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Dixon-Gray, MSW, MPHDHS Office of Family HealthWomen’s and Perinatal Health SectionFAS Prevention Program Coordinator800 NE Oregon Street, Suite 825Portland, OR 97232: Presented by Lesa A. Dixon-Gray, MSW, MPH DHS Office of Family Health Women’s and Perinatal Health Section FAS Prevention Program Coordinator 800 NE Oregon Street, Suite 825 Portland, OR 97232 Formative Research Conducted by: The Metropolitan Group Amy Columbo Jennifer Messinger- Heilbronner Research Outcomes: Research Outcomes Understanding what the target audience knows about binge drinking and unprotected sexual intercourse Understanding current level of knowledge about FAS Determining the key credible messengers and communication channels Determining opportunities for appropriate messaging and strategies to motivate behavior change Methodology: Methodology Review of data in Oregon Media Audit of alcohol-exposed pregnancy and FAS Prevention messages Executive Interviews Focus Groups Intercept Interviews Methods: Methods Project was reviewed through the DHS ODPE All focus groups were audio taped; participant permission was obtained prior to sessions No identifying information was collected; participants could use aliases if they chose Media Audit: Media Audit The national media that has previously been produced was reviewed, along with information on the Internet, discussion boards on drinking and pregnancy, and other FAS campaigns Executive Interviews: Executive Interviews 11 groups of people from various agencies and areas of expertise; 15 interviews Interviewees included community partners, health department representatives and FAS experts Interviews ranged from 20 minutes to one hour long. Focus Groups: Focus Groups 10 Focus Groups conducted between May – June, 2006 Segmented by age, location, ethnicity Communities: Portland Cornelius Beaverton Siletz Eugene Monmouth Focus Group Participants: Focus Group Participants Target audience – women 15 – 24 Groups: Urban African-American Girls (15 – 19) Urban Native-American Girls (15 –19) Urban Teen Parents (17 – 19) Urban Teens (predomantly white) (15 – 19) Urban College Women (18 – 24) Urban Latina College Women (18 – 24) Rural College Women (18 – 24) Rural Women (18 – 24) Focus Group Participants: Focus Group Participants Participants received $50 cash for their time (approx. 2 hours) Women interviewed were from a variety of racial/ethnic backgrounds African American Hispanic Caucasion Native American 72 participants 31 – 15 - 18 years 41 – 19 – 24 years Intercept Interviews: Intercept Interviews Purpose: To gather broad impressions from the Portland Community 61 'Man-on-the-street' Interviews at three locations – Pioneer Square Starbucks, NE Portland African American beauty salon, SE Portland DHS Self Sufficiency Office Questions asked were to determine opinions and knowledge level regarding binge drinking, drinking while pregnant, and FAS Focus Group Findings: Focus Group Findings Drinking habits of target audience: Drinking habits of target audience 'People think that being wasted is cool. I know it’s really not okay, but I still do it.' (urban teen) 'I’ll drink anything that will get you drunk.' (rural Latina teen) 'It’s a rite of passage, teens go through jacking, smoking weed, drinking; it’s just another stage of life. (rural Latina teen) 'Drinking is part of the college lifestyle, the social and college culture, with frats and sororities.' (rural college student) “So, what’s binge drinking mean…”: 'So, what’s binge drinking mean…' '…Going on a rampage, drinking every night and getting completely hammered.' (rural NA woman) '…when you don’t stop at a limit and throw up.' (urban teen) '…full force drinking, all morning and all night, all day and all week.' (intercept response from 35+ yo woman) '…has a negative connotation, it’s only an issue if you’re consistently doing it.' (rural college-age woman) “How much drinking is too much in one night?”: 'How much drinking is too much in one night?' 'Drinking to get drunk' 5 drinks A bottle of vodka Two forties What do you know about “unprotected sex” and birth control?: What do you know about 'unprotected sex' and birth control? 'I’ve had unprotected sex with my boyfriend… I was on birth control, however. Maybe 25% of the time we were drunk.' (rural college student) (Unprotected sex) '…is transferring body fluids without a barrier.' (urban NA teen) 'The pill doesn’t protect you from getting diseases.' (rural Latina teen) What happens when alcohol and unprotected sex are combined?: What happens when alcohol and unprotected sex are combined? 'Drunk sex is the best sex.' (urban AA teen) 'Alcohol is a boost to having sex.' (rural college student) 'People use it (alcohol) as an excuse – I was so drunk, I didn’t mean to sleep with him.' (rural, college-age women) Influencing “safe” drinking and sexual behavior…: Influencing 'safe' drinking and sexual behavior… 'I surround myself with friends at a party or a safe place when I know almost everyone.' (urban college student) 'I do a lot of things different when I am going out (to get drunk). I bring my favorite knife, bring some flats (shoes), bring an extra pair of clothes, and always may sure I am going with a friend that is reliable, trustworthy, and responsible.' (urban AA teen) Influencing “safe” drinking and sexual behavior…: Influencing 'safe' drinking and sexual behavior… 'I feel responsible for my friend (in terms of) taking care of her, so she won’t fall, go off with a guy, or get in a fight. I don’t like it, but I have to be the one taking care of her.' (urban Latina woman) 'My friend drinks too much and does stuff with guys sexually. I try to get guys away from her. I feel that some guys don’t care. Some guys think she’s stupid, but some try to get with her.' (urban teen) What about pregnant women who drink…?: What about pregnant women who drink…? 'They should be ‘whooped’.' (urban African-American teen) '…zero tolerance… If you choose to have a pregnancy, you have not greater responsibility that to bring into the world a health baby.' (rural, college-age woman) 'Why should a baby pay for the mom’s action…' (rural Latina teen) From Conception to Pregnancy Knowledge: From Conception to Pregnancy Knowledge 'I would talk to my friend if she drank alcohol when she was pregnant, but if she was the type of person who drank and then stopped when she found out (she was pregnant), then I wouldn’t ever have to worry about it.' (rural Latina teen) 'I’d only say something (about a friend’s drinking) if you can see they’re pregnant.' (urban Latina woman) Other KAB’s regarding alcohol and pregnancy: Other KAB’s regarding alcohol and pregnancy 'I’ve heard it’s beneficial (drinking wine while pregnant), it’s something about the antioxidants in grapes.' (rural college student) 'It is okay to drink in the second trimester.' (rural teen) '(Upon hearing the definition of FAS and being asked about taking precautions) I’ll still drink. I drank during my pregnancy, my doctor said it was ok and my child is fine.' (Intercept response, AA woman, 25 – 35) What do you know about FAS?: What do you know about FAS? '… is a deformed baby.' (urban NA teen) '…when the baby shakes and cries a lot.' (urban teen mom) '…not born with extremities.' (urban Latina woman) '…messes with the babies’ looks.' (rural NA woman) What providers say to women who are pregnant: What providers say to women who are pregnant Nothing… Teen moms stated that they had questions about drinking during pregnancy, breastfeeding, and childbearing… Oregon Gallup Poll Survey of Pregnant Women: Oregon Gallup Poll Survey of Pregnant Women Accessing Contraception and Sex Education: Accessing Contraception and Sex Education 'What about AIDS? Do you get that from having sex.' (rural Latina teen) 'In high school I knew a woman who used a coke bottle to douche and prevent pregnancy.' (rural college-age woman) 'If you’re under 18, you can’t go to the doctor or Planned Parenthood (to get contraception), because you don’t want your parents to know.' (rural college student) Sex Education and Contraception: Sex Education and Contraception 'In high school they tell us not to do it (sex) because it’s not a good thing until we’re married and settled down. They make sex out to be horrible.' (rural NA woman) 'In high school, they cancelled (sex education class) because someone was being immature.' (rural, college-age woman) Unplanned Pregnancies: Unplanned Pregnancies 'Five different people are pregnant that I know.' (urban teen) 'Having a baby at 16 years old and not getting done with school is my biggest fear.' (rural Latina teen) 'I don’t want to get pregnant because of all the things that I will not be able to do.' (urban NA teen) Use of Contraception: Use of Contraception 'Guys complain about condoms.' (urban NA teen) 'I thought we were in love and I wanted to know how it felt.' (urban AA teen) 'I don’t have any (condoms or birth control) because my parents can find it. My mom goes on about ‘are you having sex?’. I can talk to my mom, but I’d rather not, because she wants to do into detail.' (urban teen) Where do women get their contraception?: Where do women get their contraception? 'I don’t think people know about Planned Parenthood and how easy it is.' (urban Latina woman) 'I go to free community clinic in Siletz (for birth control), not my family practitioner, it’s like Planned Parenthood.' (rural, NA woman) Use of Plan B Contraception: Use of Plan B Contraception 'Yes (I’ve used Plan B), because it will keep me from getting pregnant.' (urban AA teen) 'Yes (I’ve used Plan B), because I wouldn’t want to take the risk of being pregnant at my age.' (urban Latina woman) Teachable Moments for the Target Audience: Teachable Moments for the Target Audience 'When I thought I was pregnant, I stopped drinking and smoking.' (urban teen) 'Yes, I have had a pregnancy scare and I did stop drinking during the two weeks that I thought I could be pregnant. However, I started (drinking) again after I knew I was not pregnant.' (rural college student) I was a few days late on my period. I stopped drinking during those days. Once I got my period, I did drink, after I was sure I wasn’t pregnant.' (rural college student) Receiving Information: Receiving Information ' I used a hotline for (getting) birth control information quickly. I spoke to someone and didn’t find it helpful. It seemed scripted.' (rural college student) 'I would not call a toll-free number. My parents will see the phone bill and try to find out what it is.' (urban teen) 'If I see information on a certified web page I feel better (about the information).' (rural, college-age woman) 'Websites are just good at finding out more, links gives more info.' (urban college student) Past examples…: Past examples… Slide35: Slide36: What do we do from here?: What do we do from here? A substantial portion of the target audience was open and willing to change their behavior if they thought they were pregnant Pregnancy scares are a common occurrence among the target audience Media Strategies: Media Strategies Use primarily a peer-to-peer strategy of personal outreach and education through friends, as trusted sources of our target audience. Incorporate a provider strategy. Incorporate use of a website. Basic message to get across…: Basic message to get across… If you drink, be sure you don’t get pregnant. And if there’s a chance you’re pregnant, don’t drink. Drinking beer, wine, or any alcohol during pregnancy, even before you know you’re pregnant can cause Fetal Alcohol Syndrome. 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