title: Evaluation of a service provider short course for prevention of fetal alcohol syndrome.
abstract: OBJECTIVE
  South Africa has among the highest reported rates of Fetal Alcohol Syndrome (FAS) globally. Primary prevention targeting women at risk for alcohol-exposed pregnancies could substantially reduce the incidence of FAS. We evaluated the effectiveness of a short training intervention to improve service providers' screening, identification, and management of women at risk for alcohol-exposed pregnancies.
  
  
  METHODS
  Training to screen and counsel women at risk for alcohol-exposed pregnancies was offered to 86 service providers (95% of whom were female) in two municipalities in the Western Cape Province, South Africa. Effectiveness was evaluated through a before-after study of service providers' knowledge and confidence levels and a comparison of service providers' practices (assessed indirectly via service user exit interviews) at intervention and control clinics.
  
  
  RESULTS
  The proportion of service providers indicating that alcohol use during pregnancy is harmful to the fetus increased after training (23% vs. 67%; p < .001). After training, providers expressed significantly more confidence for four skills indicators related to the identification and management of women at risk for an alcohol-exposed pregnancy. Female clients at intervention clinics were more likely than those at the control clinics to receive alcohol advice (odds ratio [OR] = 2.13, 95% CI [1.27, 3.53]), counseling (OR = 1.3, 95% CI [1.05, 1.56]), and an offer of family planning (OR = 1.1, 95% CI [1.06, 2.10]) after the training. Time × Group interaction variable analysis in multiple logistic regression modeling confirmed these effects as related to training.
  
  
  CONCLUSIONS
  A short training course based on brief motivational interviewing principles appears to be effective in building service provider capacity to better prevent and manage women at risk for alcohol-exposed pregnancies.
authors.affiliation: Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, South Africa.
authors.forename: Judith
authors.initials: J
authors.lastname: Mwansa-Kambafwile
authors.forename: Kirstie
authors.initials: K
authors.lastname: Rendall-Mkosi
authors.forename: Rosemary
authors.initials: R
authors.lastname: Jacobs
authors.forename: Elmarie
authors.initials: E
authors.lastname: Nel
authors.forename: Leslie
authors.initials: L
authors.lastname: London
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000473:pathology / Q000517:prevention & control* / Q000523:psychology; D002492:Central Nervous System Depressants / Q000009:adverse effects; D003376:Counseling / Q000193:education / Q000379:methods*; D004493:Education; D000431:Ethanol / Q000009:adverse effects; D005193:Family Planning Services; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000517:prevention & control* / Q000523:psychology; D017408:Guidelines as Topic; D006281:Health Occupations / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000473:pathology / Q000517:prevention & control / Q000523:psychology; D015397:Program Evaluation; D011614:Psychotherapy, Brief / Q000193:education / Q000379:methods*; D013019:South Africa; D013695:Temperance
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol