ALCOHOL SERVER EDUCATION AS A FAS PREVENTION METHOD

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Fetal alcohol syndrome is by some estimates the leading cause of developmental disability in the Western world, and one which is entirely preventable. Efforts at prevention heretofore have been largely clinic-based, which fails to access many high-risk women in time to intervene effectively. This study will investigate the potential effectiveness of intervention in another venue perhaps more frequently visited by drinking gravidas than the prenatal clinic: the public drinking establishment. Much damage can be prevented by intervention in the second trimester, when pregnancy is ordinarily visible to others such as alcohol service personnel. This study has two principle goals. First, we will examine the effectiveness of alcohol server training legislation to prevent FAS, comparing two approaches and a control: state-mandated training in two states with varying degrees of formal emphasis on FAS, and one state with no formal server training system. Second, we will develop, provide, and evaluate the effectiveness of a supplementary server training program in FAS prevention under all three state systems. Dependent variables measuring implementation and effectiveness will include: FAS knowledge, attitudes, and establishment policies assessed by large sample mail surveys; knowledge, attitudes, and self-reported practices of servers assessed by interviews in subsamples of establishments; observed server adherence to responsible practices using pseudopatrons in subsamples of establishments; and records of self-referrals to community health resources by gravidas resulting from server interventions.