Research Update

Alcohol Use and Pregnancy: An Important Canadian Public Health and Social Issue

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6.5 Multi-Component Strategies

Perhaps the most promising use of awareness-raising campaigns is in support of broader multi-component campaigns. Multi-component programs typically aim to shift attitudes and behaviours among both men and women concerning alcohol use during pregnancy through a variety of means. Elements include fully available birth control and substancespecific information routinely provided to men and women (premarital and prenatal) and from a number of sources (e.g. accompanying marriage licence applications). This is complemented by prenatal and outreach services; professional training to identify, intervene with and support those at risk; and accessibility to FASD diagnostic clinics to assess children prenatally exposed to alcohol.

Multi-component strategies are difficult to implement and challenging to evaluate. One of the few FASD-related initiatives to be evaluated was the Tuba City program involving an Aboriginal population in the US. This program used a comprehensive approach to prevention and intervention that included awareness raising, training and a diagnostic component. Although the various elements of the initiative were not separately evaluated and no control group was used, the overall program appeared effective in promoting referrals and abstinence among pregnant women.¹⁵⁷ Further, the work of Astley (2004) suggested that the various components to the strategies implemented in the State of Washington over the years together resulted in a decline in prenatal use of alcohol and FASD between 1993 and 1998.¹⁵⁸

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