Olusanya, Olufunto Anuoluwa (2018-12). Communication Practices Regarding Alcohol Consumption During Pregnancy: A Cross-Sectional Study of Texas Midwives. Doctoral Dissertation.
Thesis
Overwhelming scientific evidence indicates that alcohol consumption during pregnancy could potentially produce multiple, damaging, alcohol-induced effects in the unborn child collectively known as fetal alcohol spectrum disorders (FASD). FASD is the leading non-genetic cause of preventable birth defects, developmental disabilities, and mental retardation in the United States. The purpose of this cross-sectional study, which targeted midwives from across Texas, was to examine factors, both personal and professional, impacting communication practices regarding prenatal alcohol consumption. Specifically, this study explored whether (1) midwives' knowledge on alcohol guidelines, (2) midwives' intent to disseminate alcohol abstinence messages to pregnant patients, and (3) midwives' personal alcohol use, influenced their communication practices. Overall, a majority of midwives (96%) were informed about unfavorable birth outcomes that occurred in FASD babies, as well as the U.S. Surgeon General's abstinence guidelines regarding prenatal alcohol use. However, approximately 17% of midwives provided advice that was not consistent with the Surgeon General's guidelines regarding prenatal alcohol use, and did not counsel abstinence from alcohol use while pregnant. Many (63%) midwives were unaware of common screening tools that could detect harmful drinking behaviors among pregnant women. Participants' overall knowledge was not strongly associated with midwives' communication practices. Among the sample of midwives in this investigation, subjective norms and attitude were strong predictors of participants' intent to disseminate accurate information on prenatal alcohol consumption. Overall, predictor variables explained a significant proportion of variance in participants' intention, R^2 = 0.68, F (20, 27) = 2.88, p = 0.006. In addition, midwives' intent (coefficient = 0.34, p = 0.013), years of midwifery practice (coefficient = -0.11, p = 0.037), midwife professional group (coefficient = 2.58, p = 0.036) and average number of pregnant patients seen per week (coefficient = 0.04, p = 0.042) were significant predictors of the frequency of communication. Also, participants' intention (coefficient = 0.10, p = 0.041), an Associate degree (coefficient = -1.92, p = 0.034) and a Doctoral degree (coefficient = -1.97, p = 0.041) were significant predictors of whether information was distributed. Midwives' personal alcohol use was not statistically associated with the actual distribution of information and/or the dissemination of accurate information. That said, midwives' personal alcohol use was associated with the frequency of communication on prenatal alcohol use during 2^nd and 3^rd trimesters, even when controlling for age, years of midwifery practice, and midwife professional group. Overall, midwives with non-risky drinking behavior demonstrated better communication practices compared to their counterparts meeting criteria for hazardous drinking.
