RESUMO
BACKGROUND: Reduction of risky drinking in women of childbearing age is 1 strategy that may be employed to prevent fetal alcohol spectrum disorder, a sequela of prenatal alcohol exposure. Communities differ in risk and protective factors, necessitating culturally informed interventions for maximal efficacy. This article describes the modification of an existing web-based screening, brief intervention, and referral to treatment intervention to reduce risky drinking among American Indian Alaska Native (AIAN) women of childbearing age in Southern California into a peer-to-peer-based intervention using motivational interviewing (MI). METHODS: The modification process was iterative and included various community focus groups, interviews, and a final review. RESULTS: Intervention modification was required for cultural congruence. Components of the peer-to-peer intervention designed by this project included a flip chart used to guide the motivational interviewing, charts of the financial and physical costs of alcohol consumption, revised baseline and follow-up questionnaires, and guidance regarding the application of MI techniques. CONCLUSIONS: This study may inform the modification of future interventions among AIAN communities.
Assuntos
/etnologia , Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/prevenção & controle , Indígenas Norte-Americanos/etnologia , Entrevista Motivacional/métodos , Saúde Pública/métodos , Adolescente , Adulto , Fatores Etários , Alaska/etnologia , Consumo de Bebidas Alcoólicas/psicologia , California/etnologia , Intervenção Médica Precoce/métodos , Feminino , Transtornos do Espectro Alcoólico Fetal/etnologia , Transtornos do Espectro Alcoólico Fetal/prevenção & controle , Transtornos do Espectro Alcoólico Fetal/psicologia , Humanos , Indígenas Norte-Americanos/psicologia , Pessoa de Meia-Idade , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etnologia , Efeitos Tardios da Exposição Pré-Natal/prevenção & controle , Efeitos Tardios da Exposição Pré-Natal/psicologia , Adulto JovemRESUMO
We assessed alcohol consumption and depression in 234 American Indian/Alaska Native women (aged 18-45 years) in Southern California. Women were randomized to intervention or assessment alone and followed for 6 months (2011-2013). Depression was associated with risk factors for alcohol-exposed pregnancy (AEP). Both treatment groups reduced drinking (P < .001). Depressed, but not nondepressed, women reduced drinking in response to SBIRT above the reduction in response to assessment alone. Screening for depression may assist in allocating women to specific AEP prevention interventions.