PREVENTING ALCOHOL USE IN PREGNANT WOMEN UTILIZING WIC

这项拟议的研究是一项受控的短暂干预措施，旨在减少参加洛杉矶县WIC(妇女、婴儿和儿童)计划的低收入、种族多元化孕妇的酒精使用。将处理若干目标：在世界妇女中心人群中增加孕期饮酒的检测率；评估短暂干预对减少孕妇孕期饮酒的影响；确定影响短暂干预成效的产妇特征；确定有助于减少产妇饮酒的短暂干预的特征；以及评价短暂干预对婴儿分娩结局的影响。12家WIC诊所将被配对并随机分为两种情况之一：(1)仅评估(AO)条件(n=252)，在这种情况下，母亲将接受酒精使用的全面评估，然后接受当前的WIC护理标准；或(2)短暂干预(BI)条件(n=252)，在这种情况下，母亲接受相同的全面评估，外加旨在减少母亲酒精摄入量的标准化短期干预。在每月与WIC营养师预约期间支持饮酒的女性将被招募进行研究。在母亲产前检查期间，将由营养学家进行评估和干预。将使用多种酒精消费自我报告措施，以获得对酒精使用的准确评估。对于那些处于BI条件下的妇女，将采用手动的简短干预程序。感兴趣的母亲变量将包括：种族和文化适应、年龄、开始饮酒的年龄、饮酒史持续时间、抑郁症和社会饮酒环境。干预的特点包括：干预的时间和数量，以及营养学家的态度和信念。婴儿结局测量将包括：出生体重和身长、妊娠和新生儿并发症。只要假设得到支持，改进的评估和简短的干预技术成功地减少了WIC母亲的母亲饮酒，干预代表了一种低成本的Fas预防模式，可以在WIC系统中在全国范围内传播。

The proposed study is a controlled brief intervention designed to decrease alcohol use by low-income, ethnically diverse pregnant women enrolled in the Los Angeles County WIC (Women, Infants and Children) program. A number of aims will be addressed: To increase the detection of alcohol use during pregnancy in the WIC population; to evaluate the impact of brief intervention on reduction of maternal drinking during pregnancy; to identify maternal characteristics that influence the effectiveness of brief intervention; to identify characteristics of the brief intervention that contribute to a reduction in maternal alcohol consumption; and to evaluate the impact of brief intervention on infant birth outcomes. Twelve WIC clinics will be matched and randomized to one of two conditions: (1) the Assessment Only (AO) Condition (n=252), in which mothers will receive a comprehensive assessment of alcohol use, followed by the current WIC standard of care; or (2) the Brief Intervention (BI) Condition (n=252), in which mothers receive the same comprehensive assessment plus a standardized brief intervention designed to reduce maternal alcohol consumption. Women who endorse any alcohol use during their monthly appointment with a WIC nutritionist will be recruited for study. Assessment and intervention will be carried out by nutritionists during the mother's prenatal visits. Multiple self-report measures of alcohol consumption will be used to obtain an accurate assessment of alcohol use. For those women in the BI Condition, a manualized brief intervention procedure will be employed. Maternal variables of interest will include: ethnicity and acculturation, age, age of onset of drinking, duration of drinking history, depression, and social drinking milieu. Characteristics of intervention will include: the timing and quantity of interventions, and nutritionist attitudes and beliefs. Infant outcome measures will include: birth weight and length, gestation, and neonatal complications. Provided the hypotheses are upheld, and improved assessment and brief intervention techniques are successful in reducing maternal alcohol consumption among WIC mothers, the intervention represents a low-cost model for FAS prevention that can be disseminated nation-wide in the WIC system.