1
|
Fletcher TMD, Mullan B, Finlay-Jones A. Intention to Engage in Alcohol Use during Pregnancy: The Role of Attitudes and Prototypes. Subst Use Misuse 2023; 58:1333-1342. [PMID: 37249357 DOI: 10.1080/10826084.2023.2215292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Background: There is no known risk-free level of alcohol use in pregnancy. Despite this, many still believe that occasional drinking is safe. To-date, there is limited evidence of the influences on women's decisions about low to moderate alcohol use in pregnancy. The aim of this study was to explore alcohol use intentions during pregnancy, using variables from the theory of planned behavior, the prototype/willingness model and personality variables. The study also investigated whether priming participants with exposure to prototypes describing different alcohol use behaviors had an impact on intentions.Methods: Participants, 746 women aged 20 to 45 years, were randomized to be prompted to think of one of two different "types" of behaviors, i.e., small level of alcohol use in pregnancy and ambiguous level of alcohol use in pregnancy. They then completed measures of theoretical variables, impulsivity, venturesomeness, and self-efficacy. Participants then answered whether they intended to use alcohol during a future pregnancy.Results: Over half of the variance in intentions to consume alcohol while pregnant were predicted by the final model (R2= .527, F (1, 438) = 13.201, p < .001). Positive attitudes toward alcohol use in pregnancy, from the theory of planned behavior, were the most significant predictor of intentions and intentions did not differ between groups according to prototype exposure.Conclusions: Future research should aim to explore the efficacy of interventions to reduce low to moderate alcohol use in pregnancy that utilize both the theory of planned behavior and prototype/willingness model to target determinants of intentions.
Collapse
Affiliation(s)
- Tess M D Fletcher
- Enable Institute, Curtin University, Perth, Australia
- FASD Research Australia Centre for Research Excellence, Telethon Kids Institute, Perth, Australia
| | | | - Amy Finlay-Jones
- FASD Research Australia Centre for Research Excellence, Telethon Kids Institute, Perth, Australia
| |
Collapse
|
2
|
Channon S, Coulman E, Cannings-John R, Henley J, Lau M, Lugg-Widger F, Strange H, Davies F, Sanders J, Scherf C, Couzens Z, Morantz L. Acceptability and feasibility of a planned preconception weight loss intervention in women with long-acting reversible contraception: the Plan-it mixed-methods study. Health Technol Assess 2023; 27:1-224. [PMID: 36688498 PMCID: PMC9885302 DOI: 10.3310/nkix8285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Women with overweight (a body mass index of ≥ 25 kg/m2) or obesity (a body mass index of ≥ 30 kg/m2) are at greater risk of experiencing complications during pregnancy and labour than women with a healthy weight. Women who remove their long-acting reversible contraception (i.e. coils or implants) are one of the few groups of people who contact services as part of their preparation for conception, creating an opportunity to offer a weight loss intervention. OBJECTIVES The objectives were to understand if routine NHS data captured the pathway from long-acting reversible contraception removal to pregnancy and included body mass index; to identify the suitable components of a preconception weight loss intervention; and to engage with key stakeholders to determine the acceptability and feasibility of asking women with overweight/obesity to delay the removal of their long-acting reversible contraception in order to take part in a preconception weight loss intervention. DESIGN This was a preparatory mixed-methods study, assessing the acceptability and feasibility of a potential intervention, using routine NHS data and purposefully collected qualitative data. PARTICIPANTS The NHS routine data included all women with a long-acting reversible contraception code. There were three groups of participants in the surveys and interviews: health-care practitioners who remove long-acting reversible contraception; weight management consultants; and women of reproductive age with experience of overweight/obesity and of using long-acting reversible contraception. SETTING UK-based health-care practitioners recruited at professional meetings; and weight management consultants and contraceptive users recruited via social media. DATA SOURCES Anonymised routine data from UK sexual health clinics and the Clinical Practice Research Datalink, including the Pregnancy Register; and online surveys and qualitative interviews with stakeholders. RESULTS The records of 2,632,871 women aged 16-48 years showed that 318,040 had at least one long-acting reversible contraception event, with 62% of records including a body mass index. Given the identified limitations of the routine NHS data sets, it would not be feasible to reliably identify women with overweight/obesity who request a long-acting reversible contraception removal with an intention to become pregnant. Online surveys were completed by 100 health-care practitioners, four weight management consultants and 243 contraceptive users. Ten health-care practitioners and 20 long-acting reversible contraception users completed qualitative interviews. A realist-informed approach generated a hypothesised programme theory. The combination of weight discussions and the delay of long-acting reversible contraception removal was unacceptable as an intervention to contraceptive users for ethical and practical reasons. However, a preconception health intervention incorporating weight loss could be acceptable, and one potential programme is outlined. LIMITATIONS There was very limited engagement with weight management consultants, and the sample of participating stakeholders may not be representative. CONCLUSIONS An intervention that asks women to delay long-acting reversible contraception removal to participate in a preconception weight loss intervention would be neither feasible nor acceptable. A preconception health programme, including weight management, would be welcomed but requires risk communication training of health-care practitioners. FUTURE WORK Work to improve routine data sets, increase awareness of the importance of preconception health and overcome health-care practitioner barriers to discussing weight as part of preconception care is a priority. TRIAL REGISTRATION This trial is registered as ISRCTN14733020. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 27, No. 1.
Collapse
Affiliation(s)
- Susan Channon
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Elinor Coulman
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | - Josie Henley
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Mandy Lau
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | | - Freya Davies
- The Welsh Centre for Primary and Emergency Care Research (PRIME), Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Julia Sanders
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Caroline Scherf
- Cardiff and Vale University Health Board, Department of Sexual Health, Cardiff Royal Infirmary, Cardiff, UK
| | - Zoë Couzens
- Public Health Wales NHS Trust, Public Health Wales, Cardiff, UK
| | - Leah Morantz
- 1Centre for Trials Research, Cardiff University, Cardiff, UK
- 2The Welsh Centre for Primary and Emergency Care Research (PRIME), Division of Population Medicine, Cardiff University, Cardiff, UK
- 3School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
- 4Cardiff and Vale University Health Board, Department of Sexual Health, Cardiff Royal Infirmary, Cardiff, UK
- 5Public Health Wales NHS Trust, Public Health Wales, Cardiff, UK
| |
Collapse
|
3
|
Pehlke-Milde J, Radu I, Gouilhers S, Hammer R, Meyer Y. Women's views on moderate and low alcohol consumption: stages of the subjective transition from pregnancy to postpartum. BMC Pregnancy Childbirth 2022; 22:902. [PMID: 36464711 PMCID: PMC9721071 DOI: 10.1186/s12884-022-05247-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/25/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Alcohol consumption during pregnancy and breastfeeding is associated with a risk for the child's healthy development. Nevertheless, about 16 to 25% of all women in the European region, including Switzerland, consume alcohol during pregnancy and probably even more during breastfeeding. Little is known about how women perceive this risk and how risk perception changes during the transition to motherhood. The present study aims to explore the subjective transition from the woman's perspective, focusing on perceptions of alcohol as a risk, changes in alcohol consumption in daily life and experienced support from health professionals in this period. METHODS The longitudinal qualitative, semi-structured interview study was jointly designed and conducted by health sociologists and midwifery researchers. Using the theoretical framework of sociocultural risk and life course transition, we interviewed 46 women from the French and German speaking part of Switzerland during pregnancy and until six months after birth. RESULTS In our study, we found that pregnant and breastfeeding women perceive alcohol consumption as a risk to the health of the child. Abstinence is sought especially during pregnancy, but this does not preclude occasional and low-level consumption according to some women. Alcohol consumption and risk perception change during the transition to motherhood. We identified five stages that characterise this transition in terms of alcohol consumption and risk perception. From the women's perspective, there was a lack of counselling from health professionals, and the women expressed a desire for respectful and more individualised counselling. CONCLUSION Many women express a need for guidance and counselling by health care professionals at some stages of the transition to motherhood. The stages identified can be used as pointers to address the subject of alcohol consumption in professional practice. The stage around conception and early pregnancy should be taken more into account, as women experience themselves as particularly vulnerable during this time. Low-threshold counselling services should be therefore offered to women before or in the stage around conception and be continued until the end of the breastfeeding period.
Collapse
Affiliation(s)
- Jessica Pehlke-Milde
- grid.19739.350000000122291644Research Institute of Midwifery, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Irina Radu
- grid.19739.350000000122291644Research Institute of Midwifery, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Solène Gouilhers
- grid.5681.a0000 0001 0943 1999School of Health Sciences (Haute Ecole de Santé Vaud - HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Raphaël Hammer
- grid.5681.a0000 0001 0943 1999School of Health Sciences (Haute Ecole de Santé Vaud - HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Yvonne Meyer
- grid.5681.a0000 0001 0943 1999School of Health Sciences (Haute Ecole de Santé Vaud - HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| |
Collapse
|
4
|
Tsang TW, Kingsland M, Doherty E, Wiggers J, Attia J, Wolfenden L, Dunlop A, Tully B, Symonds I, Rissel C, Lecathelinais C, Elliott EJ. Effectiveness of a practice change intervention in reducing alcohol consumption in pregnant women attending public maternity services. Subst Abuse Treat Prev Policy 2022; 17:63. [PMID: 36045392 PMCID: PMC9429389 DOI: 10.1186/s13011-022-00490-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background The aim of this study was to examine the effect of a practice change intervention to support the implementation of guideline-recommended care for addressing alcohol use in pregnancy on self-reported alcohol use during pregnancy. Methods A randomized, stepped-wedge controlled trial in three clusters (sectors) within the Hunter New England Local Health District (NSW, Australia). We evaluated a practice change intervention that supported the introduction of a new model of care for reducing alcohol use in pregnancy, consistent with local and international guidelines, and implemented in random order across the sectors. Each week throughout the study period, pregnant women who attended any public antenatal services within the previous week, for a 27–28 or 35–36 week gestation visit, were randomly sampled and invited to participate in the survey. The intended intervention for all women was Brief advice (to abstain from alcohol and information about potential risks). Women identified as medium-risk alcohol consumers using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) were to be offered referral to a phone coaching service, and women identified as high-risk were to be offered referral to a Drug and Alcohol Service. Rates of self-reported alcohol use (AUDIT-C risk level and special occasion drinking) were summarized and compared in groups of women pre-intervention and post-intervention using multivariable logistic regression. Results Surveys were completed by 1309 women at pre-intervention and 2540 at post-intervention. The majority of women did not drink during pregnancy (pre-intervention: 89.68%; post-intervention: 90.74%). There was no change in the proportion of women classified as No risk from drinking (AUDIT-C score = 0) or Some risk from drinking (AUDIT-C score ≥ 1) pre- or post-intervention (p = 0.08). However, a significant reduction in special occasion drinking was observed (pre-intervention: 11.59%; post-intervention: 8.43%; p < 0.001). Conclusions Special occasion drinking was reduced following implementation of guideline-recommended care. Failure to change other patterns of alcohol use in pregnancy may reflect barriers to implementing the model of care in antenatal care settings and the need to address other social determinants of alcohol use. Trial registration Australian and New Zealand Clinical Trials Registry (registration number: ACTRN12617000882325; date: 16 June 2017).
Collapse
|
5
|
Women's views and experiences of occasional alcohol consumption during pregnancy: A systematic review of qualitative studies and their recommendations. Midwifery 2022; 111:103357. [DOI: 10.1016/j.midw.2022.103357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 11/23/2021] [Accepted: 04/29/2022] [Indexed: 11/19/2022]
|
6
|
Biradar RA, Halli SS. Alcohol and tobacco use among preconception women in India. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2043473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Rajeshwari A. Biradar
- Department of Epidemiology and Biostatistics, KLE Academy of Higher Education & Research, Belagavi, India
| | - Shiva S. Halli
- Institute of Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
7
|
Pedruzzi RA, Hamilton O, Hodgson HHA, Connor E, Johnson E, Fitzpatrick J. ‘We do what we can as soon as we can’ Alcohol and Other Drug workforce perspectives on preventing and responding to prenatal alcohol exposure. DRUGS: EDUCATION, PREVENTION AND POLICY 2021. [DOI: 10.1080/09687637.2020.1843600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Rebecca A. Pedruzzi
- Telethon Kids Institute, The University of Western Australia, West Perth, WA, Australia
| | | | | | - Elizabeth Connor
- Telethon Kids Institute, The University of Western Australia, West Perth, WA, Australia
| | | | - James Fitzpatrick
- Telethon Kids Institute, The University of Western Australia, West Perth, WA, Australia
- School of Psychological Science, The University of Western Australia, Perth, WA, Australia
| |
Collapse
|
8
|
Chikritzhs T, Dangardt F, Pettigrew S. Pregnancy, partners and alcohol warning labels. Addiction 2021; 116:1949-1951. [PMID: 33368760 DOI: 10.1111/add.15369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 12/01/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Tanya Chikritzhs
- National Drug Research Institute, Health Sciences, Curtin University, Perth, Australia
| | - Frida Dangardt
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Simone Pettigrew
- Department of Paediatric Clinical Physiology, The Queen Silvia Children's Hospital, Gothenburg, Sweden.,The George Institute for Global Health, Sydney, Australia.,The University of New South Wales, Sydney, Australia
| |
Collapse
|
9
|
Pregnancy and Binge Drinking: An Intersectionality Theory Perspective Using Veteran Status and Racial/Ethnic Identity. Matern Child Health J 2021; 25:1345-1351. [PMID: 33945080 DOI: 10.1007/s10995-021-03171-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Alcohol use during pregnancy is a critical public health issue that results in several adverse outcomes for both mother and child. While the prevalence of and consequences of binge drinking among pregnant women is well-documented in the literature, little is known about the intersectional effect of racial/ethnic identity and veteran status. The purpose of this study was to examine the prevalence of binge drinking among pregnant women using the intersectionality of racial/ethnic identity and veteran status. METHODS This study utilized combined data from the 2016, 2017 and 2018 Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is a telephone survey that collects health-related risk behaviors, chronic health conditions and use of preventative services among U.S residents. Generalized linear mixed models were used to examine the prevalence of binge drinking using the interaction between race/ethnicity and veteran status. RESULTS Overall binge drinking prevalence was 3.60% among the sample of 6101 pregnant women. Binge drinking prevalence was the highest among racial/ethnic minority veterans at 17.42%, compared to 5.34% among white veterans, 4.05% among non-veteran racial/ethnic minorities and 3% among non-veteran whites, supporting the theory of intersectionality. CONCLUSIONS Intersectionality Theory suggests that the stressors from membership in two vulnerable groups may lead to increased disparities. The results of this study highlight the unique experience of being a veteran and identifying as a member of a racial/ethnic minority group. This calls for a need to customize preventative measures that address the combined impact of both racial/ethnic minority group status and veteran status.
Collapse
|
10
|
My partner and my neighbourhood: The built environment and social networks’ impact on alcohol consumption during early pregnancy. Health Place 2020; 61:102239. [DOI: 10.1016/j.healthplace.2019.102239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 10/18/2019] [Accepted: 11/01/2019] [Indexed: 11/17/2022]
|
11
|
Schölin L, Fitzgerald N. The conversation matters: a qualitative study exploring the implementation of alcohol screening and brief interventions in antenatal care in Scotland. BMC Pregnancy Childbirth 2019; 19:316. [PMID: 31481011 PMCID: PMC6724251 DOI: 10.1186/s12884-019-2431-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/26/2019] [Indexed: 11/30/2022] Open
Abstract
Background Alcohol screening and brief intervention (SBI) in antenatal care is internationally recommended to prevent harm caused by alcohol exposure during pregnancy. There is, however, limited understanding of how SBI is implemented within antenatal care; particularly the approach taken by midwives. This study aimed to explore the implementation of a national antenatal SBI programme in Scotland. Methods Qualitative interviews were conducted with antenatal SBI implementation leaders (N = 8) in eight Scottish health boards. Interviews were analysed thematically and using the ‘practical, robust implementation and sustainability model’ (PRISM) to understand differences in implementation across health boards and perceived setting-specific barriers and challenges. Results In several health boards, where reported maternal alcohol use was lower than expected, implementation leaders sought to optimize enquires about women’s alcohol use to facilitate honest disclosure. Strategies focused on having positive conversations, exploring pre-pregnancy drinking habits, and building a trusting relationship between pregnant women and midwives. Women’s responses were encouraging and disclosure rates appeared improved, though with some unexpected variation over time. Adapting the intervention to the local context was also considered important. Conclusions This is the first study to explore implementation leaders’ experiences of antenatal SBI delivery and identify possible changes in disclosure rates arising from the approach taken. In contrast with current antenatal alcohol screening recommendations, a conversational approach was advocated to enhance the accuracy and honesty of reporting. This may enable provision of support to more women to prevent Fetal Alcohol Spectrum Disorders (FASD) and will therefore be of international interest.
Collapse
Affiliation(s)
- Lisa Schölin
- School of Health in Social Sciences, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Niamh Fitzgerald
- Institute for Social Marketing, University of Stirling, Stirling, FK9 4LA, UK.
| |
Collapse
|
12
|
Weaved into the cultural fabric: a qualitative exploration of alcohol consumption during pregnancy among tribal women in Odisha, India. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2018; 13:9. [PMID: 29463287 PMCID: PMC5819194 DOI: 10.1186/s13011-018-0146-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 02/11/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Evidence-based research has documented the association between alcohol intake during pregnancy and increased risk of miscarriage, stillbirth and congenital birth defects. Alcohol consumption is a complex behavior whose origins lay in cultural norms and the social structure. In tribal communities in India, alcohol misuse among women is a public health problem. This study is intended to explore perceptions and beliefs among tribal women and the community towards alcohol consumption during pregnancy. METHODS A qualitative study was conducted in a tribal-dominated district of Odisha, India. The WHO AUDIT tool was used to identify women who consumed alcohol during their pregnancies. In-depth interviews were conducted with 19 eligible women and 18 family members. Additionally, two focused group discussions were held with local community leaders and health workers. The data was transcribed, systematically coded and analyzed following the thematic framework approach. RESULTS The findings suggest that a complex interplay of drivers contributes to the unrestricted intake of alcohol by pregnant women. This could be attributed to: a lack of social monitoring, easy access to alcohol, low alcohol literacy and alcohol's normative status in daily customs and traditions. Another contributing factor is a community-wide perception that home-made alcohol poses no ill effects. CONCLUSION Alcohol consumption is deeply embedded in the daily rituals of indigenous tribal women. To address this issue, community counselling utilizing platforms of RMNCHA and VHND could be Ideal. A well-designed, culture-based intervention encompassing alcohol researchers, mental health specialists, public health workers and anthropologists is necessary.
Collapse
|
13
|
Fletcher R, May C, Attia J, Garfield CF, Skinner G. Text-Based Program Addressing the Mental Health of Soon-to-be and New Fathers (SMS4dads): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e37. [PMID: 29410387 PMCID: PMC5820459 DOI: 10.2196/resprot.8368] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/20/2017] [Accepted: 12/08/2017] [Indexed: 11/25/2022] Open
Abstract
Background Recent estimates indicating that approximately 10% of fathers experience Paternal Perinatal Depression (PPND) and the increasing evidence of the impact of PPND on child development suggest that identifying and assisting distressed fathers is justified on public health grounds. However, addressing new fathers’ mental health needs requires overcoming men’s infrequent contact with perinatal health services and their reluctance to seek help. Text-based interventions delivering information and support have the potential to reach such groups in order to reduce the impact of paternal perinatal distress and to improve the wellbeing of their children. While programs utilising mobile phone technology have been developed for mothers, fathers have not been targeted. Since text messages can be delivered to individual mobile phones to be accessed at a time that is convenient, it may provide a novel channel for engaging with “hard-to-reach” fathers in a critical period of their parenting. Objective The study will test the efficacy of SMS4dads, a text messaging program designed specifically for fathers including embedded links to online information and regular invitations (Mood Tracker) to monitor their mood, in order to reduce self-reported depression, anxiety and stress over the perinatal period. Methods A total of 800 fathers-to-be or new fathers from within Australia will be recruited via the SMS4dads website and randomized to the intervention or control arm. The intervention arm will receive 14 texts per month addressing fathers’ physical and mental health, their relationship with their child, and coparenting with their partner. The control, SMS4health, delivers generic health promotion messages twice per month. Messages are timed according to the babies’ expected or actual date of birth and fathers can enroll from 16 weeks into the pregnancy until their infant is 12 weeks of age. Participants complete questionnaires assessing depression, anxiety, stress, and alcohol at baseline and 24 weeks postenrolment. Measures of coparenting and parenting confidence are also completed at baseline and 24 weeks for postbirth enrolments. Results Participant were recruited between October 2016 and September 2017. Follow-up data collection has commenced and will be completed in March 2018 with results expected in June 2018. Conclusions This study’s findings will assess the efficacy of a novel text-based program specifically targeting fathers in the perinatal period to improve their depression, anxiety and distress symptoms, coparenting quality, and parenting self-confidence. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12616000261415; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?id=370085 (Archived by WebCite at http://www.webcitation.org/6wav55wII).
Collapse
Affiliation(s)
- Richard Fletcher
- Family Action Centre, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Chris May
- Family Action Centre, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - John Attia
- Hunter Medical Research Institute, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Craig Franklin Garfield
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Geoff Skinner
- School of Electrical Engineering and Computing, Faculty of Engineering and Built Environment, University of Newcastle, Callaghan, Australia
| |
Collapse
|
14
|
McBride N, Johnson S. Fathers' Role in Alcohol-Exposed Pregnancies: Systematic Review of Human Studies. Am J Prev Med 2016; 51:240-248. [PMID: 27017419 DOI: 10.1016/j.amepre.2016.02.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 01/21/2016] [Accepted: 02/08/2016] [Indexed: 02/01/2023]
Abstract
CONTEXT The role of paternal alcohol consumption on fetal and infant health outcomes, and on social facilitation of maternal alcohol consumption during pregnancy, has not been well established. This review identifies the range of impacts of paternal preconception alcohol consumption and alcohol consumption during partner's pregnancy, on maternal consumption, and fetal and infant health outcomes. EVIDENCE ACQUISITION The review accessed articles from the following databases: Scopus, Science Direct, Wiley Online, MEDLINE, ProQuest Central, PsycINFO, and Web of Science. The review included medium- and large-scale studies that provided separate paternal alcohol results, had a non-respondent rate ≤20%, an attrition rate ≤10% per year of data collection up to 30%, and were published between 1990 and 2014. The review included both randomly and non-randomly selected studies, and both case-control and non-case-control studies with notation on risk of bias. EVIDENCE SYNTHESIS Independent extraction and assessment of articles by two authors was conducted using predefined data fields, including study quality indicators, during 2015. Studies included in the review (11 studies, N=41,062) provide evidence that paternal alcohol consumption during preconception or during pregnancy has an impact on maternal health and alcohol consumption during pregnancy, fetal outcomes, and infant health outcomes. CONCLUSIONS Attention to paternal preconception health care related to alcohol consumption is an important future focus in policies dealing with reproductive, prenatal, fetal, and infant health.
Collapse
Affiliation(s)
- Nyanda McBride
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Sophia Johnson
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
15
|
Abstract
Fetal alcohol-spectrum disorders (FASDs) are a collection of physical and neurobehavioral disabilities caused by prenatal exposure to alcohol. To prevent or mitigate the costly effects of FASD, we must identify mothers at risk for having a child with FASD, so that we may reach them with interventions. Identifying mothers at risk is beneficial at all time points, whether prior to pregnancy, during pregnancy, or following the birth of the child. In this review, three approaches to identifying mothers at risk are explored: using characteristics of the mother and her pregnancy, using laboratory biomarkers, and using self-report assessment of alcohol-consumption risk. At present, all approaches have serious limitations. Research is needed to improve the sensitivity and specificity of biomarkers and screening instruments, and to link them to outcomes as opposed to exposure. Universal self-report screening of all women of childbearing potential should ideally be incorporated into routine obstetric and gynecologic care, followed by brief interventions, including education and personalized feedback for all who consume alcohol, and referral to treatment as indicated. Effective biomarkers or combinations of biomarkers may be used during pregnancy and at birth to determine maternal and fetal alcohol exposure. The combination of self-report and biomarker screening may help identify a greater proportion of women at risk for having a child with FASD, allowing them to access information and treatment, and empowering them to make decisions that benefit their children.
Collapse
Affiliation(s)
- Annika C Montag
- Department of Pediatrics, Division of Dysmorphology and Teratology, University of California San Diego, San Diego, CA, USA
| |
Collapse
|
16
|
Yang C, Chen J, Liu Z, Yun C, Piao J, Yang X. Prevalence and influence factors of vitamin A deficiency of Chinese pregnant women. Nutr J 2016; 15:12. [PMID: 26818747 PMCID: PMC4729160 DOI: 10.1186/s12937-016-0131-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 01/21/2016] [Indexed: 01/19/2023] Open
Abstract
Background Vitamin A plays an important role in the periods of rapid cellular growth and differentiation, especially during pregnancy, which is supplied by the mother to the fetus. The aim of this study is to assess the prevalence and potential influence factors of prenatal VAD of Chinese pregnant women. Methods China National Nutrition and Health Survey 2010–2013(CHNNS2010–2013) is a nationally representative cross-sectional study. It involved the random selection of 150 districts (urban) or counties (rural). Each site randomly selected 30 pregnant women. Because volume of blood and incomplete data was taken into consideration,the final sample was formed by 1209 participants. Serum retinol concentrations were measured by high performance liquid chromatography. Characteristics of the pregnant women were collected by a questionnaire. Comparing retinol level across categories of independent variables was tested by the Mann-Whitney U test. Logistic and linear regression analyses were used to identify influence factors of Chinese pregnant women. Results The mean serum retinol level of the pregnant women was 1.63 μmol/L (95 % CI 1.60–1.67) and 64[5.3 % (95 % CI 4.03–6.56)] had VAD. The odds of VAD were significantly higher among the pregnant women in the poor rural areas and without college or university education and low- income. Pregnant women in the second and third trimester had 2.40 (95 % CI 1.05–5.46) and 2.82 (95 % CI 1.34–5.93) times increased odds of VAD compared with those in the first trimester respectively. Pregnant women of drinker had 3.10(1.65–5.81) times increased odds of VAD compared with those no drinker. Pregnant smokers had 5.68 (95 % CI 2.23–14.49) times higher odds of VAD compared with pregnant with non-smoker without passive smoking. Conclusions VAD is of mild public-health issue in Chinese pregnant women. Such as : in the poor rural areas and without received college or university education and low- income and advanced gestational age and unhealthy lifestyles of pregnant women such as smoking and drinking. These were pertinent influence factors of VAD.
Collapse
Affiliation(s)
- Chun Yang
- Key Laboratory of Trace Element Nutrition, National Health and Family Planning Commission of the people's Republic of China, Department of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Room 236, Nanwei Road No.29, Xicheng District, Beijing, China, 100050
| | - Jing Chen
- Key Laboratory of Trace Element Nutrition, National Health and Family Planning Commission of the people's Republic of China, Department of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Room 236, Nanwei Road No.29, Xicheng District, Beijing, China, 100050
| | - Zhen Liu
- Key Laboratory of Trace Element Nutrition, National Health and Family Planning Commission of the people's Republic of China, Department of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Room 236, Nanwei Road No.29, Xicheng District, Beijing, China, 100050
| | - Chunfeng Yun
- Key Laboratory of Trace Element Nutrition, National Health and Family Planning Commission of the people's Republic of China, Department of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Room 236, Nanwei Road No.29, Xicheng District, Beijing, China, 100050
| | - Jianhua Piao
- Key Laboratory of Trace Element Nutrition, National Health and Family Planning Commission of the people's Republic of China, Department of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Room 236, Nanwei Road No.29, Xicheng District, Beijing, China, 100050
| | - Xiaoguang Yang
- Key Laboratory of Trace Element Nutrition, National Health and Family Planning Commission of the people's Republic of China, Department of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Room 236, Nanwei Road No.29, Xicheng District, Beijing, China, 100050.
| |
Collapse
|
17
|
Crawford-Williams F, Steen M, Esterman A, Fielder A, Mikocka-Walus A. "My midwife said that having a glass of red wine was actually better for the baby": a focus group study of women and their partner's knowledge and experiences relating to alcohol consumption in pregnancy. BMC Pregnancy Childbirth 2015; 15:79. [PMID: 25881173 PMCID: PMC4389416 DOI: 10.1186/s12884-015-0506-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 03/17/2015] [Indexed: 11/13/2022] Open
Abstract
Background While it is well established that alcohol can cross the placenta to the foetus and can affect an infant’s development, many women continue to drink during pregnancy. For this reason it is important to determine what information is being provided, what information may be missing, and the preferred sources of information on this issue. In order to improve prevention strategies, we sought to understand the knowledge and experiences of pregnant women and their partners regarding the effects of alcohol consumption during pregnancy. Methods The current study utilised a qualitative study design in order to gain insight into the views and experiences of pregnant women, newly delivered mothers and their partners. Focus groups examined the participant’s knowledge about the effects of alcohol consumption during pregnancy, the sources of information on this issue, and the psycho-social influences on their drinking behaviour. Five focus groups were conducted involving a total of 21 participants (17 female). A six-stage thematic analysis framework was used to analyse all focus group discussions in a systematic way. Results Seven major themes were identified from the focus group data: 1) knowledge of Foetal Alcohol Spectrum Disorders; 2) message content and sources; 3) healthcare system; 4) society and culture; 5) partner role; 6) evaluation of risk; and 7) motivation. The findings indicated that although the majority of participants knew not to drink alcohol in pregnancy they had limited information on the specific harmful effects. In addition, routine enquiry and the provision of information by health care professionals were seen as lacking. Conclusions The findings of this research provide important insights in to the relationship between pregnant women, their partners, and their healthcare providers. Several recommendations can be made on the basis of these findings. Firstly, public health messages and educational materials need to provide clear and consistent information about the effects of alcohol consumption on the developing baby. Additionally, more thorough and consistent routine enquiry for alcohol consumption in pregnant women needs to occur. Finally, it is important to ensure ongoing education for health professionals on the issue of alcohol consumption during pregnancy.
Collapse
Affiliation(s)
- Fiona Crawford-Williams
- School of Nursing and Midwifery, University of South Australia, City East Campus, Frome Road, Adelaide, Australia.
| | - Mary Steen
- School of Nursing and Midwifery, University of South Australia, City East Campus, Frome Road, Adelaide, Australia.
| | - Adrian Esterman
- School of Nursing and Midwifery, University of South Australia, City East Campus, Frome Road, Adelaide, Australia.
| | - Andrea Fielder
- School of Nursing and Midwifery, University of South Australia, City East Campus, Frome Road, Adelaide, Australia.
| | - Antonina Mikocka-Walus
- School of Nursing and Midwifery, University of South Australia, City East Campus, Frome Road, Adelaide, Australia. .,Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, UK.
| |
Collapse
|
18
|
Bell E, Zizzo N, Racine E. Caution! Warning labels about alcohol and pregnancy: unintended consequences and questionable effectiveness. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2015; 15:18-20. [PMID: 25786006 DOI: 10.1080/15265161.2014.998376] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Emily Bell
- a Institut de recherches cliniques de Montréal
| | | | | |
Collapse
|
19
|
McBride N. Alcohol use during pregnancy: considerations for Australian policy. SOCIAL WORK IN PUBLIC HEALTH 2014; 29:540-548. [PMID: 25144696 DOI: 10.1080/19371918.2014.890150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 01/29/2014] [Indexed: 06/03/2023]
Abstract
Although there is an extensive recorded history of concerns related to alcohol exposed pregnancies and possible outcomes of fetal alcohol spectrum disorder in recent scientific literature, Australia has only recently begun to accurately or systematically diagnose and record these conditions, or to provide comprehensive, coordinated, policy-guided funding, prevention, and treatment. This article discusses some considerations that can guide policy development within the Australian context including the social context and determinates of alcohol consumption during pregnancy and the need to consider the issue as one that goes beyond the decision making of individual women. The article also identifies the contribution of research to guide evidence-based policy development, including emerging evidence of epigenetics, and systematic reviews for prevention. Other policy considerations include costs, and the possibility of the prevention paradox applying to this field, with its associated impact on costs and focus of prevention.
Collapse
Affiliation(s)
- Nyanda McBride
- a National Drug Research Institute, Health Sciences, Curtin University , Perth , Australia
| |
Collapse
|