Evelyne Muggli1, Brendan Cook2, Colleen O'Leary3, Della Forster4, Jane Halliday5. 1. 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. 2. Murdoch Childrens Research Institute, Parkville 3052, Vic., Australia; Central Australian Aboriginal Congress, Alice Springs, 0870 NT, Australia. 3. Telethon Kids Institute, Perth 6845, WA, Australia. 4. La Trobe University, Melbourne 3000, Vic., Australia; Midwifery and Maternity Services Research, The Royal Women׳s Hospital, Parkville, 3052 Vic., Australia. 5. Murdoch Childrens Research Institute, Parkville 3052, Vic., Australia; Department of Paediatrics, The University of Melbourne, 3010 Vic., Australia.
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. DESIGN AND PARTICIPANTS: 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. SETTING: public hospital antenatal clinics and Mother & Child Health Centres, Melbourne, Victoria, Australia. FINDINGS: 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. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: 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.
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. DESIGN AND PARTICIPANTS: 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. SETTING: public hospital antenatal clinics and Mother & Child Health Centres, Melbourne, Victoria, Australia. FINDINGS: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. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: 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.
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