part Model of FASD Prevention is used to describe the continuum of multi-sectoral prevention efforts, including broad awareness campaigns, safe and respectful conversations around pregnancy and alcohol use, and holistic wraparound support services for pregnant and postpartum women with alcohol and other health and social concerns. Supportive alcohol policy is at the centre of these four mutually reinforcing levels of prevention, yet there has been little attention paid to the role of alcohol policy in FASD prevention and in promoting women’s and fetal health.

Alcohol policies are important because they determine the availability of alcohol and aspects of the environment in which decisions about drinking are made, such as the geographic density of alcohol serving establishments, health and safety messaging, and alcohol use guidelines (including Canada’s new Guidance on Alcohol and Health).

In 2023, researchers from the Centre of Excellence for Women’s Health wrote a review describing the state of the literature on alcohol and pregnancy policies and their impact across the four-part model of prevention. The findings primarily centered around alcohol warning labels, pregnancy guidelines and their national and regional uptake.

Alcohol Warning Labels

The findings emphasized that while the efficacy of alcohol warning labels as a single strategy is unclear, they are an important part of a comprehensive FASD prevention strategy. Further, in Canada, researchers have found that alcohol warning labels can contribute to a reduction of alcohol sales.

Pregnancy Guidelines

While there was an emphasis on the knowledge and uptake of guidelines on alcohol use in pregnancy and lower-risk drinking, the research findings demonstrated wide variability internationally, including inconsistent messaging around alcohol use. Despite this, knowledge of the risks of alcohol use during pregnancy and a belief that women are motivated to reduce their alcohol use if pregnant or planning a pregnancy were identified as facilitators to guideline adherence.

Legislative Policy

In the research, there was an increasing focus on alcohol and pregnancy legislative policy, particularly in the US. These ranged from punitive approaches that reported women’s behaviour and prompted child removal to supportive policies that improve women’s health and support the provision of early intervention and treatment services. In examining the evolution of such policies, US researchers found that the number of alcohol policies have increased and in an increasingly punitive policy environment, are often associated with restricting women’s reproductive autonomy.

Supporting FASD Prevention, Women’s Health, and Cross-System Collaboration

Shifting policies to be more supportive of FASD prevention requires the development of evidence-based policies that attend to, and proactively promote, women’s health. Moving forward, it is particularly important that alcohol policies – and supportive alcohol policies at that – are linked to child welfare policies that support mothering.  They are depicted together and central in the four part model diagram. This cross-system collaboration can help create a higher standard of care and address the barriers that prohibit women from seeking care in the first place. Through this collaboration, women will be supported to have healthy pregnancies, linked to treatment and diagnosis as necessary, and have access to services that prioritize their needs and goals.

To learn more, read the article here. 

Every Moment Matters – An evidence-based FASD prevention campaign for Australia

Click here to listen to the blog (3:54).

Every Moment Matters is a nation-wide health promotion campaign launched in Australia which shares the latest evidence-based information about alcohol during pregnancy and breastfeeding. See www.everymomentmatters.org.au/.

The messages

The messages about alcohol use in pregnancy and FASD include:

• Every moment matters when it comes to alcohol – whether you are planning a pregnancy, currently pregnant or breastfeeding.

• Planning a pregnancy is an exciting time. It’s also a great opportunity to go alcohol-free. Make the moment you start trying the moment to stop drinking alcohol.
  • The “planning a pregnancy” section includes
    • information about how alcohol affects fertility, the risk for miscarriage, and how the placenta is not a barrier to alcohol
    • ideas for action, when sharing information with friends, and finding help

• All parents want to give their baby the best start in life, which is why it’s important not to drink any alcohol during pregnancy.
  • The “currently pregnant” section includes
    • information about how alcohol passes directly to the developing baby and can damage their brain, body and organs (FASD)
    • ideas for action to garner support from partners friends and family and for talking to a doctor, midwife or obstetrician

• When breastfeeding, not drinking alcohol is safest for the health of your baby.
  • The “when breastfeeding” section includes
    • information about how alcohol enters breastmilk, noting how when there is alcohol in one’s blood, it is also in their breastmilk
    • strategies to avoid exposure when a choice is made to drink alcohol while breastfeeding

All sections of the website contain many helpful facts about alcohol and pregnancy and breastfeeding, how women can make a change in alcohol use, and how to support someone who is pregnant or planning a pregnancy. And there are links to a multitude of resources: www.everymomentmatters.org.au/resources/

The underlying research

This campaign has the most solid background research of any undertaken to date. The Foundation for Alcohol Research and Education (FARE) commissioned research to ground the campaign that involved:

• A literature review and review of previous campaigns implemented in countries around the world, in order to establish best practice approaches to a campaign such as this.
• Research to understand attitudes, perceptions of risk, and understanding of the issues by people in Australia, to identify potentially effective messages and framing of messages. This research included women who were pregnant, planning a pregnancy (in the next 2 years) or who might become pregnant, through an online survey, virtual focus group discussions, online journey mapping forums and virtual in-depth interviews.

Very comprehensive findings from this research guided the creation and testing of messaging for the campaign so that the messages would ‘grab attention’, contain information that was personally relevant to various segments of the population and be persuasive so that women would avoid alcohol during pregnancy.

Learn more about the research and its impact

The sponsors of the campaign, FARE, are hosting a webinar on Dec 8^th (in Australia) entitled Behind the Scenes of Every Moment Matters where they will explore some of the key elements of this ground-breaking national health promotion campaign. Members of the campaign team will share insights into the formative research, message testing, creative approach, media strategy, engagement of health professionals in the campaign, and its impact to date.

This event is for people working in health promotion, public health policy, social marketing, the alcohol and other drugs sector, behaviour change, or evaluation design. 

See https://www.eventbrite.com.au/e/behind-the-scenes-of-every-moment-matters-tickets-439430427237

Prompting International Collaboration through an International Seminar Series on FASD Prevention

Research about preventing FASD is advancing across the globe and it is important that it be shared and acted upon. We see from our annual annotated bibliographies the amazing international work happening on the many levels of prevention – on awareness building approaches, on safe and respectful conversations about alcohol use with pregnant women, and on holistic support services for pregnant women and new mothers’ experiences of alcohol problems and other health and social concerns.

Leveraging off the work of researchers in Canada and internationally, the Canada FASD Research Network has sponsored a five-part seminar series bringing together 14 researchers from across the globe to share what is known about preventing alcohol use in pregnancy and supporting women’s health.

The five-part seminar series focuses on destigmatizing considerations, frameworks for FASD prevention, awareness raising and community development. Throughout the series, researchers from Canada, Australia, South Africa, USA, and New Zealand shared evidence on:

• The role and implications of stigma and FASD prevention efforts;
• Different frameworks for FASD prevention, including the four-part model of FASD prevention and holistic community-based prevention efforts;
• The development of FASD prevention guidelines;
• The ways to communicate information about alcohol use in pregnancy and FASD prevention;
• How to have collaborative conversations around alcohol and other substances during pregnancy – and the ways to translate perceptions of alcohol risks into successful interventions; and,
• Programs for pregnant and postpartum women and gender diverse individuals who use substances and their children.

This seminar series prompted collaboration in ways that historically have only been done at in-person conferences. Each seminar can be viewed in its entirety or as individual presentations. The goal is to provide service providers and leaders across the globe with user friendly access to FASD prevention research to inform their work when delivering and funding prevention efforts.

Through the international seminar series, we hope to make it possible for all countries to have access to what is known about preventing alcohol use in pregnancy.

We hope you will check out the seminar series available on the CanFASD YouTube page and prevention tab of the website.

September – A Month Dedicated to Raising Awareness of FASD and its Prevention

In September each year, efforts are made to raise public awareness of FASD as a disability and of FASD prevention.  Here we describe some of the great work that is being done.

Awareness of FASD as a disability – It is important to build awareness of the disability and how to support people living with FASD. This year, a report entitled Excluded: Increasing Understanding, Support and Inclusion for Children with FASD and their Families was developed by the Office of the BC Representative for Youth, with the involvement of people living with FASD. It provides a clear description of the effects of FASD and its challenges for individuals. It also looks at the challenges and gaps in support in educational, health, justice and other systems, and makes recommendations for addressing these gaps and challenges. Another resource of note about provision of support over the lifespan is Towards Healthy Outcomes for Individuals with FASD by the CanFASD Research Network in collaboration with the University of Alberta.

Awareness about alcohol use in pregnancy via educational materials and messaging – Every province and territory in Canada is working to some degree on FASD prevention awareness through informational materials, posters or social media posts. The Saskatchewan Prevention Institute (SPI) does a remarkable job of advocating for “changing the conversation” via an informational website and posters with modern images and encouraging messages. Click here for more information. SPI is consciously working to prevent stigma and uses this approach with the language and images in their prevention messaging, which are described in guidelines created by the CanFASD Research Network. Also within this year, the BC government updated and expanded their public Health File about FASD prevention. Click here for more information.

Alcohol policy initiatives – Warning labels have been found to play a small but important part in raising awareness about not drinking in pregnancy. In the past year The Foundation for Alcohol Research and Education (FARE) in Australia led a successful campaign for mandatory, visible pregnancy health warnings on all alcohol products in Australia and New Zealand. It is worth reading about how they achieved this, through broad inclusion of 4,000 people from 180 organizations, including people with lived experience, as well as health advocates, researchers, politicians, Indigenous leaders and many others: https://fare.org.au/labelling-campaign/. There are many other aspects of alcohol policy that deserve attention as part of FASD prevention, and the CanFASD Network Action Team on FASD Prevention (pNAT) is pleased to have participants who are interested in actively working towards improved alcohol policy over the coming year.

Community development – Another approach to raising awareness of the disability and its prevention is though involving families, organizations and communities in collective health promotion action. While the pandemic has thwarted most face- to- face community action, the Able2 group in Ontario is organizing a community walk to raise awareness on September 11^th in Ottawa. For more information see: https://kitchissippi.com/2021/08/04/able2-on-upcoming-fasd-awareness-walk-pandemic-fundraising/

Promoting connection, respect and awareness is always a win!

“Learning to Understand”

When we first formed the Prevention Network Action Team over a decade ago, we insisted on calling it the Network Action Team on FASD Prevention from a Women’s Health Determinants Perspective.  We did not want FASD prevention to have a sole focus on stopping or reducing alcohol use but instead to have a wider focus on the need for changing systemic as well as personal and interpersonal influences on women’s alcohol use.  One such systemic influence is women’s experience of trauma and violence.

Understanding the impact of trauma and violence on women and gender diverse people’s lives has never been more important as we in Canada read and absorb the findings of Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls in Canada. We are called upon to understand and act against systemic processes such as racism, sexism and misogyny, and structural oppression related to ongoing and widespread violence against women, social and economic marginalization of Indigenous women, and the multigenerational effects of horrific colonial and patriarchal practices.

The MMIWG report sets out seven principles for change that inform the 231 Calls for Justice needing action across federal, provincial, territorial and Indigenous governments, industries, institutions, health care, child welfare, correctional services, and policing.  Some of these principles we have often discussed and promoted in our work on FASD prevention. They include:

1. A focus on substantive equality and human and Indigenous rights
2. A decolonizing approach
3. The inclusion of families and survivors
4. Self-determined and Indigenous-led solutions and services
5. Recognition of distinctions (i.e., the diversity of Indigenous peoples)
6. Cultural safety
7. A trauma-informed approach

In addition to the Calls for Justice, several action plans have been created in order to enact change. The Native Women’s Association of Canada has committed to taking leadership and action to end the violence and genocide, and to the full implementation of an Action Plan they have developed for: ending the violence including all forms of race-and gender-based violence, and upholding dignity and justice for Indigenous women, girls and gender-diverse people in Canada. There are many opportunities within their Action Plan where we who are working on FASD prevention can work together on key actions they have identified.  Here are three examples:

• Continue ongoing health, policy, research, training and programs to support Indigenous-led health initiatives (page 22)
• Create and implement awareness building campaigns that will educate the public about MMIWG and the issues and roots of violence (page 38)
• Monitor media stories and track inaccurate portrayal of Indigenous women (page 41), so that portrayals that perpetuate negative stereotypes of Indigenous women are challenged/stopped and the “curious silence” (page 388 of the MMIWG report) of the media in covering the lives of Indigenous women is addressed.

National and regional Inuit organizations have also developed an action plan. The National Inuit Action Plan was developed by a 10-member Working Group, co-chaired by Inuit Tapiriit Kanatami (ITK) and Pauktuutit Inuit Women of Canada. The National Inuit Action Plan also identifies a wide range of areas where concrete, timely and measurable positive changes need to be made for Inuit women, girls and 2SLGBTQQIA+ people to achieve substantive equality. The image from page 6 of that report illustrates the breadth of the work that needs to be done, how we in FASD prevention can align our actions.

Harriet Visitor, an Indigenous educator and niece of Chanie Wendak, used the expression “learning to understand” on the radio this past week. She describes this as different than simply learning, it involves unlearning, not turning a blind eye, and acting. In the case of missing and murdered Indigenous women and girls, it involves supporting decolonization and revitalization of Indigenous culture and doing everything in our power to ensure the future is one where Indigenous women can thrive as leaders, teachers and healers, and be acknowledged and honoured for their expertise, agency and wisdom.

Resources:

• Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls in Canada (Volume 1a)
• Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls in Canada (Volume 1b)
• The Native Women’s Association of Canada Action Plan: Our Calls, Our Actions
• National Inuit Action Plan on Missing and Murdered Inuit Women, Girls, and 2SLGBTQQIA+ People

The Prevention Network Action Team on FASD Prevention from a Women’s Health Determinants Perspective (pNAT)

In Canada, FASD prevention advocates work together to link up the local, provincial and national efforts through a virtual prevention research network, which receives financial support from the Canada FASD Research Network (CanFASD). Recently CanFASD refreshed their website, so national action on prevention is profiled. See https://canfasd.ca/topics/prevention/

The Prevention Network Action Team on FASD Prevention from a Women’s Health Determinants Perspective (pNAT) has four objectives. To advance prevention research, the pNAT builds multidisciplinary research teams, which develop research proposals, and conduct research, including evaluation research.  A second objective is to develop and implement strategies for moving “research into action”, for example through preparing and delivering workshops and curricula (both online and offline), and preparing and distributing policy briefs and reports. A third objective is to influence policy and service provision by proactively and collaboratively working with governments and communities to identify and implement service and policy improvements. It is through the fourth objective of networking and networked learning, that the other objectives are achievable. A virtual, national network becomes a location for sharing knowledge, expertise and skills.

The participants in the Canadian pNAT are inclusive of researchers, service providers,

This document about 10 fundamental components of FASD prevention was one of the first documents that the pNAT members wrote together, ten years ago now
https://canfasd.ca/wp-content/uploads/2016/09/ConsensusStatement.pdf

health system planners, policy analysts, community based advocates and (where possible) mothers with lived experience. To achieve this participation, the pNAT employs a virtual community of inquiry (vCoI) model, supplemented by face-to-face meetings often held in conjunction with national and international conferences. Through the vCoI, participants are able to voluntarily attend monthly webmeetings to:

• Share updates on their work;
• Learn of recent additions to the evidence on FASD prevention;
• Discuss research, service provision and advocacy developments undertaken by members and by others in Canada; and
• Plan collective action.

In this way, participants learn together about FASD prevention, and are able to situate their own work within the field.

The community of inquiry framework developed by Garrison and colleagues (2003) provides the foundational, evidence-based design of the virtual community, and grounds it as a ‘learning’ one. In communities of inquiry, people construct meaning through epistemic engagement, as learners, teachers and social connectors (Shea & Bidjerano 2009). In key ways this virtual learning community model reflects the approach that service providers are finding helpful in interactions with mothers and families: i.e. as both teachers and learners, in relationships that prioritize safety, resilience and connectedness.

In addition to the monthly virtual community meetings, the pNAT uses this blog to share outwardly some of the key issues identified in the virtual community.  Visit the https://canfasd.ca/topics/prevention/ location to learn more about the pNAT and its many activities.

Garrison, D. R. and T. Anderson (2003). E-Learning in the 21st Century: A framework for research and practice. New York, NY, Routledge Falmer.

Shea, P., & Bidjerano, T. (2009). Community of inquiry as a theoretical framework to foster “epistemic engagement” and “cognitive presence” in online education. Computers & Education, 52(3), 543-553.

Considerations for Supporting Healthy Families and Healthy Beginnings

Revitalizing Culture and Healing: Indigenous Approaches to FASD Prevention is a new resource developed by program providers and experts in Indigenous women’s health and researchers from the Centre of Excellence for Women’s Health, in partnership  with the First Nations Health Authority in BC. The resource includes a beautiful and thoughtful introduction by Marilyn Van Bibber and highlights seven community led and culture driven programs. Each program successfully integrates culture, language, and healing into their program in order to improve the health and wellness of women, children, their families, and their communities. Marilyn is well known for her development of the first resource on Indigenous approaches to FASD prevention in Canada, entitled It Takes a Community published in 1996.

The programs highlighted in this resource use the traditional holistic view of health and wellness that encourages balance between mental, physical, emotional, and spiritual health. They incorporate culture and language, coordinate basic needs, and address women, their families, and their communities’ unique and complex needs by promoting healing through language, ceremony, traditional knowledge, land-based programming, involvement of Elders, and more.

The driving principles that contribute to the success of these programs is that they are community led, culture driven, strengths-based, and provide wraparound support that address broad social and structural factors that impact individuals’ and their families’ lives across the lifespan.

Program planners and service providers can learn from the lessons shared from these programs and integrate the following 4 considerations that support healthy beginnings:

1. Use Non-Stigmatizing Language

Service providers and healthcare professionals should use strengths based language that promotes wellbeing, creates safe spaces for women and girls to discuss their substance use, and helps women and girls build confidence and ask for support. Providers should shift towards using person-first language in their practices, where clients are identified as a person rather than by their health condition or behaviours. Some examples my include shifting from language “addicts” to “women who use alcohol” and from “she admitted to drinking alcohol during pregnancy” to “she reported drinking during pregnancy.”

For more information on the strengths-based language, the Canadian Centre on Substance Use and Addiction and Canada FASD Research Network have released language guides to support the use of non-stigmatizing language when discussing substance use and FASD.

2. Identify Existing Community Strengths and Programming

Meeting with existing services to see how they are, or could be, a part of wellness and FASD prevention initiatives is an important strategy in identifying community strengths and linkages that can better support healthy beginnings and healthy families. Identifying these strengths and linkages can better support current or existing program planners in developing a realistic goal for program delivery in your community.

3. Connecting with those who have Walked the Path Before Us

The programs featured in this booklet enact approaches that have been successful at implementing community led, and culture based approaches to improving the health of women, their families, and their communities. The lessons and approaches in these programs demonstrate what decolonized approaches to FASD prevention can look like.

4. Identifying Potential Funding Partners

Building relationships with potential funders is an important step towards developing or supporting community-based prevention programs. The breadth of these programs – in addressing a multitude of needs – demonstrate the varied funding that can support families. Given how the programs enact evidence informed and wise practices, it is important that stable and long term support is provided to ensure the programs’ ongoing responsivity and development.

For more information on the seven highlighted programs, four critical considerations, and to review the eight reflection questions on how to support healthy beginnings in your community, see the booklet, Revitalizing Culture and Healing: Indigenous Approaches to FASD Prevention.

Coercive messaging for pregnant women?

In 2016, the UK Chief Medical Officer with endorsement from the Royal College of Midwives updated advice on drinking alcohol during pregnancy, stating:

“I want pregnant women to be very clear that they should avoid alcohol as a precaution. Although the risk of harm to the baby is low if they have drunk small amounts of alcohol before becoming aware of the pregnancy, there is no ‘safe’ level of alcohol to drink when you are pregnant.”

This month, the Centre for Pregnancy Culture Studies (CPCS) and others have been getting a lot of press for the claim that women are being unnecessarily frightened by this most recent advice and may be terminating pregnancies because of it (see post below for facts on this). They say that women who choose to drink at low levels during pregnancy are being stigmatized when the facts don’t support the guidelines.  Further, they claim “the exclusion of women from an ordinary activity on the basis of ‘precaution’ can more properly be called sexist than benign.” (The Guardian, May 17, 2017)

That they see alcohol as a normal activity that women should have a right to, does a disservice to both feminism and to alcohol education. There is definitely here a reluctance to examine alcohol as a substance that has the potential to negatively affect health in all situations, and is a teratogen in the context of pregnancy.  More, rather than less, discussion of alcohol on men’s and women’s health, and not only in relation to preconception and pregnancy would be welcome.  Canada’s Low Risk Drinking Guidelines could inspire more public consideration of what we know and don’t know about alcohol.

CPCS’s comments were in tandem with a larger Policing Pregnancy conference held last week. And on points of pregnancy policing, we agree. Facts show that policing pregnancy increases stigma and pushes women to the margins so that they don’t get the help they want [1]. Women should not be policed for their actions in pregnancy, rather they should have access to information and conversations that can support their decisions.

Preconception and prenatal health care with a caring and knowledgeable health care provider is critical to helping women have the best health and pregnancy possible. How many women have the kind of discussion of alcohol and the care they deserve?

As one opinion writer noted in response to the coverage, the tinkering with alcohol guidelines for pregnant women is not the harm here – it is the lack of services and care that pregnant women receive. https://www.theguardian.com/commentisfree/2017/may/20/i-can-cope-with-drinking-advice-but-not-bad-care

 

For more information, see these earlier posts:

Policing or Supportive? Why We Should Test Pregnant Women for Alcohol Use, July 7, 2015

Do Concerns about Alcohol Use during Pregnancy Lead Women to Consider having an Abortion? February 1, 2013

References

1. Poole, N. and B. Isaac, Apprehensions: Barriers to Treatment for Substance-Using Mothers. 2001, British Columbia Centre of Excellence for Women’s Health: Vancouver, BC.

 

Conversations on alcohol: Women, their partners, and professionals

3rd in Series: First-ever FASD Prevention Plenary at the 7th International Conference on FASD: PART 2

“International Research on Discussing Alcohol with Women and Their Partners, and Empowering Professionals to Have These Conversations”: Tatiana Balachova, PhD, Associate Professor, University of Oklahoma Health Sciences Center & Prevent FAS Research Group; Jocelynn Cook, Chief Scientific Officer for The Society of Obstetricians and Gynaecologists; Lisa Schölin, Consultant at WHO Regional Office for Europe – Alcohol, Illicit Drugs and Prison Health; Leana Oliver, CEO of FARR; Cheryl Tan, Health Scientist CDC

Research shows that building awareness and offering brief interventions can help women reduce alcohol-exposed pregnancies. For a variety of reasons, not all providers feel comfortable or confident in giving information or asking about alcohol use, and they may not be sure it makes a difference in preventing alcohol-exposed pregnancies. Consequently, researchers from around the world presented their findings at the 7^th International FASD Conference Prevention Plenary. They discussed whether or not brief interventions work, and if they do, then which strategies work best.

Russia – Positive Messaging Improves Knowledge and Action

Tatiana Balachova, PhD, and her research group conducted a 3-part study to develop, implement, and test a prevention program in Russia. They found that women in Russia most trusted their OB/GYN physicians, so they developed FASD educational materials and trained physicians to deliver prevention information in two face-to-face structured interventions. FASD brochures using positive messages and images improved women’s knowledge of FASD and reduced risk for alcohol-exposed pregnancies. As well, they found that women who received the intervention reduced their frequency of alcohol use – most quitting – during in pregnancy.

Canada – Care/Service Provider Education is key

Jocelynn Cook, Chief Scientific Officer for The Society of Obstetricians and Gynaecologists of Canada (SOGC) detailed the Vision 2020 strategies: advocacy, quality of care, education, and growing stronger. These strategies underpin their goals for care providers to focus on preconception as well as pregnancy, and deliver consistent messaging. In line with these goals. Alcohol Use and Pregnancy Consensus Clinical Guidelines that were first published by the SOGC in August 2010 were updated in 2016. The guidelines highlight the value of brief interventions and will be supported in the coming year with online education and training that recognizes “red flags” and provide best practices for supporting women’s health and engagement in discussions on potentially stigmatizing topics such as alcohol use.

World Health Organization – Prevalence Rates Inform Strategy

Lisa Schӧlin, consultant with the World Health Organization’s European office, described the data from Europe on alcohol consumption and drinking during pregnancy. The most recent prevalence data shows that Europe has the highest consumption rate of alcohol per capita of anywhere else in the world. As well, at 25.2%, it has the highest rate of alcohol consumption during pregnancy and the highest rate of FAS (37.4 per 10,000). These data were published in a review of the evidence and case studies illustrating good practices and areas of European action called “Prevention of harm caused by alcohol exposure in pregnancy” – you can view or download here.

South Africa – Short Messages Can Build Awareness

Leana Oliver, CEO of Foundation for Alcohol Related Research (FARR), explained how FARR builds upon existing health services by providing prenatal support, pregnancy planning and teaching of coping strategies to women through their programmes. Their “Do you have 3 Minutes?” campaign has been successful in building awareness within communities and in supporting prevention programmes (learn more here). As well, the FARR Training Academy offers accredited trainings and continued professional development on FASD to professionals, providers and educators. Research projects and FARR publications detail what has been learned such as the benefits of motivational interviewing and the need for preconception care and planning.

U.S. – Promoting Universal Screening and Brief Intervention

Cheryl Tan, Health Scientist, Centers for Disease Control and Prevention reviewed FASD activities currently underway. Surveillance of alcohol consumption by women of reproductive age is ongoing alongside efforts by the CDC to promote universal screening and brief interventions (aSBI) of adults 18+ years. She noted the wide discrepancy between how often providers say they conduct SBI (85%) and how often patients say they receive it (25%). As well, as a partner of the Collaborative of Alcohol-free Pregnancy, the CDC is helping to change healthcare practice through high-impact projects: 1) implement interprofessional model for prevention of AEP; 2) provide evidence for aSBI to insurers in the US; and, 3) reduce stigma associated with drinking during pregnancy.

For more these topics see earlier posts:

First-ever FASD Prevention Plenary at the 7th International Conference on FASD, March 22, 2017
WHO Europe: Prevention of harm caused by alcohol exposure in pregnancy, December 22, 2016
“Supporting pregnant women who use alcohol or other drugs: A guide for primary health care professionals”, May 15, 2016
How do partners affect women’s alcohol use during pregnancy?, August 11, 2014
Empowering Conversations to Prevent Alcohol Exposed Pregnancies: Extended Learning Webinars, May 8, 2014
The Prevention Conversation Project – Free Webcast on January 21, 2015 (Alberta FASD Learning Series), December 15, 2014
Alcohol and Pregnancy campaign from Norway, December 12, 2011
FASD Prevention in Russia, February 15, 2012