ALCOHOL SERVER EDUCATION AS A FAS PREVENTION METHOD

据估计，胎儿酒精综合症是西方世界发育障碍的主要原因，而且是完全可以预防的。迄今为止，预防工作主要以诊所为基础，无法及时接触到许多高风险妇女，进行有效干预。本研究将调查在另一个场所进行干预的潜在有效性，该场所可能比产前诊所更常被饮酒孕妇访问：公共饮酒场所。在妊娠中期，如酒精服务人员等其他人通常可以看到怀孕，通过干预可以预防许多损害。这项研究有两个主要目标。首先，我们将检查酒精服务人员培训立法预防FAS的有效性，比较两种方法和一种控制：在两个不同程度正式强调FAS的州进行国家强制培训，以及一个没有正式服务人员培训系统的州。其次，我们将在所有三个州的系统中开发、提供和评估FAS预防补充服务器培训计划的有效性。衡量实施和有效性的因变量将包括：FAS知识、态度和通过大样本邮件调查评估的建立政策；服务人员的知识、态度和自我报告行为通过对机构子样本的访谈进行评估；观察到在机构的子样本中使用假保护人的服务器遵守负责任的做法；以及由于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.