May P A
Center on Alcoholism, Substance Abuse, and Addictions (CASAA), University of New Mexico, Albuquerque 87106, USA.
Int J Addict. 1995;30(12):1549-602. doi: 10.3109/10826089509104417.
A comprehensive program for the prevention of fetal alcohol syndrome (FAS) and alcohol-related birth defects (ARBD) must consider multiple approaches and utilize knowledge from a variety of academic disciplines. Issues related to culture, society, behavior, belief systems, and medicine must all be considered for both etiology and solutions. A broad paradigm such as a public health model integrates various elements of approach. Because FAS and other levels of ARBD form a spectrum, from severe to negligible damage, a variety of drinking patterns with various characteristics and etiologies have to be addressed. This paper describes a multiple-level, comprehensive program with primary, secondary, and tertiary prevention components. Practical recommendations are proposed for addressing ARBD in a variety of arenas. While secondary and tertiary prevention hold promise for short-term reduction of FAS and ARBD prevalence, comprehensive prevention serves both short- and long-term effects. Multiple level prevention efforts are well served by clear and compelling vision and mission statements, and require careful evaluation.
预防胎儿酒精综合征（FAS）和酒精相关出生缺陷（ARBD）的综合项目必须考虑多种方法，并运用来自各种学术学科的知识。对于病因和解决方案，必须考虑与文化、社会、行为、信仰体系及医学相关的问题。诸如公共卫生模式这样的广泛范式整合了各种方法要素。由于FAS和其他程度的ARBD构成了一个范围，从严重损害到可忽略不计的损害，必须应对具有各种特征和病因的多种饮酒模式。本文描述了一个具有一级、二级和三级预防组成部分的多层次综合项目。针对在各种领域应对ARBD提出了切实可行的建议。虽然二级和三级预防有望在短期内降低FAS和ARBD的患病率，但综合预防兼具短期和长期效果。明确且有说服力的愿景和使命声明有助于开展多层次预防工作，并且需要仔细评估。
