Preventing FAS/ARND in Russian Children

这一建议扩大了预防胎儿酒精综合症的国际合作研究的范围 (FAS)酒精相关神经发育障碍（ARND）俄罗斯是一个非常 酗酒率高（卫生组织，1999年），包括育龄妇女。FAS/ARND是 完全可以通过避免怀孕期间饮酒来预防。我们之前的研究表明， 尽管许多俄罗斯妇女在确诊怀孕后减少饮酒，但很少有人认识到， 在诊断之前，酒精使用与怀孕的可能性相结合所涉及的风险 怀孕，因此可能有风险的大量胎儿酒精暴露在最初几周的 怀孕因此，针对高危人群的孕前双焦点（饮酒/妊娠风险）方法 女性适用于酒精暴露妊娠（AEP）的一级预防。 该研究的首要目标是降低俄罗斯AEP的风险。这项研究是一项双臂，20- 现场，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 育龄妇女异性性行为活跃，且不坚持使用避孕措施）。审判 将决定医生，在一个双重点简短的动机干预培训和监测， 与标准护理相比，通过提高护理绩效，可以更大程度地减少妇女的危险行为。如果有效， 可以在俄罗斯现有的卫生保健系统中推广BPI初级预防方案 妇女保健系统和公共妇女诊所。 该项目建立在由NIH和CDC资助的两个当前研究项目和一个已建立的 美国和俄罗斯的医学、心理学和公共卫生科学家之间的合作。的 该项目将通过俄克拉荷马州大学健康科学中心， 圣彼得堡州立大学和下诺夫哥罗德应用心理学研究所/下诺夫哥罗德 俄罗斯国立师范大学。合作的第一阶段涉及能力建设， 获取对俄罗斯制定FAS/ARND预防措施至关重要的数据。第二阶段是发展 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， 确定OBG医生对他们的健康行为有重大影响，支持选择BPI作为 这是该提案的主要预防措施。该项目旨在提高可持续发展 俄罗斯研究人员进行FAS/ARND预防研究的能力，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第一个针对 在俄罗斯，酒精暴露的怀孕和预防FAS/ARND。

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.