Native American Adolescents' Views of Fetal Alcohol Syndrome Prevention in Schools
Ma, Grace X., Toubbeh, Jamil, Cline, Janette, Chisholm, Anita, Journal of School Health
Alcohol is an integral part of American culture. Its promotion is pervasive in Western societies. Individuals drink alcohol for various reasons, and many suffer its adverse effects. Although alcohol consumption in the United States is common, its effect on female adolescents has received limited attention. Research indicates females may be at higher risk of developing alcohol-related problems at lower levels of consumption than males. These problems are closely associated with reproductive dysfunctions, rapid development of dependence, and victimization. Alcohol remains the most commonly abused substance among adolescents. Windle reports that 75% of 8th graders and 87.3% of 10th graders have used alcohol. The National Institute on Drug Abuse estimates that alcohol exposure occurs in 20% of pregnancies annually in the United States. Fetal Alcohol Syndrome (FAS) results from alcohol use, especially during the first and second trimesters of pregnancy. Babies with FAS have lower birth weights, facial abnormalities, and mental retardation. In addition, they may exhibit such behavioral abnormalities as hyperactivity; attention deficits; impulsiveness; teaming disabilities; reduced habituation; feeding difficulties; developmental, speech and hearing delays; and a range of coordination deficits. Many of these abnormalities are considered permanent.
The incidence of FAS in the general population is 1.9 per 1,000 live births. Among women who are alcohol dependent, estimates of FAS frequency are 29 per 1,000 live births. In one high-risk group of mothers who had one birth associated with alcohol problems, 25% had given birth to FAS babies. FAS is the leading cause of mental retardation in the United States today. According to studies conducted by the Centers for Disease Control and Prevention, incidence of FAS per 10,000 total births for different ethnic groups is as follows: Asians, 0.3; Hispanics, 0.8; Whites, 0.9; African Americans, 6.0; and Native Americans, 29.9. Among Native Americans, the incidence varies across cultures.[8,9]
Native Americans are four times more likely to die of alcoholism than are other ethnic minority groups in the United States, and the FAS rate in these racial groups is six times the national average.[10,11] Among Native American adolescents, there is widespread and often heavy alcohol consumption at higher rates than among non-Native American populations and with fewer gender differences.
The issue of alcohol abuse in Native American communities and its relationship to fetal development only surfaced in the 1980s. High prevalence of FAS was identified in certain Native American communities. Though there exists no data base on FAS births among adolescents, concerns have been raised about the need to develop culturally appropriate prevention strategies aimed particularly at high-risk Native American early adolescents due to the high prevalence of FAS among Native American populations in general. In addition, the selection of this population was based on the fact that initial exposure to alcohol and drugs occurs frequently in this group which is vulnerable to peer pressure. This study determined needs and strategies for developing culturally appropriate FAS prevention curriculum for Native American middle school students.
The Center for Substance Abuse Prevention (CSAP) funded a FAS prevention project targeting Native American adolescents. CSAP identified the target population survey as one effective methodological tool for providing information on unrecognized problems or service needs. It further indicated such a tool is a reliable approach and a direct way to obtain information on needs of individuals; useful in expanding information found through other techniques; and flexible with regard to cost and time. In accordance with the methodological recommendations from CSAP, the Students' Needs Assessment Survey (SNAS) was conducted among 6th through 8th grade Native American students to a) identify risk factors and alcohol/drug problems in their communities; b) assess adolescents' awareness of the risk factors associated with alcohol consumption during pregnancy; c) gather information on Native American adolescents' knowledge and attitudes toward FAS prevention; and d) identify types of FAS prevention messages and media approaches that would be appropriate for this population. …