Mapping the landscape of prenatal alcohol prevention in the UK (v1)

  • Research type

    Research Study

  • Full title

    Mapping the landscape of prenatal alcohol prevention in the UK: a collaborative review

  • IRAS ID

    293119

  • Contact name

    Cheryl McQuire

  • Contact email

    cheryl.mcquire@bristol.ac.uk

  • Duration of Study in the UK

    2 years, 2 months, 30 days

  • Research summary

    Research summary
    We aim to explore what PAE prevention activities have been carried out in the UK, how they are perceived by pregnant and postpartum people and service providers, and whether they are effective.
    This work has 3 components: an evidence search, qualitative interviews, and a scoping search to determine the feasibility of further natural experimental evaluation.

    1. Evidence search
    We will consult with members of the public and professionals including health care and third sector workers, and policy makers to find out what PAE prevention activities have been carried out in the UK and to request relevant documentation (e.g. protocols, reports).

    2. Interviews
    We will carry out semi-structured interviews with pregnant and postpartum people, and people who have provided prenatal alcohol prevention activities to find out about their views and experiences of drinking in pregnancy, and of these prevention activities.

    3. Natural experiments
    We will assess the extent to which further natural experimental evaluation of existing PAE initiatives is feasible. This will include a scoping search of relevant datasets (e.g. birth weight, gestational age and achievement of developmental milestones through NHS Digital) and approval processes, and assessment of how robust potential natural experimental designs would be.

    Overall, the results of this research will provide a summary of what activities have been carried out in the UK to prevent drinking in pregnancy, how they work in practice, how they are perceived by those that use them, and whether they improve the health of pregnant people and their children. This evidence will help us to identify priorities for future research and public health activities.

    Summary of results

    Background
    UK policy makers have called for urgent action to reduce exposure to alcohol pregnancy. However, there has been limited evidence on what UK interventions are available, how these are experienced by those delivering and receiving them, and their outcomes. We aimed to identify, evaluate, and synthesise evidence on the availability, content, experience, and impact of prenatal alcohol prevention initiatives in the UK.

    Methods
    We conducted a systematic literature search of academic journals and other unpublished sources and consulted with 61 academic, practice, policy, third sector, and public stakeholders to identify UK initiatives on prenatal alcohol prevention. We interviewed 10 pregnant people, 4 people who had had a children within the last 2-years, and 13 service providers including those who deliver prenatal alcohol prevention interventions and midwives, to discuss their views and experiences of prenatal alcohol prevention. Participants were chosen from each UK region and identified through maternity sites, social media and, for stakeholder consultees, researcher networks. Information from relevant prenatal prevention initiatives from the literature was independently collected by two reviewers. Researchers summarised information from the literature and interviews by grouping this into key themes. The number and characteristics of UK prenatal alcohol prevention initiatives were also summarised.

    Findings
    We identified 20 prenatal alcohol prevention initiatives through literature searches, stakeholder consultation, and interviews. Initiatives included screening and intervention, campaigns, and education or training. Seven initiatives were identified in the north of England. Two initiatives were identified in Scotland and two in Wales. The East of England, West Midlands, and South East of England had one each. None were identified in Southwest of England or Northern Ireland. Barriers to prevention included lack of resources, excessive workload, concerns around blame, and restrictions due to the COVID-19 pandemic. Enablers included workforce training and trust between pregnant people and service providers. Effectiveness of evidence was scarce.

    Interpretation
    Key strengths of this study included extensive searches to identify relevant initiatives and in-depth interviews with pregnant/postpartum people and relevant professionals. This research provides a comprehensive analysis of current provision, including gaps, providing crucial evidence and priorities to inform research and practice related to prenatal alcohol prevention.

  • REC name

    West Midlands - Solihull Research Ethics Committee

  • REC reference

    21/WM/0080

  • Date of REC Opinion

    23 Mar 2021

  • REC opinion

    Favourable Opinion