G-H-I

George, M. A., Masotti, P., MacLeod, S., Van Bibber, M., Loock, C., Fleming, M., McDiarmid, T., Morton, A. M., Penno, E., Prince, E., Ranford, J., Salmon, A., & Smith, C. (2006). Bridging the research gap: Aboriginal and academic collaboration in FASD prevention. the healthy communities, mothers and children project. Alaska Medicine, 49(2 Suppl), 139-141.

OBJECTIVES: The objective was to assist with the prevention of Fetal Alcohol Spectrum Disorder through a participatory research approach involving local women and health care workers. Our interest was in understanding how well communities could develop culturally appropriate methods of helping women to reduce their alcohol consumption during pregnancy. STUDY DESIGN: Four geographically distant Aboriginal communities were presented with a task of adapting a standard Brief Alcohol Intervention, and in particular to develop a culturally appropriate means of using the Intervention with women in the community. METHODS: Academic and Aboriginal community researchers worked together in partnership, using a participatory action research approach to address alcohol use during pregnancy. RESULTS: The outcome of the project was the design of four differing models of culturally appropriate community interventions designed to support vulnerable women in their childbearing years. The intervention models developed by the four communities have five core characteristics: (1) identification of women at risk; (2) assessment of the woman’s drinking/ drug use; (3) provision of information to the women; (4) delivery method facilitates the decision to adopt healthier behaviors; and (5) means to monitor changes. CONCLUSION: This project was considered successful in many respects: (1) each community developed a culturally-relevant prevention tool; (2) community involvement in the design lead to better understanding of its usefulness; (3) considerable knowledge exchange between academic and community partners took place; and (4) most importantly, it was found that community members can be active members in developing and implementing solutions to important public health issues.

Glik, D., Prelip, M., Myerson, A., & Eilers, K. (2008). Fetal alcohol syndrome prevention using community-based narrowcasting campaigns. Health Promotion Practice, 9(1), 93-103.

Preventing fetal alcohol syndrome (FAS) by encouraging pregnant women to abstain from drinking alcohol competes with commercial alcohol marketing. Two FAS-prevention campaigns using a narrowcast approach among young women of childbearing age in two disadvantaged Southern California communities are compared. The design, implementation process, and degree to which campaigns reached the priority populations are the focus of this article. Formative research shows that young women in disadvantaged communities receive mixed messages about dangers of drinking during pregnancy. A social norms approach using positive role models was the most acceptable message strategy based on materials pretesting. Differences in campaign implementation and distribution strategies between communities were documented through program monitoring. Survey research indicated the more viable messaging and implementation strategies. Findings show that low-cost community campaigns are feasible; however, variations in messaging, distribution strategies, and saturation levels determine whether such campaigns succeed or fail to reach priority populations.

Goh, Y. I., Chudley, A. E., Clarren, S. K., Koren, G., Orrbine, E., Rosales, T., & Rosenbaum, C. (2008). Development of canadian screening tools for fetal alcohol spectrum disorder. The Canadian Journal of Clinical Pharmacology = Journal Canadien De Pharmacologie Clinique, 15(2)

BACKGROUND: Fetal alcohol spectrum disorder (FASD) is the most common cause of neurobehavioural handicap in North America. Screening for FASD may facilitate diagnosis and hence management of these children. We present a variety of screening tools for the identification of children at risk for FASD. METHODS: We critically reviewed and evaluated published and practiced methods for their potential of screening suspected cases, their epidemiological characteristics (sensitivity, specificity, positive and negative predictive values) [Phase I], as well as their feasibility [Phase II]. RESULTS: The following five tools were selected for the FASD screening toolkit: screening fatty acid ethyl esters in neonatal meconium, the modified Child Behaviour Checklist, Medicine Wheel tool, Asante Centre Probation Officer Tool, and maternal history of drinking and drug use. CONCLUSIONS: The toolkit for FASD screening aims at screening different populations, from the newborns to youth and at-risk mothers. It is anticipated that the toolkit will facilitate diagnosis of FASD.

Green, J. H. (2007). Fetal alcohol spectrum disorders: Understanding the effects of prenatal alcohol exposure and supporting students. Journal of School Health, 77(3), 103-108.

Background: Fetal Alcohol Spectrum Disorders (FASD) affect a significant number of children in this country. This article addresses diagnostic issues related to fetal alcohol syndrome (FAS) and other alcohol-related disabilities, discusses associated features and behaviors of FASD, and introduces interventions to support children with FASD in school settings. Methods: A comprehensive review of FAS and FASD literature as it relates to school functioning was conducted. Results: Prenatal alcohol exposure can result in a broad range of negative developmental consequences, including deficits in cognitive and academic functioning, psychological disorders, behavioral problems, and difficulties with independent living. Children with prenatal alcohol exposure are at risk for a spectrum of difficulties at school. Conclusions: This topic is of considerable relevance to all professionals in a school setting, including teachers, administrators, school psychologists, special education providers, special service providers, and school nurses who interact with children who may be prenatally exposed to alcohol. Successful interventions will need to balance the use of environmental modifications, immediate and meaningful positive and negative consequences for behaviors, and opportunities to teach children skills to monitor and modify their behavior.

Henderson, J., Kesmodel, U., & Gray, R. (2007). Systematic review of the fetal effects of prenatal binge-drinking. Journal of Epidemiology and Community Health, 61(12), 1069-1073.

Objective: The effects of binge-drinking during pregnancy on the fetus and child have been an increasing concern for clinicians and policy-makers. This study reviews the available evidence from human observational studies. Design: Systematic review of observational studies. Population: Pregnant women or women who are trying to become pregnant. Methods: A computerised search strategy was run in Medline, Embase, Cinahl and PsychInfo for the years 1970-2005. Titles and abstracts were read by two researchers for eligibility. Eligible papers were then obtained and read in full by two researchers to decide on inclusion. The papers were assessed for quality using the Newcastle-Ottawa Quality Assessment Scales and data were extracted. Main outcome measures: Adverse outcomes considered in this study included miscarriage; stillbirth; intrauterine growth restriction; prematurity; birth-weight; small for gestational age at birth; and birth defects, including fetal alcohol syndrome and neurodevelopmental effects. Results: The search resulted in 3630 titles and abstracts, which were narrowed down to 14 relevant papers. There were no consistently significant effects of alcohol on any of the outcomes considered. There was a possible effect on neurodevelopment. Many of the reported studies had methodological weaknesses despite being assessed as having reasonable quality. Conclusions: This systematic review found no convincing evidence of adverse effects of prenatal binge-drinking, except possibly on neurodevelopmental outcomes.

Hyter, Y. D. (2007). Prologue: Understanding children who have been affected by maltreatment and prenatal alcohol exposure. Language, Speech, and Hearing Services in Schools, 38(2), 93-98.

This prologue introduces an important topic for multiple disciplines involved with children and their families. This introduction includes a review of some of the current literature on the effects of maltreatment and prenatal alcohol exposure on child development, an explanation of why this topic is essential learning for communication professionals, prevalence figures for the occurrence of these effects, and a summarization of the articles that have been contributed by a cross section of researchers from various disciplines.

Hyter, Y. D., & Way, I. (2007). Epilogue: Understanding children who have been affected by maltreatment and prenatal alcohol exposure–future directions. Language, Speech, and Hearing Services in Schools, 38(2), 157-159.

This epilogue summarizes the six articles presented in the clinical forum focused on understanding children who have been affected by maltreatment and prenatal alcohol exposure. It presents common themes that emerged among the articles and future research directions.