■在远洋地区,在Mazovia(波兰)实施和评估了基于证据的多成分社区干预措施,为了防止酒精暴露的怀孕,从而防止FASD。
■来自不同服务的多学科专业人员(社会,上瘾,和心理学),在当地社区招募育龄妇女(怀孕和未怀孕),筛查他们的酒精风险,并将参与者(n=441)分配到低(70%)组,中度-(23%),或高风险(7%)的酒精暴露怀孕,提供适合他们需求的干预措施。非参数符号检验,在干预前后对观察结果的差异进行检验,以评估结局.
■随访数据(从93%的参与者收集)表明关键结果变量发生了积极变化:危险酒精消费量下降了81%,避孕药具使用增加了15%,去看妇科医生增加了39%;以及相关的心理社会风险因素(香烟和药物使用减少,家庭暴力和抑郁症状)。其他服务使用频率没有变化(医疗、心理,或社交)。在中等风险组中观察到最明显的变化。
■在地方一级改变危险行为(饮酒和不避孕的性行为)以防止酒精暴露怀孕是可行的,即使没有医疗专业人员的参与。关键挑战,与专业人士和地方当局有关,必须解决;程序应适应当地的情况和需求。
UNASSIGNED: Within FAR SEAS, a multi-component evidence-based community intervention was implemented and evaluated in Mazovia (Poland), with the aim of preventing alcohol-exposed pregnancies, and therefore preventing FASD.
UNASSIGNED: Multi-disciplinary professionals from different services (social, addiction, and psychology), recruited women of child-bearing age (pregnant and not pregnant) in local communities, screened them for alcohol risk, and allocated participants (n = 441) to groups for low- (70%), moderate- (23%), or high-risk (7%) of alcohol exposed pregnancy, to provide interventions tailored to their needs. The non-parametric sign test, testing differences between pairs of observations before and after intervention was used to evaluate the outcomes.
UNASSIGNED: Follow-up data (collected from 93% of participants) indicated positive changes in the key outcome variables: risky alcohol consumption dropped by 81%, contraception use increased by 15% and visiting a gynecologist increased by 39%; as well as in associated psychosocial risk factors (decrease in cigarette and drug use, domestic violence and depressive symptoms). No changes were noted in frequency of other service use (medical, psychological, or social). The most prominent changes were observed in the moderate-risk group.
UNASSIGNED: Changing risky behaviors (alcohol consumption and sex without contraception) to prevent alcohol exposed pregnancies is feasible at the local level, even without engagement of medical professionals. Key challenges, related to engaging professionals and local authorities, must be addressed; and procedures should be adapted to local contexts and needs.