ALCOHOL SERVER EDUCATION AS A FAS PREVENTION METHOD

据估计，胎儿酒精综合症是西方世界导致发育障碍的主要原因，而且是完全可以预防的。到目前为止，预防努力主要是以临床为基础的，未能及时接触到许多高危妇女，以便进行有效的干预。这项研究将在另一个可能是饮酒孕妇比产前诊所更常去的场所调查干预的潜在效果：公共饮酒场所。许多损害可以通过在怀孕中期进行干预来防止，因为怀孕通常是其他人可以看到的，比如酒精服务人员。这项研究有两个主要目标。首先，我们将检查酒精服务器培训立法预防Fas的有效性，比较两种方法和一个对照：两个州的国家强制培训，其中两个州的正式重点不同，而一个州没有正式的服务器培训系统。其次，我们将开发、提供和评估在所有三个州系统下预防Fas的补充服务器培训计划的有效性。衡量执行和有效性的因变量将包括：通过大样本邮件调查评估的FAS知识、态度和机构政策；通过机构子样本的访谈评估的服务器的知识、态度和自我报告的做法；在机构的子样本中观察到的服务器对负责任做法的遵守情况；以及服务器干预导致的孕妇自我转介到社区卫生资源的记录。

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.