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Competency 4: Prevention

Addiction Disorders in Women

Risk and Protective Factors

Preventive interventions are designed to minimize risk factors and maximize protective factors. Risk factors increase the chances of engaging in harmful behaviors. Protective factors decrease the chances of engaging in harmful behaviors. Risk and protective factors exist in a variety of domains in a person’s life:

  • Individual. Biologic and psychological dispositions, attitudes, values, knowledge, skills, problem behaviors
  • Peers. Norms, activities, bonding
  • Family. Function, management, bonding
  • School and work. Bonding, climate, policy, performance
  • Community. Bonding, norms, resources, awareness/mobilization
  • Society. Norms, policy/sanctions, environment

The following table provides examples of risk and protective factors in the various domains related to alcohol use during pregnancy.

Risk and Protective Factors in Various Domains
Domain Risk Factors Protective Factors
Individual Low self-esteem, unemployment, tobacco use, frequent binge drinking Prenatal care, meaningful employment, education
Peers Friends who drink while pregnant Supportive peers who share messages about the harm of drinking while pregnant
Family Heavy drinking by parents and siblings Supportive partners and relatives who share messages about the harm of drinking while pregnant
School/work Drinking behavior of coworkers Alcohol-free social gatherings
Community Tolerance toward heavy drinking Education of health care and social service providers and law enforcement officers
Society Alcohol industry Norms against drinking while pregnant

Sources: Stratton, K.; Howe, C.; and Battaglia, F., eds. 1996. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: National Academy Press; Wilsnack, S.C., and Beckman, L.J. 1984. Alcohol Problems in Women: Antecedents, Consequences, and Intervention. New York: Guilford Press; Wilsnack, S.C.; Klassen, A.D.; Schur, B.E.; et al. 1991. Predicting onset and chronicity of women’s problem drinking: A five-year longitudinal analysis. American Journal of Public Health 81:305-318.

Most women reduce or stop drinking during pregnancy. This reduction may be linked in part to prevention messages in reading material and radio and television advertisements. Various media campaigns have helped raise awareness of the dangers of alcohol use during pregnancy. For example, the National Clearinghouse for Alcohol and Drug Information has several posters, rack cards, and booklets available encouraging abstinence during pregnancy.

Universal approaches can help raise awareness about an issue but rarely bring about behavior change. Warning labels on alcoholic beverages appear to have a preventive effect on lighter drinkers. But they have little effect on the heaviest drinkers, who are most at risk of bearing a child with an FASD. Therefore, other approaches are needed with the heaviest and most long-term drinkers.3

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