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Indicated Prevention of Fetal Alcohol Spectrum Disorders in South Africa: Effectiveness of Case Management

Author

Listed:
  • Marlene M. De Vries

    (Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa)

  • Belinda Joubert

    (Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa)

  • Marise Cloete

    (Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa)

  • Sumien Roux

    (Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa)

  • Beth A. Baca

    (Center on Alcoholism, Substance Abuse, and Additions (CASAA), The University of New Mexico, Albuquerque, NM 87106, USA)

  • Julie M. Hasken

    (Gillings School of Global Public Health, Department of Nutrition, Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA)

  • Ronel Barnard

    (Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa)

  • David Buckley

    (Center on Alcoholism, Substance Abuse, and Additions (CASAA), The University of New Mexico, Albuquerque, NM 87106, USA)

  • Wendy O. Kalberg

    (Center on Alcoholism, Substance Abuse, and Additions (CASAA), The University of New Mexico, Albuquerque, NM 87106, USA)

  • Cudore L. Snell

    (School of Social Work, Howard University, Washington, DC 20059, USA)

  • Anna-Susan Marais

    (Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa)

  • Soraya Seedat

    (Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa)

  • Charles D. H. Parry

    (Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
    Tobacco & Other Drug Research Unit, Medical Research Council of South Africa, Alcohol, Tygerberg 7505, South Africa)

  • Philip A. May

    (Center on Alcoholism, Substance Abuse, and Additions (CASAA), The University of New Mexico, Albuquerque, NM 87106, USA
    Gillings School of Global Public Health, Department of Nutrition, Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA)

Abstract

In the Western Cape Province of South Africa (ZA) a subculture of binge drinking produces the highest global documented prevalence of fetal alcohol spectrum disorders (FASD). FASD prevention research activities in ZA use the Comprehensive Prevention approach from the United States Institute of Medicine. Case management (CM) was delivered as a method of indicated prevention to empower heavy drinking pregnant women to achieve cessation or a reduction in drinking. CM activities incorporated life management, Motivational Interviewing (MI) techniques and the Community Reinforcement Approach (CRA). Data were collected at baseline, 6, 12 and 18 months. Mean drinking decreases 6 months into CM; but overall alcohol consumption rose significantly over time to levels higher than baseline at 12 and 18 months. Alcohol consumption drops significantly from before pregnancy to the second and third trimesters. AUDIT scores indicate that problematic drinking decreases significantly even after the vulnerable fetus/baby was born. CM significantly increases client happiness, which correlates with reduced weekend drinking. CM was successful for women with high-risk drinking behaviour, and was effective in helping women stop drinking, or drink less, while pregnant, reducing the risk of FASD.

Suggested Citation

  • Marlene M. De Vries & Belinda Joubert & Marise Cloete & Sumien Roux & Beth A. Baca & Julie M. Hasken & Ronel Barnard & David Buckley & Wendy O. Kalberg & Cudore L. Snell & Anna-Susan Marais & Soraya S, 2015. "Indicated Prevention of Fetal Alcohol Spectrum Disorders in South Africa: Effectiveness of Case Management," IJERPH, MDPI, vol. 13(1), pages 1-14, December.
    • Handle: RePEc:gam:jijerp:v:13:y:2015:i:1:p:76-:d:61142
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    References listed on IDEAS

    as
    1. May, P.A. & Gossage, J.P. & Brooke, L.E. & Snell, C.L. & Marais, A.-S. & Hendricks, L.S. & Croxford, J.A. & Viljoen, D.L., 2005. "Maternal risk factors for fetal alcohol syndrome in the Western Cape Province of South Africa: A population-based study," American Journal of Public Health, American Public Health Association, vol. 95(7), pages 1190-1199.
    2. Watt, Melissa H. & Eaton, Lisa A. & Choi, Karmel W. & Velloza, Jennifer & Kalichman, Seth C. & Skinner, Donald & Sikkema, Kathleen J., 2014. "“It's better for me to drink, at least the stress is going away”: Perspectives on alcohol use during pregnancy among South African women attending drinking establishments," Social Science & Medicine, Elsevier, vol. 116(C), pages 119-125.
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    Cited by:

    1. Philip A. May & Anna-Susan Marais & Marlene De Vries & Julie M. Hasken & Julie M. Stegall & Dixie M. Hedrick & Cudore L. Snell & Soraya Seedat & Charles D.H. Parry, 2019. "“The Dop System of Alcohol Distribution is Dead, but It’s Legacy Lives On….”," IJERPH, MDPI, vol. 16(19), pages 1-17, October.
    2. Babatope O. Adebiyi & Ferdinand C. Mukumbang & Charlene Erasmus, 2019. "The Distribution of Available Prevention and Management Interventions for Fetal Alcohol Spectrum Disorder (2007 to 2017): Implications for Collaborative Actions," IJERPH, MDPI, vol. 16(12), pages 1-24, June.

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