PREVENTING ALCOHOL USE IN PREGNANT WOMEN UTILIZING WIC

这项拟议的研究是一项控制性的短暂干预措施，旨在减少参加洛杉矶县WIC（妇女、婴儿和儿童）计划的低收入、种族多样化的孕妇的酒精使用。 将致力于实现若干目标：增加对妇女、儿童和青少年人口怀孕期间饮酒情况的检测;评估短期干预对减少孕妇怀孕期间饮酒的影响;确定影响短期干预效果的孕妇特征;确定有助于减少孕妇饮酒的短期干预特征;并评价短期干预对婴儿出生结局的影响。 12个WIC诊所将被匹配并随机分配到以下两种条件之一：（1）仅评估（AO）条件（n=252），其中母亲将接受酒精使用的全面评估，然后是当前的WIC标准护理;或（2）短暂干预（BI）条件（n=252），其中母亲接受同样的综合评估，外加旨在减少母亲饮酒的标准化简短干预。 在每月与WIC营养师预约期间同意饮酒的女性将被招募进行研究。 营养学家将在母亲产前检查期间进行评估和干预。将使用多种自我报告的酒精消费措施，以获得准确的评估酒精使用。 对于BI条件下的女性，将采用手动简短干预程序。 感兴趣的母亲变量将包括：种族和文化适应，年龄，饮酒开始的年龄，饮酒史的持续时间，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。 婴儿结局指标将包括：出生体重和身长、妊娠和新生儿并发症。 如果假设成立，并且改进的评估和简短的干预技术成功减少了WIC母亲的母亲饮酒量，那么该干预措施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推广。

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.