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Screening and Intervention Practices for Alcohol Use by Pregnant Women and Women of Childbearing Age: Results of a Canadian Survey

      Abstract

      Objective

      To determine health care providers’ familiarity with and use of the Society of Obstetricians and Gynaecologists of Canada's (SOGC's) 2010 Alcohol Use and Pregnancy Consensus Clinical Guidelines and to identify barriers and enablers that affected guideline uptake.

      Methods

      We conducted an online pan-Canadian survey of midwives, obstetricians, family physicians, and nurses. The survey was divided into five sections: knowledge, SOGC guidelines, screening and intervention practices, attitudes and beliefs, and demographic information.

      Results

      Just over half of the 588 respondents who provided care to pregnant women or to women of childbearing age were familiar with and used the guidelines. Most respondents screened for alcohol use by asking women about alcohol consumption, but relatively few used a screening questionnaire. Approximately two-thirds of respondents provided brief intervention and referral to harm reduction or treatment services. Enablers of guideline adherence included knowledge about the risks of alcohol in pregnancy, perceived responsibility to identify and address at-risk drinking, and a belief that women are motivated to reduce their alcohol consumption if pregnant or planning to become pregnant. Lack of confidence in ability to use screening questionnaires and to provide brief intervention, as well as a lack of belief in the effectiveness of both practices, were barriers to use.

      Conclusion

      Strategies are needed to improve familiarity with and uptake of the Alcohol Use and Pregnancy Consensus Clinical Guidelines. Particular attention should be given to education and training regarding the use of validated screening questionnaires and brief intervention practices.

      Résumé

      Objectif

      Déterminer le niveau de connaissance et d'utilisation chez les fournisseurs de soins de santé relativement à la Directive clinique de consensus sur la consommation d'alcool et la grossesse que la Société des obstétriciens et gynécologues du Canada (SOGC) a publiée en 2010 et déterminer les obstacles et les facilitateurs qui ont influencé l'adoption de la directive clinique.

      Méthodologie

      Nous avons réalisé un sondage pancanadien en ligne auprès de sages-femmes, d'obstétriciens, de médecins de famille et d'infirmières. Le sondage a été divisé en cinq sections : connaissances; directives cliniques de la SOGC; pratiques en matière de dépistage et d'intervention; attitudes et croyances; et données démographiques.

      Résultats

      Un peu plus de la moitié des 588 répondants qui ont fourni des soins aux femmes enceintes ou aux femmes en âge de procréer connaissaient bien les directives et les utilisaient. La plupart des répondants effectuaient le dépistage en interrogeant les femmes sur leur consommation d'alcool, mais très peu ont utilisé un questionnaire de dépistage. Environ deux tiers des répondants ont fourni une intervention de courte durée et ont orienté les patientes vers des services de traitement ou de réduction des dommages. Les facilitateurs de l'application de la directive clinique comprenaient la connaissance des risques liés à la consommation d'alcool pendant la grossesse, la responsabilité perçue relativement à la détection et la rectification d'une consommation problématique d'alcool, et la croyance voulant que les femmes soient motivées à réduire leur consommation d'alcool si elles sont enceintes ou prévoient le devenir. Les obstacles à l'utilisation de la directive étaient le manque de confiance des répondants dans leur capacité à utiliser les questionnaires de dépistage et à fournir une intervention de courte durée, ainsi qu'un manque de confiance en l'efficacité de ces deux pratiques.

      Conclusion

      De nouvelles stratégies seront nécessaires pour améliorer la connaissance et l'utilisation de la Directive clinique de consensus sur la consommation d'alcool et la grossesse. Il y a lieu d'accorder une attention particulière à l’éducation et à la formation relativement à l'utilisation de questionnaires de dépistage validés et aux pratiques d'intervention de courte durée.

      Keywords

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