Interventions for Prevention of Fetal Alcohol Spectrum Disorders

Interventions focused on fetal alcohol spectrum disorders (FASD) are designed to reduce alcohol-exposed pregnancies and FASD among American Indian/Alaska Native (AI/AN) communities. The emphasis among many AI/AN communities on the health of future generations has prioritized this research.

FASD represents the range of lifelong physical, behavioral, and cognitive impairments produced by alcohol exposure before birth. FASD symptoms may be mild or severe, and they contribute to a variety of issues that include learning disabilities, behavioral issues, mood disorders, speech and language delays, and physical impairments.

Optimal prevention strategies for communities, as well as the prevalence of FASD, will differ based on local patterns of alcohol and contraceptive use, environment, cultural practices, and traditions. Recent prevalence studies indicate that FASD rates among AI/AN communities are similar to those in non-AI/AN communities.

The lack of familiarity with FASD among the public and medical providers hampers intervention efforts. Many people with FASD are unable to obtain a formal diagnosis. FASD often is not identified until a child encounters challenges in school. Not only do underdiagnosis and stigma contribute to low recruitment and retention in studies relating to alcohol-exposed pregnancy or FASD, but they also affect the interpretation of findings.

The following interventions were selected from published peer-reviewed studies, using a rigorous set of criteria. Native and non-Native researchers led this review, conducting alcohol research in Native populations. The About NativeAIR page describes the intervention selection criteria and coding scheme, which includes elements of cultural or Tribal inclusion.

Interventions can be filtered and sorted by different variables to help find the interventions that may be most appropriate for your needs. The Description of Intervention Variables page contains a more detailed description of all the intervention variables.

**Educational Intervention**FAS prevention curriculum that used educational materials (video, study guides, and experiential activities) geared toward Native American middle school students.
Outcomes	Medium/Mixed Level of Change
Costs	Start-Up Cost: Medium Ongoing Cost: Low
Cultural Engagement	Cultural Inclusion: Medium Tribal Inclusion: Low
Setting	School
Participants	Adolescent; Native; Female, Male
Delivery	Medium Group
Staffing Needs	Educator
Research Design	Pre-/post-intervention data
Developmental stage of research	Early Stage

**Screening, Brief Intervention, and Referral to Treatment (SBIRT)**Culturally tailored, web-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) administered to AI/AN women of childbearing age.
Outcomes	Medium/Mixed Level of Change
Costs	Start-Up Cost: Medium Ongoing Cost: Low
Cultural Engagement	Cultural Inclusion: Medium Tribal Inclusion: Medium
Setting	Clinical/Healthcare, Reservation, Urban
Participants	Young Adult, Adult; Native; Female
Delivery	Individual, e or m/health
Staffing Needs	Community Member
Research Design	Randomized controlled experimental design
Developmental stage of research	Early Stage

**Media Campaign and Remotely Delivered Screening and Brief Intervention (CHOICES)**After a media campaign to prepare and recruit Native women, a telephone-based adaption of an evidence-based intervention to prevent alcohol-exposed pregnancies was delivered.
Outcomes	Medium/Mixed Level of Change
Costs	Start-Up Cost: High Ongoing Cost: Low
Cultural Engagement	Cultural Inclusion: Medium Tribal Inclusion: Medium
Setting	Community Wide, Reservation, Rural
Participants	Young Adult, Adult; Native; Female
Delivery	Individual, Multi-level, Telephone Call
Staffing Needs	Not Specified
Research Design	Pre-/post-intervention data
Developmental stage of research	Unknown

**Oglala Sioux Tribe (OST) CHOICES Program**The Oglala Sioux Tribe CHOICES Program is a cultural adaptation of an evidence-based intervention to reduce alcohol-exposed pregnancy by reducing drinking and/or improving contraception use.
Outcomes	Medium/Mixed Level of Change
Costs	Start-Up Cost: High Ongoing Cost: Medium
Cultural Engagement	Cultural Inclusion: Medium Tribal Inclusion: High
Setting	Community Wide, Reservation, Urban
Participants	Young Adult, Adult; Native; Female
Delivery	Individual, Face-to-Face
Staffing Needs	Community Member
Research Design	Pre-/post-intervention data
Developmental stage of research	Early Stage

**Nationwide Primary Prevention of FAS**A nationwide fetal alcohol syndrome (FAS) primary prevention project employing public education, training of clinicians, establishing clinics and referrals, and developing prevention materials for Native Americans and Alaska Natives.
Outcomes	Low Level of Change
Costs	Start-Up Cost: High Ongoing Cost: Medium
Cultural Engagement	Cultural Inclusion: Medium Tribal Inclusion: Low
Setting	Community Wide, Clinical/Healthcare, Reservation, Rural, School
Participants	Child, Adolescent, Young Adult, Adult; Native; Female, Male
Delivery	Multi-level
Staffing Needs	Advanced Degree (post BA) Professional, Certified Professional, Community Leader, Educator
Research Design	Pre-/post-intervention data
Developmental stage of research	Unknown

**Comprehensive Program for High-Risk Women**This comprehensive fetal alcohol syndrome (FAS) prevention program included presenting educational materials; screening for alcohol use in prenatal clinics; and providing case management, counseling, personal support, and social and medical services.
Outcomes	Medium/Mixed Level of Change
Costs	Start-Up Cost: High Ongoing Cost: High
Cultural Engagement	Cultural Inclusion: Low Tribal Inclusion: Low
Setting	Clinical/Healthcare, Reservation
Participants	Adolescent, Young Adult, Adult; Native; Female
Delivery	Individual
Staffing Needs	Not Specified
Research Design	Pre-/post-intervention data
Developmental stage of research	Early Stage

**Enhanced Case Management**Case management (CM) intervention provided to women at high risk of drinking during pregnancy as a part of a comprehensive fetal alcohol syndrome (FAS) epidemiology and prevention program.
Outcomes	Medium/Mixed Level of Change
Costs	Start-Up Cost: High Ongoing Cost: Medium
Cultural Engagement	Cultural Inclusion: None Reported Tribal Inclusion: Low
Setting	Reservation
Participants	Young Adult, Adult; Native; Female
Delivery	Individual, Face-to-Face, Telephone Call
Staffing Needs	Certified Professional
Research Design	Pre-/post-intervention data
Developmental stage of research	Early Stage