Curriculum for Addiction Professionals > Competency 4: Prevention > 5a. Risk and Protective Factors

Please Select One 1. Competency Description 2. Pretest 3. Learning Objectives 4. Introduction 5. Addiction Disorders in Women 5a. Risk and Protective Factors 5b. Screening Tools 5c. Treatment Considerations 5d. Ongoing Assessment To Obtain Accurate Diagnosis 5e. Brief Intervention and Motivational Interviewing 5f. Appropriate Preconception Planning Methods 5g. FASD Prevention Resources 6. Techniques to Engage Women Who Abuse Substances Into Treatment and Recovery 7. Community Awareness and Education 8. Training Primary Care and Other Helping Professionals 9. Outreach Services 9a. Guiding Principles for Service Delivery 9b. Comprehensive FASD Prevention Programs 10. Role of Men and Significant Others in FASD Prevention 9. Issues Related to Professional Values and Ethics 11. Matching Activity 12. Posttest 13. References

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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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