Article Text

  1. G. Quinn1
  1. 1University of Washington School of Medicine, Seattle, WA.


Purpose of Study Fetal alcohol spectrum disorder (FASD) was identified as a significant health problem in the rural Native American community of Plummer, Idaho. An evidence-based prevention approach was designed to reduce the amount of alcohol-exposed pregnancies in this community.

Methods An extensive literature review and consultation with experts in the field found empirically supported motivational interviewing to be the most effective way to change patient behavior using very brief interventions. Motivational interviewing uses open-ended questioning and summary statements to develop discrepancies between the patient's current behaviors and their values or future goals. Resistance from patients is explored rather than confronted to avoid entrenchment and support autonomy. Techniques used in previously successful research studies were synthesized into a provider-delivered intervention. Using a previously validated approach, two groups were targeted: pregnant women and women who drink and use ineffective means of contraception.

Results Community health providers were taught the motivational interviewing style and the developed intervention via a 30-minute PowerPoint presentation. The intervention was organized into an easy to follow flowchart and a copy was given to each provider. Community education and awareness materials about FASD were also updated.

Conclusion Initial implementation of an evidence-based program to prevent FASD in the community is a step in the right direction. Targeting key community members and arming them with empirically supported techniques allow them to reach a larger audience.

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