"If it burns going down... ": how focus groups can shape fetal alcohol syndrome (FAS) prevention

Despite public health campaigns and clinical interventions that encourage women to abstain from alcohol during pregnancy, some women continue to drink while pregnant. To provide a more in-depth understanding of how at-risk women regard--and emotionally react to--warnings about drinking alcohol during pregnancy, we conducted focus groups in 1997 with 11 pregnant and recent postpartum Native American and African American women in Los Angeles, California. The main objective of these groups was to uncover relevant aspects of women's beliefs and opinions about drinking during pregnancy that may not have been elicited by other research instruments. Results would then be used to shape a large survey of pregnant at-risk women. Analysis of the transcripts revealed three emergent themes, which had the greatest impact on our subsequent survey. These were women's exposure to and perceived believability of messages, their perception of risk associated with drinking, and the barriers to cutting down on alcohol consumption during pregnancy. Questions added to our survey instrument because of these findings included whether women think that some alcohol beverages are safer to drink than others; how they value cutting back alcohol use; their views on the irreversibility of fetal alcohol syndrome; and what pressures they feel from peers and family to drink during pregnancy. Given the small sample size associated with focus groups, these results cannot be generalized to larger populations; however, these women's words revealed important underlying issues and barriers that should be considered in studying and intervening with larger representative samples.