Fetal Alcohol Spectrum Disorder (FASD) Prevention among AI/AN Women in San Diego County

Includes bibliographical references (pages 121-139).Prenatal alcohol exposure results in a variety of diverse conditions known collectively as Fetal Alcohol Spectrum Disorders (FASD). FASDs range from mild to severe and present a burden to the affected individual themselves as well as to their family and community. In the present study, we explore risk factors for vulnerability to prenatal alcohol exposure among a sample of 263 AIAN women of childbearing age in Southern California. In addition we evaluate the outcome of a culturally tailored web-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) intervention over a 6-month follow-up period. Our findings are that a subset of our participants, roughly a third, was vulnerable to alcohol-exposed pregnancy. Approximately half of participants reported not drinking alcohol but those who did drink tended to drink in a heavy episodic or "binge" pattern. A quarter of participants used no form of birth control (including abstinence) while less than a quarter used highly effective contraception. Risk/protective factors included knowledge regarding the risks associated with alcohol consumption, religiosity, and the perception of cultural norms. Participation in assessment alone, without exposure to the intervention, was sufficient to result in significant positive behavioral change (decreased drinks per week, p<0.001; frequency of binge drinking episodes, p=0.017; risk of alcohol-exposed pregnancy, p