title: Increasing accurate self-report in surveys of pregnancy alcohol use.
abstract: BACKGROUND
  pregnancy alcohol research relies on self-reports of alcohol consumption. Reporting bias may contribute to ambiguous and conflicting findings on fetal effects of low to moderate pregnancy alcohol exposure.
  
  
  OBJECTIVE
  this study aimed to identify the determinants which would enable women to provide accurate data in surveys of alcohol use in pregnancy.
  
  
  METHODS
  six focus groups were held with a total of 26 pregnant women and new mothers. Participants reviewed a set of alcohol survey questions followed by a guided discussion. Transcripts were analysed using inductive content analysis.
  
  
  METHODS
  public hospital antenatal clinics and Mother & Child Health Centres, Melbourne, Victoria, Australia.
  
  
  RESULTS
  women's emotional responses were generally favourable, although the potential for anxiety and fear of judgement was acknowledged. Barriers to accurate self-report were recall, complexity and use of subjective language. Facilitators were appropriate drink choices, occasional drinking options and contextualising of questions. Confidentiality and survey method, including a preference for methods other than face-to face, were also important factors.
  
  
  CONCLUSIONS
  questions embedded in clear context may reduce anxiety around questions about alcohol use in pregnancy. Methods using shorter recall periods, a list of drinks choices, measures of special occasion drinking and minimising complex and subjective language will increase accurate self-report. A setting perceived as confidential and anonymous may reduce a desire to provide socially acceptable answers.
authors.affiliation: Murdoch Childrens Research Institute, Parkville 3052, Vic., Australia; Department of Paediatrics, The University of Melbourne, 3010 Vic., Australia. Electronic address: evi.muggli@mcri.edu.au.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Muggli
authors.affiliation: Murdoch Childrens Research Institute, Parkville 3052, Vic., Australia; Central Australian Aboriginal Congress, Alice Springs, 0870 NT, Australia.
authors.forename: Brendan
authors.initials: B
authors.lastname: Cook
authors.affiliation: Telethon Kids Institute, Perth 6845, WA, Australia.
authors.forename: Colleen
authors.initials: C
authors.lastname: O'Leary
authors.affiliation: La Trobe University, Melbourne 3000, Vic., Australia; Midwifery and Maternity Services Research, The Royal Women׳s Hospital, Parkville, 3052 Vic., Australia.
authors.forename: Della
authors.initials: D
authors.lastname: Forster
authors.affiliation: Murdoch Childrens Research Institute, Parkville 3052, Vic., Australia; Department of Paediatrics, The University of Melbourne, 3010 Vic., Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Halliday
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D057566:Self Report / Q000592:standards*; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D014739:Victoria
keywords: Antenatal alcohol exposure; Ethanol; Pregnancy; Qualitative Research; Questionnaires