The effect of a community-supported alcohol ban on prenatal alcohol and other substance abuse.

A systematic review of prevention interventions to reduce prenatal alcohol exposure and fetal alcohol spectrum disorder in indigenous communities

“…After combining references in Endnote and removing duplicates, a total of 522 articles were identified. All papers identified in Ospina et al [ 17 ] with Indigenous components were retrieved except for Bowerman 1997 [ 25 ] which was added manually having not been identified using their original search strategy. After initial title and abstract screening, the full text of 17 articles was reviewed and 10 met the inclusion criteria (Fig.…”

“…Programs aimed to encourage women to participate in sponsored community-wide workshops, including school and senior citizen programs. Individual counselling was provided at clinics FAS Knowledge See brief summary in text RJ Bowerman, 1997 [ 25 ] US, Alaska American Indian and Alaskan Native populations Pregnant women from six remote villages in Barrow in Arctic Alaska Cross-sectional pre- and post-intervention surveys with different groups 1994 ban on alcohol possession in the town of Barrow Alcohol consumption: reported by trimester as percentage engaged in “alcohol abuse” (not defined) The proportion of women engaged in alcohol abuse was reported as 42% for the pre-intervention sample and 9% for the post-intervention sample (RR = 0.21, 95% CI = 0.08, 0.55) Alcohol abuse in the 1st Trimester was reported as 43% pre-intervention and 11% post-intervention (RR = 0.25, 95% CI = 0.07, 0.94) Differences in pre- and post-intervention groups for Trimester 2 (17% and 7%) and Trimester 3 (14% and 5%) were not significant (RR, p value, and CI not reported) JD Hanson et al, 2012 [ 32 ] US Three tribal American Indian communities located 400–600 miles apart in the Northern Plains American Indian Women of child bearing age (18–44 years) self-enrolled by calling a 1–800 phone line Post-intervention evaluation A culturally and linguistically tailored media campaign included: posters displayed in community settings and local newspapers; radio advertisements; pens; brochures; and t-shirts. The campaign was delivered through: information booths set up at local fairs or community events, community centres, health clinics and local tribal colleges; community presentations at local schools and treatment facilities; and Public Service Announcements and live interviews broadcast on local radio stations Post-campaign telephone surveys assessed participants attitudes regarding the effects of the campaign including: Alcohol consumption FASD knowledge Cultural appropriateness of the campaign See brief summary in text …”

“…Except for the community-wide alcohol ban in [ 25 ], all studies described their interventions as culturally appropriate or modified for use with local populations, typically in collaboration with local Indigenous community members. Five studies [ 26 , 27 , 29 , 32 , 33 ] explicitly reported that local Indigenous staff implemented the interventions, while this was not made clear in the remaining studies.…”

“…The Alcohol Use Disorders Identification Test was explicitly identified as the measurement tool in one study [ 30 ] and implicitly in another two studies [ 28 , 31 ]. A 10-item questionnaire from Boston hospital was used in one study [ 29 ], and the remaining three studies [ 25 , 27 , 34 ] used their own set of self-report questions with no reported validation. The use of family planning/birth control/contraception was also assessed.…”

Article Commentary: Political will is Necessary to a Comprehensive Prevention Approach

“…As for advertising, existing laws appear ineffective to monitor new marketing tools such as internet communication, drinking at social events and alcohol industries' support for sporting activities. Also, while prohibition as a control strategy has been found to be effective (Bowerman 1997), it encourages local indigenous alcohol production (Österberg & Haavisto 1997). Similarly, increased taxation, though effective, attracts more income for the Governments at the expense of the community (Odejide 1988).…”