Preventing FAS/ARND in Russian Children

描述(由申请人提供)：这项建议扩展了俄罗斯预防胎儿酒精综合症(FAS)和酒精相关神经发育障碍(ARND)的国际合作研究系列。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。通过避免在怀孕期间饮酒，Fas/ARND是完全可以预防的。我们之前的研究表明，尽管许多俄罗斯女性在被诊断为怀孕后减少了饮酒，但很少有人认识到在诊断怀孕之前饮酒与怀孕可能性相结合所涉及的风险，因此在怀孕的最初几周可能面临大量胎儿酒精暴露的风险。因此，针对高危妇女的先入为主的双重重点(酒精使用/怀孕风险)方法被认为是酒精暴露怀孕(AEP)的一级预防。这项研究的主要目的是降低AEP在俄罗斯的风险。这项拟议的研究是一项双臂、20个地点的随机试验，测试对高危妇女(高危饮酒育龄妇女，异性恋活跃，但没有始终如一地使用避孕措施)的短暂医生干预(BPI)。这项试验将确定，与标准护理相比，接受双重重点短暂动机干预和绩效监测的医生是否可以更大程度地减少女性的危险行为。如果有效，公众宣传局的初级预防方案可以在现有的俄罗斯卫生保健系统和公共妇女诊所中传播。该项目建立在美国国立卫生研究院和美国疾病控制与预防中心目前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业已建立的合作基础上。该项目将通过俄克拉荷马大学健康科学中心、圣彼得堡州立大学和俄罗斯下诺夫哥罗德应用心理学研究所/下诺夫哥罗德国立教育大学之间的联盟进行。合作的第一阶段涉及能力建设和获得对发展俄罗斯的FAS/ARND预防至关重要的数据。第二阶段包括为初级预防编写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医生对她们的健康行为有重大影响，支持选择BPI作为这一建议的主要预防干预措施。该项目旨在提高俄罗斯研究人员进行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。这项拟议的研究将是俄罗斯第一项针对酒精暴露怀孕和预防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.