Alcohol and Pregnancy: Educational Resources for Health Professionals
The Alcohol and Pregnancy Project (2006-2008) provided educational resources for Western Australian (WA) health professionals to inform them about the prevention of prenatal alcohol exposure and Fetal Alcohol Spectrum Disorder (FASD).
Studies conducted in WA in 2002 and 2004 showed that WA health
professionals were poorly informed about alcohol consumption in
pregnancy and Fetal Alcohol Syndrome (FAS). The majority of
these health professionals requested educational resources for
themselves and information to give to clients. These results
led to the formation of the Alcohol and Pregnancy Project.
We developed educational resources for WA health professionals using formative research. We used project management and incorporated consumer and community representatives' expertise into all aspects of the project.
In 2007, the educational resources were distributed to 3,348 health professionals (Aboriginal health workers, allied health professionals, community nurses, general practitioners and obstetricians), and to 159 paediatricians.
Six months later, we surveyed 1,483 health professionals and 133 paediatricians. We compared health professionals' responses with results from 2002 and paediatricians' with results from 2004 using prevalence rate ratios and 95% confidence intervals.
At the end of the project we conducted a survey to evaluate
researchers' (n=16) and consumer and community representatives'
(n=13) perceptions of the process, context and impact of consumer
and community participation in the project. We also conducted
a post-project review of researchers' (n=16) opinions on project
management and whether it made a difference to the project.
The response fraction for health professionals was 67.7%. Of these, 69.8% had seen the educational resources and of these, 77.1 % had used them. Comparing results from 2002 with 2007, there was a 35% increase in the proportion who knew all the essential features of FAS and there was a 52% increase in the proportion who had diagnosed FAS.
There was no increase in the proportion who routinely asked about alcohol consumption, but there was a 31% increase in the proportion that routinely provided information about the consequences of alcohol consumption in pregnancy. The response fraction for paediatricians was 61.7%. Of these, 65.9% had seen the educational resources and of these, 66.7% had used them.
Comparing results from 2004 with 2007, there was no increase in the proportion who knew all the essential features of FAS or who had diagnosed FAS, and no increase in the proportion who routinely asked about alcohol consumption when taking a pregnancy history.
There was a 93% increase in the proportion that provided information on the consequences of alcohol consumption in pregnancy (based on very small numbers). Fifteen researchers (93.8%) and seven (53.8%) consumer and community representatives completed an evaluation questionnaire and both thought that consumer and community participation had significant influence on the success of project outputs and outcomes.
Fifteen researchers (93.8%) completed a post-project review and
reported that project management increased the effectiveness of the
project, communication, teamwork, and application of researchers'
expertise. The evaluation of the project showed that although
the measure of effect was not large, the extent of change has
public health significance because the reach was extensive.
Following the distribution of the educational resources to WA health professionals, we demonstrated some improvement in their knowledge, attitudes and practice in relation to alcohol consumption in pregnancy and FAS.
FASD is a serious public health problem. The educational resources have potential to increase health professionals' capacity to reduce prenatal alcohol exposure and FASD. They are novel products that have been evaluated and sustained into routine organisational practice.
We also demonstrated that consumer and community participation made a difference to this research and participation was valued by community and consumer representatives and researchers. Project management was comprehensively endorsed by researchers and contributed substantially to the research and benefited both management and scientific outcomes.
There are very few previously published reports on consumer and
community participation and project management in health and
medical research. Our research has made a unique contribution
to knowledge and the evidence base about the role of educational
resources in the primary prevention of prenatal alcohol exposure
and FASD, and to good practice in health and medical research in
the areas of consumer and community participation and project
Funders of the project: Health Promotion Foundation of Western Australia, Healthway Project Grant #15177; NHMRC Program Grant #353514 (JP, HD'A, CO'L); NHMRC Enabling Grant #402784 (EE); NHMRC Fellowships #353628 (CB) and #457084 (EE).