“If you can have one glass of wine now and then,why are you denying that to a woman with no evidence”: Knowledge and practices of health professionals concerning alcohol consumption during pregnancy

BackgroundAlcohol consumption during pregnancy has the potential to cause significant harm to the foetus and the current Australian guidelines state that it is safest not to drink alcohol while pregnant. However, conflicting messages often appear in the media and it is unclear if the message to avoid alcohol is being effectively conveyed to pregnant women.AimsThis research aims to explore the advice that health professionals provide to pregnant women about alcohol consumption; the knowledge of health professionals regarding the effects of alcohol consumption; and their consistency with following the Australian guidelines.MethodsTen semi-structured face to face interviews were conducted with health professionals who regularly provide antenatal care. These include midwives, obstetricians, and shared care general practitioners. A six-stage thematic analysis framework was used to analyse the interview data in a systematic way to ensure rigour and transparency. The analysis involved coding data extracts, followed by identifying the major themes.FindingsHealth professionals displayed adequate knowledge that alcohol can cause physical and mental difficulties that are lifelong; however, knowledge of the term FASD and the broad spectrum of difficulties associated with alcohol consumption during pregnancy was limited. Although health professionals were willing to discuss alcohol with pregnant women, many did not make this a routine part of practice, and several concerning judgements were noted.ConclusionCommunication between health professionals and pregnant women needs to be improved to ensure that accurate information about alcohol use in pregnancy is being provided. Further, it is important to ensure that the national guidelines are being supported by health professionals.     

Work stress and alcohol use: developing and testing a biphasic self-medication model

This study developed and tested a moderated-mediation model of work stress and alcohol use, based on the biphasic (stimulant and sedative) effects of alcohol and the self-medication and stress-vulnerability models of alcohol use. The model proposes that exposure to work stressors can increase both negative affect and work fatigue, and that these 2 sources of strain can subsequently motivate the use of alcohol. However, the relations of negative affect and work fatigue to alcohol use are conditional on the joint moderating effects of alcohol outcome expectancies and gender. Data were collected from a national probability sample of 2808 U.S. workers. Supporting the model, the results indicated that work stressor exposure was conditionally related via negative affect to heavy alcohol use among both men and women holding strong tension-reduction alcohol expectancies and to after work alcohol use among men holding strong tension-reduction alcohol expectancies. Also, work stressor exposure was conditionally related via work fatigue to both heavy alcohol use and workday alcohol use among men holding strong fatigue-reduction alcohol expectancies. The results have application in the identification of individuals at higher risk of problematic alcohol use and are relevant to workplace safety and to the design of appropriate interventions.     

Religion and vulnerability among low-risk adolescents

Studies of resilient youth have documented the helpful influence of religion in their lives. In the absence of positive influences among high-risk youth, religion and religious organizations in particular often serve to promote prosocial outcomes. This study, on the other hand, investigates whether religion and religious change are comparably effective influences in reducing the vulnerability of low-risk youth to drinking, drug use, delinquency, problems in school, and poor grades. Using data from the National Longitudinal Study of Adolescent Health, this study identified at least one influential aspect of religion that serves as a direct protective factor across each mode of vulnerability, and also documented indirect pathways of religious influence. We discuss the findings and consider the variable influence of religion on youth.     

Work-related stress, coping resources, and heavy drinking in the restaurant business

On the basis of findings of high levels of alcohol consumption and risk of alcohol-related disease among employees of the restaurant business, the ability of the Karasek work-strain model to predict heavy drinking was investigated in a cross-sectional study of 3204 Norwegian male and female waiters and cooks. In the logistic regression analyses, no strong associations between work stress and heavy drinking were found. However, the effectiveness of individual coping resources, measured as frequency of difficulty in relaxing after work, was an important predictor of heavy drinking, as were household type, age group, and occupation. Although no strong direct associations between work stress and heavy drinking were found, the results are consistent with a model where coping resources are the mediatiing variable between work stress and heavy drinking.     

Family structure and adolescent alcohol use problems: Extending popular explanations to American Indians

Competing explanations of the relationship between family structure and alcohol use problems are examined using a sample of American Indian adolescents from the National Longitudinal Study of Adolescent Health. Living in a single-parent family is found to be a marker for the unequal distribution of stress exposure and parental alcohol use, but the effects of other family structures like non-parent families and the presence of under 21-year-old extended family or non-family members emerge or remain as risk or protective factors for alcohol use problems after a consideration of SES, family processes, peer socialization, and social stress. In particular, a non-parent family structure that has not been considered in prior research emerged as a protective family structure for American Indian adolescent alcohol use problems.     

Age of Onset of Alcohol Consumption and Subsequent Negative Health Outcomes in Gay and Bisexual Men Who Have Sex With Men

ABSTRACT

The correlation between current alcohol use and sexual risk behaviors among men who have sex with men (MSM) is well documented, but little is known about age of drinking onset and current risks among this population. Data from a 2008 Internet survey of 8,452 MSM in the United States were used to assess factors associated with age of onset of alcohol use. In a multivariable model, drinking onset before age 15 was significantly associated with a higher number of lifetime male anal sex partners and being behaviorally bisexual in the past 12 months. Men who reported depressive symptoms in the past two weeks or who screened positive for alcohol abuse in the past 60 days were more likely to have early age of drinking onset. Findings suggest the need for targeting younger adolescents for alcohol screening, particularly sexual minority youth, to prevent risk behaviors in adulthood.     

Different forms of spirituality and heavy episodic drinking among college students

Objective: The current study examined prospective, bidirectional relationships between 3 measures of spirituality (Daily Spiritual Experiences, Positive Religious Coping, and Negative Religious Coping) and frequency of heavy episodic drinking. Participants: Three hundred ninety-one students attending a large, public university in the Midwest. Methods: Electronic surveys assessing predictors of college alcohol use were sent to participants in the winter of their freshman and sophomore years. Structural equation modeling was used to analyze data. Results: A latent factor comprised of Daily Spiritual Experiences and Positive Religious Coping (ie, “positive spirituality”) was negatively related to future frequency of heavy episodic drinking. Negative Religious Coping was unrelated to heavy episodic drinking. Additionally, heavy episodic drinking did not prospectively predict any measures of spirituality. Conclusions: Data are supportive of continued efforts to integrate positive spirituality into interventions for collegiate heavy episodic drinking.     

Sector-dependent framing effects of corporate social responsibility messages: An experiment with non-alcoholic and alcoholic drinks

Corporate social responsibility (CSR) communications can be paradoxical in their effect on consumers attitudes and skepticism toward an organization, buying intentions and the organization's reputation. In this research, we investigated the effects of sector dependence and the framing of CSR messages. A 2 × 3 between-subjects experiment was used with six advertisements for two fictional organizations: one in the alcohol industry (a so-called socially stigmatized industry) and one in a non-alcohol industry. The experiment included 188 participants. The results show that the framing effects of CSR messages are sector specific: in the non-alcohol sector, CSR messages and frames had a positive effect on consumers, whereas in the alcohol sector, they had a negative effect on consumers.     

The moderating effect of alcohol use on protective and risky sex behaviors among college students in the Southeast United States

ABSTRACT

Objective: College students are a high-risk population for new human immunodeficiency viruses (HIV) diagnoses. Although condom use self-efficacy and HIV knowledge can protect against risky sexual behavior (RSB), these same protective factors have been shown to exacerbate RSB. The influence of alcohol use can further complicate these protective factors to influence RSB. Participants: 689 African American/Black and non-Hispanic White college students attending a public university in the Southeast United States. Method: This study sought to examine the relations between condom use self-efficacy and HIV knowledge with RSB and the moderating effect of alcohol use. Results: Findings showed positive associations between RSB and HIV knowledge and alcohol use. Unexpectedly, low frequency drinkers with high condom use self-efficacy were at increased risk for RSB compared to high frequency drinking counterparts. Conclusions: Findings point to the need to target prevention services for low-risk drinkers in college settings.     

Estimation of Benchmark Dose as the Threshold Amount of Alcohol Consumption for Blood Pressure in Japanese Workers

In order to determine the threshold amount of alcohol consumption for blood pressure, we calculated the benchmark dose (BMD) of alcohol consumption and its 95% lower confidence interval (BMDL) in Japanese workers. The subjects consisted of 4,383 males and 387 females in a Japanese steel company. The target variables were systolic, diastolic, and mean arterial pressures. The effects of other potential covariates such as age and body mass index were adjusted by including these covariates in the multiple linear regression models. In male workers, BMD/BMDL for alcohol consumption (g/week) at which the probability of an adverse response was estimated to increase by 5% relative to no alcohol consumption, were 396/315 (systolic blood pressure), 321/265 (diastolic blood pressure), and 326/269 (mean arterial pressures). These values were based on significant regression coefficients of alcohol consumption. In female workers, BMD/BMDL for alcohol consumption based on insignificant regression coefficients were 693/134 (systolic blood pressure), 199/90 (diastolic blood pressure), and 267/77 (mean arterial pressure). Therefore, BMDs/BMDLs in males were more informative than those in females as there was no significant relationship between alcohol and blood pressure in females. The threshold amount of alcohol consumption determined in this study provides valuable information for preventing alcohol-induced hypertension.