Rural and small-town attitudes about alcohol use during pregnancy: A community and provider sample

Context: While there has been considerable research on prenatal alcohol use, there have been limited studies focused on women in rural and small-town environments. Purpose: This 2-part study examines gender differences in attitudes and perceived barriers to intervention in a large community sample of persons living in rural and small-town environments in Kentucky (n = 3,346). The study also examines rural/small-town prenatal service providers' perceptions of barriers to assessment and intervention with pregnant substance abusers (n = 138). Methods: Surveys were administered to a convenience sample of employees and customers from 16 rural and small-town community outlets. There were 1503 males (45%) and 1843 females (55%) ranging in age from under 18 years old to over 66 years old. Surveys also were mailed to prenatal providers in county health departments of the 13-county study area, with 138 of 149 responding. Findings: Overall results of the community sample suggest that neither males nor females were knowledgeable about the harmful effects of alcohol use during pregnancy. Results also indicate substantial gender differences in alcohol attitudes, knowledge, and perceived barriers. Further, prenatal care providers identified several barriers in assessment and treatment of pregnant women with alcohol use problems in rural and small-town communities, including lack of knowledge and comfort with assessment as well as a lack of available and accessible treatment for referrals.