Authors:
Muggli E, Cook B, O'Leary C, Forster D, Halliday J.
Authors notes:
Midwifery. 2015;31(3):e23-e8.
Keywords:
Antenatal alcohol exposure, Ethanol, Pregnancy, Qualitative Research, Questionnaires
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: womens 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.