Preventing FAS/ARND in Russian Children

描述（由申请人提供）：本提案扩展了俄罗斯预防胎儿酒精综合征（FAS）和酒精相关神经发育障碍（ARND）的国际合作研究。俄罗斯是一个酒精使用率非常高的国家（世卫组织，1999年），包括育龄妇女。怀孕期间避免饮酒是完全可以预防FAS/ARND的。我们之前的研究表明，尽管许多俄罗斯妇女在诊断出怀孕后减少了饮酒量，但很少有人在诊断出怀孕之前认识到将饮酒与怀孕可能性结合在一起的风险，因此在怀孕的最初几周，胎儿可能面临大量酒精暴露的风险。因此，建议针对高危妇女采取孕前双重重点（酒精使用/妊娠风险）方法，用于初级预防酒精暴露妊娠。这项研究的首要目标是降低俄罗斯AEP的风险。该研究是一项两组、20个地点的随机试验，对高危妇女（异性性行为活跃的高危饮酒育龄妇女，没有持续使用避孕措施）进行简短医师干预（BPI）。该试验将确定接受双重重点简短动机干预培训并对其表现进行监测的医生，与标准护理相比，是否能更大程度地减少女性的危险行为。如果有效，BPI初级预防方案可以在俄罗斯现有的卫生保健系统和公共妇女诊所中传播。该项目建立在目前由美国国立卫生研究院和美国疾病控制与预防中心资助的两个研究项目以及美国和俄罗斯医学、心理学和公共卫生科学家之间建立的合作基础上。该项目将由俄克拉何马大学健康科学中心、圣彼得堡国立大学和俄罗斯下诺夫哥罗德应用心理学研究所/下诺夫哥罗德国立师范大学联合开展。合作的第一阶段涉及能力建设和获取对俄罗斯发展FAS/ARND预防至关重要的数据。第二阶段涉及编制初级预防的专业培训和公共印刷材料。在我们之前的研究中，俄罗斯妇女认为OBG医生是影响她们健康行为的主要因素，支持本建议选择BPI作为一级预防干预措施。该项目旨在提高俄罗斯研究人员从事FAS/ARND预防研究的可持续能力，并加强我们现有的国际多学科合作。这项拟议中的研究将是俄罗斯首个针对酒精暴露妊娠和预防FAS/ARND的随机试验。

DESCRIPTION (provided by applicant): This proposal extends a line of international collaborative research for preventing Fetal Alcohol Syndrome (FAS) and Alcohol Related Neurodevelopmental Disorder (ARND) in Russia. Russia is a country with very high rates of alcohol use (WHO, 1999), including among women in their childbearing years. FAS/ARND are completely preventable by avoiding alcohol use during pregnancy. Our prior studies have suggested that although many Russian women reduce alcohol consumption after pregnancy is diagnosed, few recognize the risks involved in combining alcohol use with the potential to become pregnant, prior to the diagnosis of pregnancy, and therefore may be at risk for substantial fetal alcohol exposure during the early weeks of pregnancy. Therefore, a preconception dual-focus (alcohol use/pregnancy risk) approach targeting at-risk women is indicated for primary prevention of alcohol exposed pregnancies (AEP). The overarching aim of the study is to reduce risk for AEP in Russia. The proposed study is a two-arm, 20- site, site-randomized trial testing a Brief Physician Intervention (BPI) for at-risk women (at-risk drinking childbearing age women who are heterosexually active, and not consistently using contraception). The trial will determine whether physicians, trained in a dual-focused brief motivational intervention and monitored for performance, can foster greater reduction of women's risk behaviors compared to standard care. If effective, the BPI primary prevention protocol could be disseminated throughout the existing Russian health care system and public women's clinics. The project builds on two current research projects funded by the NIH and CDC and an established collaboration between scientists from medicine, psychology, and public health in the US and Russia. The project will be conducted through a consortium between the University of Oklahoma Health Sciences Center, St. Petersburg State University, and the Nizhniy Novgorod Institute for Applied Psychology/Nizhniy Novgorod State Pedagogical University in Russia. The first phase of the collaboration involved capacity building and obtaining data critical to developing FAS/ARND prevention Russia. The second phase involved developing professional training and public print materials for primary prevention. In our prior studies, Russian women identified OBG physicians as a major influence on their health behaviors, supporting the selection of BPI as the primary prevention intervention for this proposal. The project is designed to increase the sustainable capacity of Russian researchers to pursue FAS/ARND prevention research and to strengthen our existing international multidisciplinary collaboration. The proposed study would be the first randomized trial targeted at alcohol exposed pregnancies and preventing FAS/ARND in Russia.