empowering significant others to prevent fetal alcohol spectrum disorders (fasd) samhsa’s...
TRANSCRIPT
Empowering Significant Others to Prevent
Fetal Alcohol Spectrum Disorders (FASD)
SAMHSA’sPartnership to Prevent FASDFASD Center for Excellencefor Materials Development
Memi Miscally, M.P.H.Rebecca M. Buchanan, Ph.D.
Scott Crosse, Ph.D.Gwyndolyn Ensley, M.Ed.Giovonna Miller, M.P.H.
November 17, 2003
Learning Objectives
1. Articulate at least 3 reasons why significant others should be empowered to support women in abstaining from alcoholconsumption
2. List at least 5 factors that influence significant others’ decisions to support women
3. Identify at least 2 ways for providers to help empower significant others to support women
Research Methods
• Literature review (medicine, public health, social science)
• Focus groups in four pilot sites – Women:
• 97 participants in 11 groups• 33% White, 30% Hispanic/Latino,
24% Black/African American, 13% Other
– Significant others: • 141 participants in 16 groups• 49% Black/African American, 23% White,
23% Hispanic/Latino, 5% Other
Overview of the Partnershipto Prevent FASD
Background
• Funder SAMHSA/CSAP
• Period July 2001-June 2004
• Resources Funds from CSAP Contributions from partnerships in 4 pilot communities
• Final Task Share community-based model
Pilot Communities and Coordinators
Erie County, NYErie County Council for the
Prevention of Alcohol and Substance Abuse
Sumter County, SCThe Prevention Center, SCADA
East Baton Rouge Parish, LACapital Area Human
Services DistrictDoña Ana County, NM
Ben Archer Health Center
Strategies
Initiate and sustain FASD prevention activities
Local Partnerships
Increase perceptions
of risk
Encourage women to abstain
from alcohol
Significant Others
Increase perceptions
of risk
Abstain from alcohol
Preconceptional/Pregnant Women
Advise women and significant
others
Providers
Definition of Providers
Pilot CommunityCoordinator
PromotorasHealth Educator
OB/GYN
Wellness Coordinator
Social Worker
Why Significant Others?
Personally Connect with Women
Significant Others Have Opportunities for Discussion
• They live with or spend time with her at home
• They accompany her to restaurants, bars, parties, etc.
• They accompany her to prenatal visits
• They are “there for her”
Significant Others Are Committed
to Supporting Women“I would go the whole 9 yards.”
Significant Others Influence Women’s Alcohol
Consumption During Preconception/Pregnancy
To Drink
Take part in social settings where women drink alcohol
Approve of women’s alcohol consumption
Not To Drink
Disapprove of women’s alcohol consumption
Help women find non-alcoholic options
Talk women through cravings
Please note “women” is used as an abbreviation for preconceptional/pregnant women to save space on this slide.
How Do Significant Others
Decide Whether or Notto Advise Women
ConcerningDrinking During
Pregnancy?
Consider the Challenges
Barriers to Initiating a Conversation
• Not aware of the pregnancy
• Concern over other issues– Unexpected pregnancy– Financial status
• Perceive advice as unwanted
Low Perceived Likelihood of Relevance
• “Not me”
• Rather, people who know women who are:– Alcoholics, heavy drinkers– Teens– Non-white, low income, single women
Perceptions of Women’sDrinking Behaviors
• Social– At home, with fathers-to-be who drink– Out, with others who drink
• Moderate– “Sip” or 1-2 drinks– Occasionally– Not during 1st-2nd trimester– Beer, wine, wine cooler, “mild” mixed drink (not
hard liquor)
Skepticism
• Women can drink alcohol and give birth to healthy babies
• Women can abstain from alcohol use and give to unhealthy babies
Low Perceived Self-Efficacy
• What do I say to her?– How much alcohol harms the baby?– What are the specific consequences of
drinking alcohol during pregnancy?
• How do I tell when she needs support?
• Will I actually make a difference?
Negative Consequences
• Denial
• Anger
• Loss of a friend
Consider the Facilitators
Positive Consequences
• Healthy babies
• Influence in bearing and raising children– Children are the future
• Personal fulfillment
Sources of Support
• Parents/grandparents (esp. mothers/grandmothers)
• Couples
• Friends
• Neighbors
• Providers
How Can Providers Empower Significant
Others?
Advise Significant Others1. Help disseminate materials
– Hang up posters– Write newsletter articles
2. Counsel – One-on-one conversation– Support group– Class– Workshop
3. Reinforce the positive
4. Leave behind booklets, rack cards
5. Develop a referral system
6. Ensure relevancy
Questions