Preventing FAS/ARND in Russian Children

描述（由申请人提供）：该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。俄罗斯是一个饮酒率很高的国家（世卫组织，1999年），包括育龄妇女。FAS/ARND完全可以通过避免怀孕期间饮酒来预防。我们以前的研究表明，虽然许多俄罗斯妇女在诊断怀孕后减少饮酒，但很少有人认识到在诊断怀孕前将饮酒与怀孕潜力结合起来所涉及的风险，因此可能有大量胎儿酒精暴露的风险在怀孕的最初几周。因此，孕前双重点（酒精使用/妊娠风险）的方法，针对高危妇女的酒精暴露妊娠（AEP）的一级预防。该研究的首要目标是降低俄罗斯AEP的风险。拟议的研究是一项双臂，20个地点，现场随机试验，测试了一个简短的医生干预（BPI）的风险妇女（风险饮酒育龄妇女谁是异性恋活跃，并没有一贯使用避孕）。该试验将确定，与标准护理相比，接受过双重点简短动机干预培训并监测其表现的医生是否可以更大程度地减少女性的风险行为。如果有效的话，可在俄罗斯现有的保健系统和公共妇女诊所中传播公众宣传局的初级预防议定书。该项目建立在NIH和CDC资助的两个当前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的既定合作基础上。该项目将通过俄克拉荷马州大学健康科学中心、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/下诺夫哥罗德国立师范大学之间的联合体进行。合作的第一阶段涉及能力建设和获取对俄罗斯制定FAS/ARND预防措施至关重要的数据。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医生对她们的健康行为有重大影响，支持选择BPI作为本提案的一级预防干预措施。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.