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Tsang TW, Kingsland M, Doherty E, Anderson AE, Tully B, Ward S, Wiggers J, Elliott EJ. Written information and health professionals are the information sources about alcohol use in pregnancy most often used by pregnant women. Drug Alcohol Rev 2022; 41:1599-1609. [PMID: 35836339 DOI: 10.1111/dar.13512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Alcohol use in pregnancy remains common in Australia, despite national guidelines recommending that pregnant women abstain. The aims of this study were to investigate where pregnant women obtain information about alcohol use in pregnancy and the relationship between the information source used and women's demographic characteristics and alcohol use. METHODS In this cross-sectional survey of pregnant women attending public maternity services in the Hunter New England region (New South Wales), women were asked, 'Where did you get information to help you make decisions about alcohol use during pregnancy?'. The number and types of information sources were analysed using descriptive statistics. Associations between women's information sources, and their demographic characteristics and alcohol use in pregnancy were assessed using chi-square tests and logistic regression. RESULTS Of 4511 pregnant women surveyed, 80.1% used at least one type of information source (range 0-5). Written/electronic information (45.4%), health providers (37.6%) and family/friends (19.5%) were the sources most reported. Higher use of written/electronic information, antenatal health providers and family/friends was associated with first pregnancy, younger age and higher education. The type of information source used was associated with alcohol use in pregnancy. Women who reported alcohol use were more likely to receive information from written/electronic sources. Almost 20% of women (older, multiparous [>1 pregnancy] and more highly educated) obtained no information regarding alcohol use in pregnancy. DISCUSSION AND CONCLUSIONS Antenatal providers should routinely provide information on alcohol use in pregnancy, including for women least likely to access available information.
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Affiliation(s)
- Tracey W Tsang
- Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney, Sydney, Australia.,Sydney Children's Hospitals Network, Kids Research, Sydney, Australia
| | - Melanie Kingsland
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Emma Doherty
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Amy E Anderson
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Belinda Tully
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
| | - Sarah Ward
- Foundation for Alcohol Research and Education, Canberra, Australia
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney, Sydney, Australia.,Sydney Children's Hospitals Network, Kids Research, Sydney, Australia
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Manyeh AK, Chirwa T, Ramaswamy R, Baiden F, Ibisomi L. Evaluating context-specific evidence-based quality improvement intervention on lymphatic filariasis mass drug administration in Northern Ghana using the RE-AIM framework. Trop Med Health 2021; 49:16. [PMID: 33602322 DOI: 10.1186/s41182-021-00305-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Over a decade of implementing a global strategy to eliminate lymphatic filariasis in Ghana through mass drug administration, the disease is still being transmitted in 11 districts out of an initial 98 endemic districts identified in 2000. A context-specific evidence-based quality improvement intervention was implemented in the Bole District of Northern Ghana after an initial needs assessment to improve the lymphatic filariasis mass drug administration towards eliminating the disease. Therefore, this study aimed to evaluate the process and impact of the lymphatic filariasis context-specific evidence-based quality improvement intervention in the Bole District of Northern Ghana. Method A cross-sectional mixed methods study using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the context-specific evidence-based quality improvement intervention was employed. Quantitative secondary data was extracted from the neglected tropical diseases database. A community survey was conducted with 446 randomly selected participants. Qualitative data were collected from 42 purposively selected health workers, chiefs/opinion leaders and community drug distributors in the study area. Results The evaluation findings showed an improvement in social mobilisation and sensitisation, knowledge about lymphatic filariasis and mass drug administration process, willingness to ingest the medication and adherence to the direct observation treatment strategy. We observed an increase in coverage ranging from 0.1 to 12.3% after implementing the intervention at the sub-district level and reducing self-reported adverse drug reaction. The level of reach, effectiveness and adoption at the district, sub-district and individual participants’ level suggest that the context-specific evidence-based quality improvement intervention is feasible to implement in lymphatic filariasis hotspot districts based on initial context-specific needs assessment. Conclusion The study provided the groundwork for future application of the RE-AIM framework to evaluate the implementation of context-specific evidence-based quality improvement intervention to improve lymphatic filariasis mass drug administration towards eliminating the disease as a public health problem.
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Petryk S, Siddiqui MA, Ekeh J, Pandey M. Prenatal alcohol history - setting a threshold for diagnosis requires a level of detail and accuracy that does not exist. BMC Pediatr 2019; 19:372. [PMID: 31647016 PMCID: PMC6806531 DOI: 10.1186/s12887-019-1759-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/09/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The revised 2015 Canadian Guidelines requires a more specific prenatal alcohol exposure (PAE) threshold for a Fetal Alcohol Spectrum Disorder (FASD) diagnosis. The unintended consequences of adhering to the suggested PAE threshold for an FASD diagnosis and the challenges professionals face in obtaining an accurate PAE history were explored. METHODS Using a mixed methods study design, the study was carried out in two parts (Quantitative and Qualitative). PAE history and FASD diagnosis was reviewed retrospectively from 146 patient charts referred for an FASD assessment between 2011 and 2016. The challenges experienced when collecting the PAE history were explored through interviews with 23 professionals. Statistical analysis was performed using SPSS (IBM SPSS Statistics 20.0). RESULTS Of 146 assessments, only 21.9% met the revised 2015 PAE guidelines while 79.4% met the previous 2005 PAE criteria. Of 146 clients, 54.1% met brain criteria for FASD yet of those only 29.1% met the revised PAE criteria whereas 70.9% did not and therefore could lose their FASD diagnosis under a diligent application of PAE level suggested in the 2015 Guidelines. Thematic analysis of the interview data indicated that obtaining a reliable PAE history was challenging and a combination of methods are employed to get credible information. CONCLUSION Confirming PAE history can be difficult, but ensuring reliable and accurate details on quantity, frequency, and timing of exposure is impossible in a clinical setting. Three out of every four individuals in the present study lost their FASD diagnosis following implementation of 2015 Canadian FASD Guidelines. A threshold might also imply that alcohol consumption below threshold is safe. The 2015 Canadian Guidelines need further refinement regarding the PAE criteria.
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Affiliation(s)
- Susan Petryk
- Developmental Paediatrician, Clinical Associate Professor, University of Saskatchewan, Child and Youth Services, 1680 Albert Street, Regina, Saskatchewan S4P-5A6 Canada
| | - Muhammad A. Siddiqui
- Department of Research, Saskatchewan Health Authority, Regina, Saskatchewan Canada
| | - Juliet Ekeh
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - Mamata Pandey
- Department of Research, Saskatchewan Health Authority, Regina, Saskatchewan Canada
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Shanley DC, Hawkins E, Page M, Shelton D, Liu W, Webster H, Moritz KM, Barry L, Ziviani J, Morrissey S, O'Callaghan F, Wood A, Katsikitis M, Reid N. Protocol for the Yapatjarrathati project: a mixed-method implementation trial of a tiered assessment process for identifying fetal alcohol spectrum disorders in a remote Australian community. BMC Health Serv Res 2019; 19:649. [PMID: 31500612 PMCID: PMC6732837 DOI: 10.1186/s12913-019-4378-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 07/29/2019] [Indexed: 11/22/2022] Open
Abstract
Background Fetal alcohol spectrum disorder (FASD) is a highly prevalent neurodevelopmental disorder associated with prenatal alcohol exposure. Early identification can improve functioning for individuals and reduce costs to society. Gold standard methods of diagnosing FASD rely on specialists to deliver intensive, multidisciplinary assessments. While comprehensive, prevalence rates highlight that this assessment model cannot meet demand, nor is it feasible in remote areas where specialist services are lacking. This project aims to expand the capabilities of remote practitioners in north Queensland, Australia, where 23–94% of the community identify as First Nations people. Integrating cultural protocols with the implementation science theories of Knowledge-To-Action, Experience-Based Co-Design, and RE-AIM, remote practitioners with varying levels of experience will be trained in a co-designed, culturally appropriate, tiered neurodevelopmental assessment process that considers FASD as a potential outcome. This innovative assessment process can be shared between primary and tertiary health care settings, improving access to services for children and families. This project aims to demonstrate that neurodevelopmental assessments can be integrated seamlessly with established community practices and sustained through evidence-based workforce development strategies. Methods The Yapatjarrathati project (named by the local First Nations community and meaning ‘to get well’) is a mixed-method implementation trial of a tiered assessment process for identifying FASD within a remote Australian community. In collaboration with the community, we co-designed: (a) a culturally sensitive, tiered, neurodevelopmental assessment process for identifying FASD, and (b) training materials that up-skill remote practitioners with varying levels of expertise. Qualitative interviews for primary, secondary and end users will be undertaken to evaluate the implementation strategies. RE-AIM will be used to evaluate the reach, effectiveness, adoption, implementation and maintenance of the assessment and training process. Discussion Co-designed with the local community, integrated with cultural protocols, and based on implementation science theories, the assessment and training process from this project will have the potential to be scaled-up across other remote locations and trialed in urban settings. The Yapatjarrathati project is an important step towards increasing the availability of neurodevelopmental services across Australia and empowering remote practitioners to contribute to the FASD assessment process.
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Affiliation(s)
- Dianne C Shanley
- School of Applied Psychology, Griffith University, Gold Coast, Australia. .,Menzies Health Institute of Queensland, Gold Coast, Australia.
| | - Erinn Hawkins
- School of Applied Psychology, Griffith University, Gold Coast, Australia.,Menzies Health Institute of Queensland, Gold Coast, Australia
| | - Marjad Page
- North West Hospital and Health Service, Mt Isa, Australia
| | - Doug Shelton
- Women's and Children's Health Services, Gold Coast University Hospital, Gold Coast, Australia
| | - Wei Liu
- School of Applied Psychology, Griffith University, Gold Coast, Australia.,Menzies Health Institute of Queensland, Gold Coast, Australia
| | - Heidi Webster
- Child Development Services, Sunshine Coast Health Services, Sunshine Coast, Australia
| | - Karen M Moritz
- Child Health Research Centre and School of Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Linda Barry
- Queensland Statewide Child and Youth Clinical Network, Centre for Children's Health Research, Brisbane, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation, The University of Queensland, Brisbane, Australia
| | - Shirley Morrissey
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | | | - Andrew Wood
- School of Social Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Mary Katsikitis
- School of Social Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Natasha Reid
- School of Applied Psychology, Griffith University, Gold Coast, Australia.,Child Health Research Centre and School of Biomedical Sciences, The University of Queensland, Brisbane, Australia
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Martinez JL, Duncan LR, Rivers SE, Bertoli MC, Latimer-Cheung AE, Salovey P. Healthy Eating for Life English as a second language curriculum: applying the RE-AIM framework to evaluate a nutrition education intervention targeting cancer risk reduction. Transl Behav Med 2017; 7:657-666. [PMID: 28275976 PMCID: PMC5684068 DOI: 10.1007/s13142-017-0479-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Medically underserved US immigrants are at an increased risk for death from preventable or curable cancers due to economic, cultural, and/or linguistic barriers to medical care. The purpose of this study was to describe the evaluation of the pilot study of the Healthy Eating for Life (HE4L) English as a second language curriculum. The Reach, Effectiveness Adoption, Implementation, Maintenance (RE-AIM) model was used to design a mixed-methods approach to the evaluation of the HE4L curriculum. Successful implementation was dependent upon enthusiastic teacher and manager support of the curriculum, teachers' ability to flexibly apply the curriculum to meet student needs, and researcher provision of curriculum workbooks. HE4L can be implemented successfully in various adult education settings to teach healthy eating behaviors and English language principles. Scale-up of HE4L may depend on the development of an online version of the curriculum to avoid the costs associated with printing and distributing curriculum materials.
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Affiliation(s)
- J. L. Martinez
- School of Medicine, Yale University, PO Box 208093, New Haven, CT 06520-8034 USA
| | - L. R. Duncan
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Currie Gymnasium, Montreal, QC H2W 1S4 Canada
| | - S. E. Rivers
- Yale Center for Emotional Intelligence, Department of Psychology, Yale University, PO Box 208205, New Haven, CT 06520-8205 USA
| | - M. C. Bertoli
- Yale Center for Emotional Intelligence, Department of Psychology, Yale University, PO Box 208205, New Haven, CT 06520-8205 USA
| | - A. E. Latimer-Cheung
- Canada Research Chair, Tier 2—CIHR, Physical Activity Promotion and Disability, School of Kinesiology and Health Studies, Queen’s University, 28 Division St., Kingston, ON K7L 3N6 Canada
| | - P. Salovey
- Chris Argyris Professor of Psychology, Office of the President, Yale University, P.O. BOX 208229, New Haven, CT 06520-8365 USA
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Craike M, Hill B, Gaskin CJ, Skouteris H. Interventions to improve physical activity during pregnancy: a systematic review on issues of internal and external validity using the RE-AIM framework. BJOG 2016; 124:573-583. [PMID: 27571933 DOI: 10.1111/1471-0528.14276] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Physical activity (PA) during pregnancy has significant health benefits for the mother and her child; however, many women reduce their activity levels during pregnancy and most are not sufficiently active. Given the important health benefits of PA during pregnancy, evidence that supports research translation is vital. OBJECTIVES To determine the extent to which physical activity interventions for pregnant women report on internal and external validity factors using the RE-AIM framework (reach, efficacy/effectiveness, adoption, implementation, and maintenance). SEARCH STRATEGY Ten databases were searched up to 1 June 2015. Eligible published papers and unpublished/grey literature were identified using relevant search terms. SELECTION CRITERIA Studies had to report on physical activity interventions during pregnancy, including measures of physical activity during pregnancy at baseline and at least one point post-intervention. Randomised controlled trials and quasi-experimental studies that had a comparator group were included. DATA COLLECTION AND ANALYSIS Reporting of RE-AIM dimensions were summarised and synthesised across studies. MAIN RESULTS The reach (72.1%) and efficacy/effectiveness (71.8%) dimensions were commonly reported; however, the implementation (28.9%) and adoption (23.2%) dimensions were less commonly reported and no studies reported on maintenance. CONCLUSIONS This review highlights the under-reporting of issues of contextual factors in studies of physical activity during pregnancy. The translation of physical activity interventions during pregnancy could be improved through reporting of representativeness of participants, clearer reporting of outcomes, more detail on the setting and staff who deliver interventions, costing of interventions and the inclusion of process evaluations and qualitative data. TWEETABLE ABSTRACT The systematic review highlights the under-reporting of contextual factors in studies of physical activity during pregnancy.
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Affiliation(s)
- M Craike
- Institute of Sport, Exercise and Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, Melbourne, Vic., Australia.,Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
| | - B Hill
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
| | - C J Gaskin
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
| | - H Skouteris
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
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7
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Mutch RC, Watkins R, Bower C. Fetal alcohol spectrum disorders: notifications to the Western Australian Register of Developmental Anomalies. J Paediatr Child Health 2015; 51:433-6. [PMID: 25412883 DOI: 10.1111/jpc.12746] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2014] [Indexed: 11/29/2022]
Abstract
AIM There is increasing attention on fetal alcohol spectrum disorders (FASD) in Australia, but there are limited data on their birth prevalence. Our aim was to report on the birth prevalence of FASD in Western Australia. METHODS Data on notified cases of FASD born in Western Australia 1980-2010 were identified from the Western Australian Register of Developmental Anomalies. Tabulated denominator data were obtained from the Midwives Notification System. Prevalence rates per 1000 births were calculated by demographic variables. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of Aboriginal compared with non-Aboriginal prevalence rates were calculated. PRs were also calculated to compare rates for births 2000-2010 with 1980-1989. RESULTS Two hundred ten cases of FASDs were identified: a birth prevalence of 0.26/1000 births (95% CI 0.23-0.30). The majority of cases reported were Aboriginal (89.5%), a rate of 4.08/1000, compared with 0.03/1000 in notified non-Aboriginal cases, giving a PR of 139 (95% CI 89-215). The prevalence of FASD in 2000-2010 was over twice that in 1980-1989 for both Aboriginal (PR 2.37; CI 1.60-3.51) and non-Aboriginal (PR 2.13; CI 0.68-6.69) children. CONCLUSIONS There has been a twofold increase in FASD notifications in Western Australia over the last 30 years. Population surveillance data such as these are valuable in advocating for and monitoring the effectiveness of preventive activities and diagnostic and management services.
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Affiliation(s)
- Raewyn C Mutch
- Paediatric and Adolescent Medicine/Refugee Health, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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8
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Payne JM, Watkins RE, Jones HM, Reibel T, Mutch R, Wilkins A, Whitlock J, Bower C. Midwives' knowledge, attitudes and practice about alcohol exposure and the risk of fetal alcohol spectrum disorder. BMC Pregnancy Childbirth 2014; 14:377. [PMID: 25366388 PMCID: PMC4228156 DOI: 10.1186/s12884-014-0377-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 10/17/2014] [Indexed: 01/26/2023] Open
Abstract
Background Midwives are an influential profession and a key group in informing women about alcohol consumption in pregnancy and its consequences. There are no current quantitative Australian data on midwives’ knowledge, attitudes and practice in relation to alcohol consumption during pregnancy and Fetal Alcohol Spectrum Disorder. We aimed to reduce this knowledge gap by understanding midwives’ perceptions of their practice in addressing alcohol consumption during pregnancy. Methods This cross-sectional study was conducted at 19 maternity sites across the seven health regions of country Western Australia. A questionnaire was designed following review of the literature and other relevant surveys. Midwifery managers of the maternity sites distributed questionnaires to all midwives working in their line of management. A total of 334 midwives were invited to participate in the research and (n = 245, 73.4%) of these were eligible. Results The response fraction was (n = 166, 67.8%). Nearly all (n = 151, 93.2%) midwives asked pregnant women about their alcohol consumption during pregnancy and (n = 164, 99.4%) offered advice about alcohol consumption in accordance with the Australian Alcohol Guideline, which states “For women who are pregnant or planning a pregnancy, not drinking is the safest option”. Nearly two thirds (n = 104, 64.2%) of the midwives informed pregnant women about the effects of alcohol consumption in pregnancy, they did not always use the recommended AUDIT screening tool (n = 66, 47.5%) to assess alcohol consumption during pregnancy, nor conduct brief intervention when indicated (n = 107, 70.4%). Most midwives endorsed professional development about screening tools (n = 145, 93.5%), brief intervention (n = 144, 92.9%), and alcohol consumption during pregnancy and FASD (n = 144, 92.9%). Conclusion Nearly all midwives in this study asked and advised about alcohol consumption in pregnancy and around two thirds provided information about the effects of alcohol in pregnancy. Our findings support the need for further professional development for midwives on screening and brief intervention. Policy should support midwives’ practice to screen for alcohol consumption in pregnancy and offer brief intervention when indicated.
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9
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Anderson AE, Hure AJ, Kay-Lambkin FJ, Loxton DJ. Women's perceptions of information about alcohol use during pregnancy: a qualitative study. BMC Public Health 2014; 14:1048. [PMID: 25297463 PMCID: PMC4195901 DOI: 10.1186/1471-2458-14-1048] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 09/29/2014] [Indexed: 01/23/2023] Open
Abstract
Background A number of alcohol guidelines worldwide suggest that pregnant women should abstain from alcohol. However, high prevalence rates of alcohol consumption during pregnancy still exist. It is unknown whether there are problems with the dissemination of guideline information that is potentially contributing to such consumption. This qualitative study aimed to explore women’s perceptions of information they received about alcohol use during pregnancy after the introduction of abstinence guidelines. Methods Nineteen women from the Australian Longitudinal Study on Women’s Health (ALSWH) 1973–78 cohort that reported a pregnancy in 2009 were recruited for semi-structured telephone interviews. The interviews were conducted until data saturation was reached. Interviews were transcribed, then thematically analysed. ALSWH survey data was used to augment the findings. The main outcome measure was women’s perceptions of information received about alcohol use during pregnancy after the introduction of the 2009 Australian guidelines promoting abstinence during pregnancy. Results Women reported a number of problems with the information about alcohol use during pregnancy and with its dissemination. There were inconsistencies in the information about alcohol use during pregnancy and in the advice provided. Mixed messages and confusion about identifying a safe level of consumption had implications on women’s decisions to drink or abstain during pregnancy. Women expressed a need for a clear, consistent message to be provided to women as early as possible. They preferred that the message come from healthcare professionals or another reputable source. Conclusions To make an informed decision about alcohol use during pregnancy, women must first be provided with the latest evidence-based information. As this study found a number of limitations with information provision, it is suggested that a systematic approach be adopted by healthcare professionals, in line with best-practice guidelines, to ensure all women are made aware of the alcohol recommendations for pregnancy.
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Affiliation(s)
- Amy E Anderson
- Priority Research Centre for Gender, Health and Ageing, HMRI Building, University Drive, University of Newcastle, Newcastle, NSW 2308, Australia.
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10
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Sweet SN, Ginis KAM, Estabrooks PA, Latimer-Cheung AE. Operationalizing the RE-AIM framework to evaluate the impact of multi-sector partnerships. Implement Sci 2014; 9:74. [PMID: 24923331 PMCID: PMC4072487 DOI: 10.1186/1748-5908-9-74] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 06/03/2014] [Indexed: 11/12/2022] Open
Abstract
Background The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework is a reliable tool for the translation of research to practice. This framework has been widely applied to assess the impact of individual interventions. However, RE-AIM has rarely been used to evaluate implementation interventions, especially from multi-sector partnerships. The primary purpose of this paper is to operationalize the RE-AIM approach to evaluate large, multi-sector partnerships. SCI Action Canada, a community-university partnership aimed to promote physical activity among adults with spinal cord injury, is used as an example. A secondary purpose is to provide initial data from SCI Action Canada by using this conceptualization of RE-AIM. Methods Each RE-AIM element is operationalized for multi-sector partnerships. Specific to SCI Action Canada, seven reach calculations, four adoption rates, four effectiveness outcomes, one implementation, one organizational maintenance, and two individual maintenance outcomes are defined. The specific numerators based on SCI Action Canada activities are also listed for each of these calculations. Results The results are derived from SCI Action Canada activities. SCI Action Canada’s reach ranged from 3% (end-user direct national reach) to 37% (total regional reach). Adoption rates were 15% (provincial level adoption) to 76% (regional level adoption). Implementation and organizational maintenance rates were 92% and 100%, respectively. Conclusions We have operationalized the RE-AIM framework for larger multi-sectoral partnerships and demonstrated its applicability to such partnerships with SCI Action Canada. Future partnerships could use RE-AIM to assess their public health impact.
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Affiliation(s)
- Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Ave W, Montreal, Quebec H2W 1S4, Canada.
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Abstract
Birth defects are an urgent global health priority. They affect millions of births worldwide. But their prevalence and impact are largely under-ascertained, particularly in middle- and low-income countries. Fortunately, a large proportion of birth defects can be prevented. This review examines the global prevalence and primary prevention methods for major preventable birth defects: congenital rubella syndrome, folic acid-preventable spina bifida and anencephaly, fetal alcohol syndrome, Down syndrome, rhesus hemolytic disease of the fetus and the newborn; and those associated with maternal diabetes, and maternal exposure to valproic acid or iodine deficiency during pregnancy. Challenges to prevention efforts are reviewed. The aim of this review is to bring to the forefront the urgency of birth defects prevention, surveillance, and prenatal screening and counseling; and to help public health practitioners develop population-based birth defects surveillance and prevention programs, and policy-makers to develop and implement science-based public health policies.
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12
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O'Leary CM, Halliday J, Bartu A, D'Antoine H, Bower C. Alcohol-use disorders during and within one year of pregnancy: a population-based cohort study 1985-2006. BJOG 2013; 120:744-53. [PMID: 23418853 DOI: 10.1111/1471-0528.12167] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine alcohol-use disorders in pregnant women and the extent of under-reporting. DESIGN Population-based cohort study. SETTING Western Australia. POPULATION Women with a birth recorded on the Western Australian Midwives Notification System (1985-2006). METHODS Mothers with an International Classification of Diseases 9/10 alcohol-related diagnosis, indicating heavy alcohol consumption, recorded on population-based health datasets (non-Aboriginal n=5,839; Aboriginal n=2,583) were identified through the Western Australian data-linkage system. This 'exposed' cohort was frequency matched (on maternal age, year of birth of offspring, Aboriginal status) with comparison mothers without an alcohol-related diagnosis (non-Aboriginal n=33,979; Aboriginal n=8,005). MAIN OUTCOME MEASURES Trends in maternal alcohol diagnoses in relation to pregnancy for non-Aboriginal and Aboriginal women. The proportion of children diagnosed with fetal alcohol syndrome (FAS) who had a mother with an alcohol diagnosis recorded during pregnancy. RESULTS The proportion of Aboriginal mothers in Western Australia with an alcohol diagnosis (23.1%) is ten times greater than for non-Aboriginal mothers (2.3%). There has been a six-fold increase in the percentage of non-Aboriginal births with a maternal alcohol diagnosis recorded during pregnancy and a 100-fold increase for Aboriginal births. Around 70% of the mothers of children diagnosed with FAS did not have an alcohol diagnosis recorded during pregnancy and 18% of the mothers had no record of an alcohol diagnosis. CONCLUSIONS Maternal alcohol exposure during pregnancy is significantly under-ascertained. Given the severe risks to the fetus from heavy prenatal alcohol exposure, assessment and recording of alcohol use should be routinely undertaken in maternity and other health settings.
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Affiliation(s)
- C M O'Leary
- Centre for Population Health Research, Curtin University, Perth, WA, Australia.
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Payne JM, France KE, Henley N, D'Antoine HA, Bartu AE, Elliott EJ, Bower C. Researchers' experience with project management in health and medical research: results from a post-project review. BMC Public Health 2011; 11:424. [PMID: 21635721 PMCID: PMC3135535 DOI: 10.1186/1471-2458-11-424] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Accepted: 06/02/2011] [Indexed: 11/16/2022] Open
Abstract
Background Project management is widely used to deliver projects on time, within budget and of defined quality. However, there is little published information describing its use in managing health and medical research projects. We used project management in the Alcohol and Pregnancy Project (2006-2008) http://www.ichr.uwa.edu.au/alcoholandpregnancy and in this paper report researchers' opinions on project management and whether it made a difference to the project. Methods A national interdisciplinary group of 20 researchers, one of whom was the project manager, formed the Steering Committee for the project. We used project management to ensure project outputs and outcomes were achieved and all aspects of the project were planned, implemented, monitored and controlled. Sixteen of the researchers were asked to complete a self administered questionnaire for a post-project review. Results The project was delivered according to the project protocol within the allocated budget and time frame. Fifteen researchers (93.8%) completed a questionnaire. They reported that project management increased the effectiveness of the project, communication, teamwork, and application of the interdisciplinary group of researchers' expertise. They would recommend this type of project management for future projects. Conclusions Our post-project review showed that researchers comprehensively endorsed project management in the Alcohol and Pregnancy Project and agreed that project management had contributed substantially to the research. In future, we will project manage new projects and conduct post-project reviews. The results will be used to encourage continuous learning and continuous improvement of project management, and provide greater transparency and accountability of health and medical research. The use of project management can benefit both management and scientific outcomes of health and medical research projects.
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Affiliation(s)
- Janet M Payne
- Population Sciences, Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Subiaco, 6008, Western Australia, Australia.
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