Interactive Server Training for Fetal Alcohol Prevention

DESCRIPTION (provided by applicant): Fetal Alcohol Syndrome is the leading preventable cause of developmental disabilities in the Western world, but some 20 percent of American women and 40 percent of the heavy drinkers among them continue to consume alcohol during pregnancy. Efforts thus far at prevention have employed "universal" methods such as warning labels on alcoholic beverage containers and information or screening in prenatal health care settings. However, high-risk drinkers tend to seek prenatal care late in pregnancy and are often unpersuaded by perfunctory warning labels, failing to recognize or fully appreciate the serious and unpredictable risks of prenatal alcohol exposure. A venue frequently visited by this high-risk population is the public drinking establishment. A high percent of this population have favorite bars they visit regularly, positioning their familiar bartenders and servers to function as credible and potentially effective prevention and early intervention agents by distributing verbal and written information and friendly encouragement to their customers. On occasion a visibly pregnant woman orders alcohol, an event disturbing to servers and one with which they are usually unprepared to deal diplomatically. Previous NIAAA-supported projects have identified a high level of interest and receptivity to this training within the alcohol service industry. This Phase II program will improve and expand our Phase I prototype for comprehensive FASD prevention training for alcohol servers and managers, which has been well received by test subjects and has produced significant increases in knowledge and confidence. Live trainings of alcohol servers and managers incorporating this same content in a NIAAA-supported project have produced large effect sizes in subsequent "pseudopatron" tests. Phase II will include an enlarged sample of video models in a range of alcohol-serving environments with diverse customers and customer responses, as requested by many test subjects, and will develop a companion website providing the more detailed medical and legal information in which many of our test subjects also expressed interest. The Web site will be regularly updated with new medical findings or changes in legislation and case law, and will provide local treatment resources for alcohol treatment referrals. The program will be evaluated in 60 bars in two states, employing a quasi-experimental, pre-post design with controls, using survey measures of knowledge, attitudes, self-efficacy, and reported and anticipated behavior, and observed behavior in response to pregnant-appearing pseudopatrons.