Alaskan physicians' knowledge, attitudes, and behaviors related to fetal alcohol spectrum disorders

Fetal alcohol spectrum disorders (FASDs), caused by maternal consumption of alcohol during pregnancy, constitute the leading known preventable birth defects in the US. Given high prevalence rates and lifetime costs of FASDs in Alaska, it is imperative that healthcare providers have an adequate foundation of knowledge related to FASDs, as well as a strong sense of self-efficacy vis-a-vis their personal capacity to engage in primary and secondary prevention activities. The purpose of this study was to examine Alaskan physicians' self-reported levels of knowledge, attitudes, and practice behaviors related to FASDs, and identify effective ways to educate and train physicians about primary and secondary FASD prevention. Study goals were accomplished via an explanatory mixed methods research design involving three distinct phases; namely, a quantitative, qualitative, and application phase. Through study participation, Alaskan physicians shared their perceptions and opinions about systemic and professional barriers that affect educational and training needs related to FASD prevention and clinical intervention, as well as challenges that impede access to care for individuals who are affected by FASDs. Results based on surveys from 243 physicians and interviews with 24 key informants revealed that physicians are generally knowledgeable about the risks of alcohol consumption during pregnancy. However, physicians are in need of support to provide effective services related to FASD prevention and intervention. These needs include: 1) specialized education during medical school and residency; 2) easily accessible continuing education opportunities; 3) development and dissemination of best practice protocols related to FASD care; 4) workforce development to increase referral options for patients; and 5) changes to healthcare systems to support primary and secondary prevention practices. Clearly, many challenges and obstacles identified by physicians are beyond their control and need to be addressed not only as independent practice issues but as larger medical education and healthcare systems issues. Given these realities and findings, the study concludes with suggestions and resources for physicians related to needed changes in FASD-related practice behaviors, as well as recommendations about how universities, medical schools, healthcare systems, and State and federal entities can better support physicians' efforts to reduce and treat these entirely preventable birth defects.