Preventing FAS/ARND in Russian Children

该提案扩展了一系列预防胎儿酒精综合征的国际合作研究 俄罗斯的Fas和酒精相关神经发育障碍(ARND)。俄罗斯是一个非常 酒精使用率高(世卫组织，1999年)，包括育龄妇女。Fas/Arnd ARE 怀孕期间避免饮酒是完全可以预防的。我们之前的研究表明 尽管许多俄罗斯女性在被诊断怀孕后减少饮酒，但很少有人认识到 在诊断为糖尿病之前，将酒精使用与怀孕的可能性结合起来所涉及的风险 怀孕，因此在怀孕的最初几周可能有大量胎儿接触酒精的风险 怀孕了。因此，针对高危人群的先入为主的双重关注(饮酒/怀孕风险)方法 妇女被建议用于酒精暴露怀孕(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。拟议的研究是一项双臂、20- 现场-现场-随机试验测试针对高危女性(高危饮酒)的简短医生干预(BPI) 育龄妇女是异性性行为活跃的，并且没有始终如一地使用避孕措施)。这场审判 将决定医生是否在双重重点的短暂动机干预中接受培训并接受监测 与标准护理相比，绩效评估可以更大程度地减少女性的危险行为。如果有效， 公众宣传局初级预防议定书可在现有的俄罗斯医疗保健体系中传播 系统和公共妇女诊所。 该项目建立在由美国国立卫生研究院和疾病控制与预防中心资助的两个当前研究项目和一个已建立的 来自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。这个 该项目将通过俄克拉荷马大学健康科学中心、 圣彼得堡国立大学和下诺夫哥罗德应用心理学研究所/下诺夫哥罗德 俄罗斯国立教育大学。合作的第一阶段涉及能力建设和 获取对发展俄罗斯的Fas/ARND预防至关重要的数据。第二阶段涉及开发 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，俄罗斯女性 认为OBG医生是影响他们健康行为的主要因素，支持选择BPI为 这项提议的主要预防干预措施。该项目旨在增加可持续发展的 俄罗斯研究人员进行Fas/ARND预防研究并加强我们现有的能力 国际多学科合作。这项拟议的研究将是第一个有针对性的随机试验 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.