Community Perceptions of Alcohol Exposed Pregnancy Prevention Program for American Indian and Alaska Native Teens.

Umit Shrestha,Jessica Hanson,Karen Ingersoll,Tess Weber

doi:10.3390/ijerph16101795

Abstract

A community needs assessment during a tribally-led Changing High-Risk Alcohol Use and Increasing Contraception Effectiveness Study (CHOICES) intervention highlighted the need to reduce the risk for alcohol exposed pregnancy (AEP) among American Indian and Alaska Native (AIAN) adolescent girls. The CHOICES for American Indian Teens (CHAT) Program aims to reduce the risk of AEP among AIAN teens in one Northern Plains tribal community. The CHAT team adopted an iterative process to modify the tribally-led CHOICES curriculum for AIAN teens. This paper describes the iterative process as well as the community perception towards AEP prevention among AIAN teens. The CHAT team conducted several levels of formative and qualitative research, including one-on-one interviews (n = 15) with community members, AIAN elders and school counsellors; and three focus groups with AIAN adolescent girls (n = 15). A qualitative data analysis identified several recommendations that centered on making the information regarding alcohol and birth control appealing to teens; ensuring the confidentiality of the participants; making the program culturally relevant; and including boys in the program. This study outlines various components prioritized by community members in creating a culturally-relevant and age-appropriate AEP prevention program and provides community perceptions of AEP prevention for the teens in this community

Highlights

Fetal Alcohol Spectrum Disorder (FASD) is the umbrella term that denotes the continuum of disabilities resulting from prenatal alcohol exposure
This paper describes the iterative process adopted by the CHOICES for American Indian Teens (CHAT) team in designing a culturally-appropriate alcohol exposed pregnancy (AEP) prevention program for AIAN teens
A total of 15 key-informant interviews (KIIs) were conducted with both women (n = 11) and men (n = 4) who ranged in age from 27 to 78 and were American Indian (AI) (n = 14) or African American (n = 1)

Summary

Introduction

Fetal Alcohol Spectrum Disorder (FASD) is the umbrella term that denotes the continuum of disabilities resulting from prenatal alcohol exposure. Fetal Alcohol Syndrome (FAS) is the most recognized and most severe impact of prenatal alcohol consumption. FAS has damaging effects, including poor growth, small head size, and facial abnormalities, along with the potential for the delayed development of important organs in the fetus and of social and behavioral issues later in life [1,2,3]. Other diagnoses on the FASD spectrum include partial FAS, alcohol-related neurodevelopmental disorder, and alcohol-related birth defects [1,2]. FASD remains one of the leading preventable neurodevelopmental disorders in the world [4]. It is difficult to obtain community-specific FASD prevalence data for a variety of reasons, including issues with the self-reporting of maternal drinking during pregnancy, sampling, and a lack of consistent

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