Foetal alcohol spectrum disorder : mediating interventions through pregnant women's responses and choices

• Main Author: De Waal, Johanna Maria
• Other Authors: Vorster, Jan
• Format: Others
• Published: Stellenbosch : University of Stellenbosch 2010
• Subjects: Foetal alcohol spectrum disorder; Pregnancy; Drinking; Behaviour change intervention; Risk factors; Protective factors; Mediators; Moderators; Dissertations > Sociology; Theses > Sociology
• Online Access: http://hdl.handle.net/10019.1/4368

Thesis (MPhil (Sociology and Social Anthropology))--University of Stellenbosch, 2010. === ENGLISH ABSTRACT: The study examines the implementation of an intervention aimed at stopping alcohol consumption during pregnancy in order to decrease Foetal Alcohol Spectrum Disorder (FASD) and how this affected changes in alcohol consumption. FASD is a growing concern in South Africa where the prevalence rate is almost 12/100 at some schools in the Western Cape; the highest reported FASD rate in the world. FASD is caused by alcohol consumption during pregnancy and it is an irreversible mental and physical disability in children. FASD is preventable through abstinence from alcohol consumption during pregnancy. The intervention study (referred to as the Ceres Intervention Study), utilised a cluster-randomised trial design, with a control and intervention group, where the control arm of the study received basic screening and information on FASD, while the intervention arm of the study received a more comprehensive intervention, consisting of a variety of screening and counselling techniques. The study took place during 2007/2008 in the Witzenberg sub-district in Ceres in the Western Cape Province of South Africa. The Study used research techniques combined with therapeutic methods and techniques to mediate behaviour change in pregnant women. From the Ceres Intervention Study it was found that 60% of pregnant women changed their drinking behaviour, which led to questions around how this behaviour change took place. The main aim of this study therefore is to examine how pregnant women changed their drinking behaviour during this intervention and also what facilitated the change that was observed. In order to examine the behaviour change, data from the intervention arm and control arm of the study was analysed and a profile of the women was developed. A focus on the intervention arm of the study resulted in distinguishing further between two sub-groups within the intervention arm, namely, the change and no-change groups. Mainly quantitative data was obtained with the use of various tools, however from the comments and experiences of participants, qualitative data could be used as complementary to quantitative data to provide more clarity as to how behaviour change was facilitated in the study. Results from the study suggest that there is a dialectical interplay between client and counsellor which facilitate generative mechanisms that may lead to behaviour change. === AFRIKAANSE OPSOMMING: Hierdie studie lig die implementering van 'n intervensie toe met die doel om die gebruik van alkohol gedurende swangerskap te stop teneinde Fetale Alkohol Spektrum Afwyking (FASD) te verminder en die gepaardgaande gedragsverandering by swanger vroue te ondersoek. FASD is 'n groeiende probleem in Suid-Afrika waar die voorkoms van FASD by 12/100 kinders by sommige skole in die Weskaap gerapporteer is. FASD word veroorsaak deur alkohol-gebruik tydens swangerskap en kan permanente verstandelike en fisiese gestremdheid by kinders veroorsaak. FASD kan voorkom word deur geen alkohol tydens swangerskap te gebruik nie. Die intervensie (of die Ceres Intervensie-studie) maak gebruik van 'n kliniese ontwerp met 'n kontrole en 'n intervensie groep, waar die kontrole arm van die studie basiese assessering asook inligting oor FASD ontvang het, terwyl die intervensie arm 'n meer omvattende intervensie bestaande uit 'n verskeidenheid assesserings sessies en beradingstegnieke ontvang het. Die studie is gedurende 2007/2008 in die Witzenberg sub-distrik in Ceres in die Weskaap, Suid-Afrika, geïmplementeer. Die studie maak gebruik van navorsingstegnieke gekombineer met wetenskaplik gebaseerde intervensie metodes en tegnieke om gedragsverandering by swanger vroue te onderhandel. In die Ceres Intervensie-studie is bevind dat 60% van die swanger vroue hul alkohol-gebruik gedrag verander het. Dit het aanleiding gegee tot vrae rondom hoe hierdie gedragsverandering plaasgevind het. Die hoofdoel van hierdie studie is dus om te kyk na hoe swanger vroue hul alkohol-gebruik verander het gedurende die intervensie asook wat hierdie verandering in gedrag moontlik gemaak het. Om hierdie gedragsverandering te ondersoek is data van die intervensie arm en kontrole arm ontleed en is 'n profiel van die vroue saamgestel. Die fokus op die intervensie arm van die studie het aanleiding gegee tot die verdere onderskeiding tussen twee sub-groepe binne die intervensie arm, naamlik, die groep wat verander het en die groep wat nie verander het nie. Kwantitatiewe data is hoofsaaklik ingesamel, alhoewel kwalitatiewe data wat verkry is uit opmerkings en ondervindings van deelnemers as aanvullende inligting tot die kwantitatiewe data gebruik is teneinde die gedragsverandering wat plaasgevind het toe te lig. Bevindinge uit die studie dui op 'n dialektiese verhouding tussen klient en berader wat skeppende meganismes teweeg bring en sodoende moontlike gedragsverandering bevorder.