Principal Investigator: Philip A. May, Ph.D.
American Indians have been characterized as having high rates of Fetal Alcohol Syndrome (FAS). There is, however, substantial variation in FAS rates among Indian communities and tribes. This research will continue a unique multi-site prevention trial and FAS/ARND diagnostic trial. It will extend the measurement of effectiveness of the comprehensive, public health model, FAS prevention program modeled from the Institute of Medicine (IOM) report on FAS. It will also continue the further standardization and operationalization of the IOM diagnostic criteria recommended for diagnosing FAS spectrum disorder (FASD).
The prevention program utilizes a combination of control and pre/post measure designs to assess indicated, compared to selected, and universal prevention techniques applied by four Plains Indian communities two controls and one urban research site. Utilizing specific techniques of research and prevention developed previously in American Indian communities, this study will further determine whether comprehensive, community-wide prevention of FAS is effective, to what extent, and which specific techniques are most viable. This proposal continues to define and measure the epidemiologic characteristics of FAS, adult drinking characteristics, maternal risk factors for FASD and the diagnoses of FAS, Partial FAS, ARBD, and ARND.
The specific aims of this research are: to continue the well established, multi-site/system of comprehensive IOM-based FAS prevention program for American Indians to measure effectiveness over an extended period through: change in age-specific FAS prevalence rates, formative evaluation of specific prevention components, and specific secondary (proxy) measures; to monitor adult drinking and associated risk factors (KABB) in the target communities over time; to determine the overall effect of comprehensive FAS prevention across sites; to further delineate and define maternal risk factors for FAS, and to advance the diagnostic rigor of FASD. The preventive interventions are implemented by 2.0 FTE personnel at each of the 4, and eventually 6, prevention sites and by university-based researchers. In indicated prevention, research-defined maternal risk behaviors guide case management strategies to change unhealthy practices of high risk individuals; brief interventions using the principles of community reinforcement approach (CRA) and motivational enhancement therapy (MET) are used; and birth control and individual skill building. In selected and universal prevention, routine screening for alcohol abuse, targeted messages to specific aggregates, policy advocacy, and community motivation are used. Results are applicable to most American Indian and Alaska Native communities, and also national and international communities.
American Indians have been characterized as having high rates of Fetal Alcohol Syndrome (FAS). There is, however, substantial variation in FAS rates among Indian communities and tribes. This research will continue a unique multi-site prevention trial and FAS/ARND diagnostic trial. It will extend the measurement of effectiveness of the comprehensive, public health model, FAS prevention program modeled from the Institute of Medicine (IOM) report on FAS. It will also continue the further standardization and operationalization of the IOM diagnostic criteria recommended for diagnosing FAS spectrum disorder (FASD).
The prevention program utilizes a combination of control and pre/post measure designs to assess indicated, compared to selected, and universal prevention techniques applied by four Plains Indian communities two controls and one urban research site. Utilizing specific techniques of research and prevention developed previously in American Indian communities, this study will further determine whether comprehensive, community-wide prevention of FAS is effective, to what extent, and which specific techniques are most viable. This proposal continues to define and measure the epidemiologic characteristics of FAS, adult drinking characteristics, maternal risk factors for FASD and the diagnoses of FAS, Partial FAS, ARBD, and ARND.
The specific aims of this research are: to continue the well established, multi-site/system of comprehensive IOM-based FAS prevention program for American Indians to measure effectiveness over an extended period through: change in age-specific FAS prevalence rates, formative evaluation of specific prevention components, and specific secondary (proxy) measures; to monitor adult drinking and associated risk factors (KABB) in the target communities over time; to determine the overall effect of comprehensive FAS prevention across sites; to further delineate and define maternal risk factors for FAS, and to advance the diagnostic rigor of FASD. The preventive interventions are implemented by 2.0 FTE personnel at each of the 4, and eventually 6, prevention sites and by university-based researchers. In indicated prevention, research-defined maternal risk behaviors guide case management strategies to change unhealthy practices of high risk individuals; brief interventions using the principles of community reinforcement approach (CRA) and motivational enhancement therapy (MET) are used; and birth control and individual skill building. In selected and universal prevention, routine screening for alcohol abuse, targeted messages to specific aggregates, policy advocacy, and community motivation are used. Results are applicable to most American Indian and Alaska Native communities, and also national and international communities.
