Fetal Alcohol Spectrum Disorder (FASD)
Year 5 Evaluation of the Government of Alberta’s
FASD 10 Year Strategic Plan
Outcome 1a
January 31, 2013
Outcome 1a:
Albertans understand that alcohol use during pregnancy can lead to FASD, that FASD can be prevented
and that FASD prevention is a shared responsibility.
Evaluation Question 1a:
Has there been an increase in understanding among Albertans that: alcohol use during pregnancy can
lead to FASD; FASD can be prevented; and FASD prevention is a shared responsibility?
Prepared by:
Cecilia Bukutu, MPhil, PhD
Tara Hanson, MACT
Suzanne Tough, MSc, PhD
2
Acknowledgements
The Alberta Centre for Child, Family and Community Research (The Centre) would like to acknowledge
the work and efforts of the University of Alberta Population Research Lab, who implemented the survey.
Suggested Citation
Bukutu, C., Hanson, T., & Tough, S. Fetal Alcohol Spectrum Disorder Awareness Campaign Project Final
Report prepared for The Alberta Centre for Child Family and Community Research, 2012.
Related Materials
Tough S, Clark M, Hicks M, Clarren S. Attitudes and Approaches of Canadian providers to preconception
counseling and the prevention of Fetal Alcohol Spectrum Disorders (FASDs) JFAS Int 2005;3:e3
Tough, S. Clarke, M., Hicks, M. Knowledge and attitudes of Canadian Psychiatrists regarding fetal
alcohol; spectrum disorder. The Canadian Child and Adolescent Psychiatry Review. 2003;12(3):64-71.
Additional Copies
Questions about this survey or requests for copies of this report may be directed to
Tara Hanson, Director of Knowledge and Partnership Development
(780) 408-8730 or thanson@research4children.com.
3
Executive Summary
Background
The purpose of this report was to assess Albertans’ awareness of Fetal Alcohol Spectrum Disorder
(FASD). A telephone survey was conducted, asking Albertans questions in the following categories:
general FASD knowledge (e.g. Do you think FASD can be prevented?), contact with FASD (e.g. Do you
know anyone who you think might have FASD?), support (e.g. Do you think a woman should be
supported by others not to drink while pregnant?), and behaviour (e.g. If you saw a pregnant woman
that you knew drinking alcohol, would you tell her that using alcohol during pregnancy might harm the
baby?).
The telephone survey consisted of ten questions, and 1203 adult Albertans responded. Participants
were equally distributed between Edmonton, Calgary, and other areas in Alberta, and there was an
equal distribution of males and females. Respondents also had similar demographic characteristics
when compared to the general Albertan population.
Key Results
 85.7% of respondents have heard of FASD.
 Over 96% of Albertans who have heard about FASD know that alcohol use during pregnancy










causes FASD, that FASD can be prevented, and that the best way to prevent FASD is by not using
alcohol while trying to get pregnant and during pregnancy.
14.3% of respondents had not heard of FASD. These respondents were more likely to be male
(62.8%), between the ages of 18 and 44 years, non-Caucasian, and born outside of Canada.
A significant proportion of Albertans know someone with FASD (40.1%) and/or someone who
cares for an individual with FASD (39.1%).
Respondents most likely to know a person with FASD were: aged between the ages of 25 to 34
years (45.0%) and 55 to 64 years (46.2%), employed, and living outside of Calgary (either
Edmonton or other areas of Alberta).
Respondents likely to know someone who cares for an individual with FASD were female,
between 25 and 34-years-old, employed, Canadian born, and living outside of Calgary.
Most respondents (89%) reported that they would tell a pregnant woman they knew who was
drinking alcohol, that using alcohol during pregnancy may harm the baby.
Those most likely to tell a woman were: female, between 25 and 34-years-old, living outside of
Calgary and employed.
Nearly half (49.7%) of the respondents reported that they would tell a pregnant woman they did
not know, who was drinking alcohol, that using alcohol during pregnancy might harm the baby.
Those most likely to tell a woman were: female, between 25 and 34-years-old, living outside of
Calgary, with an annual household income below $40,000/year.
Almost all participants responded that they believed a woman should be supported by others not
to drink while pregnant, regardless of whether or not they had heard of FASD (98.6%) or not
(95%).
When broken down by groups (healthcare provider, partner/spouse, family, friends, community,
or government), the woman’s family and partner/spouse were identified most often as the main
sources of support, both by respondents who had and had not heard of FASD.
4
 Healthcare providers, government, and community were all implicated by many respondents
(60+%) as having roles in supporting pregnant women not to drink.
Recommendations
To address some of the limitations related to data collection, future surveys should include a wider
range of individuals: those under the age of 18, non English-speaking Albertans, individuals who only
own cell phones or who do not have a telephone. For a better understanding of the needs of caregivers,
future studies could also include questions about caregivers’ needs for and access to information and
support.
The findings regarding supporting pregnant women not to drink suggest that Albertans recognize that
collective efforts are required to support women at risk of an alcohol exposed pregnancy. This finding
also suggests that health care providers, communities, and government should feel empowered to take
a leading role in the implementation of effective, accessible, and respectful supports for women at risk.
Additionally, those working in agencies and programs where they may encounter women at risk of
drinking during pregnancy should have training that enables them to identify these women and help
them by providing supports or referrals.
In this study, many Albertans responded that they would be willing to discuss alcohol use during
pregnancy with women they do not know, which may reflect the care and concern Albertans have for
those in their communities. This finding is further evidence that policy and decision makers can be
reassured that actions taken to support women would be valued by Albertans.
5
Table of Contents
Outcome 1a: ............................................................................................................................................................................... 7
Evaluation Question .....................................................................................................................................................................7
Introduction and Background ............................................................................................................................................ 7
Methods ....................................................................................................................................................................................... 7
Demographics ........................................................................................................................................................................... 9
Respondents’ Knowledge/Awareness about FASD ................................................................................................. 10
General FASD Knowledge........................................................................................................................................................ 10
Contact with FASD ..................................................................................................................................................................... 12
Support ............................................................................................................................................................................................ 16
Behaviour ....................................................................................................................................................................................... 20
Discussion ................................................................................................................................................................................. 24
Limitations ............................................................................................................................................................................... 25
Recommendations................................................................................................................................................................. 26
References ................................................................................................................................................................................ 27
Appendix A: Characteristics of Survey Respondents .............................................................................................. 28
Characteristics of Survey Respondents ............................................................................................................................. 28
Appendix B: About the Centre .......................................................................................................................................... 30
About the Alberta Centre for Child, Family, and Community Research ............................................................ 30
6
Research Report: Outcome 1a
Outcome 1a:
Albertans understand that alcohol use during pregnancy can lead to FASD, that FASD can be
prevented, and that FASD prevention is a shared responsibility.
Evaluation Question
1: Has there been an increase in understanding among Albertans that: alcohol use during pregnancy can
lead to FASD; FASD can be prevented; and FASD prevention is a shared responsibility?
Introduction and Background
Drinking alcohol is a common social activity for many women. In a Canadian Addiction Survey, 76.8% of
the female respondents reported drinking in the past year.1 Alcohol use during pregnancy can result in
serious life-long health outcomes for the baby. The Public Health Agency of Canada2 warns that there is
no safe amount or safe time to drink alcohol during pregnancy.
Outcome 1a of the Government of Alberta FASD 10 Year Strategic Plan addresses the issue of Albertans
awareness of FASD.
Outcome 1a is: Albertans understand that alcohol use during pregnancy can lead to FASD, that FASD can
be prevented and that FASD prevention is a shared responsibility.
Evaluation Question 1a: Has there been an increase in understanding among Albertans that: alcohol use
during pregnancy can lead to FASD; FASD can be prevented; and FASD prevention is a shared
responsibility?
In 2003, Alberta formed a Fetal Alcohol Spectrum Disorder Cross-Ministry Committee (FASD-CMC) with
a mandate to be the primary driving force behind the delivery of FASD programs offered by the
provincial government. This report is intended to address Evaluation Question 1a by providing a
measurement of the FASD-CMC’s awareness and prevention efforts. Specifically, the results presented
in this report establish a baseline measure for Outcome 1a of the Strategic Plan.
Methods
The Centre submitted research questions to the Population Research Laboratory (PRL) at the University
of Alberta for inclusion in the 2011 Alberta Survey. The Alberta Survey is an annual telephone survey,
which explores public opinion on a wide range of public policy concerns.
The PRL conducted the 2011 Alberta Survey from May 25 to June 22, 2011. 1203 Albertans over the age
of 18 participated, with approximately equal representation from men and women, and the same
number of individuals from Calgary, Edmonton and the rest of the province. The overall response rate
for this survey was 26.1%.
7
The Population Research Lab provided the survey data to The Centre for analysis which was conducted
by their Child and Youth Data Laboratory. This report includes responses to questions as well as
demographic information about the population surveyed. It serves as a baseline measure to define the
extent to which Albertans understand that alcohol use during pregnancy can lead to FASD, that FASD
can be prevented and that FASD is a shared responsibility.
The Centre submitted the following questions for inclusion in this survey:
General FASD Knowledge
1. Have you heard of Fetal Alcohol Spectrum Disorder or FASD before?
2. Can alcohol use during pregnancy cause FASD?
3. Do you think FASD can be prevented?
4. What is the best way to prevent FASD?
a. No alcohol use in the first three months of pregnancy
b. No alcohol use in the first six months of pregnancy
c.
No alcohol use in the last three months of pregnancy
d. No alcohol use during pregnancy or while trying to become pregnant
Contact with FASD
5. Do you know anyone who provides care for someone with FASD or who you think has FASD?
6. Do you know anyone who you think might have FASD?
Support
7. Do you think a woman should be supported by others not to drink while pregnant?
8. Who should be involved in encouraging a woman not to drink alcohol during pregnancy;
a. the woman's health care provider
b. the woman's partner or spouse
c. the woman's family
d. the woman's friends
e. the community
f. the government
Behaviour
9. If you saw a pregnant woman that you knew drinking alcohol, would you tell her that using alcohol
during pregnancy might harm the baby?
10. If you saw a pregnant woman that you DID NOT know drinking alcohol, would you tell her that using
alcohol during pregnancy might harm the baby?
8
The following definition of FASD was provided to survey participants who had not heard of FASD, did not
respond or responded with ‘I don’t know’ to the question have you heard of FASD before?
“FASD is completely preventable. It can occur in an individual whose mother drank alcohol during
pregnancy. Alcohol use during pregnancy can lead to babies born with permanent disabilities. FASD can
result in reduced IQ, speech and vision impairment, hyperactivity, behavior and learning problems, and
physical malformations.”
Descriptive statistics of responses to survey questions were calculated. Respondents were grouped
according to various characteristics and compared to respondents in other groups. This was done to see
if certain characteristics made respondents more or less likely to give a certain answer. Respondents
were compared based on the following demographic characteristics:
 Gender (male vs. female)
 Age (various age-groups)
 Area of residence (Edmonton, Calgary vs. Other Alberta)
 Place of origin (Canadian born vs. Born outside Canada)
 Religious affiliation (those who self-identified as religious vs. those who did not)
 Highest Level of Education (completed high school or less vs. completed further education)
 Employment status (employed (full or part time) vs. unemployed/retired)
 Annual household income (high-income vs. low-income households)
The number of participants who responded to particular question items varies. That is, not every
participant answered every question item. Question item response percentages are calculated by
dividing the number of respondents who indicated a specific response category divided by the total
number of respondents who answered the question item.
Demographics
In a survey of this type, only part of the total population is surveyed. The information collected is then
used to make inferences about the whole population. To ensure that the current survey is providing a
reasonably reliable picture of the whole Albertan population, information describing the respondents to
the survey should closely match data from the Canadian Census when the two are compared. Census
data is collected from every unit in a population making it truly representative of the whole population.
In the following section the current survey information is presented to show how comparable the
respondents were to the Albertan population based on the most recent Canadian census (2006). Certain
characteristics of respondents from the Alberta Survey were compared to Albertan population census
information. Generally respondents had similar demographic characteristics to the general Albertan
9
population (see Appendix A). Therefore, the results of this report likely reflect the knowledge and
attitudes of Albertans.
Respondents’ Knowledge/Awareness about FASD
General FASD Knowledge
Survey respondents were asked
1) Have you heard of Fetal Alcohol Spectrum Disorder or FASD before?
Where respondents had not heard about FASD they were provided information regarding what FASD
was and were not asked any further questions in the general FASD knowledge section. They were
however, asked other FASD related questions later in the survey.
Of the Albertan adults who participated in the survey, 85.7% (n=1028) were aware of what FASD is,
where as 14.3% (n=172) had not heard of FASD (Figure 1).
Figure 1. Have you heard of Fetal Alcohol Spectrum Disorder or FASD before?
Heard of FASD
Not heard of FASD
14%
86%
Characteristics of respondents who had not heard of FASD.
Respondents who had not heard of FASD were different to respondents who had heard about FASD
(Table 1). Compared to respondents who had heard about FASD, those who had not heard of FASD
were more likely to be male (62.8%), to reside in Calgary (48%), to have been born outside Canada
(47%), to be younger (aged between 18 and 44 years)(48%), to have children (42%), and to be nonCaucasian (36%).
10
Table 1. Characteristics of respondents who had heard of FASD compared to those who hadn’t heard
of FASD.
Characteristic
Of those who had heard of Of those who had not heard of
FASD (%)
FASD (%)
(N=1028)
(N=172)
Age
18-44 years
35.8
47.9
45 and older
64.2
52.1
Gender
Male
47.9
62.8
Female
52.1
37.2
Ethnic background
Caucasian
92.4
63.7
Non-Caucasian
7.6
36.2
Children
Yes
34.5
42.4
No
65.5
57.6
Religion
No Religion
27.6
20.6
Not Christian
6.8
18.1
Christian
65.6
61.2
Canadian Born
Yes
86.1
52.9
No
13.9
47.1
The rest of this section focuses on the respondents who had heard about FASD (86%, n=1028) and their
responses to the following general knowledge questions about FASD;
2) Can alcohol use during pregnancy cause FASD?
3) Do you think FASD can be prevented?
4) What is the best way to prevent FASD?
a. No alcohol use in the first three months of pregnancy
b. No alcohol use in the first six months of pregnancy
c. No alcohol use in the last three months of pregnancy
d. No alcohol use during pregnancy or while trying to become pregnant
Of respondents who were aware of FASD, 99% knew that alcohol use during pregnancy causes FASD.
The same percentage knew that FASD is preventable (99%).
When asked the best way to prevent FASD, 96% of respondents who were aware of FASD selected the
best answer, which was: no alcohol use during pregnancy or while trying to become pregnant, followed
by 2.1% who selected ‘no alcohol used in the first 3 months of pregnancy, 0.9% who selected no alcohol
use in the first 6 months of pregnancy and lastly 0.1% who selected no alcohol use in the last 3 months
11
of pregnancy (Figure 2). Respondents (4%) who did not select the best answer were predominantly male
(62%). The 2.1% of respondents who selected the answer ‘no alcohol used in the first 3 months’ were
mostly (67%) male.
Figure 2. What is the best way to prevent FASD?
96.3
100
% of respondents
80
60
40
20
2.1
0.9
0.7
0
No alcohol use in the No alcohol use in the No alcohol use in the No alcohol use during
first 3 months of
first 6 months of
last 3 months of
pregnancy or while
pregnancy
pregnancy
pregnancy
trying to become
pregnant
Contact with FASD
Both respondents who had heard of and not heard of FASD (n=1200) were asked the following
questions.
5) Do you know anyone who you think might have Fetal Alcohol Spectrum Disorder?
6) Do you know anyone who provides care for someone with FASD or who you think has FASD?
Of the respondents that had heard of FASD, just over 40% reported knowing someone who has or they
think might have FASD. Almost the same number of respondents knew someone who provided care for
an individual who has or might have FASD (39.1%) (Figure 3).
Of the respondents who had not heard of FASD, 6.5% reported knowing someone who has or they think
might have FASD, and 7.1% reported knowing someone who cares for an individual who has or might
have FASD (Figure 3).
12
Figure 3. Do you know anyone who you think might have Fetal Alcohol Spectrum Disorder (FASD)? Do
you know anyone who provides care for someone with FASD or who you think has FASD?
Heard of FASD
Not heard of FASD
50
% of respondents
40
40.1
39.1
30
20
10
7.1
6.5
0
Know someone with FASD
Know anyone who cares for
someone with FASD
Responses from respondents who had heard about FASD were analyzed to see if there were differences
in responses based on certain characteristic such as gender.
Gender
No gender differences were reported regarding whether respondents knew a person with FASD or not
(p=0.19). Females were more likely to report knowing anyone who provided care to a person with FASD
(45%) than males (32.6%) (Figure 4).
Figure 4. Respondents who knew anyone who cared for someone with FASD by gender
50
45.0
% of respondents
40
32.6
30
20
10
0
Male
Female
Gender
13
Age
Respondents in the age-groups 25-34 (45.0%) and 55-64 (46.2%) (Figure 5) were the most likely to know
someone with FASD and to know anyone who cares for a person with FASD (45.8% and 44.2%
respectively). Those aged 65+ were least likely to know anyone who has FASD (29.1%) and someone
who cares for a person with FASD (24.8%) (Figure 5).
Figure 5. Respondents who knew someone with FASD or who cared for a person with FASD by age
60
Know somoene with FASD
Know anyone who cares for someone with FASD
50
40.0
% of respondents
46.2
45.0 45.8
39.3
40
40.7
44.2
41.0 40.1
34.8
29.1
30
24.8
20
10
0
18-24
25-34
45-54
35-44
Age in years
14
55-64
65+
Region of residence
Fewer respondents in Calgary knew someone with FASD (32.2%) or anyone who cares for someone with
FASD (32.2%) compared to respondents from Edmonton (41.6% and 41.4% respectively) and the rest of
Alberta (42.8% and 45.8% respectively) (Figure 6).
Figure 6.Respondents who knew someone with FASD or who cares for a person with FASD by region
of residence
Know somoene with FASD
Know anyone who cares for someone with FASD
50
45.8
41.4
42.8
41.6
% of Respondents
40
32.2
32.2
30
20
10
0
Edmonton
Calgary
Other Alberta
Area of residence
Born in Canada
Respondents born in Canada were more likely to know anyone who cared for someone with FASD 41%
than respondents not born in Canada (27.3%).
15
Employment
Respondents who were employed were more likely to know someone with FASD and someone who
cares for a person with FASD (Figure 7).
Figure 7. Respondents who knew someone with FASD or who cared for a person with FASD by
employment status
Know someone with FASD
Know anyone who cares for someone with FASD
80
% of Respondents
60
42.4
42.9
40
32.8
35.1
20
0
Employed
Not employed/retired
Employment status
Support
All respondents (including those who had not heard of FASD (N=172)) were asked the following
questions to gauge their views regarding support for pregnant women not to drink:
7) Do you think a woman should be supported by others not to drink while pregnant?
8) Who should be involved in encouraging a woman not to drink alcohol during pregnancy?
a) The woman’s healthcare provider (e.g. Doctor)
b) The woman's partner or spouse
c) The woman's family
d) The woman's friends
16
e) The community
f) Government
Most respondents believe that women should be supported by others not to drink while pregnant
regardless of whether they had heard of FASD (98.6%) or not (95%).
Among respondents who had heard about FASD, the woman’s family (95.5%) was identified as the main
group to be involved in encouraging a woman not to drink alcohol during pregnancy. Partner/spouse
(93.4%), friends (89.7%), and health care provider (88.2%) were also viewed the as a key resource in
terms of supporting women not to drink during pregnancy. The community (77.2%) and government
(70.8%) were also identified as important resources/supports, but not to the same extent as family
(including partners or spouses), friends, or healthcare providers.
Among respondents who had not heard of FASD (n=172), the pregnant woman’s partner/spouse (88%)
and family (88%) were the two main sources of support selected, followed by health care provider
(78%), friends (77%), government (62%), and community (60%) (Figure 8).
Figure 8. Who should be involved in encouraging a woman not to drink alcohol during pregnancy?
Heard of FASD
100
95.5
93.4
88.0
88.0
89.7
88.2
77.0
80
% of respondents
Not heard of FASD
78.0
77.2
70.8
60.0
62.0
60
40
20
0
Partner/Spouse
Woman's family
Woman's friends
Healthcare
provider
Community
Government
Support group
Responses from respondents who had heard about FASD were analyzed to see if there were differences
in responses based on certain characteristic such as gender.
17
Gender
There were no significant differences by gender in respondents’ beliefs that the family and
partner/spouse should be involved in encouraging a woman not to drink alcohol during pregnancy.
Differences by gender existed for friends, health care providers, community, and government (Figure 9).
More women than men believed that a pregnant woman’s health care providers (90.6% vs. 85.5%), the
community (81% vs. 73%) and government (75.5% vs. 65.6%) should encourage a pregnant woman not
to drink during pregnancy. While more men believed that a pregnant woman’s friends should encourage
her not to drink during pregnancy.
Figure 9. Who should support a pregnant woman not to drink alcohol during pregnancy by gender?
Male
100
92.5 94.2
94.6 96.4
Female
98.2
91.9
90.6
85.5
81.0
% of Respondents
80
75.5
73.0
65.6
60
40
20
0
Partner/Spouse
Woman's family
Healthcare
provider
Support group
Woman's friends
Community
Government
Age
Differences existed by age for the responses to the question of who should be involved in encouraging a
woman not to drink alcohol during pregnancy. Respondents aged 25-34 had the highest percentage of
individuals that believed the health care provider (95%), community (91%) and government (85%)
should be involved (Figure 10). Comparably, respondents 65-years-old and over had the least
percentage of individuals who felt this way: 81%, 64%, and 57% respectively.
Within the age groups, the pattern of selection for who should be involved in encouraging pregnant
women not to drink was similar; health providers were the most frequently selected, followed by
community and then government. The exception was for young adults (ages 18-24) where respondents
identified health care providers (89%), government (76%), and the community (70%).
18
Figure 10. Who should support a pregnant woman not to drink alcohol during pregnancy by age?
Healthcare provider
100
89.1
% of Respondents
80
94.7
90.8
84.7
Community
89.787.4
89.2
77.7
76.1
69.6
77.9
73.7
Government
87.3
80.8
73.8
65.6
60
64.3
57.0
40
20
0
18-24
25-34
35-44
45-54
55-64
65+
Age-group (years)
Employment status
Employed respondents were more likely to report the importance of the various support groups than
unemployed respondents. The biggest difference between employed and unemployed respondents is
observed where the support group is the ‘community.’ More employed respondents (81.4%) viewed the
community as an important support for pregnant women than unemployed respondents (70%) (Figure
11).
19
Figure 11. Who should support a pregnant woman not to drink alcohol during pregnancy by
employment status?
Employed
100
96.4
95.7
89.5
94.1
92.7
Unemployed
90.0
85.0
84.5
81.4
80
74.9
% of Respondents
70.0
63.8
60
40
20
0
Partner/Spouse
Woman's family
Woman's friends
Healthcare provider
Community
Government
Support group
Behaviour
All respondents (including those who had not heard about FASD) were asked the following questions:
9) If you saw a pregnant woman that you knew drinking alcohol, would you tell her that using alcohol
during pregnancy might harm the baby?
10) If you saw a pregnant woman that you DID NOT know drinking alcohol, would you tell her that
using alcohol during pregnancy might harm the baby?
Among respondents who had heard about FASD, 89% said that if they saw a pregnant woman who they
knew drinking alcohol, they would tell her that using alcohol during pregnancy might harm the baby.
When it came to informing pregnant women who the respondents did not know, nearly half (49.7%) of
the respondents would tell the woman of the potential harm to the baby. The findings among
respondents who had not heard about FASD were similar, respondents indicated they would tell a
woman who they knew (89%) and did not know (50%) that using alcohol during pregnancy might harm
the baby.
Responses from respondents who had heard about FASD were analyzed to see if there were
differences in responses based on certain characteristics such as gender.
20
Gender
Regarding whether respondents would tell a woman (who they knew) who was pregnant and drinking
alcohol, about the potential harm to the baby, women were slightly more likely to do so than men (91%
vs. 86.6%) (Figure 12). Where the respondents did not know the pregnant woman drinking, more
females (54.7%) than males (44.5%) were likely to inform the pregnant woman of the potential harm to
the baby.
Figure 12.Respondents who would tell a pregnant woman drinking alcohol about the potential harm
to the baby by gender
Male
Female
100
86.6
91.0
% of Respondents
80
60
54.7
44.5
40
20
0
Respondent knew the pregnant woman
Respondent DID NOT know the pregnant
woman
Age
The majority (over 80%) of respondents regardless of age would tell a pregnant woman (who they knew)
who was drinking alcohol that using alcohol might harm the baby. Young adults (ages 18-24) were most
likely to do so whether they knew the woman (100%) or not (66.7%), while respondents over 65 were
least likely to do so (80.7% and 42.4% respectively) (Figure 13).
21
Figure 13. Respondents who would tell a pregnant woman drinking alcohol about the potential harm
to the baby, by age
Knew the pregnant woman
DID NOT know the pregnant woman
100.0
100
94.4
91.0
89.6
89.1
80.7
80
% of Respondents
66.7
56.7
60
52.3
51.3
46.4
42.4
40
20
0
18-24
25-34
35-44
45-54
55-64
65+
Age-group (years)
Region of residence
Compared to individuals living in Calgary (40.3%), respondents from Edmonton (54.3%) and the rest of
Alberta (53.7%) were somewhat more likely to tell a pregnant woman they did not know, who was
drinking, that alcohol use may harm the baby (Figure 14). No other differences in beliefs or attitude
towards FASD were seen by area of residence.
Figure 14. Respondents who would tell a pregnant woman drinking alcohol about the potential harm
to the baby, region of residence
60
54.3
53.7
% of Respondents
40.3
40
20
0
Edmonton
Calgary
Area of residence
Income
22
Other Alberta
Respondents earning less than $40,000 were the most likely to tell a pregnant woman they did not know
that alcohol use might harm the baby (61.5%). (Figure 15)
Figure 15. Respondents who would tell a pregnant woman who was drinking alcohol about the
potential harm to the baby: differences by income
80
61.5
% of Respondents
60
49.2
46.9
40
20
0
<$39,999
$40,000-$79,999
>$80,000
Annual household income
Religion
Respondents with some religious background were more likely to tell a pregnant woman who was
drinking alcohol that alcohol use may harm the baby, regardless of whether they knew the woman or
not (Figure 16). No other differences by religion in responses to the FASD questions were observed.
23
Figure 16. Respondents who would tell a pregnant woman who was drinking alcohol about the
potential harm to the baby; differences by religious background
No religion
100
Belong to a religious group
90.8
86.1
% of Respondents
80
60
52.4
43.7
40
20
0
Respondent knew the pregnant woman
Respondent DID NOT know the pregnant woman
Discussion
The current survey provides contemporary data on Albertans’ knowledge and attitudes about alcohol
consumption in pregnancy, its effects on the fetus, and their understanding of FASD. In the survey,
85.7% of respondents had heard about FASD, this finding is consistent with the results of a 2006
Canadian nation-wide survey commissioned by the Public Health Agency of Canada3 where 86% of 3,633
respondents reported having heard of FASD. Additionally, as in the Public Health Agency of Canada
study,3 the current study found that more women than men had heard of FASD.
In the current survey, a disconcerting proportion of respondents had not heard of FASD (14.35%).
Compared to the population of respondents who had heard about FASD, respondents who had not
heard of FASD were more likely to be male, between 18 and 44 years of age, born outside of Canada,
non-Caucasian and non-Christian. This shows population level gaps in FASD knowledge that exist within
Alberta and provides information that is useful in the strategic planning process of FASD programs
aimed at increasing awareness and education within the province.
Of respondents who were aware of FASD, almost all (99%) knew that alcohol use during pregnancy
causes FASD and that it can be prevented (99%). There was a slightly lower level of knowledge regarding
alcohol consumption at different stages of pregnancy, with 4% of respondents unable to select the
correct answer of ‘no alcohol use during pregnancy or while trying to become pregnant’.
Over 40% of respondents in the study knew someone with or they suspected had FASD, and 39% of
respondents knew someone who cared for an individual with or they suspected had FASD. Respondents
24
who knew someone with FASD were more likely to be between 55 and 64 years of age, employed and
living outside of Calgary. Respondents, who knew anyone who cared for someone with FASD tended to
be female, between 25 and 34 years of age, born in Canada, employed, and living outside of Calgary.
Evidence shows that a woman’s ability to create an environment conducive to a healthy pregnancy, such
as changing her alcohol use, is influenced by the availability and access to adequate supports and
services, and underlying factors such as poverty and violence.4 A pregnant woman’s ability to make
healthy choices can be influenced by the actions of her partners and family members. In the current
study, 96% of respondents believed that women needed to be supported by others not to drink while
pregnant. The respondents selection of main supporters to be involved in encouraging women not to
drink during pregnancy were in the following order; family, partner, spouse, friends, health care
provider, community, and government.
Studies indicate that alcohol use can be influenced by social factors and the broader determinants of
health including social norms and expectations.4,5 Multiple factors can influence alcohol use before and
during pregnancy, including access to resources and social norms and expectations.4,5 In the current
study, to gauge the acceptable social norms in relation to alcohol use during pregnancy, respondents
were asked whether they would tell a pregnant woman using alcohol that alcohol might harm the baby.
Where respondents knew the pregnant woman drinking alcohol they were more likely (89%) to tell the
woman about the potential harm of alcohol to the baby, compared to those who did not know the
pregnant woman (50%). Those least likely to tell a pregnant woman the potential harm to the baby were
male, over 65 years old, residing in Calgary, earning more than $40,000 and non-religious.
Limitations
Limitations of the current study include:
 The survey was completed by telephone which may have led to under-representation of
respondents who do not own a telephone, or those that have a cell phone and not a landline.
 The survey was completed in English and not conducted in other languages.
 Although the survey used random sampling, resulting variation in survey demographics may
affect comparisons.
25
Recommendations
1. While the current study provided detailed information about FASD awareness among adults in
Alberta, determining FASD awareness among those under age 18 is important. This would
provide information to further inform prevention strategies that reduce the likelihood of an
alcohol exposed pregnancy as well as normalize alcohol abstinence among those who may
become pregnant.
2. Given the relatively high proportion of people who know someone with FASD and/or know
someone who cared for an individual with FASD, there is an opportunity to better understand,
through future surveys, if the needs of caregivers for information and support are being met.
3. The finding that all elements of society have a role to play in supporting alcohol abstinence
during pregnancy suggests that Albertans recognize that collective efforts are required to
support women at risk of an alcohol exposed pregnancy. This finding also suggests that health
care providers, communities, and government should feel empowered to take a leading role in
the implementation of effective, accessible, and respectful supports for women at risk.
4. The finding that many Albertans would be willing to discuss alcohol use during pregnancy with
women they do not know may reflect the care and concern Albertans have for those in their
communities. This finding is further evidence that policy and decision makers can be reassured
that actions taken to support women would be valued by Albertans.
5. While those who responded to the survey represented the Alberta Census data with respect to
education, employment, marital status, and ethnicity, there remains an opportunity to better
understand alcohol awareness among women who may be most highly at risk, (past experience
in child welfare, poor educational attainment, exposure to abuse or violence, underemployed,
women of childbearing age not using birth control).
6. The finding that Albertans believe that government agencies, health care providers, and
communities share responsibility for mitigating risk for FASD suggests that those working in
agencies and programs where women may be at risk of drinking during pregnancy should be
trained to identify these women and be able to provide supports or referrals.
7. Future surveys should be made accessible to a wider range of people, including those who do
not speak English, and those who do not have a land line or a cell phone.
26
References
1. Ahmand N, Flight J, Singh VA, Poole N, Dell C. Canadian Addiction Survey (CAS): Focus on Gender
Ottawa: Health Canada; 2008.
2. Sensible Guide to a Healthy Pregnancy: Government of Canada; 2011.
3. Thanh NX, Jonsson E. Drinking alcohol during pregnancy: Evidence from Canadian community health
survey 2007/2008. Journal of Population Therapeutics and Clinical Pharmacology. 2010;17(2):e302e307.
4. Thanh N, Jonsson E. Costs of fetal alcohol spectrum disorder in Alberta, Canada. Canadian Journal of
Clinical Pharmacology. 2009;16:80-90.
5. Stade B, Ali A, Bennett D, et al. The burden of prenatal exposure to alcohol: Revised measurement of
cost. The Canadian Journal of Clinical Pharmacology. 2009;16(1):e91-e102.
6. Stratton K, Howe C, Battaglia F, eds. Fetal Alcohol Syndome: Diagnosis, Epidemiology, Prevention,
and Treatment. Washington, DC: National Academy Press; 1996.
7. Environics Research Group. Alcohol use during pregnancy and awareness of fetal alcohol syndrome
and fetal alcohol spectrum disorder: Results of a national survey Toronto: Public Health Agency of
Canada; 2006.
8. Burgoyne W, Best Start Resource Centre. What we have learned: Key Canadian FASD awareness
campaigns. Canada: Public Health Agency of Canada;2005.
9. Roberts G, Nanson J. Best practices: Fetal Alcohol Syndrome/Fetal alcohol effects and the effects of
other substance use during pregnancy. Ottawa: Health Canada; 2000: http://www.phacaspc.gc.ca/hp-ps/dca-dea/publications/pdf/03-bestpractices_e.pdf.
27
Appendix A: Characteristics of Survey Respondents
Table A1: Characteristics of survey respondents (n=1203) compared to 2006 Census information.
Census information
Number of
for the Albertan
Survey respondents characteristics
survey
%
Population
respondents
( %)
Highest educational attainment
Less than high school
99
8.2
-
High school completed
223
26.7
24.1
Post-secondary
881
73.2
-
Employed (Full or part-time)
752
66.0
70.9
Retired
235
20.0
-
Other (Unemployed, maternity, students, disabled)
131
14.0
-
Married or in a common-law relationship
829
69.1
65.0
Single, divorced, separated or widowed
371
30.9
-
Caucasian
1047
88.3
-
Non-Caucasian
139
11.7
13.9
Canada
979
81.4
-
Other
224
18.6
16.2.
No religion
300
26.5
24.0
Christian
734
65.0
71.0
Other
96
8.5
-
Employment
Marital status
Ethnicity
Country of Birth
Religion
Characteristics of Survey Respondents
This survey had 1203 Albertans that participated. Respondents were eligible to participate if they were
over 18 years of age and resided in Alberta. Households were selected by random-digit dialing and
respondents were selected by gender to ensure equal representation of males and females.
28
Approximately one third of respondents lived in Metropolitan Calgary, one-third in Metropolitan
Edmonton and one-third in the rest of Alberta; about half of respondents were male.
In the current study 26.7% respondents had completed high school; this is comparable to the 2006
census finding that 24.1% of Albertans had a high school certificate or equivalent. Most respondents
were employed (66.4%) – either full-time (52%) or part-time (14.4%) which is consistent with the Census
finding that 70.9% of adults aged 15 and older are employed.
Just over 69.1% of respondents were married or in a common-law relationship and 30.9% were single,
divorced, separated or widowed. This is comparable to the 2006 Census finding that 65% of Albertans
over the age of 20 were married or in a common-law relationship.
About 11.7% of respondents were non-Caucasian, which is comparable to the Census report that 13.9%
of Albertans were non-Caucasian. Non-Caucasian respondents in this sample were a diverse group that
consisted of individuals who self-identified as Aboriginal, Asian, Latin American, and Black. About 18.6%
of respondents were born outside of Canada. This is consistent with the Census report that 16.2% of
Albertans were foreign-born.
About 26.5% respondents reported bring non-religious and just over 65% were Christian. This is close to
the most current Census religion statistics (2001) that almost 24% of Albertan residents identify with no
religion and that about 71% identify as Christian.
29
Appendix B: About the Centre
About the Alberta Centre for Child, Family, and Community Research
The Alberta Centre for Child, Family and Community Research is a public-sector, innovative resource for
evidence. The Centre develops, supports and integrates research across sectors and disciplines to
provide a strong, evidence-based foundation for identifying and promoting effective public policy and
service delivery to improve the well-being of children, families and communities in Alberta, Canada, and
internationally.
Vision Improve the well-being of children, their families and communities in Alberta, Canada and
internationally, by mobilizing evidence into policy and practice.
Mission Collaboratively develop, support and integrate evidence across sectors and disciplines to
provide a strong foundation for identifying and promoting effective public policy and service delivery to
improve the well-being of children, families, and communities.
The Centre has six key areas of focus:
 Developing a policy-relevant research agenda
 Funding unique research driven by and meeting the needs of policy makers, while providing
current knowledge to fill in gaps
 Gathering, analyzing and disseminating relevant and emerging national and international research
that is of relevance to Alberta’s child well-being agenda
 Mobilizing evidence into policy and practice
 Building transdisciplinary and cross-sectoral research capacity
 Analyzing government administrative data to inform policy through the Child and Youth Data
Laboratory
The Centre works in conjunction with Alberta Children and Youth Services, eight other Alberta childserving ministries, the Government of Canada and numerous other partners and collaborators to
improve the well-being of children by:
 Identifying the needs for evidence;
 Supporting high priority initiatives of Children and Youth Services and the Government of Alberta;
 Supporting research capacity building;
 Providing direction to leading edge research initiatives; and
 Developing an extensive network of collaborative partnerships.
30
 The Centre also manages The Child and Youth Data Laboratory (CYDL) Initiative that analyses
linked data from nine ministries to provide a comprehensive profile of the trajectories and
outcomes children and youth experience as they access multiple programs across several
provincial government programs.
For more information, please visit www.research4children.com
Networks engaged with community partners to learn and report on gaps in service, and network
leadership teams conducted strategic planning to enhance existing services and develop new services. In
addition, a SharePoint Site and protocol was developed and implemented by the networks
(Communication Working Group) to facilitate and improve inter-network communication.
31